The Cure America's Guatemala Maternal and Child Health Project, 2011 to 2015, included implementation research designed to assess the effectiveness of an approach called CBIO+, composed of, 1, the census-based, impact-oriented, CBIO approach, 2, the care group approach, and, 3, the community birthing center approach. This is the second paper in a supplement of 10 articles describing the implementation research and its findings. This article was authored by Henry B. Perry, Mario Valdez, Stanley Blanco, and others.


Okay, welcome back everyone, we're ready to resume with the open session of the advisory council meeting. We have five concepts to present to you this afternoon. Two of them are directly related to diversity workforce issues. And we thought it would be appropriate to have events bottom give you a presentation in advance of those concepts. A year ago Eric formed charged events with the responsibility to form a working group directly to address the issue of workforce diversity in the broadest sense possible. And so the first two concepts that we have for you this afternoon are kind of the leading edge or an initial products of the working group that Vince has formed. I should say events as a member of the internal research community. He is also a senior advisor to Eric Green. So events before you start your presentation, I'm going to invite Eric. Is there anything else you would like to add about your charge to events. Yeah, thank you. Thank you Rudy I did just want to say a couple things to contextualize not only events is presentation but then the two concepts that will follow is that it was striking during the entire two plus year strategic planning process, how many times and how frequently issues of diversity and equity and health disparities would come up. So even at an early stage when we started to synthesize the input we absolutely knew this was going to be featured in multiple parts of the ultimate strategic vision that was published. And so with that in mind, I turned to my senior advisor in genomics and health disparities that spot him and just basically said, get a running start. Let's not wait for the strategic vision to be published and then start active. This is one of these examples we should get a running start. And so Benz will tell you the details of the group you put together internally but this is what you are seeing basically now is the is some of the first products of this internal group that really had spent the last phase of the strategic planning process already started to thinking about implementation of we think is among the most important areas in the new strategic vision. And so it is not a coincidence that literally the first things we came out with publicly after the late October publication of our strategic vision in terms of specifics about how we're implementing elements of the strategic vision. It is around workforce diversity. And as you will see in his pencil say we sort of had we had it teed up so that when the new calendar year started literally the first week of January, we came out with some of the things that Benz is going to describe. And all this was very deliberately choreographed and I really want to emphasize reflects the commitment of the Institute to move the needle really try to think through with help of Council and other advisors to the Institute, what we could be doing in areas of diversity, equity, health disparities and so forth and this is going to focus on is specifically in the area today is going to focus on workforce diversity. So with that I'll turn this over to that. Okay, great. So thank you Eric and I am so pleased Council to be able to share with you this afternoon, the new NHGRI action agenda for genomics workforce diversity. So, Eric discussed in his director's report, the 2020 NHGRI strategic vision, and as Eric just articulated, as you review that strategic vision you see very clearly in a number of areas, the importance of diversity, both diversity with regards to ancestral populations and research, but also the importance of diversity with regards to the workforce and that our Institute has a responsibility to help to lead those efforts. This vision is highlighted several important areas of guiding principles and values foundational areas for genomics areas to break down barriers and compelling genomics research projects. One of the major themes is the issue of increasing diversity in the genomic workforce. And this is highlighted in several areas. One is in the guiding principles and values. And here with regards to the guiding principles and values, we have nine guiding principles and values as part of the strategic vision. And one of them is clearly focused on how do we think about and what is the role with regards to strategic vision for increasing diversity. So the one guiding principle and value is the need to champion genomics workforce. And this principle is clearly articulated in this value as the promise of genomics cannot fully be achieved without attracting, developing, retaining a diverse workforce, which includes individuals from groups that are currently underrepresented in the genomic enterprise. And we really explore this issue with regards to the efforts about thinking about diversity in a very broad way, but the needs to increase the diversity within the workforce. This is not the only area as guiding principles but robust foundational establishment of our work as an institute. So we do not see this just as an aspirational guiding principle and value, but a foundation for NHGRI. We provide sustaining and improving a robust foundation to foster a diverse workforce as a vital area for NHGRI over the next 10 years. And so if you look at this box here and you look at the variety of areas and the highlighting of training and training of a diverse area as an important part for our institute. As Eric stated, in December of 2019 he asked me to chair this NHGRI committee to develop the plan and to increase the diversity of the workforce. And I'm pleased that we presented this to the genomics community in January of this year. This included the publishing of our action agenda, but also a commentary that was published in American Journal of Human Genetics. And I refer both of them to you. I believe that they are in your council members package of documents to review. And to the broader community I refer the action agenda to you. You see here the website on genome.gov, as well as the American Journal of Human Genetics commentary, the reference to this commentary. So what are the goals? The action