In the U.S., the term junk food is often used to describe commonly known less healthy food categories such as candy, ice cream, chips. However, there's no consistent definition, so nutrition researchers came up with the concept of ultra-processed. The term ultra-processed food, if you want to call it that, describe industrial formulations that are typically seen in those long lists of ingredients, which, besides salt, sugar, and fat, aren't typically found in any cookbook, like the various flavors, colors, sweeteners, most fires, and other additives used to imitate real foods or to disguise undesirable qualities of the final product. This roughly corresponds to my idea of red light foods and my traffic light system, and indeed, most of what people eat are in the red, soda, ice cream, candy, cakes, most bread and breakfast cereals, TV dinner type, ready-to-heat products, chicken nuggets, fish sticks, sausages, burgers, hot dogs. This has been a dramatic rise in ultra-processed foods. In fact, the U.S. food supply is dominated by it. More than 200,000 products were assessed, and 71% were classified as ultra-processed. And of course, they aren't only in grocery stores, sugary drinks and processed junk are ubiquitous, even at non-food retailers, providing pervasive cues to consume products that are dense in calories, but poor in nutrition. As the former president of Coke put it, they want to keep Coca-Cola within an arms reach of desire. Another major candy brand boasted, we put them everywhere, grocery stores and supermarkets, gas stations and car practice offices, bowling alleys and grocery stores, which we already mentioned, not sorry. So this is where we are today. What is the proportion of food consumed by U.S. children and adolescents that's classified as junk?  Okay, yeah, but kids will be kids. In the United States of America, more than half of the calories taken in across the board is junk. In fact, around the world, ultra-processed foods consistently account for more than 50% of the dietary caloric intake in higher-income countries. No wonder that unhealthy diets are humanity's greatest killer. Leading risk factor for death on planet Earth. What exactly are the health consequences? The biological effects of modern foods has been studied on rats, showing they gorge themselves into dramatic weight gain inflammation and metabolic and cognitive abnormalities. And just as ultra-processed foods were taken over, a new eating disorder was recognized, binge eating, which grew into the most common form of eating disorder. And not surprisingly, binge foods were found to be 100% ultra-processed. I say no surprise because these foods are engineered so you can't have just one, right? People don't tend to binge on broccoli. About nine out of 10 studies found that ultra-processed food consumption was associated with adverse health outcomes and not just obesity, but cancer, types of diabetes, cardiovascular diseases, irritable bowel syndrome, depression, frailty, all-cause mortality, meaning living a shorter life. Studies on youth add asthma to the list, as well as higher DNA damage. Not a single study reported an association between ultra-processed foods and beneficial health outcomes. In contrast, populations with low meat consumption and higher fiber and minimally processed food intake have far less chronic diseases, enjoy lower obesity rates, and live longer disease-free. But most findings were derived from observational studies. You don't know for sure if ultra-processed foods themselves are to blame until you put it to the test. There's never been a randomized controlled trials on ultra-processed food until now. 20 people were essentially locked in a hospital ward and received both ultra-processed and unprocessed diets for 14 days each. And here's the kicker. Diets were matched for presented calories, sugar, fat, fiber, and macronutrients. See, in response to criticism, manufacturers are now proposing reformulating their products, keeping them ultra-processed, but just tweaking them by adding some fiber, for instance, or reducing the sugar, fat, or salt. So that's why the researchers wanted to give the study subjects the same amount of calories, sugar, fat, fiber, carbs, and protein in each of the two diets, in order to try to tease out the effect of ultra-processing. So, for instance, instead of giving people cheerios and a muffin for breakfast in the ultra-processed weeks or a cheese and egg McMuffin with Turkey Bacon and OJ, they give people oatmeal with blueberries and almonds. Both meals had the same amount of overall sugar and fat, but the unprocessed option was presented more in whole food form. For lunch, the ultra-processed group might get a turkey sandwich with non-fat Greek yogurt, canned peaches, baked potato chips, and sugar-free crystal light lemonade, versus a Southwest entree salad with black beans, avocados, and nuts, and grapes, and apples on the unprocessed diet. The same amount of calories offered with the instruction to eat as much or as little as they wanted. So what happened? On the ultra-processed diet, they ate about 500 more calories a day, so no surprise, they gained about 2 pounds on the processed diet or actively lost 2 pounds on the less processed diet. So it wasn't just the unbalanced nutrient profile of ultra-processed foods, so simply tweaking them wouldn't magically make them healthy. But that's what the industry would rather do. Reformulation is referred to as an unobtrusive strategy, creating the prospect of nutritional improvement without dietary change. What this study showed, however, it may be better to limit the consumption of ultra-processed foods altogether. Why does industry love them so much? They're made with dirt cheap ingredients, like taxpayer-subsidized corn syrup, allowing for huge corporate profit margins, but at what cost? The food industry takes in more than a trillion dollars, yet most of our healthcare dollars go to treat chronic disease exacerbated by these very same foods, like diabetes and heart disease, so you could argue we lose triple what the food industry pockets. The industry argues that in modern societies, it's unrealistic to advise people to avoid ultra-processed foods, given societal time constraints and the difficulties of food prep. But this may just be acquiescing to the same propaganda and disinformation campaign that the processed food industry has used to co-opt families for decades. Those who think healthy foods can't be convenient have never met an apple. That was a response to Dr. Lustig's essay on processed food as a failed experiment. I don't like his mother blaming, but I do appreciate his prescription. There's only one recourse, real food. We need to start thinking outside of the box.


Hello everyone. We're excited to be here at O and E as September 2020. My name is Renu Nable and I'm VP and GM of the Edge Computing and Ecosystem Enabling Division at Intel. With me I have Prakash Kartha who is the Director of Edge Services segment at Intel. Together we're going to be presenting to you how we're bringing in real-time optimizations to edge deployments. Now the whole industry is shifting massively towards edge computing. The reasons for this are multi-fold. There's an explosion of data across different types of devices and different types of, you know, locations. There is the rise of artificial intelligence and analytics as well as the advent of 5G. All of this is propelling the industry massively towards edge computing. And some of the underlying drivers are low latency, high bandwidth, end-to-end security, as well as seamless and frictionless connectivity. Almost every business or enterprise or industry is looking at how they can take advantage of edge computing to derive, you know, actionable insights from the data so they can then impact their own business or attribute value to their own business. Intel is looking at edge computing from two different directions. On from one direction we're looking at how to continue to extend our clarification and network transformation of the network transformation efforts that we've been at since 2011. At the same time we're also looking at it from the IoT side where we're looking at how single function embedded devices are getting transformed to be multi-function intelligent edge platforms. Both of these efforts are together complementing and creating robust edge platforms that can address a variety of different use cases both on the on-premise edge as well as the network or the telco edge. As we look at what the Intel strategy is for edge computing it's threefold. Intel has a diverse portfolio of silicon, CPUs, accelerators, ethernet, storage. So all of this diverse portfolio has been optimized specifically for edge computing. In addition to that we have a robust set of developer tools, developer tools that are driving the convergence of analytics and inferencing media capabilities or media optimizations as well as a variety of networking workloads with some very vertical industry specific offerings. Some of these tools are called OpenVINO for AI deep learning inferencing, OpenNAS which is being used for networking and 5G capabilities, OpenVisual Cloud for media enhancements and DPDK for data plane acceleration. And on the third pillar of our strategy is ecosystem scale. We work with over 1200 ecosystem partners and over 15,000 end users in order to drive scale of these deployments and we use a variety of different initiatives such as the market-ready solutions, the RFP ready kits, the Intel network builders program as well as the Intel select solutions. I will now hand off to Prakash who will dive deeper into some of these very specific optimizations that we are doing for the edge. So Prakash. Thanks Surno, great to be here. So the topic for the day is really around how to enable different types of locations on the edge with cloud native capabilities. So whether you are on the access edge or the near edge or the on-premise edge our belief is that you need a common set of building blocks to have a uniform view of the architecture when it comes to different edge locations. So there are three things that are very critical to understand before we get deeper into the topic. Number one is to have a scalable platform. To have a architecture that works on all of these different edge locations you need a cloud-like environment and that's why cloud native has become so critical for the edge. You need a very modular approach too because once you start to put these different building blocks together you can piece these things together in different ways to serve specific use cases for these different edge locations. And you can you can drive all kinds of synergies between software investments that you're making between the cloud native capabilities and you do that by putting together these common sets of building blocks coming out of a common technology pool and if you have these common sets of building blocks then you can enable the ecosystem in a very uniform way. So there are three things we want to talk about. One is you kind of start at the bottom of the pyramid that you see here in terms of having a cloud native architectural foundation. We talked about it being scalable modular flexible so that's the foundation. Once you have that depending on the workload that you're trying to enable whether it's a base station, a 5G base station or a core network you can start to implement certain KPIs and the kind of KPIs that you're looking at in all of these locations would be things like high throughput, very low latency and high determinism. So to get these kinds of KPIs across these different edge locations you need these consistent scalable cloud native platforms underneath that and once you have that then you can start to enable all kinds of services innovation on top of it starting with convergence of workloads. You start out with enabling your core workload whether it be a networking workload whether it's a 5G base station or a D-PAC inspection or a user plane function but then you also start to integrate other non-networking workloads because that's where the future is going and to enable the cloud native workload converge kind of environment you also