Tenani Cat Nigel! acceptable I've been married a long time ago what age come from what age girl where did you come from cot not no but the Glove Rick! It's so juice. It's so juice. Bang! Also, I'll press the YouTube channel in the subscription below. The bonfire was so big at Scott's house the other night that we actually, I hadn't singed arm hairs bald and fire. James bald and fire. We're doing a Bengali trailer reaction. This just, this just dropped. I think yesterday actually, this is a new trailer. Read all this for me.  And Johnny likes it perfectly. God, it was gonna be such a good joke. It was gonna be good. Go on. Ha ha ha ha ha! Where are we here? Okay, Anasandan, official trailer. Kamalaswar, Saswata, Reedy, Trini, Payal, Priyanka. Starring Saswata Chatterjee and Reedy Sen. Yes! Anasandan, Onu Shundam is a crime thriller based on a 1956 novel called Dangerous Game. Interestingly, both this film and Chara faces the film starring Big B and Emron is based on the exact same story. Which came first, The Chicken or the Egg? The Bengali version stars great actors, the Bengali industry and with the capable director at the helm. So this is the same story? If it's the same story, which one came first? No, this is just released. Like this trailer just came out. This is exactly what you said. When we reacted to faces, the Chara thing, as you said, weren't we talking about, was that the reaction where we brought up Jungle Book and two different stories? No, that was the big bull. Oh, okay. Sorry, it was around the same time. It was the same story as Scam, 1992. So this is that exact thing, where you have that story being told in two different films.   Because also, that has Big B in it. I know. So you know that's gonna get the more, I'm not saying it's better, but I'm just that if you have people will pay attention to that. Yeah, yeah. I'm not saying it should or shouldn't, but that's- You know what would be cool?  They might have just had to do it because that came out. God, if it's released at the same time. Or maybe they're just going for Bengali audience. But this one is Reedy Sen. You know, we love Reedy Sen. Love Reedy Sen. But a Bengali audience would go watch Big B. Yeah, but obviously they'll probably go watch the Bengali version first. Yeah, obviously. I would assume. I would assume everybody is gonna wanna see something in their mother tongue first. Probably. In their region. I would assume that. I know Bengalis would like to check it out here. Check it out here. Let's pop. Let's pop. Let's pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Pop. Is that Reedy Sen? That's Reedy Sen. Renee. If you don't want to talk about it, I'll give you a card. What are you going to say? Don't talk about it, I won't do it.  By the way, how long are you going to keep this case? Keep it safe, we're going to court. See? Indra, you might want to take it easy. If you're going to do it, it's up to you. Madad, happily, 11 years. Shantan, it's a joke. Indra said that she was in the middle of a business. How? If you don't want to talk about it, you can break it. Unfortunately, you and I are going to cut it and change it. There's no other way. Why?  That's what I'm going to do. I've got my protein from the car. I've got a lot of things to do. I've got a lot of things to do. I'm going to try my best. I'm going to play this game. It could be a game, but no one is going to play it. Which one do you want to watch? I will probably wait for the reviews. Yeah, I want to hear what people have to say. I want to see people that have... I know Rohan is the one that sent me this. And he's been golly. So I know he'll watch both and tell me. But they both look really good. They look very different as well. They look very different stylistically. And not saying these are the films, but the trailers are... That one was a bit more knife-zaudish-cluish. With a little sprinkling of suspense. This one felt darker. Yeah. I... My leaning... And yeah, it may be Bengali preferential treatment.  Is this because of the darker Bob? Yeah, I do love Bob. And Reedy Sen. Yeah, I do love Reedy Sen. Reedy Sen looked good on this too. This just... But I... It would be really cool if we've never done this before. If we saw them both and reviewed them at the same time, we did a comparison of the two. And is this adapted? Is this from a story? I don't know. But clearly it's a story everybody knows. So I assume... I was assuming it was... Because they did the same story. Right. But is it just a story? Is it from a book? Get ready to unleash the suspense. And it's very unusual. Like it was strange for me with Jungle Book because what typically happens is exclusivity that if you want to do a film, someone has the rights to it and no one else is going to touch that. Like even now, if somebody wanted to do, and I know this from having looked into it, if you wanted to do Bridges of Madison County, Warner Brothers isn't going to let you do it. Unless you're going to do it like as a Warner Brothers film. So this person says, actually Chichiri and this movie plot the same because both movies are based off of a 1956 novel called The Dangerous Game. So... Because I'm betting some people thought Bollywood was remaking. Oh. But also they're coming out at the exact same time. Yeah, it's very unusual. Which is strange. Very unusual.  There's a Hindi version. Now we have to release it right now so people don't compare. We wanted to see it before. And you know there's probably somebody... Do you know this is probably happened that somebody somewhere or somebody's wanted to do a film of the 1956 novel The Dangerous Game and their treatment is just done and they've seen the trailer for both of these films and they're like, Well, there goes my idea. Man, that's happened quite a bit. Yeah. This one is coming out within... I think it might be coming out at the exact same time. And both trailers looked intriguing and interesting and I want to see them. I would see both of them just depending on... Man, I hope they both do well. Yeah. They're good. Absolutely. Because you hate it.  I know. They're both going to lose out on viewers. They're both going to lose out on money. They're both going to like... I don't know. That's a sucky situation. It is. But I don't know because there could be bragging rights if you go and you see both and you could say, Oh yeah, the Hindi one's better. Oh yeah, the Bengali one's better. I don't know. That's unfortunate. But I would love to see more Reedy Sen and Bob. Oh. Reedy Sen, let us know what's the next of both of them, but especially Reedy Sen, everything we've seen him in, he's been phenomenal. He's been a great young actor. Very good actor. Very great. He could be the next Timothée Chalamet. Yeah, I guess that would be a very similar, that's not what I was going to say. Oh, I thought, okay. Yeah, that's that he reminds me, his capacity reminds me of Chalamet. Yeah. Absolutely.  I'd put Reedy Sen in his role. Yeah, probably. Right? Absolutely. I'd either put him or Adarsh Guaro. In fact, there are more gay love stories in Indian cinema. We've only seen, what happened to that film? We saw, we watched the trailer to it and it just kind of went away. Which one? It was, it was the story from our, our, the guy, we first, we saw him in Udapunjab. Didn't he do it? Or maybe it wasn't him. It was a film where it was a gay love story. It was a Bollywood romantic comedy about two guys. Did the trailer like a year ago? I don't remember. Yeah. Maybe you guys know, maybe it was terrible and that's why it wasn't recommended. But yeah, or a serious film like Brokeback Mountain. Yeah, why wasn't that remade? That could easily be remade and made very India. Absolutely. And you could, with a lot of different layers to it. Brokeback, you could also do that with, call me by your name. You know what else would be a really fun remake if you got the right people? The bird cage. Oh yeah. You would just have to get the right people. Screaming funny. I put Big B and Gene Hackman's role. For Brokeback, there's so many actors I think could play those characters. And the ones that have come to mind are Manoj could easily play one of them. Obviously Fafa could easily play one of them. And if you want to. Nawaz, of course. Of course Nawaz. He could do anything. Vijay Varma could easily do one of them. Oh, now here you go. How about this?  Different, it's different.  But there's a lot of dynamics with their wives in that film. It's true. But obviously you'd have to change it to be India because there's not really cowboys in India. And Brokeback is so cowboy centric. Yeah. But anyway. We digress. It could be ranchers. It could be farmers. It could be all. And then obviously there's a big overall story of the taboo, the taboo-ness of it in India. So anyways, I think it could be done. How do we get off onto this tangent from where we were? We're talking about Reedysen. He's a good actor. There you go. That was it. And Timothy Chalamet. That would be the closest we've got his film where he was the transgender. Yeah. That was speaking of gay love stories. That was absolutely. Anyways, let us know. Which of these two are you going to watch? Let us know.