agenda sets forth four goals for NHGRI's efforts. The first goal is to develop and support initiatives that provide early exposure and access to careers in genomics. So we recognize that we can't start once an individual is in a graduate program. We must go back and look at K-12 and our efforts and activities of what we can do within middle schools and high schools to help to make students aware of genetics and genomics as a potential career area. And to highlight how do we expose the general public to careers in genomics. So there is a recognition of the early pathway or pipeline responsibilities for the institute. The second goal is to develop and support training programs and networks that connect undergraduate and graduate education to careers in genomics. And this will get highlighted today by Dr. Gatlin and her discussions of one of the concepts. But this issue of this importance with regards to what happens within undergraduate education and really exposing those students that are excited about science to careers in genetics and genomics. What can we do to help facilitate them moving from undergraduate to graduate school and then ultimately to careers. So building this network and this connection between undergraduate and graduate education is important in our ability to move forward with the workforce. The third goal is to develop and support training career development and research transition programs that lead to independent research and clinical careers in genomics. And here we really are highlighting on that ability to once an individual is completed their postdoc their their training within the field. How do we get them to independent careers. And I want to just highlight for you that we are talking about both research careers and clinical careers. We recognize that not everyone is going to be a researcher, but that we are going to need clinicians who are exposed and prepared for the fields of genetics and genomics to be prepared to work within various types of clinical settings. And so what can we do as an institute to help to move that forward in a way to have a much more diverse a population of individuals within clinical careers. At the working group highlighted this as a significant problem as we looked at clinical geneticists across the country and the lack of diversity within the field, as well as in the field of genetic counseling. And then finally to evaluate progress toward achieving greater diversity that we must evaluate our efforts as we go through this process of this action agenda to make sure that we are meeting our targets make changes as appropriate. So that we are not just waiting to 10 years from now down the road to see what we did. So this is an ongoing process of evaluating our efforts and activities with this action agenda. So I want to highlight here, the working group members that put in bi-weekly meetings that we had over a nine month period to prepare this action agenda. These individuals are from all areas of the Institute including our intramural program, extramural program directors and our office of director and I just want to acknowledge and thank them for their hard work and their important work to getting us to the stage that we're at today. And so this is just the beginning. And as you hear the two concepts that are presented today. And as we move forward. We will be coming back to you on a regular basis to update you on things that are happening with this action agenda as we extend the action agenda to efforts in our intramural program and our office of director. We will bring that back to you to let you know what is going on. But I want to highlight that one key component of this action agenda is partnership with other organizations. We're already partnering with three professional societies, the American Society of Human Genetics, the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors, as they are leading a survey to better understand the landscape of the genetics and genomics workforce today. And working with them in collaboration, we will also be working with other professional societies and industry, and with academic institutions. It's going to take all of us working together to actually make the kind of change that we hope to make. So with that, I'll take any questions, and then give it over to my colleagues. Thank you, Vince. Council members. Any questions for Vince? I don't see any hands up. So we're going to have Ford. Oh, Sharon. Sharon, you're on mute. My mute button is buried. Thanks so much and thanks for all the efforts. I did have a question about the pipeline issues and I can speak more from issues related to women in academics where people often comment on the pipeline but in fact women have been more than 50% of biology and medical school MDs, PhDs and MDs for I think it's 30 years or something. And so I do wonder sort of how do you balance the pipeline versus people leaving or being discriminated against as they sort of move forward with regard to your plan. Yeah, so one of the areas that we highlighted in the action agenda is that we need to focus on what can we do to help to increase the number of women and senior leadership positions within the field of genetics and genomics, where there clearly is a lack of women when you think about senior positions. And so we will target our efforts and activities on those areas where to one where we think we can make the most difference and to where there's clearly a lack of diversity so taking your comment and consideration, you know, we will target our areas around senior leadership around issues with women. Yeah, no, I'm sorry just to be clear, I wasn't really talking about women. I was just saying the experience with trying to bring women into the workforce is that the pipeline is not enough. And so I think when you look at African Americans, Hispanic other other individuals that are underrepresented there's also as a tendency to blame the pipeline. And I just want to make sure you're sort of encompassing the fact that the pipeline itself is not enough. Now I totally agree with you and the broader issue of culture is a part of this, you know, development of this action agenda is how can we make the community much more inclusive and welcoming of individuals from diverse background so you know, one of the things that's clear is there's a lot of individuals who are really excited about the field, but don't don't always get the opportunities and so what can we do as an institute working with our partners, including, you know, investigators to help to create a culture that's