need open APIs because once you have those open APIs then you can accelerate your application development. So a lot of what we're going to talk about today is how all these concepts are going to come together into building blocks put together in the form of blueprints. So now let's dive a little bit deeper into one particular example. In this case we're going to talk about the VRAN the virtualized RAN and how all these different cloud native building blocks all the concepts we talked about so far come together to enable a cloud native VRAN platform. In this example we're going to talk about FlexRAN and FlexRAN is the containerized layer one for a 5G base station and we'll talk about how FlexRAN layered on top of the openness framework which provides the cloud native ingredients builds together brings together the full platform. So let's talk through some examples. The first one we'll talk about is the container network interfaces the CNIs. So FlexRAN requires multiple CNIs so the first thing you would need to consider is multis. So multis CNI enables you to attach multiple network interfaces to you to your pod. So typically in Kubernetes each pod has just one network interface with multis you can create a multi-homed pod which is multiple network interfaces. That's the first thing to consider. The default CNI that we have in this particular configuration is Calico but there's more to it. So for example the next question that comes up is how do you connect your containers to your NIC interfaces? So SRIOE for example the SRIOE CNI is used when you want containers to get access to virtual functions on your NIC ports that are SRIOE enabled meaning those NICs that have both physical functions and virtual functions and you're able to treat each virtual function as a separate network interface and you can configure its own MAC, VLAN IP and so on. Now that's one option. The alternate is if you want a simpler plug-in you would use something like a host device CNI which will essentially move the requested device from the host network namespace or the containers network namespace. Again you would use this if you did not have any complicated configuration that mentioned earlier. You can use a more simplified CNI like the host CNI or host device CNI. The next example of another CNI you would use is the user space CNI. Now the user space CNI is designed to implement user space networking as opposed to kernel space networking. So an example of that would be dpdk you know something like OBS dpdk with containers. So that's an example. So another one would be the bond CNI. So bonding basically provides a method to aggregate multiple network interfaces into a single logical bonded interface. So for that you would use a bond CNI. There's another one called tuning CNI. A very utilitarian CNI that you would use for changing certain system controls, interface attributes in a network namespace and so on. So ultimately what we're talking about here is a multi CNI type interface and you pick different CNIs based in the particular aspect that you are trying to accentuate. So the next element of the architecture are the one of the system parts that you would need to have. Node feature discovery is a Kubernetes plugin that you can use to detect and add you know basically detect and advertise hardware and software capabilities on a platform so it can be discovered and it facilitates intelligent scheduling. Again a very useful microservice to have within your within your VRAN cloud native architecture. The next one is core pinning. A core pinning is a again a Kubernetes plugin that provides core affinity for applications deployed as Kubernetes parts. Now let's take a look at some of the the platform parts. So an interesting microservice that we added to this particular configuration is something called RMD or resource management demon. So RMD is based on Intel's resource director technology. What it does is it provides a framework for monitoring and allocating cache and memory. So in the VRAN context, RDT aids detection of code and code noise neighbors which helps reduce performance interference. That's one example. Another example is you need specialized hardware like FPGAs for managing certain parts of your VRAN pipeline like the forward error correction. So we provide a Kubernetes operator that manages the software update the automation of the FPGA which can get quite complex without without this infrastructure. And finally in an ORAN type context we have a dynamic device profile or a DDP for the SMODNICS that Intel offers which basically run filters for different types of ORAN profiles like the ORAN front hall. So you can see how all these different building blocks become essential for you to consider as you build the overall platform. Now as we move forward let's talk about let's do a little bit of a double click and think through what are those specific real-time optimizations that we've enabled through openness for FlexRAN and for VRAN. So we're going to double click a little bit further. So first let's talk about deterministic IO. So you're talking about deterministic IO on the front hall to achieve ultra low latency and high performance. So openness provides a number of optimizations to achieve this including optimizations in DPDK, offloads to NICS, con level optimizations for SRIOV. So overall with these optimizations we are able to achieve less than 20 microseconds max latency on the front hall and we've tested this on an extended or an extended period with various conditions like noisy neighbors, a mix of real-time and non-real-time traffic and this 20 microseconds is the max. So the average is closer to the min but that's the max we've been counted. The next element is deterministic acceleration. So you know similarly openness provides a highly optimized implementation of 4G and 5G effect. We talked about this in the previous slide. So these are through optimizations in DPDK. We have flexible APIs to execute in either hardware or software in the FPGA or in an EASIC. Look aside models for hardware arbitration with optimizations for configuring up-link down-link ratios, configuring number of queues and so on and so forth. So a lot of good optimizations around just running forward error correction on that FPGR and EASIC. The next element is cloud native orchestration and how to do that in a deterministic fashion. We spoke about this a little bit on the previous slide but just going to couple you know pick out a couple more points. So NUMA awareness. So NUMA awareness is something that you achieve with a module called topology manager. Topology manager is a part of you know upstream to Kubernetes but it's in a very important component that you would need to have in your architecture. What the topology manager does is that it maximizes the performance by ensuring that the workload in this case flexRAN is placed on the socket in such a way that it removes the need for cross-UPI communication. What that means is UPI stands for ultra path interconnect. So it's interconnect that connects to CPUs. So if you have NUMA aware nodes and you're able to actually land your workload in this case flexRAN on certain sockets that minimizes that you know cross-UPI communication. Again it's all about determinism and latency. We talked about core pinning you know support for hyper threading, allocating CPU resources to parts and then we also talked about node feature discovery as another important part. And finally after all the software optimization you still need a very deterministic overall platform. So foundational to this is going to be implementing real-time and real-time preemption and Linux. So this is work that Intel has enabled with our operating system partners for several years and now we're making this available with Kubernetes as part of the openness experience kit. What this enables you to do in addition to the real-time is also enable that core isolation, allowing a user to deploy a deterministic workload like flexRAN like the RAN DU for example on an isolated core and then operate without any interference from other kernel threads. And even if you have a context switch let's say from you know context to a higher priority kernel thread then you are able to switch back to the real-time thread in a very deterministic manner. That's the key point. So it's not that you cannot context switch when you come back you do that in a very deterministic manner. There are optimizations specifically for that. Similarly we have optimizations for BIOS on this configuration. Again an example of that would be from our determinism standpoint is there are certain extensions, certain advanced kernel instructions like AVX 512 that is required for flexRAN which may take higher power and that may cause certain fluctuations in frequencies which may impact determinism. So we have implemented optimizations to minimize those fluctuations and then finally power management putting cores to lower frequencies, lower idle states with power states and so on. So collectively what we're saying here is a lot of these you know pointed optimizations are coming together in the form of this recipe that we've built an openness that makes it kind of easy for you to go deploy the far edge or the access edge. So now let's talk a little bit about another use case. So now let's talk about the near edge. So near edge is the next level of aggregation from the far edge. So what's obviously the big difference with the near edge is what is the workload running on it right? So now we're talking about the 5G, UPF, you're talking about deep packet inspection, network analytics but also we have AI, you have media, all of these different use cases are now starting to converge. So what we have done is if you think about the the platform that we talked about for RAND, the exact same platform with a slightly different set of ingredients, we are enabling that for the near edge. So we start with a solid foundation, right? The solid foundation is our hardware ecosystem. So through the Intel Select program we have for example what's known as the NFVI Forwarding Plane which is an Intel Select solution for the near edge which has the right skew of CPU, of Ethernet, NAICS, Quick Assist, even the ability to take that into select and start to add on different types of accelerators like AI cards. So you start with that as a baseline and then what you do is you add on top of that the high throughput data plane, right? So you see the whole DPDK family, OVSTPDK. So that becomes the data plane on top of that. Then you layer on top the openness distribution that we just talked about, tweak for the near edge use cases. And then finally you bring in reference implementations for the network functions, the edge services. What we've done is we put all this stuff together into essentially a blueprint. And let's move forward to show you how this blueprint is not just for the near edge but also for other locations. So now let's talk about how this one blueprint is kind of expanded to different edge locations. So we talked about the near edge which is more of a 5G UPF. But this architecture, something that we've been investing in for almost 18 months now, something we call the converged edge reference architecture. The idea that you can take an architectural blueprint and bring together workloads from different starting points, a networking workload, an inferencing and vision and media workload all coming together into a common architecture, what we call the converged edge reference architecture or SETA. So we in fact launched this in 2019 with the first instantiation for 4G and on-premise type environment which included a private wireless recipe for outdoor ruggedized type deployments. What we're doing now is we're taking the same concept and we're starting to build out SETAs or converged edge reference architectures for different network edge locations. The first one that we're releasing later in September is going to be for the near edge. So we'll have a converged edge reference architecture that we make available through the openness distribution for the near edge. And then we're also working to upgrade the on-premise edge SETA with support for 5G. So you can see how