Yes, thank you very much wait. No, it's it's it's working. Can you hear me? Yes, okay So let me start with a very simple example today just With example of discrete sign process So this is just a measure on On Zero one also, this is Stefan or now I can take this opportunity to thank the organizers and Just it's a very great pleasure to be here and in fact so much. It is true that My very first international conference in my life was in this very hole in 98 So the time is going fast. Okay. Yes, so it's a great pleasure to be here again okay, so now This is just a measure on the space of binary sequences and I will use I Will use slightly unusual notation. So let me first write it in usual notation, but then in a little bit unusual notation so the probability of a Cylinder given by So many Ones at such at given positions. I am equals one Is given by determinant and then determinant s Alpha I K I L K L from one to N and S alpha of X Y is by definition equal to Sine Alpha X minus Y over pi X minus Y So this is understood as By so to speak lopital rule even if X and Y are integers alpha over pi if X equals So clearly the kernel S alpha only depends on the difference of the Values and so this measure is by definition stationary. It's not obvious that such measure actually exists So that this formula actually gives a measure. This result is called my key Soshnikov's theorem for French Physicist Odil my key and Russian mathematician Alexander Borisovich Soshnikov so, okay, so but such measure exists and And this is the first example that we shall study today Let me say how this measure Appears it appears in a study of young diagrams. So if one considers large young diagram Large young diagram and for example one one draws it in the so-called Russian way so like this emphasizing the symmetry between columns and rows and if one considers the Configuration so what a young diagram one can assign binary sequence. Is it possible to see when I right there? Is it okay? Not down. Okay. Let me be let me draw it here. So if to young diagram One assigns configuration So by putting a particle or by putting the symbol one in Position where the graph of the diagram goes down Where the graph of the particle goes down Then one obtains distribution on space of binary sequences and in the limit So if now one considers the limit as n goes to infinity Of so-called plancherelle measure in the limit here In the bulk of the diagram one gets this discrete sign process Which is how it was introduced by Borodino-Kunikov and Dalshansky. So discrete sign process is of course very close relative of the usual sign process of Dyson and In fact the sine kernel is very similar to the the discrete sign kernel is very similar to the usual side kernel So one takes function f one takes the Fourier transform One restricts to the interval from minus alpha to alpha and takes the inverse Fourier transform. So this is the Form of this kernel Okay, so a lot is known about the discrete sign process. This is a very interesting dynamical system it is Chaotic, so it is it's Kolmogorov and in fact even Bernoulli so Kolmogorov by work of Kolmogorov system by work of Lions Russell lions and in fact even Bernoulli by work of lions and stifle Just excuse me one second. Yeah, sorry. Excuse me. What? That's excellent question. So alpha that's excellent question. In fact, I did not say this But in fact alpha is the position of the observer. So the law the Limit depends on where you place yourself where you look at at the limit and in fact if you place yourself at position alpha square root n Let's say a square root n Then this alpha is there So what is it the cosine of alpha is to a Okay, so one has to be careful that this a should be strictly between minus two and two So if it's equal to two or minus two then it's different situation, but here it's in the bulk of the spectrum So alpha is the position of the observer Okay, so In continuous case, of course all there is no alpha because there is homotity So all these kernels are equivalent up to the homotity, but in discrete case, they're all different Okay, so so it is called more often Bernoulli at the same time its spectral density has spectral density of Just the characteristic function of one has a Zero at zero so this is the form of the spectral density in the neighborhood of zero so in particular the variance the variance of the number of particles number of particles in Minus n to n Grows as logarithm of n Grows as logarithm of n so grows very slowly Precisely because there is zero of the spectral density Okay, on the other hand the number of particles number of particles Minus expectation Over square root of the variance of course satisfies the central limit theorem Which is a result of Kostin-Lebovitz and also Soshnikov so In greater generality so in fact the Fact that this density has a zero that spectral density has a zero It is relatively easy To show and this was in fact done by Kolmogorov in the 1920s so that the position It's I think 1927 That if I consider the stationary process in broad sense corresponding to this system So I just consider the sequence omega n just considered as elements of L2 Then omega zero belongs to span of omega to span of omega n and nautical n non zero So this is quite Unusual situation So let us look at this property more attentively if I know The configuration in the complement of zero so it is convenient for me to Represent configuration as a collection of particles so binary sequence So in position or if omega n equals to one then this means that I put a particle here So if now at zero So if I know the configuration in the complement of zero so beyond zero Then this configuration Determines in fact what is here at zero almost surely whether it's particle or whole So and this follows again it This follows from the form of the spectral density, but in fact this was this is a result of gosh and Paris from 2000 so in fact in this case it's result of gosh and in a different case It's result of gosh and Paris from 2012 So he gosh essentially reproofed use the argument reproofed Komogorov's lemma in this situation More generally one can Take a bigger window so window from minus n to n Bigger window So and then The config it follows from the work of gosh and gosh and Paris so that the Configure the configuration outside of the window Determines so this is what they call rigidity rigidity So configuration outside the window and Again configuration I just mean binary sequence where I put particles in positions where the binary sequence has one configuration outside the bounded window The bounded window Determines determines the number of particles The number of particles Number of particles inside of particles inside, so this is the result of gosh So in fact, this is a little bit paradoxical property of this or How to say property of this model that goes in the opposite direction of chaos, right? So it is not possible to put one more particle. It is not possible. So the configuration outside of the Outside of finite window determines the number of particles inside So this raises a natural question. Is there anything else are there? Is there anything else that the particle outside knows about what is going on inside? and so the main result of this talk is that no there is not and So now I am ready to formulate the main result in this particular case main result. So this is on the archive So and it is that the measure PS alpha so this measure that I Defined here. Let me write it like this PS alpha is quasi invariant is quasi invariant Under the action of the infinite symmetric group the action of s infinity So the infinite symmetric group the group of finite permutations the group of finite permutations of So the infinite symmetric group it's a countable group it naturally permutes the entries of the Sequence and So it naturally acts on the space of sequences and The statement is that the measure is quasi invariant under this action It's quasi invariant under this action. So Radonnik-Adim derivative will be found explicitly I will find it explicitly and to motivate The analogy just I will give explicit formula Okay, let me let me first write the formula and then I will explain the analogy with Gibbs measures So the Radonnik-Adim derivative is the following. So if I act By permutation, so let's Sigma PQ be just permutation of two C of two positions Sigma PQ permutes P and Q So and let's assume that So Sigma PQ permutes P and Q. So then the Radonnik-Adim derivative So and it is here that I want to start changing notation a little bit. So instead of Denoting binary sequence by the symbol omega I will denote So again, I will use a slightly different notation because I will also use it in the in more general situation Of which this is particular case. So I will denote My binary sequence or my configuration by X. So X so this space of binary sequences it is space of configurations and so Configurates on that and I configuration will be denoted by X by X is a collection of particles So particles are positions where the ones are and so instead of this I will write like this I 1 I am belong to X So in other words the measure is just measure on subsets of that Configurations are simply subsets of them. So the formula doesn't change but it will be more convenient for me to write it in this notation So at configuration X is equal to some constant Times product X minus P over X minus Q square where product is over X in X so product is over all particles and So which one goes on top which one is at the bottom. So if Q is in X and P is not in X and obviously the product is Taken by all particles except Q Okay, so this is the formula for the Radon Nicodim derivative So there is Question here in what sense does this product? Converge so it converges in principle value So what do I mean by this clearly this product? So it's product over all particles X in my configuration, but the configuration is realization of stationary process So particles have some frequency Clearly this product diverges absolutely because harmonic series diverges But this product does converge conditionally in the same way as for example, one can write some 1 over n over n in that equals 0 So in this