much more inclusive. Okay I've got Olga and then how. Go ahead Olga. I'm delighted to that I'm wondering if you're thinking at all about also looking at additional barriers like for women, for example childcare right where you know women are traveling a lot less because they're in child, you know, they need to be at home so then obviously they're going to rise. I have a feeling this is not based on data but based on the anecdotal evidence that for a lot of minority, especially for generation situations right like they're maybe helping care for aging parents maybe similar things regardless of gender as well. And so, are you at all thinking about basically reducing these sort of barriers in addition to all the other issues. So we're thinking broadly and trying to capture and learn from other institutes and empirical work that NIH has initiated and funded about some of the challenges and clearly. The challenge that's been highlighted with regards to the current pandemic we're in, and the impact is having. So, as we go forward, we need to think about different strategies for different target populations and different stages of an individual's career so I recognize that you know clearly the pandemic is identifying that so this is clearly in the broader scope of how we work with professional societies and organizations and going forward that something we should be aware of. And thank you for all your work on this. Right, thank you. How go ahead. Yes, fence. Thank you for your important work in this area to build upon comments by Sharon and Olga. I'm wondering if there's any effort to identify minority individuals who have entered our pipeline, but then who have gotten lost along the path to a sustained career in genomics and genetics. If we were able to identify them and engage them we might learn more about where this is failing many individuals. We have a great point as part of our development of the action agenda. We had an opportunity to do focus groups with early stage individuals within the field, and we heard some really important themes from those individuals that have gotten incorporated in the action agenda but will be part of our work going forward. I also think and identify clinical medical geneticists. We tried to identify individuals who are from certain backgrounds across the country so that we can have focus groups and have conversations with them to learn about how to be successful in their path in reaching their careers and what kind of barriers they have had. So our ability to continuously listen and to to learn how we can modify our action agenda highlight areas and opportunities by engaging with those that are in the field, and those that have moved on to other areas will be extremely important. So last call for questions for Vince. So, I look forward to coming back to update you on the action agenda. And I know my colleagues will now present two concepts. Thank you.


The best is the woman who her focus in life is not her children Is not her husband Is not her career is not her beauty. It's not her house It's only one answer Al Wahid The one the one How many of you and don't show me hands this is between you and Allah and he knows How many of you can say it? Confidently as if she's in front of Allah and says Ya Rabbi I lived for you. I did everything for you. I Got married for you. I Had children for you. I Studied worked hard to make my career for you. I Wanted to be educated for you Memorized the Quran for you Islamic studies started Islamic institutions you name it For you how many can claim this now and In front of Allah will say it The answer is if I want to be very honest with everybody if I say this am I right? Am I honest with myself? That's what's missing ladies my beautiful sisters young and old Don't blame the young. I stopped a long time ago blaming the young. You know why? because What they are seeing in me? What are they seeing? And I'm not defending them, but it's again reality


I think we'll start this out with an example of what the Helmholtz chain is going to have to eat. Yeah, I wonder why I'm alive. You're grabbed by the function of a bullet lighter. In order to understand it. So what's that level?  Wrong! I guess we're still on punishment. Today we're going to... Today, I always do that. Someone needs to punish me for that and it cannot be the cameraman because his punishments are mildly ineffective and rather humorous, which might serve to reinforce all the BS that I tend to say. And I'm going to step in this tide poolish thing. Ladies and gentlemen, I just want you to know that as I'm staring at the water, about ready to fall into this gigantically deep tide pool in the middle of a place where there is no saltwater other than in the aquariums, the cameraman waves me over to step over it.  Anyway, I think he's trying to punish me for bad jokes, but it's not going to work. I'm going to keep him coming. I promise. So we're going to start out with all the problems of punishment because we've been talking about how to make it effective. No. See, it worked. He reduced it. She reduced it, whatever. It reduced its behavior. It's going to even get mad at me. I can see that. Anyway. Behavioral contrast. It's yelling over there now. So let's just start out with behavioral contrast. It's something that pops up as a side effect with punishment, right? So behavioral contrast is really simple. I'm going to just give you a better example here. That example, I mean, not that the crow example is a bad one, it's doing exactly what it's supposed to do. So behavioral contrast is when we punish in one, ooh. So that's going to sound really funny. Sorry, folks. That's going to sound really odd. So when we punish in one context, the same behavior will pop up with an increased frequency in another context. This is the whack-a-mole game of punishment, right? So whack. I whack it down here and the same behavior pops up over here but in a different environment. YouTube has done a wonderful job. I mean a frunking awesome job of getting me to stop swearing on when I talk about this content. However, I swear like a bloomin' sailor at home. Like, you can't even imagine what it's like. That's behavioral contrast, okay? So behavioral contrast, again, you punish in one context, behavior pops up in another. Let's see, what are some other problems that go on with punishment? No, competing contingencies.  