we've taken the idea of a cloud native platform building out a blueprint and then scaling it out into different edge locations. So the end game for all the stuff is that the SETA is kind of a starting point from a design perspective. It's an architecture and SETA is based on openness as the underlying cloud native platform. Now for us it's all about the ecosystem at the end of the day because the ecosystem has to be able to take these reference architectures and be able to scale that into the actual deployments. So we have an excellent set of scale programs at Intel. One of the scale programs is called Intel RFP ready kits program. What the Intel RFP ready kits program is is you have the ability to work with commercial partners to construct essentially kits that are ready to be deployed at customer RFPs. So what we're doing now is we're taking these SETAs, these converged edge reference architectures and then converting them into RFP ready kits. We already have RFP ready kits for the 4G on-prem SETAs that we built earlier. So those are already available as part of the catalog that you can get access to. And then for the new SETAs that we're building we're going to convert those also into Intel RFP ready kits but we don't stop there. So once an RFP ready kit is available the next step is to actually give them deployed in commercial instances. So that's when that RFP ready kit becomes what we call a market ready solution. The market ready solution is another scale program focused more on deployment. So once you have a number of these RFP ready kits deployed in the market then you can start to get scale. That's when system integrators come in and take these market ready solutions and then you have this ransom repeat. You get the same solution deployed with different types of use cases at different customers at different enterprises and telcos. So you can see how we've taken the idea of a cloud native platform converted into a reference architecture and scaled into the market. Okay so that that was our presentation. Hopefully you enjoyed it. We are really looking forward to having more and more you know investments in cloud native architecture specifically for the telco edge with the access and far edge going into the near edge and continuing to make investments and optimizing it converting them into reference architectures like the setup program we talked about and scaling into the ecosystem. Thank you very much and have a good day. Thank you so much we have you on. Feel free to answer any questions now that are in the Q&A panel. We have about five minutes left. You are live whenever you're ready. So Prakash I think we have one question here which is are there any good resources to learn more about the real-time optimizations to edge deployments? I think on our website which is openness.org you should find a number of resources white papers and other documents that also talk more about the real-time optimizations. Prakash anything you want to add? No that's good right now. So if you go to openness.org just look for a specific white paper on grand and you'll see a pretty detailed playbook and all the different things we talked about are documented there. Yeah and these these optimizations are included in the public version of OpenNEL. So that is the open source version so you should be able to get it from the open source version. I think there's another question on do you plan to include NSVI acceleration in any kit OBS or VR? I believe we do Prakash do you want to take that? Yeah yeah so for OBS we have two versions of the OBS and this is the OBS DPDK. Both are supported as CNIs through a project called cube oven and so again if you go to openness.org just do a search for cube oven cube OBM and you'll see a specific CNI that we've integrated to you know if you want to implement OBS or OBS DPDK in your cloud native environment that's the recipe that you can use. There's another question on have any components of CERA be deployed in telcos already? Yes so we have so like like we talked about earlier there are deployments today for the 4G on-premise version of CERA. We have deployments in a in more of an enterprise context. This includes a private wireless deployment in an industrial context as well as a retail context. We are moving now into the near-edge so you'll start to see more near-edge type deployments in the future. Any more questions or anything else from the OBS? Well if not Prakash, thank you so much for your time. This is great. We'll go into the end of the minute early. Thanks for your time. Thank you so much. Thank you for having us here.  Thank you.


Good day everybody. Dr. Sanjay Sanyal, Professor Department chair. So this is going to be a demonstration of the lumbar plexus originating from the lumbar region abdomen first abdominal wall going all the way to the thigh. This is a supine cadaver We are standing on the left side of the cadaver. The camera person is also on the left side So just to bring up to speed We have completely opened up the thorax in the abdomen and this is the first abdominal wall This muscle that we see here This is the so-as major muscle on the left side. This muscle that we see above here This is the quadratus lumborum and This is the ilio lumbar ligament and below that this is the iliacus So therefore this is the combined ilio so-as which is going to the thigh So these are the muscles of the posterior abdominal wall. Now, let's take a look at the nerves which are emerging from the lumbar plexus We can feel the twelfth rib here and we can see that the diaphragm is attached to that and we can also see the quadratus Lumborum is attached to that so now which is emerging from just below the twelfth rib is this one This is the subcostal nerve T12 this supplies the lower abdominal muscle and After that it also supplies a skin the next now that we can see here is this one which I have lifted up here This is L1 and the L1 divides into two branches and we can see the two branches very clearly here The upper one is the ilio hypo gastric and the ilio inguinal. The ilio hypo gastric supplies only the lower abdominal muscles Namely the transverse abdominis and the internal oblique in the region of the conjoint tendon It does not go below the inguinal ligament the ilio inguinal on the other hand It also supplies the same two muscles and it continues into the lower abdomen and from there It continues into the inguinal region and it supplies the skin of the upper medial thigh And it also supplies the skin of the anterior aspect of the scrotum or the labia Where it is known as the anterior scrotal nerve or the anterior labial nerve So therefore the ilio inguinal goes through the inguinal canal this ilio inguinal nerve when it is cutaneous It serves as the afferent limb of the cremaster reflex in young mage children which I shall elaborate again a little later coming to the next nerve We can see this nerve here, and I'm going to lift this up And when I pull here, I will draw your attention to below the inguinal ligament. So please watch carefully We can see one of moving here This is the lateral femoral cutaneous nerve lateral cutaneous nerve of the thigh This goes just under the inguinal ligament close to its attachment to the anterior superior spine Close just under the attachment of the sartorius muscle and we can see the nerve fibers coming here And it supplies the skin of the antrolateral aspect of the thigh and This can get entrapped when a person gains weight It can get entrapped under the inguinal ligament and that can lead to numbness, stinging and parasthesia on the antrolateral aspect of the thigh And that condition is referred to as Meralgia parasthetica. So that is the next nerve that we can see here. Then I will draw your attention to this nerve This is the one which is running on top of the suas major muscle and we can see it is going here This is the genitofemoral L12. It's got two components, a genital component and a femoral component The femoral component supplies the skin of the upper anterior thigh a little bit The genital component goes through the inguinal ligament It goes through the spheromatic cord and it supplies the cremaster muscle and it also supplies the antrolateral scrotum This genitofemoral nerve, the genital branch, supplies as the efferent limb of the cremaster reflex What is this cremaster reflex? When we stroke the upper medial thigh skin in a young male child It produces retraction of the testis into the inguinal canal by virtue of the contraction of the cremaster muscle. So that is the cremaster reflex. To continue We can see the next nerve which is coming out from the lower lateral aspect of the suas major And I will go under the suas major and I am going to reflect the suas major and we can see the other portion of the nerve here This is L234 posterior division, the femoral nerve And I'm going to show you the continuation of the femoral nerve under the inguinal ligament So my finger is going under the inguinal ligament This is the inguinal ligament and we can see the femoral nerve is going and I'm going to turn the inguinal ligament And we can see the rest of the femoral nerve here So this is the femoral nerve coming into the thigh and we can see the moment it comes into the thigh It's got a very short segment in the thigh in the femoral triangle and it divides into hundreds of branches which supplies anterior compartment the quadriceps muscles and the muscles of the anterior compartment and it also supplies the skin of a large portion of the anterior thigh as The anterior femoral cutaneous nerve. So therefore if you watch carefully when I exert traction here We can see it is moving here and We can also see it is moving here. So this is the femoral nerve L234 posterior division Again to go back to where we started from if you look we will see another nerve coming out also from the L234 This is the operator nerve L234 anterior division This runs on the medial side of the soas major and it goes into the pelvis and it goes through the operator canal Which is a small opening in the operator membrane and it comes to the medial thigh And I shall show you the continuation of this operator nerve So if you keep looking I'm lifting up the operator nerve here and now we will shift our focus to the medial side of the thigh And I'm going to exert traction here, and if you look carefully You see this nerve here Watch carefully This is the operator nerve Operator nerve goes to the operator canal and it emerges on the thigh between the adductor Magnus and the revis And it supplies the muscles on the medial aspect That is the adapter compartment And it also supplies a little bit of the skin on the middle medial portion of the thigh So that is the operator nerve that is also L234 anterior division And finally we can see yet one more big nerve going into the pelvis and that is this one which I have lifted up here This is the lumbosacral trunk L45 This lumbosacral trunk does not come out instead. It goes into the pelvis and It unites with the S123 and it participates in the formation of the sciatic nerve Which exits the greater sciatic foreman has the sciatic nerve. So therefore to summarize We have seven nerves some books do not consider L1 as part of lumbar plexus, but then some books do So we have already mentioned the sub-postal We have the ilio-ing-1-L in the ilio-hypogastric that is L1 Then we have the genitofemoral the lateral femoral cutaneous nerve the femoral nerve femoral nerve Operator nerve Lumbosacral trunk So these are all the branches that we can see from the lumbar plexus Which arises from under the swast major muscle some of them continue to the thigh and some of them supply the muscles of the lower abdomen Just to mention another important clinical correlation This is the left kidney We have lifted up the left kidney to show the posterior abdominal wall and We can see that these three nerves the sub-postal The ilio-hypogastric and the ilio-ing-1-L they form a very close posterior relation of the kidney The same thing applies to the right side This is what an important clinical correlation when we are doing any surgery on the kidney And as you can see this kidney is highly honeycomb and it's a very atrophied kidney We usually do a posterior approach that is we approach the kidney for any purposes from the posterior aspect even for nephrectomy the posterior relations are The transfer sub-dominus quadratus lumborum and the swast major and of course the diaphragm while we are reaching the kidney We have to safeguard these three nerves sub-costal nerve ilio-hypogastric and ilio-ing-1-L because injury to a one or more of these nerves is likely to produce weakness of the muscles the lower abdomen and Can also lead to a post-operative hernia and also it can lead to sensory loss So these are the three nerves which have to be safeguarded. So this is the full distribution of the lumbosacral plexus that I wanted to show you Thank you very much for watching. Dr. Sanjay Sanyal signing out if you have any questions or comments Please put them in the comment section below. Please like and subscribe