sense this some Diverges absolutely, but it but it converges in principle value So precisely in this sense of principle value is understood as this product Okay, so let me Formulate let me explain the analogy with Gibbs measures So analogy with Gibbs measures The constant does not depend on X the constant depends on P and Q of course The constant is just constant of normalization The constant is just constant of normalization constant is just constant Okay, so clearly if P and Q both are inside the configuration or both do not belong to the configuration then this quantity is just one But when when one so when the permutation actually does something as in this example then this is so to speak the price to pay So analogy with Gibbs measures so if I have Gibbs measure corresponding to Hamiltonian H Then so if I have P Gibbs measure corresponding to Hamiltonian H Let's say of pairwise interaction with Hamiltonian H Then the corresponding Radon Nicodem derivative will be Just exponential Well up to a constant it will be exponential of the sum H precisely Px Minus H Qx Overall X X obviously not equal to Q So precisely for Gibbs measures how do I say? the permutation will if I if the particle goes from Q to P as here then of course interaction with all other particles How do you say the potential of the interaction precisely will enter the Radon Nicodem derivative? so then this result can be understood in the sense that it is some analog of Gibbs property with potential to log X minus Y with Hamiltonian to log X minus Y so this is this is The meaning of this result So I formulated this result in This specific case, but in fact the result is much more general so there is there is first let me say very briefly about Previous work and about why this How to say why it is it could be natural to expect such formula for Radon Nicodem derivative So the main example that motivates study of determinable point processes let me erase here is the case is the One of the main objects of let's say theory of random matrices the Orthogonal polynomial ensemble Orthogonal polynomial ensemble which it is possible to consider in both in discrete and in continuous case DXI in continuous case, but it's also possible to consider in discrete case So these are orthogonal polynomial ensembles In the limit they give they give Determinant open processes so in particular sign process arises as the limit of such orthogonal polynomial ensembles with hermit polynomials Other processes arise in different situations, but it is clear that if one considers Such orthogonal polynomial assemble even maybe in discrete case Let's consider some orthogonal polynomial assembly in discrete case and one considers the action of the permutation sigma pq Then it is clear just from the formula that the Form of the Radon Nicodem derivative will be like will be this so it is just clear From definition, so I substitute x1 equals p. I substitute x1 equals q and I divide Just this is just the form of the Radon Nicodem derivative So and in fact as I said this result has predecessor In the case of so-called gamma kernel gamma kernel Determinant process with gamma kernel which is not stationary which is just a different example of the terminal point process Gregorio Alshanski proved This was invariance in 2011 so in 2011 proved was invariance for gamma kernel and Roughly the idea of Alshanski's argument and he obtained similar expression for Radon Nicodem derivative It's similar, but there is also one important difference. I will explain it a little bit later The expression is similar, but different in important way. I will explain this so but It is so to speak ideologically very similar. So Alshanski's argument Alshanski approximated gamma kernel by finite dimensional approximations of this kind and Obtained the formula for Radon Nicodem derivative by passing to the limit of finite dimensional approximations So the difficulty with this and in fact one can see The paper of Alshanski there are it's long and there are many computations The difficulty with this is that it is very non-trivial to pass to the limit in a statement that two measures are equivalent To measures may be equivalent, but after passage to the limit they can stop being equivalent So it's not observed that the Radon Nicodem derivative is not bounded It's not bounded. It can be arbitrarily large. So the fact that this Statement survives limit transition requires a lot of effort So and Alshanski did it in the case of gamma kernel So the argument in my paper is completely direct. It avoids limit transition and it works in Substantially greater generality. I formulated the result for sine process Just for concreteness, but in fact the result works for a very wide class of determinant point processes and Namely determinant point processes with integrable kernels so again We keep our eye on the orthogonal polynomial ensemble here. So It is well known that such Measure is determinant. I can write this like this KN XI XJ where XI where KN is Christophel Darbukernel Is Christophel Darbukernel? But Christophel Darbukernel, it has its kernel of the projection on the first n orthogonal polynomials, but Christophel Darbukernel Has integrable form It is after some constant Pn of X Pn minus 1 of Y minus Pn of Y Pn minus 1 of X over X minus Y. So now the point is that In many examples while this is not There is no reason for this to hold a priori, but in many examples This integrable form is preserved under limit transition So in many problems It is very typical that the kernel of our operator has integrable form in the following sense. So and again, there are many examples Of course the sine kernel which we just saw for example the airy kernel Where it's The functions a and b are the airy function at its derivative the best cell kernel which arises In the study of singular values of random matrices so where the best cell functions arise as the in the kernel In this integral for so the gamma kernel of Olszanski where a and b for so for gamma kernel a and b are Expressions involving gamma functions a is a And b involve gamma functions. Let me not write the exact formula It's just some ratios of gamma functions with some shift involved Okay, so these kernels arise in many examples. So And the result again is completely general. So it exists in Discrete and continuous case So let me start with formulation in discreet case and then I will give formulation in continuous case as well So in discreet case In fact, there is very little to change. So Let pi the integrable kernel integrable kernel of projection operator And then Then the result stays the same But there is one important detail So the important so the result and the result stays completely the same The result stays completely the same, but there is one important detail namely this detail with principle value so the definition of this multiplicative functional is the following so the Meaning of multiplicative functional is the following is that one takes So what does what is this by definition? by definition This is the limit as m goes to infinity Of this product X minus p over X minus q square Over X less than n Divided by the expectation of the same Divided by the expectation of the same. So this is just normalized product and then this limit This is exactly what we consider I should say expectation with respect to what there is little technical detail expectation with respect to what not with respect to the measure With respect to the conditional measure Corresponding to the condition that there is a particle in q. Let me write it like this so this constant still remains but it's Immediately computable expectation with respect to this so in this sense the result stays completely the same I would like to stress however that the meaning of the limit transition Can be very different depending on the specific model and in fact, I will illustrate this precisely by the example of the gamma kernel So gamma kernel arises again in the study of young diagrams But in fact, I just redraw this picture in fact by very definition of young diagram So it is clear that configuration which codes young diagram Has very special structure. So clearly there are since We put Particle when the configuration goes down So and we put whole when configuration goes up like this. So clearly by definition Beyond the young diagrams, there will be only particles will be only particles To the right beyond the young diagrams, there will be only holes so in on the right on the right I have not very many particles in a sea of holes and To the left I have the opposite not very many holes in a sea of particles Okay so When one takes the limit the limit Which leads to gamma kernel This situation Remains to some extent so gamma kernel is not stationary and it is true that the sum of Inverses of particles converges on the right and some of inverses on holes converges on the left and therefore the meaning of this let me just write g of x The meaning of this normalized functional is Completely different from what it was for sine process for sine process normalized functional It was just the usual function. So This quantity is just a constant and in fact the limit if in the case of the same process this limit It was just the limit But in the situation with gamma kernel, it will be completely different. It will be the following it will be product of g of x over x greater than zero particle times So this normalized product times. So in fact, it will not be x and x anymore because it will be Product of g inverse of y Times y less than zero and y is a hole Pardon me g is any function For example g in this example g is x minus P over x minus q, but it doesn't matter g is any function of the form one plus something small So but the point is that How to say in gamma so in the example of the gamma kernel This in the example of the gamma kernel This procedure gives a complete this procedure of regularization gives completely different result So it gives product of particles over positive particles product of over holes on the negative side Because of course so to speak product over product over holes How do I say product over particles in finite in finite situation product over particles