Hey, this is Brett, and this 2020 Ram 1500 Crew Cab 5'7'' Short Box Limited Level 1 Package is stock number 13934ZB. I am here at Summit Automotive in Fond du Lac, Wisconsin, you're new and use light-duty truck and Ram headquarters. This 2020 Ram 1500 has the 5.7-liter V8 Hemi engine. It's paired up with the 8-speed automatic transmission. This truck has been fully safety and inspected by our service shop per the state Wisconsin inspection process. It has a fresh oil and filter change, all the fluids have been checked and topped off, and it is 100% ready to go. I'm going to go all the way around in this video. Inside, underneath, start it up and take a look under the hood to give you the most accurate representation possible of this vehicle. Diamond black pro coats of color, if you like the video, consider subscribing to the YouTube channel, which is youtube.com slash summit auto. Click the bell notifications and you'll get updates on the videos I do each and every day as well as having access to one of the largest catalogs of vehicle and light-duty truck walk-arounds on YouTube, almost 9,000 videos and counting. This one comes with the 22-inch kind of granite crystal-painted alloy wheels, and these wheels are part of the black appearance package. It also has brand-new Goodyear Eagle Touring 285-45R22 tires on here, brand-new tires. We put those on in our safety inspection, so have the little wear knobs on there. This one does have the 4-cloner air suspension. This is a one-owner, clean title history, clean car fax out of Wisconsin. It was traded in on a TRX, I believe. LED headlamps, LED running lights, and LED fog lamps. Front bumper is in excellent condition. I didn't see any major dents or dings on there. You get the front bumper parking sensors. I'm going to turn on all these lights at the end of the video, so stick around for that because they are very bright and impressive. The hood is in absolutely perfect condition. I didn't see any dents or dings on there. Passengers' side front fender is in excellent shape as well, and the passengers' side front wheel, no major scuffs or scrapes on there.  It's got a lot of gold flake in it, a couple of little green flakes in there too, but really good-looking color, especially in the sunlight. It really sparkles. As you go down this side of this 2020 Ram 1500 Crew Cab, short box, limited. Take note of how clean that body is, how reflective, and mirror-like that paint is. I take these HD videos, so if you're far away or even if you're close by, you just cannot make the trip down, but you're still interested in purchasing the truck. You can see the truck, hear the truck, and have confidence in the vehicle that you're looking at so that you can make a smart buying decision before you even get here. And even if this video helps you make a smart buying decision, let your salesmen know that you saw the video, that it was helpful, and then Brett sent you. That way I can keep taking these videos each and every day for our great customers all over the U.S. Back tires are brand new as well, and you get the plastic wheel well liners, which keeps your frame and underbody looking great. And even though this is a one owner from Wisconsin, the underbody looks really, really good. It does have the factory power running boards, and they are working. I always like showing those. Pastner side box, no denser dings on there. Has the LED tail lamps. The rear bumper is absolutely perfect. No major denser dings on that. You get the black chrome-ish looking tailpipes. Towing package, which includes receiver hitch four pin and seven pin wiring. The tailgate is in perfect condition. You get the blacked out limited RAM and four by four logos. Has a power drop down tailgate with the shock down assist, so it's never going to slam on you. This is a factory fold up tonneau cover. Spray and bed liner LED bed lights. You get the box rail system in here, cargo management system. You get four tie down cleats. The bed is absolutely perfect, and that bed liner goes on to the tailgate, which is a really nice feature to have. Shuts nice and solidly, and as you go down the driver's side, just as clean as that passenger's side, no denser dings on there. And for full disclosure, this back wheel is just as nice as the rest. You do get the capitalist fuel fill. Sorry about that. I sprayed my wrist two days ago. Has a capitalist fuel fill. Never get gas on your hands again. Driver's side doors and cab all look fantastic. No denser dings on them. You get the heated fold up tow mirrors, blind spot wiring built in directional signals. They do fold up like so, and then they fold in like that, but I'm pretty sure their power fold in. So I'll show you that in a little bit too. Driver's side running boards are working nicely. Back here you get the black leather seats. These seats are heated and cooled on the outboard side. You get the power sliding rear window with the built-in rear defrost. You also get the Harman Kardon speakers in the ceiling. These headrests fold down. Get that nice stitching, the gray piping on there. Really a good looking interior for a truck factory, all-weather floor mat back here. They're your heated seats, cooled seat buttons, and two USBs, two USBCs, and 115 volt, 400 watt plug-in. These seats do fold up. There is a little bit of storage down there. These seats also recline a little bit, and you get in-floor storage on each side with removable bins for easy cleaning. You can put ice and drinks in there. It's like you have too many coolers wherever you go, or if you're not in Wisconsin, just extra storage space. Child safety locks on the back doors and the inside and bottoms of the doors all look really, really good. Has the enter and go system as well. You just have to have the key fob in your pocket. Here's a look at the VIN sticker, and we do not have Canadian trucks here. It's good for you. Tire and loading information sticker as well.  This truck's never been smoked in. Smells very clean. You get the gray piping up front as well. Both these seats are heated and cooled and power. Driver's side lumbar, factory, all-weather floor mats in the front, power pedals, auto headlamps, tilt telescopic steering wheel, power windows, locks, and mirrors, and memory driver seat. And it does not have the power folding feature, so I'm glad I showed you that. You get this kind of Gore-Tex finish on the bolster there and the wood grain trim. Really like these silver Harman Kardon speaker covers. Top inside, check out the miles, the radio, and everything that this truck has to offer on the interior. You get the nice limited animation, the seven inch LCD display, digital spinometer, compass. You can change all those corners to read whatever you want. You can see that this truck only has 19,374 miles on it. Just a really, really low mileage nice truck because you get the heated and wood grain trim steering wheel does have adaptive cruise controls, regular cruise controls, gear selector, Bluetooth and information center controls, audio controls on the back of the steering wheel. Push button start, eight speed automatic transmission, push button four wheel drive, get the Harman Kardon badge up there. 12 volt power point and this is the Uconnect 4C radio, 12 inch radio, really a nice system. It has the factory navigation system. There's highway 41, so you know that's working nicely. You get AM, FM, and Sirius XM radio capabilities. You get your heated and cooled seat buttons, backup camera. I'll show you that real quick. That is working nicely. They've made those HDs so they're crystal clear and you can zoom in on that receiver hitch. Here are all your different apps. Does have projection manager. You can project your cell phone to the screen. We did a demo on Android Auto if you wanna check that out. And then all the other apps there. Down here is your factory brake controller, four-conner air suspension. You can raise it and lower it off-road mode, one off-road mode, two entry exit mode and normal mode. Stability control toe-haul, front and rear parking sensors, two USBs, two USB-Cs, and an aux jack. You also get your RAM, wireless cell phone charge pad, 115-volt, 400-watt plug-in. And then you get your cup holders and your coin slot holders there. Keyless entry with remote start and power drop-down tailgate. You also get the limited badge on the center console. Passengers side glove boxes, floor mat and seat are in fantastic condition and this one does have the panoramic sunroof. So the second row fixed glass, the power sunroof in front. Really a nice feature. Up here you get assist and SOS buttons, power drop-down tailgate, map lights, sunshade, sunroof and power siding. Rear window controls, auto dimming mirror and the home link buttons for your garage door security systems and lighting systems. We'll start it up and take a look under the hood. Also check out all those LED lights in the front. Starts right up, no check engine lights or anything like that. I would personally like to thank you for checking out the video today. And hopefully from this HD video, you've been able to verify the quality, condition options and of course, cleanliness of this truck all the way around inside and out, all those lights are working very nicely. And under the hood, we have the 5.7 liter V8 Hemi engine so it does have the MBS where it'll shut off the cylinders on the highway but it does not have the e-torque so it doesn't have the start-stop feature which I think a lot of people like not having that. But it's kind of rare to see these limited, at least nowadays, with the 2023s and 2022s without the e-torque. But anyways, engine bay is very clean, runs very smooth, this truck has been fully safety that is inspected by our service shop has a fresh oil and filter change. All the fluids have been checked and topped off and it is 100% ready to go. There is the emission sticker. And yeah, this one's all set to go. Four brand new tires, really clean inside out, one owner, clean title history, clean car facts. I'd ship this one anywhere, California, Texas, New York, Florida. Whoever's gonna get this truck's gonna absolutely love it. And to see more pictures of this truck or one of our 550 new new cars, trucks, SUVs, minivans, Wranglers, half tons, decoder tons, one tons, you name it, we gotta go to the website right there, summitauto.com. Full pictures and descriptions of every single vehicle all at summitauto.com. If you'd like to check out more HD videos, you can go to youtube.com slash summitauto. Click the bell notifications, get updates on the videos I do each and every day as well as having access to one of the largest catalogs of vehicle and light duty truck walk-arounds on YouTube. Fact in a second, you will see a link to subscribe to my YouTube channel, the upper left, a link to more Ram 1500 videos that I've done in the upper right, a link to this vehicle on our website, and the lower left, and a link to one of our latest YouTube videos in the lower right. Click those, check us out. We're super excited to help you with this Ultra Clean 2020 Ram 1500 Crew Cab Short Box, limited level one, black appearance package and diamond black crystal pearl. Thanks again for checking out the video. Remember to like, subscribe, and share on the YouTube channel. I really appreciate it. Thanks again.