times product over holes Right, it's is equal to a constant Is equal to product of g over everybody, right? So constant So clearly product over particles is up to a constant the same thing as product of the inverse function over holes But this quantity survives limit transition while this one doesn't Okay, so up to this important Remark that the meaning of principle value depends on the model the result is completely the same and in particular I stress that the form of the radonikadim derivative does not depend on specific process So it's the same for all process with integrable kernels Okay, so now let me formulate the result in continuous case. So the result in continuous case It's actually very similar There is in continuous case main result So again So now it will be a measure on configurations on our So Continuous case of our or maybe our plus. So again pie is projection operator by locally trace class projection Trace class projection on our Projection Hey Whose kernel has integrable form Kernel has integrable form and again The examples apart from the sign process Examples are for example every process or vessel process and I let me note that for these results for these process rigidity Also holds and this is a little note from 2015 so Rigidity it also holds for all these processes So, okay has integrable form Then the measure This by P is quasi invariant under the group the group of Defiomorphins of our with compact support With compact support under the group of different more things of our with compact support and The formula for the radon nicotine derivative is has similar Gibbs form. So I take some diffiomorphins with compact support I Take some configuration F F has compact support So let's say F is equal to identity to the complement of some open set V Okay, so then The formula is the same Again product is regularized And I put X minus F P X minus P Square so P is in V P in X Intersection with V and X not in X But not in V. So and the formula is completely the same One can ask It's possible to choose the set V in different ways It is possible to choose the set V in different ways and so in particular so to speak to develop some If I may say so parasitical points, which are actually fixed points. So when f of P is equal to P, but this will not Imply any change in the form of radon nicotine derivative. So this much so this similar result holds again with this clarification on principle value holds For the case For the case of continuous continuous determinant process. Yes P is in V and X is in complement So excuse me. Oh, maybe it's not. Okay. Let me rewrite this P is in V and X small is in complement. So it's just the same as for Gibbs measures interaction of Those who move with those who do not move Okay. Okay. Okay. There is of course also. There is of course also ratio of There is of course also ratio How to say interaction of those who moves of ratio of interaction of those who move between themselves and also Of course the product of derivatives F prime of PI Okay, there is of course interaction of those who those who move between themselves. Okay, there we go P f of PI Okay, so let me very quickly say Just two words about the proof the proof uses The main point is the equivalence of so-called palm measures for Determinant all processes and the main point is that It is in general difficult To check that it is not easy to check the two measure I'm sorry to say such a banality, but it's not easy to check that two measures are equivalent So that just if you have two measures given a different way how to check that they're equivalent It's not immediate But It is possible to check in simple way that two determinant all measures are Taken one into another by multiplicative functional and This is again a little observation from russian's medical service 2012 so that just if I take multiplicative functional So multiplicative functional being just product of that of values of a function over particles and configuration so it It's possible to think of it as Laplace transform of additive functional usually one can say that it functional But in fact determinant all measures interact very well with multiplicative functions Okay, so then the statement is that if I consider determinant all measure and I multiply by multiplicative functional And I normalize so I normalize so that this probability measure then in fact It is a gain determinant all measure again determinant all measure where kernel Transforms in very simple way Namely if P is projection onto l onto some subspace l then PG is projection onto square root of GL and Again, it's very clear if you one thinks about Orthogonal polynomial ensemble if I multiply orthogonal polynomial ensemble by some multiplicative functional Then this is just Product I put G in the weight So precisely this will be the say so what is what is Christofield double projection? It is projection onto polynomials times the square root of the weight So precisely if I multiply measure by multiplicative functional it comes down to Multiplying the subspace base square root of G which is exactly what is written here But in fact, it's true not just for some polynomial ensembles But for all this is true in complete generality for all determinant open process. This is just completely general fact With very short. It's an observation with very short and simple proof so I Would like to stress that it is very important that here it is convenient to work with range of Operator it is not convenient to work with kernel I would like to stress that even if I consider some Superclassical orthogonal polynomial ensembles the one you like most of all Jacobi are meet legend or whatever you like And I multiply the weight by some function G It is not possible to say how orthogonal polynomials get deformed They get deformed in some very complicated way So only if G is some very simple special function for example fraction linear something like this It's possible to say how they deform but in general this transformation completely harsh They destroy the kernel if I have some nice kernel then For if P some nice kernel with some super nice formula when I modify it by G there is nothing There is no nice formula anymore On the other hand it is possible to say this so this statement It is possible to verify directly and this verification is what lies at the bottom of these Points all of these Proofs so one uses the result of Shirai Takahashi from 2003 That palm measures of the terminal point processes are the same are themselves determinant corresponding to subspace of functions which are annulled at a given point and Then so if I for if I set LP is subspace of functions in L Which are take value zero at a given point You might think I'm writing some kind of nonsense What does it mean L2 function which takes value zero at a given point But in fact since my function is range of operator admitting a kernel It's fine. It's this is well-defined and so this point is reduced to Verification of this kind L of p is equal to x minus p over x minus q L of q something that is completely immediate for Polinomials in fact, we all know that polynomials that take value zero at given point are divisible by x minus q But in fact it's also possible to prove in much greater generality In fact in the generality of operators with integrable kernels and just to finish I want to formulate one more case of this result Just so one other situation where Such result clearly holds is the situation of Hilbert spaces of holomorphic functions so and In the station of Hilbert spaces of holomorphic functions, this is joint work with Yanxi shiu from Senres so in 2015 so The result is the following one can consider Hilbert space of holomorphic functions in two situations So to speak on Euclidean plane and in the Lobachev ski plane so on the sea and on the unit disc so in the first case this is Geneva ensemble and this is just the space L is just Fox space and the Colonel is this and In this case, this is Bergman space and the Colonel is the Bergman colonel So and this determinant of point process by the way was studied by Paris and Virac This is process of zeros of Gaussian analytic function So this process of zeros of Gaussian function are detrimental point process with this current and so in this case with Yanxi shiu We obtain similar results. I should say that in this case Using approach of Olshanski essentially using approach of limit transition in this case There is work simultaneous work a bit earlier of Posada and Shirai But in this case and I want to finish with this in this case Everything is the same Except the formula for Radonnikadjim derivative. So formula for Radonnikadjim derivative It becomes different So instead of so in fact such formula does not make any sense does not make any sense in case of Disc just this product is just completely meaningless. So in fact in this case one has to consider ratio of Blyashki products In the same in the same way, let me not write So the chair is looking at me with reproach. So let me not write it completely But let me just say that instead of usual product. There is Blyashki product. Thank you so very much


Guys, I've been feeling real feminine lately. Current outfit, notwithstanding. I'm not really a dress person, but maybe I could be. I have bought three dresses, all for under $20, so let's try them on. Dress number one. I actually think I really like this. It was $16 from Target. Current version of my leg socket just does not go with the vibe, but that's okay. Maybe pairing with like some boots. I think this one's a winner. And we have a very flouncy option here. I don't think it quite fits. Come on guys, this skirt would be so fun for twirling and dancing in. I'm also apparently really feeling the green this season. Is there a tag on the bag? Did I even zip it up? Hold on. Didn't zip it up. All right, here we go. Still has a tag on it too. This was like 20 bucks from Amazon. And here we have old Navy like $7 on clearance. Dress number three. I got this actually for the premiere of the Barbie movie a little while ago, but it's super comfy and also very swishy, which is all girls really want. Which of these should I wear? Let me know in the comments.


Hi and welcome to the class today. Today we're going to be talking about some of the more common medications that our clients might be on. Antidepressants, atypical antipsychotics, and a little bit with the typical antipsychotics, if you will, and mood stabilizers. And so the first thing you might say is why do I care? Why is this important to me? Well, in my opinion, for several reasons. Number one, because we need to know what these medications are supposed to be doing for our clients. But number two, a lot of our clients have this white coat phobia, if you will. And if they're on a medication that's not working for them, they don't speak up to their doctors. So educating them about the fact that there are multiple different types of antidepressants, atypical antipsychotics, mood stabilizers, all that act a little bit differently, all that may or may not have similar or different side effects. And some people find that there are certain side effects that are just intolerable. So at that point, they end up being medication non-compliant, which in and of itself causes a problem with our end of treatment. So again, we want to know what the medication is supposed to do. We want to educate our patients to enable them to advocate for themselves. And we also want to be aware from a clinical standpoint, if when they're taking the medication, they actually seem to be getting worse and not better. So for each of the following antidepressants, antipsychotics and mood stabilizers, we'll look at their method of action in general, explore the types of disorders they're used to treat. And let me tell you, there are a lot of them and review the most common medications in those classes. That way you have a general idea when you're doing someone's intake, if they say they're on risk per doll, you can go, okay, I know that one. Well, identify where to get more information for patients. There are some really good resources on the web that not only provide basically your box information, but also provide patient reviews where they say, this is how I felt when I started taking it. These are the side effects that I personally experienced yada yada. And they talk about their experience with it, as well as their experiences with other medications. Obviously, they're patients, not doctors. So it's not medical advice. But it does help normalize what some of our patients are going through, especially when they first start taking a medication, and they may start feeling foggy or weird. And then we'll discuss, if we've got time, the benefits and drawbacks to off-label prescribing. Some people feel very adamant about off-label prescribing and or not off-label prescribing. So if we have time, I will open the floor up for discussion. As always, if you have any questions while I'm presenting, feel free to type it in the chat window and I will try to answer it as we go along. So we're going to do a brief review of, pardon me, dopamine and some of our neurotransmitters. And let me see if I can move this move to new window. And so in your course, in the classroom, there is a PDF that's your neurotransmitter quick guide. I'm one of those people who likes lists. I really do, because it gives me the ability to visualize things and see that, for example, depression pops up in a lot of different places. Anxiety pops up in a lot of different places. But you can also get a feeling for the neurotransmitters that excess dopamine tends to, in one way or another, sort of rev people up. Hypersexuality, unnecessary movements, repetitive ticks. Whereas not enough dopamine slows them down. And then you've got your negative symptoms of schizophrenia, ADHD, lack of attention, lack of motivation, fatigue, serotonin. You've got anxiety if there's not enough. And if you've got excess, you can also have depression because you're basically revving the system up too much. Noripinephrine. Again, you see anxiety if there is an excess. So it's a rev upper, rev upper, same thing with acetylcholine. Both of those are rev uppers.  But if you don't have enough, you're pretty slow, loss of alertness, difficulty focusing, difficulty concentrating. So you can see where there's a lot of overlap in these. One of the things I want you to really consider is the fact that most mental health issues that come up are probably not due to just one of these chemicals being too low or too high. It's probably a lack of balance between a lot of them. So helping clients understand that we need to figure out kind of what's out of whack and get it back in balance is going to be a big part of kind of what we talk about today. So dopamine is implicated in cognitive control. So if you've got too much dopamine, you may have racing thoughts, attentional control, impulse control and working memory, symptoms of excess dopamine, unnecessary movements, psychosis, hypersexuality, most of your anti psychotics and your atypicals that we're going to talk about are dopamine antagonists. It reduces the amount of dopamine available. Symptoms of insufficient dopamine, we're talking about your negative symptoms of schizophrenia, your flatness, and just lack of movement, lack of your catatonia, those sorts of things. More sense of pain, symptoms of Parkinson's disease. Restless legs, interestingly, that's the one where it's more revved up than down. And ADD, where people are having difficulty focusing their attention. Other more common signs of low levels of dopamine, lack of motivation, fatigue. Remember, dopamine is our feel good chemical. It's our reward chemical. So if we don't have enough of it, we don't have a lot of motivation to get off the couch. We don't have a lot of motivation to concentrate. And it may be more difficult to sleep because that is throwing a lot of other neurochemicals out of balance, which is going to affect our circadian rhythms, our serotonin levels, our melatonin levels, and so on. Medications. And we're going to talk more about these. Risperdone, Haldols, Iprexa, these are the ones we're going to talk about as some of your more common dopamine antagonists, your atypical anti psychotics. Agonists, just so you can be aware, if your client has Parkinson's syndrome or restless leg syndrome, and I see restless legs a fair amount, they will be taking a dopamine agonist. So if they're also taking an anti psychotic, they're probably canceling themselves out. So we need to help educate our clients, especially ones that go to multiple doctors. Mechanism of action of serotonin helps regulate mood, sleep patterns, appetite, and pain. A lot of your serotonin is in your gut. There are a lot of interactions with serotonin and you can see implications with serotonin in irritable bowel and a variety of different neurological problems, which you'll see when we talk about what things SSRIs are prescribed for. They're prescribed for a lot of neurological pain as well as a whole host of other things. Symptoms of excess, depression, apathy, emotional flatness. When serotonin goes up, some of the other happy chemicals go down. So we got to remember that just because someone's depressed doesn't necessarily mean they have too little serotonin. Difficulty concentrating and learning, poor memory, difficulty making decisions, and sexual dysfunction. Insufficiency, that's a short list, depression, anxiety, and pain sensitivity. Norepinephrine, this is one of your get up and go, fight or flight chemicals. It mobilizes the brain and body for action. It increases arousal, alertness, but also anxiety and restlessness. It can promote hypervigilance and vigilance and focus attention. So if you're reading through this, you might go, well, that kind of sounds like some of the PTSD symptoms. Then I'm like, yeah, it kind of does. We need to look at norepinephrine if we've got a client who is hypervigilant, who startles really easily, seems like they're keyed up and on edge a lot. Excess anxiety, increased startle reflex and jumpiness, impaired concentration, restless sleep, rapidly fatigued. They get up, they start going in the morning, and by 10 o'clock they're like, I need a nap. Now, you know, some of us would like to have a nap, but this is regular for them. They just, they can't get through a day without just being completely exhausted. Muscle tension and cramps because this hypervigilance and startle response, they tend to be tighter in their chest, neck area, you know, holding a lot of that tension, which can contribute, in my opinion, to irritability and edginess. So your norepinephrine medications are going to be your alpha two agonists, which have a sedating effect and are commonly used in anesthesia, as well as in the treatment of drug or alcohol dependents. So, again, talk about those in a few minutes. I just wanted to review the neurotransmitters. Stimulants and antidepressants increase dopamine and serotonin, as well as increasing levels of norepinephrine. So remember, I talked about how you can't, well, you can try at least, to increase just one. But when somebody is taking an antidepressant or a stimulant, like an ADHD medication, not only are they increasing serotonin, but they're also probably increasing norepinephrine and dopamine. So I found this one interesting. So just bear with me for a brief little second. There are different receptors in the brain. Pre-synaptic terminal excretes neurotransmitters into the synaptic space, and then there are all kinds of different locks, if you want to envision it as lock and key, on the receiving neurons. Your D receptors, D1 through D4, are typically associated with dopamine. I'm like, thank you for giving me a clue there. Then you go down to 5HT1 and through 5HT7 with subtypes like 5HT1A, 5HT2A, lots of subtypes. Those are serotonin. Now I don't know how they got serotonin from HT, but alpha receptors, and you'll see the little alpha sign and a little sub number, are associated with your adrenergic receptors, your adrenaline, norepinephrine, norepinephrine, epinephrine, and adrenaline. So if you see a little alpha, that's your get up and go receptors, and whether you're increasing them or working against them.  