Today we're down here in South Arkansas on a logging job. It's a first thinning, one of the crews out is doing a first thinning as you can tell. It's a little damp and this time of year weather has a big issue with everything. We had about 14 inches of snow about two weeks ago, so ground is hard to find and right now our crews are looking for good ground and maybe a lot of first thinning going on instead of log stands. But here on this job we're doing a first thinning trying to get it into chipping saw and to small logs and trying to increase the growth on our stand in September. This time of year is very very hard to find, but of course with hundreds of thousands of acres we are able to find it and to keep our logging crews busy and keep our meals functioning and keeping the employment with the meals going and that's all very crucial for the forest industry. Now our log meals they've increased their prices quite a bit and each meal is competing against each other right now so that has really drove the price of the timber up some. Now we have record prices in lumber we had in November now they're still very high very you can look it's $1,000 a thousand it's very high and it really has it translated back down to the land owner until the last month. In the last month we've seen an increase in stumpage prices for private landowners and for our industrial landowners. Now the biggest thing and it's in our legislator today is our business school forestry at UAM that we're trying to get that funded. They've okayed I think the the concept of it but we need funding for it and that funding is very crucial. We are third or fourth largest producer in the in the south on pine lumber or pine trees but we are badly and I'm talking about tremendously at a disadvantage because the other states so they have a business school they have economists and different ones working on getting in all the data that these people that own the mills are building the mills they call today they want to know how many tons excess tons we're growing where we're growing 20 million excess tons a year right now. So we could cut 25 to 30 million tons right now a year which creates economic benefits for the for the landowners it creates economic benefit for your industry you can have more loggers but we need to get this funded where we can get a business school and we can have all this data on hand when that when that mill comes in says I need this data we need to be able to hand it to them and and get new industry in without new industry we're going to be suppressed and we got to get mills in and it's an economic and GDP boost for the state the more mills we have come in is better for the state more more employment more loggers more everything and the GDP would increase tremendously on on having more industry in it's supplying demand


GRAPHLN is a graphical phylogenetic analysis tool designed to produce high quality, compact visualizations of microbial genomes and metagenomes. It can be used to generate phylogenetic trees spanning up to thousands of taxa, as well as annotate these trees with metadata such as microbial community abundance and microbial physiological or environmental characteristics. GRAPHLN is available both as a local command line tool and via an online Galaxy web application, making it easy to integrate into existing bioinformatics workflows. Examples of its use include taxonomic and phylogenetic visualization of microbial communities, metabolic function analysis, and biomarker discovery. This article was authored by Francesco Asnicar, George Weingart, Timothy L. Tickel, and others.


This research found that overweight dogs are less likely to engage in regular walking activities than non-overweight dogs. Additionally, the study showed that longer walks and more frequent walks were associated with lower odds of being overweight. This article was authored by Alexander J. German, Emily Blackwell, Mark Evans, and others.


Welcome, welcome. Yeah, so it's nice to be the leadoff speaker here at EHS.  Would you believe me? Well, so anyway, my name is Todd Becker. I've been taking cold showers every morning since 2009. It's my wake-up routine. And I'm hoping to convince some of you to at least try this by explaining some of the benefits and maybe some easy ways to get into experiencing the cold. So I've given now six previous talks at EHS on a really wide variety of topics, everything from improving your vision, reducing myopia, to overcoming obesity, to improving memory last year was my topic. And this year I'm going to be talking about cold. And the common theme in all these topics, and it's also the theme of my blog, Getting Stronger, is hormesis. What's hormesis? It's the application of low-dose intermittent stress to improve your health. Low-dose intermittent stress to benefit yourself in different ways. A lot of people try to avoid it. But I'll try to convince you that increasing your exposure to cold is probably one of the most actionable, practical ways to experience hormesis in your life. So here's an outline of the talk. There's a connection with evolutionary mismatch. That's why we're here at EHS. Basically, we evolved in an ice age. And we didn't evolve to live in with central heating and air conditioning. So that's a relatively modern innovation. And it has a lot of implications. When our ancestors, our forebears, migrated from Africa into Europe, they developed the ability to adapt to the cold. And we'll go into that a little bit. If you expose yourself to the cold, you're still able to activate those ancestral genes for cold adaptation. It takes practice, but you actually have to expose yourself to cold to turn on those genes. And there are several ways to do this that are practical. And I'll get to that at the end. But I'll start out with more of the benefits.  So animal adaptation of cold. It's ubiquitous, fish, mammals, all animals that have moved into colder climates. They're genes that have evolved. And their metabolism has changed. So let's look at our early evolutionary cousins, the Neanderthals, who were some of the first to move from Africa into Europe and Asia. And also, woolly mammoths moved from Africa into Europe and Asia. And they developed similar adaptations, right? More body fat, body hair. And interestingly, some researchers at Tel Aviv University were able to look at the genetics of the Neanderthals and woolly mammoths. And they found that we have some coevolution. Some of these genes evolved the same types of allele. So there's a gene called LEPR, which codes for the leptin receptor. And that was highly upregulated.  And the MC1R gene, which caused evolution of lighter skin and pigmentation, which allowed better absorption of vitamin D. So this was just the effect of the environment on convergent evolution. And this happened over a very long time scale. It was really about 350,000 years ago that the Neanderthals and the Denisovans migrated north. And they had to adapt to these colder climates in Europe and Asia. Our own species, Homo sapiens, left Africa about 60,000 years ago. But there was a lot of interbreeding. So we picked up a lot of the Neanderthal genes. I think some of us may have around 2% if you check here at ancestry.com. Interestingly, some of those cold adaptation genes, like EPSI, are found in modern Tibetans. And there's a couple of other genes that are found in Inuits that, again, help with adaptation to the cold, better utilization of fat. So again, our progenitor, Homo sapiens, has arrived on Earth about 400,000 years ago, but stayed a long time in Africa. During the Ice Age, the Pleistocene, which lasted up until really just about 12,000 years ago with the advent of agriculture, we were living in basically a cold environment. So we had all these cold adaptations. And even when agriculture started and the Earth warmed, we didn't have access to hot water all the time, right? We didn't have access to air conditioning. Central heating is only about 100 years old in terms of most of the population having access to it. We bathed in cold water. That was the way we typically lived our lives. So it's a recent lifestyle. It's a mismatch that we're always living in this warm climate-controlled environment. So we can live indoors. I mean, it's great. It's convenient. So why would you even consider getting cold? I mean, just think about it emotionally. What do you prefer? Warm or cold, right? I mean, heat you think of sitting out on the beach here in Santa Monica, relaxing. Cold, it's uncomfortable. You're shivering, you're miserable. That's the way most of us think of it. So we would just avoid getting into cold water. So why deliberately expose yourself to cold? Well, let's take a look at what it does. And I think it's important when you talk about adaptation to distinguish three levels of adaptation. First, there's the primary response that happens when you first get into a cold shower or jump into a lake. You're uncomfortable. Your skin vasodilates. All of the warm blood rushes into the core to maintain body temperature. You start shivering. Your sympathetic nervous system kicks in. You have noradrenaline. That's your sympathetic system. That's your fight or flight nervous system. It makes you anxious and anyway, it starts to produce more energy. Now, after a while, if you hang out in the cold shower or the lake, after a few minutes, that shivering will warm you up. That's called shivering thermogenesis. Your body's actually generating heat by the contractions of the muscles. And you might start to feel a little bit more comfortable. You also start to turn on some anti-inflammatory cytokines which helps sort of calm you. And if you try this, you'll start to experience a slight elevation in mood. And when you step out of that cold shower or get out of the lake, you actually feel pretty good and it can last for a while and we'll get into that. The third phase is the adaptation. This is when you've done it many times, over days, over weeks. And this happens to a lot of types of hormetic adaptation. If you repeat it, your body adapts. And this is what I mean by adaptation. It's not the initial exposure.  And you get some benefits from this and I'll go into some of these benefits.  You get some immune benefits and you get the sustained mood and resilience benefit and we'll go into some of these attributes. So let's start with thermogenesis. That's your body producing its own heat. How does that work? Well, when you step out into the cold or get into cold water, you have these cold thermoreceptors in your hand on your skin all over. And that's through these afferent fibers, it sends a signal to your hypothalamus.  