Muscarinic receptors are more active when we talk about GABA, and we're not talking about that today.  Remember, histamines are the things that your body excretes to when there's an allergy or something that kind of make you itchy, just to be aware. So these are the different receptors that they look at when they're evaluating the efficacy and what receptors are being affected when people take different psychotropic meds. And one last review, higher acetylcholine and higher norepinephrine, so those are your two get up and go neurochemicals, together with low serotonin. So your happy chemicals low and your fight or flight chemicals are high, produces anxiety, irritability, anger, aggressiveness, go figure. When epinephrine, which norepinephrine is your get up and go and your motivation chemical, dopamine is your reward chemical and serotonin is your happy chemical for lack of a better term. But acetylcholine is low. The result is depression. And you're like, Well, how did that happen? You've got get up and go reward and happiness, but we're depressed. So you see how the balance is so important. And increasing serotonin levels will lower acetylcholine levels. So it's important to understand that there is an interaction and it will also potentially lower norepinephrine over here and your dopamine. So you can't just increase one without affecting the other three. So now on to antidepressants. Yay! Your selective serotonin reuptake inhibitors decrease serotonin blockers in the brain. It makes it so there is more serotonin getting through that into that post synaptic terminal. It's going through there. The ones we talk about or the, you know, ones we first learn about in in school, and a lot of doctors still kind of prescribe as your first line because they're the older, more researched are your Zoloft, Prozac and Paxil, sertraline, fluxitine and peroxitine. Heuristic evidence when we talk to patients is that Zoloft tends to be more neutral as far as making people sleepy, making people gain weight. Prozac tends to be more stimulating and a lot of people report they have a lot more anxiety when they're taking that. But if you've got a client who just can't get out of bed or who has no motivation, sometimes Prozac is the kick in the butt that helps them. Paxil, on the other hand, tends to sedate a lot of our clients. One of the suggestions that the docs I've worked with have made to clients is to take their Paxil at night before bed. They won't feel as sleepy the next day. But if you've got a client who is complaining that they're on an antidepressant, they're on Paxil and they just can't wake up and they even try taking it at night and they just can't wake up, encourage them to talk with their docs so they don't discontinue because of the side effects and look at some of the others that are available. Satalapram, I'm just going to go with the trade names, they're easier to pronounce. Cilexa, Lexapro, Luvox, and Ulptro are all available and they are all pretty commonly prescribed as well. All of them work slightly differently. Some of them work on slightly different 5-HT receptors. Remember there's 5-HT1 through 5-HT7 plus subtypes of those. So there's lots of serotonin receptors and we got to figure out which locks are broken in our particular clients and we haven't figured out a great way to really identify that yet with that kind of pinpoint accuracy. We're trying to figure that out. Which takes us to our SNRIs, your serotonin and norepinephrine reuptake inhibitors. So maybe somebody has not enough serotonin but they also are not, don't have enough norepinephrine, not enough get up and go if you will. Pristique, Zimbalta, and Afexer have come on the market recently compared with Zoloft, Prozac, and Paxil and have been found to be very effective. Zimbalta also has the added benefit of pain relief in addition to treating depression. Now again, I'm using the trade names simply because they're easier to pronounce. I'm sorry. And I'm not advocating for any particular pharmaceutical company. And you want to look at the generic name anyway to see if it's available in generic for your clients. While I'm on this little side note and tirade, if your clients cannot afford their medication, go to the website of the pharmaceutical company that makes it. Almost every pharmaceutical company has a patient assistance program. Print out the form, have the doctor sign it. It's usually a one page form that indicates that the patient can't afford their medication. The doctor faxes it in and they usually are able to get a voucher for either free or low cost access to that medication. And when I say low cost, I mean like four bucks, not anything huge. Also make sure to compare the different formularies at places like Walgreens, Publix, Walmart, Sam's Club, and you know, the list goes on the different drug stores to see which medications are on the low cost plans like $4 for 30 days worth or $12 for 90 days worth. A lot of patients don't have prescription coverage. So making sure that they're able to get a medication, which is almost always going to be a generic at an affordable price is going to be like really huge.  Tricyclics. Now, once you exhaust your SSRIs and SNRIs and if they're not working as well, and in some cases the doctor may decide to start with your tricyclics, they tend to have more significant side effects and be harder to manage for a lot of patients than your regular SSRIs and SNRIs. But I know I've had clients on Pamelaur before. I've had clients on Tophrenil. Being aware that they're there, they may be prescribed. You really, in my experience at least, working with clients with co-occurring disorders, most of the time I would see SSRIs in atypical antipsychotics. If I saw tricyclics, I would start to really think about whether this person had treatment-resistant depression and want to talk to them about what else helps them. Vupropion or Wellbutrin is a dopamine reuptake blocker. So it prevents the dopamine from being sucked up, which means it's more available in that synaptic space. It has been used for depression, seasonal affective disorder, and also smoking cessation. However, because people with bulimia, when they purge, can make their electrolytes get out of whack, something about this medication makes it more likely for them to have seizures if their electrolytes are imbalanced. So it's not advised for people with history of bulimia. MAOIs prevent the breakdown of norepinephrine dopamine and serotonin. If you've read the back of just about any over-the-counter medication, it says don't take this if you're on an MAOI. It doesn't play nice with others. It doesn't play nice with a lot of foods, including cheeses and wines. It's just not a play nice in the sandbox kind of med. It may be a last resort for some of our clients, so you need to be aware of it. Again, I know I've had clients before on Nardal, so being aware that sometimes, for whatever reason, the psychiatrist may choose the MAOI, likely they've already exhausted most of the other options because there is a lot of risk associated with the MAOIs. But again, it makes norepinephrine. Your fight-or-flight, your active, your peppy sort of neurochemical, dopamine, your reward chemical, and serotonin, your happy chemical, and also your I don't feel a lot of pain and I've got decent sleep. So these three chemicals are pretty important, and it makes them more available. And then remeron. I felt the need to put this in because, and it's not as much anymore, but in the past, I had seen a lot of our attendings, and I don't know about your attendings, had prescribed remeron for patients that were having difficulty sleeping, etc., and had some, you know, ongoing depression. Remeron gave a lot of our clients really bad munchies. Not every client, but that was one of the big complaints with remeron. It is a noradrenergic antagonist, which means it's going to try to prevent noradrenaline. Like I said, I don't see it used as much anymore, but it's still out there, and you'll still see it. So how do you find the right one? Well, because depression can cause, because by an imbalance in one or more neurotransmitters, we need to take a lot of things into consideration. First and foremost, being patient treatment compliance. Can they afford it, and are they going to be able to deal with the side effects? Please advise your clients, because a lot of times, and I don't mean to diss doctors here, but a lot of times, the doctors that are prescribing the anti, the psychotropic medications, don't tell people that the first couple of days you're taking it are going to feel wonky. Some, not very much at all. Sometimes it feels like flu-like symptoms, and for some medications like Zoloft, if you miss a dose, or if you're more than 12 hours late on a dose, you may start feeling kind of lightheaded and like you've got the flu. I like to tell my patients that right up front, when they start taking a medication, I'm like, let's talk about what other people have reported that they have experienced, just so you know. That first three days may not feel so good, but after that three days, those side effects often go away.  So we need to talk to them about what are intolerable side effects. Some clients will tell you from the get-go, I will not take something that makes me gain weight. Okay, good to know. We want to talk with them about if they have any close blood relatives that have used an antidepressant that's worked for them. If so, that's probably a good place to start, because we know there is some sort of a genetic component. We also need to look at what other medications they're taking, and look at any contraindications. Like I told you, if you have somebody on medication for restless leg syndrome, you're going to have to figure out how to handle that if they also need an antipsychotic, because both of them are working in opposite ways on dopamine. And we need to think about health conditions and pregnancy. Anything that may affect blood pressure, and if the person's pregnant, what the drug category is. I'm not going to get into that a lot, because that's something the doctor will talk about with them. If you're not familiar, drugs are rated in pregnancy category, pregnancy safety category. I think it's A through D. D being just completely unacceptable, but some of your SSRIs are in the category B, where they're pretty sure it's not going to cause big problems in the infant, but they can't ethically test on pregnant women. So all they're going from is any reports that may have come in from someone who was taking the medication while they were pregnant. So again, that's something for the doctor to worry about, but do know that there are considerations for pregnancy, especially with your mood stabilizers and your atypical antipsychotics. So what antidepressants treat everything? It's like throwing the kitchen sink. Anorexia and feeding problems. We know that serotonin's involved in hunger, anxiety and panic, anxiety and stress, binge eating. So again, with the food. So we've got anxiety, food, mood swings, body dysmorphic disorder. And I was reading the best practice on that recently, that the SSRIs that are used to address body dysmorphic disorder are often used, prescribed at much higher levels than you would see for, quote, normal depression treatment. I'll be doing a class on that, but just kind of be aware if your patient says they've got BDD and they report taking Zoloft at, you know, 400 milligrams, which is like a huge, huge dose of Zoloft, that might not actually be incorrect. Borderline personality disorder, bulimia, again, with the food, depression, fibromyalgia with the pain, anxiety, again, hot flashes. So, you know, not sure how that works, but it is prescribed for hot flashes, intermittent explosive disorder, irritable bowel. Remember, I said a lot of your serotonin is in your gut, like 80% of it. Depression, OCD, PTSD, postpartum, premature ejaculation, PMDD, schizoaffective social anxiety, and somatiform pain disorder. So basically, there's depression, anxiety, mood swings, and food issues, pain and food issues. Now onto your atypical antipsychotics. Generally known as major tranquilizers, and if you've been around clients who are on these, you will know that they can really slow somebody down. While I'm on that, some resourceful patients with co-occurring disorders may take their atypical antipsychotic in combination with another depressant in order to get high. In treatment, in residential treatment, it is not uncommon for clients to cheek their saraquil and save it for later. And then they take it in the morning, and they stay up through that sleepy period. And they're in sort of a weird, hypnotic state at that point is what one of my patients described it as. So being aware that atypical antipsychotics as well as typical antipsychotics can be abused because they're a tranquilizer, combining them with other depressants can be deadly, but it can also be a way that some of our patients try to get high. And neuroleptics. Now these are more your first generation antipsychotics, but it's important to know that they do have some neurological effects. Atypical antipsychotics, your antipsychotics in general when you're talking about them, block receptors in the brain's dopamine pathways causing a reduction in dopamine stimulation. They're reducing the amount of dopamine available. But interestingly, they failed to significantly improve the negative symptoms and cognitive dysfunction. Now, we've found out recently that a lot of that has to do with receptor, dopamine receptor 3. So if they're reducing the amount of dopamine and dopamine receptor 3 is involved in the cognitive problems and the negative symptoms, so they need to ramp that one up, they've got to figure out how to find something that's a selective dopamine inhibitor, if it's even possible. So what do we have available to us? Zeprexa is one that a lot of my clients have been on.  And you may have a client in there and you're thinking to yourself, well, this client doesn't have schizophrenia, so why are they on an atypical antipsychotic? That's a good question because they are used to treat a whole host of things. Partially, because those neurotransmitters work in synchrony, but partially because antipsychotics are good at sort of slowing people down. They're good for treating agitation, anxiety, bipolar disorder, especially the manic symptoms. Interestingly, body dysmorphic disorder, borderline, depression. Sometimes you will see an atypical antipsychotic with a NSSRI for people with, quote, treatment-resistant depression. Anxiety, again, intermittent explosive disorder. People who have nightmares, night terrors, maybe prescribe these to help them sleep. OCD, post-traumatic stress disorder, psychosis, schizoaffective disorder, schizophrenia. Again, with a social anxiety, tick disorder, and Tourette syndrome. So, what I want you to notice, and I think I highlighted that, is the fact that a lot of these mood disorders, quote, unquote, that we work with, that we typically think SSRI, may also be treated or affected by antipsychotics, which tells us that dopamine's involved in this whole process. So it may not just be a serotonin thing for somebody. Side effects. Unfortunately, even the newer antipsychotics have many side effects. And just because they're atypicals, doesn't mean that they have fewer side effects than some of your older ones, like your prolixin. Bear that in mind. Drowsiness, dizziness, restlessness, weight gain, constipation, nausea, vomiting, blurred vision, low blood pressure, uncontrollable movements, such as ticks and tremors. Yeah, wanted to sound like a commercial. But be aware of your normal side effects. There is a checklist that I put in the classroom. It is wonderful. I wish I would have had it in all the years I was actually working in residential facilities, is the antipsychotic side effect checklist. And it breaks it down into layman's terms for our clients to be able to say, yeah, I'm experiencing that. And for our counselors, to be reminded of all the different symptoms that actually may be a side effect of the antipsychotic, for example, switching back and forth, being restlessness and switching back and forth in their chair. A lot of times, counselors, not knowing, may attribute that to either anxiety, or lack of attention and being disruptive in group. When we go back and we look and say, oh, well, Jim Bob was just started on an atypical, then we might be able to talk with Jim Bob and talk with the doctor and figure out if that side effect is going to pass for him. But it's also a way to avoid blaming the client for something that's not their fault. They're not trying to be disruptive. They just literally cannot sit still. So you can print that out. It's a great checklist to have. Clausapine and onizapine are associated with the greatest effects on weight gain and decreased insulin sensitivity followed by Risperdone and Quedepoctin. I got to work on those. Anyway, Risperdoll is one we see a lot. So it's important to recognize that these four are going to likely have the side effect of producing more weight gain. They also are likely going to have the side effect of increasing insulin sensitivity, which may exacerbate diabetes or hyperglycemia. Again, this is something the doctor is going to be more concerned with than you are. But if you're in a residential facility, someone just started on an atypical antipsychotic, they're in group and they go into some sort of a diabetic crisis. It's important to understand, oh, this may be what's happening instead of just going, I don't know, he just fell out. So these are important things for the paramedics to know, for your staff to know if someone has recently started on an atypical antipsychotic. Mood stabilizers. They're comprised of a variety of drugs used to reduce mood swings. Most of them are GABA receptor agonists. They're going to increase the amount of GABA available. They all kind of fall into different categories, but you have lithium, which is just a straight up mineral. Lithium can be really hard on the kidneys. So there are a lot of, it's very important for our clients to be well monitored by their doctor. Now you may think, well, that's the doctor's problem. We see the clients a lot more than they probably see their attending physician or psychiatrist. And so if they cancel with their psychiatrist, it may be another month before they can get in. If they cancel with us, we may only miss a week with them. So it's important for us to keep talking to them about their medication compliance, how it's going, how they're feeling, if they're having any side effects. Your anticonvulsants. Depicote is the one that was most commonly used where I was from. I've seen lamyctal and tegritol also used. These typically have sedating effects, but are typically well tolerated in general by our clients. They are not recommended for women who are pregnant or nursing, nor is lithium. So it's, when people are pregnant and nursing and have bipolar disorder, it's a sticky wicket to figure out what's going to happen. So far, I have never run into an attending physician that's willing to prescribe any mood stabilizers during pregnancy and or if the person is nursing. The recommendation usually is for the person to not nurse so they can get on their medication and be emotionally stable to be there for the infant. So just being aware of someone is pregnant and they were on mood stabilizers, they will probably come off. So they're going to need some tips and tools to figure out how to deal during their pregnancy and during the unmedicated state. Mood stabilizer side effects, itching and rash, excessive thirst, frequent urination, shakiness, nausea and vomiting, slurred speech, changes in heartbeat, changes in vision, potentially seizures, hallucinations, loss of coordination, and swelling of the eyes, face, lips, tongue, throat, hands, feet, etc. So mood stabilizers, stabilizers, wow I'm having difficulty talking today, do have a lot of side effects. They are potent medications. If people are having side effects, they need to talk with their doctor sooner rather than later to figure out if it's a normal side effect, if their dose is too high for them, and if it's a side effect that's going to