And it's maintaining that 98.6 degrees at all costs or 37 degrees C for those of you from Europe. If it drops too low, you're gonna get hypothermic. So when you're exposed to the cold, that process happening. Now what happens then? Your hypothalamus sends a signal to your, your skeletal muscles. It's time to start shivering. It turns on noradrenaline, which causes that shivering, right? And that's what's called shivering thermogenesis. That's what all of us experience on the first pass. But what happens if you do this again and again, the adaptive response? Well, there's an interesting hormone called irisin. Really exciting hormone that's produced in the skeletal muscles. And that turns on your brown fat. It activates your brown fat. It gets those mitochondria revved up. It grows for mitochondria. And then your brown fat, brown adipose tissue, it's sometimes called BAT, B-A-T. It also has a couple other proteins called thermogenin, which is also called uncoupling protein one and FGF 21. Now thermogenin is, or uncoupling protein is very interesting because what it does is it bypasses the TCA cycle, which is what you use to convert sugar, sugars and fatty acids into energy, you use ATP to move your muscles, to digest, to do everything. It just short circuits that. It's called a feudal cycle. And it just says we need heat and it just starts dumping heat and you get warm fast when you're turning on this thermogenin. And that's called non-shivering thermogenesis. You only get that when you become adapted, okay? So that's absolutely key here. Now what is brown fat? Babies are born with a lot of brown fat. Animals have it, babies don't shiver as well, so they need that brown fat to stay warm, but you lose a lot of brown fat as you age. You get less and less. If you look at this picture here, the person on the left is a healthy fit young person with a lot of brown fat. Where is it?  I was surprised when I saw that, really? That's where that is. So when you do cold exposure, try to get the cold water around your neck and your shoulders because that's gonna stimulate the brown fat. The person on the right is an older person who's lost most of their brown fat. And I would venture to say there's a lot of people in the world who look like that person on the right. Now if you look at it on a cellular level at the bottom here, you'll see white fat, WAT, white outer post tissue on the left. Brown fat looks very different. It's this dense, reddish, brownish fat that's got a lot of mitochondria, a lot of iron in it. And it is primed to generate heat. It's very anti-inflammatory. And what's interesting, and this has only been known for the last decade, you can convert white fat to brown fat. That's called Beijing by exposure.  And that's what you do when you expose yourself to the cold. So if you zoom out here a little bit, it actually, this is part of a much bigger story, which I could talk about a whole lecture on this one slide.   And this responds to all manner of different stresses, not just cold, but hypoxia, high altitude, low oxygen, exercise, calorie restriction. It turns on the PGC-1-alpha.  But it also inhibits mTOR. It also turns on BDNF in your brain. It also suppresses appetite, gives you the urge to exercise. It improves insulin sensitivity, autophagy. It's system-wide. So again, cold is particularly effective at activating the brown fat, but it has all of these other benefits in terms of anti-inflammatory, mood and ability to lose weight. So speaking of cold exposure, does anybody here recognize this gentleman? He's one of my heroes. He's, Wim Hof is this wild Dutchman who's probably done more than anyone to popularize the idea of cold exposure. And he has a whole following. He's big following on the web. He leads nature expeditions, takes people out into the snow, gets them comfortable with that. He has records for running marathons in the arctic and swimming 50 meters under the ice. And, but he can even adapt himself to the heat. He's hiked, he's run marathons through the desert. So anyway, he also, he's big on cold, but he has developed a breathing technique based on this two-mo breathing cycles of hyperventilation and breath-holding. And so he puts these two together. Now, he is controversial. He's made this claim that he can voluntarily control his immune system. And he went into a Dutch hospital and had himself hooked up, had himself injected with bacterial endotoxin with lipopolysaccharides. And in fact, they monitored him and his vitals were pretty steady. His inflammatory cytokines didn't boost. But, but you know what?  So anyway, Wim said, I think anybody can do this, right? So he, he, he set up a study with, I think it was 48 healthy males. And he had the, one group of them practiced the breathing technique when due cold exposure and cold exposure, he actually had them take ice baths and cold showers and run around in the snow. The breathing technique, he had them all practice this for four days. So they got, they had it down. And then there was a control group and they were injected with tune in diagrams per kilogram body weight of this lipopolysaccharide and monitored for symptoms over two and a half hours. And so, and so what did they find? It's a pretty interesting result. The cyclic breathing alone, 30% drop in pro-inflammatory cytokines, like interleukin-6, not really much effect on an anti-inflammatory cytokine, interleukin-10. The cold exposure actually didn't have any significant event effect by itself. But when you combine the two, this had the best effect. You had a similar reduction in the inflammatory cytokines, but a huge boost in IL-10, which is the anti-inflammatory one. And there's statistical significance around this. You can read the study by SWAG. So I think that's interesting.  What about long-term effects? Can you get immune enhancement by repeated exposures? And yeah, there is actually an interesting study by Buija et al. in 2018 where they took over 3,000 people. This was very large statistical study. Ages 18 to 25, who had no prior experience with cold exposure. And for 90 days, they did cold showering. All right, 90 days. And all kinds of measures on them. But the one that was, I think, the most significant was they looked at days of absence from work, sick days, basically. And interestingly enough, almost 30% of the group that did the cold showering had, there's a 30% reduction in sick days among that group and not in the control group. And that had a very high statistical significance there, too. So I think that's a pretty interesting. Now, my own anecdotal experience, I've been cold showering since 2009. And I don't get colds and flus. I haven't missed a day of work. Now, that could be a coincidence, right? I do a lot of other things, too. But I think studies like this help to sort of provide a little bit of scientific backing. So another benefit of cold exposure is it's an anti-inflammatory, right? All trainers know that what you do when you get a muscle injury or you need to recover is soak in ice, you know? And yes, there is that short-term benefit in terms of the cytokines. What I think is interesting, though, is there's also a long-term anti-inflammatory effect through the PGC1-alpha cascade, through the conversion of white fat to brown fat. So I think if you do this repeatedly, you get this anti-inflammatory effect. Okay, this next benefit is one I'm really excited about and people don't believe it until they've tried it. Cold really helps the mood. It's a natural antidepressant. And this was known all the way back in Greek and Roman times, the orator and stoic philosopher Seneca. He was a great lover of cold baths. And in the Roman baths, they had warm baths, but they also had the frigidarium where people would hang out in the cold. So this was very common.  You know, cold is not something new. So to me, the key thing here is it isn't just mood, it's resilience. When I started exposing myself to cold, I found that, you know, the hassles, the arguments, the emotional turmoil that you can run into just by day-to-day exposure, they tended to dissipate. But I found this feeling of resistance that I could basically just not be as bothered. And this is something that I think goes back to the Stoics and to Seneca. Now, the question is, is this just an observation or is there actually an explanation for it? And I think the best explanation for this is the work that Richard Solomon and J.D. Corbett did, and it's summarized in a paper, a 1980 paper, on the opponent process theory of emotion. And here's kind of how it works. So Solomon, he was trying to explain this weird effect that skydivers, you know, that's a pretty frightening thing jumping out of a plane. They would be very frightened on their first exposure. And when they landed on the ground, they would actually have this feeling of euphoria for a while. Well, the more they did it, the fright went down and the period of elation and euphoria was extended. So how can this be? And this is shown in the graph here.  So that middle line says neutral. So any intense event is a deviation from that and that's summarized as state A, an intense experience. It could be skydiving, it could be getting into a cold shower, it's frightening, the noradrenaline gets going and it tends to with time plateau. But then when you stop that frightening experience, when the skydiver lands or you get out of the cold shower, you actually get an opposite effect, an opponent process that's trying to inhibit that state. Basically, the brain wants to bring you back to the same state so it overcompensates through counter-regulatory hormones. But that state B, that inhibitory response at first is sort of weak and shallow. It maybe lasts an hour or so. Now here's what Solomon found and this I think really rings true. The more you do it with repeated stimulations and that's the graph on the right, you can see that state A is diminished. Your body's kind of prepped for this. It knows how to, you know this is coming, you're gonna jump or you're gonna get in the cold shower so it's already providing the counter-regulatory hormones and when you stop that intense stimulus, it's a prolonged, more profound, deeper, longer effect. So that's the opponent process theory. This also has some other physiological correlates and this has to do with, again, your autonomic nervous system.  