go away. Other great resources and I'm going to see is this, oh of course it'll open somewhere else. The drug interacts and interactions checker on drugs.com. Love this thing. You click I agree, it just basically says this is not a drug, this is not a doctor's advice, this is just kind of what we know. So you can type in medications like Sertraline and Remeron. And let's just get in there with Halbal. And then we want to check for interactions. So if somebody happened to be on these, which I would hope you would never see, I intentionally chose things that shouldn't be together, it will tell you if there are major or minor potential interactions between the medications. It tells you which medications may not play nice together. And the clients can use this to educate themselves and to talk with their doctor. Sometimes the risk of the interactions is worth it in the patient and doctor's opinion, and that's totally between them. But this is a cool thing. You can email it to yourself or the patient. You can print it out so they can take it to their doctor. It's a great thing to have. It's a great resource. Another resource that you have available to you, again drugs.com. Find drugs by disease or condition. So let's say we have somebody who has depression. And then we can look and see the medications that are typically prescribed for depression. And you can see the patient rating as far as effectiveness and satisfaction with the medication. And obviously we'll look down at Xanax. We know that Xanax is highly abused, but it gets an 8. People found it to be really, really helpful, probably because they're really, really sort of stoned when they take it. But it does work quickly as opposed to SSRIs that do take four to six weeks to get in your system. So you can click on the reviews, remembering and reminding our clients that these are by patients, not by doctors.  But you can get an idea on what it might feel like to take this medication and whether it sounds like it might work for you. You can figure out, it says your pregnancy category here. Yes, D here. So D is positive evidence of risk. If you take Xanax when you're pregnant, there is evidence that it will hurt the fetus. Category C, they can't rule out risk because they just don't have enough data or information. Paxil is a D. So it gives you an idea. And it also gives you an idea about what options are out there for your clients. And if you have a client that comes in that seems to be on a weird cocktail of medications, not that we're doctors, but we do know that some of our clients will doctor shop and not tell Dr. A about Dr. B, C and D. So it's, you know, good to be able to look at some of these medications and try to figure out what's there. And they may not realize that the medication for restless legs is going to impact their antipsychotics. It may not be intentional. But so these are two great resources that I really like to have available. Let me show you really quick. The side effect checklist. Yeah, you know, lots of verbiage talks about the different items and defines what we're talking about. So daytime sedation or droughtiness, whether it's a common side effect, it gives you some information. Scroll down. This is the part for the clients. Loss of energy and drive. Client can say not a problem or it is a problem. And this is why muscles trembling and shaking, being too tense or too stiff, restlessness, jitteriness need to move around and pace and inability to sit still. Is it a problem? Is it not a problem? Most of our clients will understand the explanations that are here because it's not overly like medical jargony. So I like to give it to them, give them a couple of copies and have them rate them their symptoms or lack of symptoms every week. For a couple of weeks when they first start taking atypical antipsychotics, that way we have sort of a record and we can look at the progression to see if some things are wearing off and then they have something to give their doctor and I have something to put in the chart. So those are three of your big ones. Obviously, we didn't talk about your anxiolytics today.  So are there any questions? Okay, cool. If you think of any questions, you are more than welcome to send me an email at support.allcews.com. That goes straight, pushes straight to my email and I can answer any questions that you may have. In the meantime, the quiz is open. You can go in and take it and print your certificate of completion and we will be good to go. I'm glad the websites are helpful and let me know if you need anything.


Russian forces defend Putin's palace in Valdai. Leningrad is left defenseless against drones. Russia's air defenses in the city of St. Petersburg and the surrounding Leningrad region are stretched thin, as President Vladimir Putin has pulled the majority of his resources to defend his prized residence at Lake Valdai, a Russian telegram channel reported. According to Newsweek, the Vechik-OGPU outlet, which purports to have inside information from Russian security forces, said on Sunday that, according to its source, recent drone attacks on St. Petersburg and the Leningrad region are due to an acute shortage of technical means for detecting small air targets and mobile air defense missile systems capable of shooting them down. Russia's Pantsir S1 air defense systems were deployed to protect a particularly important facility in Valdai. The telegram channel said Ukraine launched a drone attack on January 18 on the St. Petersburg oil terminal. It marked the first time a drone had targeted Putin's home region, Leningrad, since the full-scale war in Ukraine began. One of the drones, launched in that attack, flew over Putin's Valdai residence, RBC Ukraine reported, citing a source in the special services. Putin's residence in Valdai is located in between Russia's Tver and Novograd regions, some 250 miles away from the Kremlin. After the start of the war, almost all of the Pantsirs were sent to protect a strategically important facility in Valdai, where the residence of the President of the Russian Federation is located. Some went to the combat zone and one complex was lost in 2023 due to an accident in the Leningrad region, the Vchik-OGPU outlet said.


You too team keep it clean This thing is crazy This thing is wild and this thing is just it's really insane when you think about it Now my apologies for the the videos not being in order But that's what happens when you internet ain't the fastest, but it's all good Because I did just finish doing a video About Antonio Brown requesting his release from the Raiders via Instagram But we needed to we didn't well we kind of knew why but we didn't know know why and now we know why it's because They took away his guaranteed money That 29 mil there were 29 point have a much meal. They that's gone That's gone They that's that's completely gone First let's look at what Jeff Darlington said He said that he had just got an email from Antonio Brown saying that the team took away my guarantees He also added that there's no way I play after they took that and made my contract week to week Adam Schefter said in addition to finding Antonio Brown 215 thousand seventy three dollars and fifty three cents for conduct detrimental to the team that that voided that voided That voided the twenty nine million point one two five or twenty nine point one two five million dollars So over twenty nine million dollars that voided over twenty nine million dollars worth of guaranteed money in his contract So because he was fine the two hundred fifteen thousand Conduct detrimental to the team that voided. Oh, man, like I don't know why I felt that so much Because I ain't even seen that much money in my life but that that hurt me and Like I'm not I'm not the one going through this. Well, that hurt bad, man because because for a fraction like for a tiny fraction of The you're guaranteed money for two hundred fifteen thousand for two hundred for two hundred fifteen thousand You lose that on over twenty nine million. You lose that on over twenty nine million I'm sorry that that hurt me Wow, it says that they also so They they took it up a notch too, man. It said the raiders also send brown a letter Saying that he's no longer entitled to termination pay if he is released so It's sounding like he's gonna be released Because if they're letting him know that if they're taking away the guarantees and they're letting him know that It sounded like he's gonna be released Tom Pellecero said the raiders also say the conduct detrimental fine it voids the guarantees in his contract AB got a sizable raise from the raiders upon the trade from Pittsburgh, but they haven't paid him yet Most of 2019 conversation is in a fourteen point six to five mil base salary That's now in jeopardy. This is uh, so it's really ugly.  It's it's on the way. It's being uploaded But in that video, I was just saying like man, the raiders have really been they've been going to they've been going to his tune They've been following his lead like he's been the one dragging him around like a y'all gonna do it my way, but Behind the scenes man behind the scenes the raiders have been they've been Working on this and they've been putting all this stuff together like a oh he think he got us now We straight we we got this and they do Because if you can get off the hook for for over twenty nine million dollars You can get off the hook for twenty nine million dollars Yeah, they um, they came back hard and this woman They came back hard man The raiders they came back hard They not messing around They came back they they with it man raiders all with it That is crazy, man. That is crazy. It makes stuff that much more clear on why he asked for his release this morning But anyway team keep it clean that video will be out in a little while. It's looking like it's gonna be out in about an hour We'll see if the internet decides to pick up but This is just a crazy situation. Anyway, I love y'all Well that that That 29 mil that hurt me man, and I'm not gonna see a dime of that but that that hurt But like a B probably will be with the raiders soon Yeah, I'm out