Well, there's actually bio-hackers use a technique called heart rate variability to follow this and what is heart rate variability? If you look at the figure on the right, you can see some heart beats. These are not evenly spaced, as you can see. Some are longer, some are shorter. If you have low heart rate variability, which would be not this figure, but metronomic every second, beep, beep, beep. Your heart is basically locked into a situation where it can't easily move faster or slower. You can't gear yourself up or calm down. So you have, it's called sympathetic dominant system, right? And that means you're not very fit, you're not ready for action. A high heart rate variability, something like this figure where you have a lot of variation is healthy. It indicates you're ready for action and I think the physiological reason for this is you can vary the heart rate if it needs to go faster or slower depending on the demand. So this has been shown in a study, shown here by Mechanan on the bottom left, that cold exposure indeed does cause this short-term rise in sympathetic activity, but if you repeat it, you get a shift upward in parasympathetic activity and HRV. And I found this personally.  Single biggest negative effect on my HRV was having more than one alcoholic drink. So I know one, I'm fine, two, three. My HRV is going down to the toilet. The thing that gave me the biggest boost in HRV, cold showers and then I'll tell you later something was even more than cold showers. That's coming up. Well, so cold showers. I take a cold shower every morning. I know you think that's crazy. People tell me they could never do it. My wife still won't take a cold shower.  I go, no, no, no, no, no. You jump into the cold shower, cold turkey. So let me take you through, because I actually wrote about this. It was one of my first posts on my blog in 2010. And I love, because this is my experience here. I jump into the cold shower. I find myself smiling or even laughing. I brace myself, I grit my teeth. I'm stiffening my muscles. I'm trying to put my head in. It isn't working. Finally, after a few minutes, I start to feel warm. But I force myself to put the most sensitive parts in. My shoulder, my head and my hands. When I get out, my mood is great. I'm feeling wonderful. My stress tolerance is up. Arguments at work don't bother me. After a couple weeks, the period of time that's uncomfortable is shorter and shorter and down to a couple of minutes. Now it's about 10 seconds, all right? So this is again the opponent process theory at work. So I'm gonna give you some tips on how to do this when you try it the first time. There's two ways to do it. You can take the cold ending, which is the way for the wimps to do it, all right? But if you have to start somewhere, start warm and turn it down and at least end cold. What I recommend is the cold turkey approach. Take your watch timer in. Try to last full five minutes, but here's the key. Write down the time where you start to feel the warmth, where you start to feel the comfort. Note that. Is it after two minutes, three minutes? And then the next day you do it, do it again and see if it gets shorter and that's a sign of progress. Cold baths, okay? This is a little bit more uncomfortable. It's more effective because you're covering all of your skin with cold water and here I am reading this great book, Chill, which I really recommend. We'll talk about that a little bit. Try to get into your neck.  I stand for 20 minutes and I notice the first time I did it, it took 10 minutes to feel before I was even comfortable. Now about a minute. When you get out though, there's some interesting effects. At first, the vasodilation, your skin is turning white. Now the blood's rushing back in, you get this kind of lobster hand effect and it takes a while, it's nothing unusual.  You also can feel what's called the cold drop, which is after about 20 minutes, you might feel a surge of the cold blood in your circulation shifting and you feel cold on the extremities again. So what I recommend is if you do this, go for a walk right afterward. Stay active and that kind of gets the blood mixing. Now another effect is since I've been doing this, I'm warm all the time and this is a picture at the San Francisco Exploratorium. My wife on the left, look at her hands. By the way, white means warm, black means cold in infrared.  Ice baths, very popular on the blogosphere. A lot of athletes do it. If you wanna go out and do it, try it. It's a lot colder. My view, it's not worth it. You gotta buy the ice, it takes time. It's less convenient and I think there's other ways to do it but there's a lot of believers out there so I'd like to talk to you if that's the way to do it. Tim Ferriss recommended another approach which is ice packs. You can buy these and just wear them on your neck while you're watching TV or working at the internet for half an hour and you're localizing it in the right space, in the right spot by your shoulders and your neck where your brown fat is. Open water swimming. I love doing this. I live about half an hour from Half Moon Bay. Love to go dipping in the water. There's this great book called Chill, The Cold Water Swim Cure by Mark Harper. He is an anesthesiologist who looked at the usefulness of cold to prepare people for operations and he found that it made recovery better and he teamed up with a guy named Mike Tipton and he started these swim clubs. All throughout the UK he's got 20 swim clubs. He finds the social benefits combined with the cold water exposure have a great effect in treating mood disorders like depression, PTSD and the book's got a lot of great information there. Whole body cryotherapy. I had to try this. I had stayed away for it but I said I'm giving this talk. So a month ago I started and I was scared out. Minus 200 degrees or colder. Minus 200 degrees Fahrenheit for three minutes. Liquid nitrogen. So it's invented in Japan. It's very effective. It's actually not that bad because it chills your skin but it's got very low, the vapor has a very low thermal conductivity and so it doesn't penetrate into the core so it chills the skin and you can see the skin temperature in blue, it drops from 30 to 15 degrees centigrade until you get out. Core temperature barely changes but it has a number of benefits. This has been studied. Not a lot of measured benefits in terms of anti-inflammatory cytokines but this study at the bottom by Rimsakowski was looking at it as a depression treatment and added to the normal course of medication statistically significant improvements in 11 out of 14 anxiety symptoms and 12 out of 16 depression symptoms. For me, amazing mood boost and this is for a guy who takes cold showers every day. I stepped out of there and I'm like wow, the rest of the day, that was like the best day. I was just really energetic and so I've gone back. Now I've done four sessions. My HRV, it hit the highest it's ever hit too. My heartbeat was just having a lot of fun. Contrast baths, a lot of people ask about this. The fins do this, right? They hang out in the warm sauna and then they go jump in the ice and it's back and forth and that has an effect where it acts sort of like a pump, right? Your blood vessels are dilating and you can remove toxins and cellular debris, athletes like it. I actually kind of against this because I think you're cutting short the benefit of the cold, which is that opponent process. You're not letting it play out. So if you're gonna do saunas, do it at a different time. But going back and forth, I think you're kind of short circuiting some of these mood benefits. Cool sleeping. A very interesting effect. Did you know that not only do we have a circadian cycle that responds to light and dark, but that when you go to sleep, your body temperature decreases by about two to three degrees Fahrenheit. I didn't know that. And if you have poor sleep, consider sleeping cooler and paradoxically, you can improve the rate at which your body cools by first making sure your extremities are warm. So you can take a warm bath, there was a study showing that by warming the feet and hand before sleep, the rate of insomnia in the second half of the night dropped from 58% to 4%. Just by that pre-warming. And then sleep cool, keep your room at 65 or lower, open the window. So what's the best method people ask me? It really depends. It depends what you're looking for. If you live near the ocean, open water swimming, but we don't wanna live by the ocean. So I've rated these by the metabolic benefits, psychological benefits and just simple convenience. And my vote goes for the ones on the two ends, daily cold showers and cool sleeping because you can do it anywhere. I still think you should try whole body cryotherapy and cold baths and open water swimming. It's just that they're less convenient. So to kind of summarize, there's a lot of benefits to cold adaptation. The one above, the obvious one is just you're gonna be more tolerant to the cold. That's the tip of the iceberg, but you've got all these deeper benefits, more energy, more resilience, better mood, enhanced immunity, fewer colds and flus. It can help you with losing weight because that brown fat is just burning the energy. It can improve sleep quality. There are some risks. If you have renal syndrome or your hands turn these weird colors, you might wanna be careful. Although I cite here in the references a couple of people who had renal syndrome who cured it by gradual progressive cold exposure. Hypothermia, Mike Tipton and Mark Harper's book on the chill talks about the risks here. Get in slowly, don't get in all at once and same with heart attack. Don't jump in, head first if you have any risk. Get in slowly and there's some good tips on how to do this here. So to kind of put it all together, we evolved, right? Our ancestors evolved in the cold. We have those adaptations. We just have to turn them on by frequently exposing ourselves. We can reduce inflammation, enhance our immunity, improve our mood by getting in cold water, try open water swimming in cryotherapy, try cool sleeping, but I do wanna give you a homework assignment and I'm gonna ask you guys about this tomorrow morning, try a cold shower, time how long it is before you start to feel comfortable. That's Friday and you get one more chance on Saturday and I'd like to see if this works and then go with it, try it for the whole week. Keep it up for the whole week. So I've got here some references. When we do the videos, you can pause it here and I've got another set of references here and so I wanna just return to that picture I showed. Hopefully I've changed your view of the hot and the cold. Heat, great, but it can make you sort of sleepy and dull. Cold, it's uncomfortable, but it's exhilarating. It kind of makes life worth living. So I'll leave it with that and see if there's any questions. Use this mic to come up and ask a question. Thank you for your talk. Cold showers is something I've been resisting for a long time and now I'm kind of motivated to try it. I am curious, is there any data, you spoke to improving circadian rhythms and sleep cycles. Is there any data around improving hormone balance, specifically female bio rhythms with cold exposure? That's a really good question. I didn't research that. Women's physiology is different than men's. It should be studied separately. One of the studies in there by Meccanin was just looking at females' athletes. And I think she did look at hormones like ACTH, cortisol, but I don't know about other hormones. So you might look at that paper by Meccanin. Cool, thanks. Great, great, great, great talking topic. Thank you, Todd, you did a great job with this. I'm a big fan of this and have renode syndrome. So I'm really proud of you for putting that in there. I wanna see if you can expand a little bit on that because I find I have a grocery store three minutes from my house. So if I turn on the tub, I get my 50 pounds of ice and the tub is still not full when I get back home again. So it's not inconvenient to do that, but I've usually lift some weights before I get into the cold bath, but I still have days as a renode's person where my response is I'm freezing all day and I'm in socks and slippers the whole day in the summer. Usually not, but I haven't had a. Warm showers are yucky and you can't even get cold enough water to go five minutes because it's too hot. Like the tap water is too hot. But if you could just expand if you know what's going on, what's the technique problem? I think it's something you just have to try gradually until you get more exposure to it. The two references. No, I've been doing, I haven't had a hot shower in three and a half years and I do cryotherapy, but they all closed down with COVID. Okay, so you're doing it. When I run and get ice, whenever I'm in pain, the best answer to inflammation, arthritis and pain go to Kroger and get some ice, right? But there's still that, there's more, obviously we're early days understanding this, but I wondered if you had thoughts about why sometimes I can never warm up again. Even if I'm going out in the sun. It's a good question. Yeah, okay. I don't have an answer. Yeah, thanks. Go ahead. So I spent, you wanna come to the microphone? Sure, yeah, just to ask about it. I was with Wim Hof maybe seven or eight years ago. I was one of the first certified instructors in the US. And one of the things he said, because there was a lot of competition in our group with like who could stay in the longest. And he always said, never leave with the cold in your bones. So for him it was like, if you're cold but you can't warm up, you overdid it. And he would recommend warming up before you go. Yeah, that's a really good point. In fact, I think his breathing technique does help promote the thermogenesis. So it pre-warms you so you can tolerate the cold better. So that's a great answer. Maybe combining the breathing technique and the cold for somebody who needs to work on the tolerance. Yeah, part of his technique can warm you up to go in. I was just wondering if you found a minimum dose. Because like when I was with Wim and when we practice, like you can do five minutes, you can do 10 minutes, but sometimes you only need like 30 seconds. Have you found that to be? You know, I did find that when I get in colder water, it doesn't take, I don't need as long to get the same benefit. I did a cold shower when I was on business trip in Finland, that's cold. I was like energized, the cryotherapy, that's intense, very short, three minutes. And oh my gosh, that had a big effect. So I do think there is a sort of coldness and time and dose response effect and you just have to investigate it for yourself. Cool, thank you. Oh, all right, well, I guess I better make this good. Hi, my name is Adae. So I was very interested in this talk and I wanted to know, you talked about how Homo sapiens, modern Homo sapiens, developed these adaptations to cold after leaving the equator in Africa. So what about for people who never left, who live in warm environments? Are there no adaptations? Is this worth doing for black people, for people who are from the equator? Really good question, well, a couple things. Even in Africa, the nights can be cold, right? So I think I showed some of the groups, hunter-gatherers, but sleep and huts. So cold doesn't have to be snow, right? It can be 50 degrees Fahrenheit. That's enough to activate it. So that's one thing. Another is even African-Americans, typically there's some, none of us are genetically pure anything, right? So we have some of those genes that have crossed from the Neanderthals, the Denisovans. So there's genetic variability within any population. The other thing is even in Africa at altitude, the certain populations that have gone to high altitude and some of those same high altitude genes cross over into cold protective genes. So it's not all as simple as hot and cold, right? Well, how cold does it have to be to develop these adaptations? Yeah, from what I've read, it varies, but for cold water and cold water swimming, you wanna be below 65 degrees. And if you can be below 60 degrees Fahrenheit, you really turn on a lot of the adaptations. Certainly you can do an ice bath, but you don't need to be on ice, right? Just take a shower here at the hotel or in the dorms. It's not that cold, but it will still activate some of that same response. So you don't have to be freezing. Thank you very much, Todd. I'm looking forward to reviewing that when it's on YouTube again.


What's going on everyone Sam here with late in sports cards, and I am ripping 12 boxes for Jeff a we've got 10 22 clearly authentic baseball in two 2021 top scrum sapphire formula one So we'll start with our clearlies, and then we'll get into our What's it called again to our F1 after so good luck here Jeff Cool 68 out of 99 green Jake burger rookie auto white socks there you go Jeff not too bad of a start there Of course Jeff no problem Pull some fire for you guys want to see some big stuff come out of F1 Got nasty 13 out of 99 Steve Carlton For the Cardinals that's so cool nice hit there Jeff. Congrats, buddy That's it. It's 66 out of 99 green Jesse winker for the Reds nice hit on that one as well now a mariner Take that that's cool 18 out of 50 Jim Abbott That's awesome for the Angels That's really cool with the classic glove over the hand pose. That's awesome. Oh, yeah, that's so impressive It's pretty good Yeah, that glove switch he did like after the pitch is just that's like extraordinary We've got wow red Bobby with Jr. Congrats Jeff Nice hit, buddy. That's what we're looking for. Let's go Auntie that'll play right there. We got nice. How about a Raphael Devers on the generation? now Heck yeah, nice Red Sox hit for you there Jeff Take that one buddy. We've got that's nasty seven seventy four out of ninety nine Dwight Gooden That's so cool doc. Gooden. Oh, yeah, that's legends There you go nice one there Congrats Jeff Bobby is nasty Anthony Such a cool for it. Wow Didn't even know he had autos We've got thirty eight out of seventy five Rockies rookie auto Ryan Valade Take that one for sure nice little hit there for you Jeff Two to go eighty six out of ninety nine Mark Burley Pitcher for the whites. I love Mark Burley that perfect game. I watch this off So cool nasty Yeah, now you're hooked All right last box for you here Jeff Nice, that's cool 21 out of 99 Julio Urias on a tops tech Part of that world series Dodger's rotation and currently still there obviously but really cool hit for you there, buddy All right, let's do some f1 sapphire Here we go One sapphire Full some fire good Louis Hamilton. We've got Simone Resta That is the teal 65 out of 99 nice We've got Daniel Ricardo and Andreas Seidel got Liam Lawson future stars Grand Prix Daniel Riccardo George Russell That is let me take a look really quick not the variation Max Verstappen That's the thing I'm keying my eyes in on is that those variations Yeah, it's like one of the numbers is different forget what it is Alessio Dalletta Grand Prix Sergio Perez Voltaire Botas and Daniel Riccardo We've got Toto Wolf green of Christian Lundgaard Greens are 42 out of 75 nice Charles Leclerc Not the variation on the Leclerc and mix you marker. So we got a yellow slash gold Nikita Mazepin Got jury vips future stars 85 out of 199 nice hit for you there Jeff Fernando Alonzo and Zau a mixed Schumacher Not the variation Louis Hamilton Max Verstappen and Marcus Armstrong George Russell Not the variation. We've got Joe's capito for Williams racing one out of 199 on the yellow.  Here we go. All right. We've got here we go See what we've got Sepia George Russell Sebastian Vettel Nice one there to a hundred for that's for Ferrari. That's cool Valteri Botas and Daniel Riccardo Kimi Raikkonen that is Esteban O'Conn Charles Leclerc and mix Schumacher Lando Norris Daniel Riccardo Fernando Alonzo Alpine And Is that that too that Louis Hamilton got pure ghastly on the teal 23 out of 99 nice one there Alphatari Got a box on late in gaming. Nice. What'd you get? Sorted shields nice Kayla will be there tomorrow to rip it for you. I believe Max Verstappen Marcus Armstrong same with Cole Anthony and Michael Carter Williams from the NBA will both be there tomorrow to frosty And Antonio Giavonazzi that is Not the variation Got Lando Norris on the teal nice 11 out of 99 Evolving skies. Yeah, it looks nasty Michael Louis Hamilton and pure ghastly I love Evolving skies We looked at any lost origin yet Lando Norris not the variation James Key Felipe Drogovic and Max Verstappen Esteban O'Conn Not the variation The dope I'm Rianna. Oh, yeah, Giavonazzi jewelry vips and pure ghastly And last the pack for you here Jeff Yuki Sunoda Got David Beckman F2 on the sepia 10 out of 15 Nice hit there future stars got Marino Sato and Louis Hamilton on the back that's gonna do it for your break there Jeff congrats on all the hits buddy We'll get them right out to you appreciate it