So I'm going to reduce this behavior. You don't have to punch, right? It's just an example. So I'm going to reduce this particular behavior. I've got it going down. We've got to punish the contingency in place. Things are going good. I swear that I'm doing punishment that the behavior's not going away. Why not? Because you probably forgot to find out what's reinforcing the behavior, folks. There's a competing contingency. If a behavior's happening, then it's being reinforced. Most likely. There might be situations where that's not the case. But for the most part, you've got a behavior that's being maintained by a reinforcer and you're trying to punish it. Now you've got this sort of thing going on. Guess which one's going to win? Reinforcement almost always wins, right? So when you punish behaviors, make sure that you've identified what the reinforcers are and that those reinforcers are no longer being used or in place, right? So in other words, put the behavior on extinction and punish it. Drops really quick. So let's see what else. We've got behavioral contrast. Oh, modeling, right? So when I model punishment, or when I engage in punishment behavior, especially with humans, they tend to learn that that's an effective tool. Because this is I'm going to double up on you here. So if my punishing a behavior reduces that behavior, that negatively reinforces me for using the punishment, right? Which then the punished person observes that effectiveness of punishment and I'm now modeling punishment and getting negatively reinforced for its use. Do you see what's happening here? You create this spiral, right? So kind of an interdependency. When I punish, it's going to work. That's great. So I'm more likely to use the punishers. That's not necessarily great. And then someone else is likely to copy my punishing, which perpetuates all that punishment stuff and that can be a problem, right? So we want to get people to focus on reinforcement. So just keep that in mind as you're using punishment, that it can create the spiral of maintaining its use. You can go the other direction and focus on reinforcement, a little bit of punishment, a lot of reinforcement, and then you can start a spiral going that direction, modeling appropriate use of reinforcement, encouraging appropriate behavior, and reinforcing it keeps that cycle going. So you can go that direction. Let's see. Oh, punishing when that's the only, punishing a behavior when that's the only source of reinforcement for someone. That's just blatantly unethical. So sometimes a behavior sticks around, you start to punish for various reasons, but then you worry about the fact that maybe that is the only source of reinforcement going on in that person's environment. So make sure that when you are punishing a behavior, that you're also reinforcing an alternative. Every video on punishment, I'll say that. Every single one. Reinforce an alternative behavior. Punish the inappropriate behavior. It's that simple. Okay? I'm trying to think. Mr. Brad, have I forgotten anything? Nothing I could think of. I don't know what else to tell you, folks. I mean, I could tell you more. Punishment, I'll just kind of wrap it up a little bit. Punishment is an effective tool. It's really, really effective, but you have to watch out for those pitfalls, okay? You have to watch out for these particular problems with the use of punishment. I don't want you to think that this is your go-to tool. It's just another tool in your tool box. All right, see you guys.


What's up everybody and welcome back here for another episode here on torque drift on the mobile platform We are on our galaxy s10 plus and today We're going to be doing something that I was asked in the comment section before but before we do that We're going to collect some sponsorship crates so we can add more for the upcoming update for another build of That mysterious car that they posted on Instagram that we all know is that a 86 So today we're going to talk about tires So a lot of people asked why I was running stock tires on the back of my e46 Well, that's because I spent a lot of time driving the car and I realized that while those tires in the back actually helped Make the car controllable. So Today we're going to take a look at some different tires. We're going to go through and basically Go and show the difference between the tires and why I chose the tires I did We got to make sure we don't have any of the nexon Gold tires. So unfortunately won't be able to show those but we do have We don't have any of those. So we're going to pick up a set of those We do have 31 of those 48 hundred 32 and then plenty of those other tires So we're going to take a look at some tires and why I chose to use those tires in the rear The stock tires other than running Non-stock tires so for the purpose of this We are going to go enter into Cali banks and we're basically going to show the difference between how the car reacts We're going to be using the e46 how the car reacts on the different sets of tires and why I chose the way I did So first we're going to start off with all custom tires on the car And you'll see what I'm talking about of how the car handles on the bank how it reacts how it transitions And how I have it set up to why I chose the way I did and why I think Having stock tires in the real me for six is the best so Acceleration and grip is pretty good with those and when you enter in You have a lot of speed, but the car for me seems to be a little bit twitchy I mean it's snap on transition and very quick and it runs kind of the line you want to line you put it in Other off the gas there But it doesn't float how I want it to and I find myself correcting a lot. So Not a bad not a bad run on those tires by any means so You go back to the lobby And we're gonna throw on some other tires and see how the car reacts We're gonna go down to some pro sets of tires we're gonna go run all pros and You will see kind of the difference on how the car reacts and how it handles Mind you the grip level for my starting is kind of the same on all these tires See I can enter in and see It's not as twitchy. It kind of I don't have to correct as much on the lower grip tires It kind of slides a little more So you have to make sure you break a lot because the grip isn't there So if you snap a lot faster on the custom tires, obviously, it's gonna grip faster because the grip factor is higher so as You can see that's the way that car reacted on those Now what I want to really show you is why I was running what I was running So we're gonna set these on the front Come on Then we're gonna go all the way to the rear and set the rear tires To stock tires Now the reason I have the front tires the way I have them custom is for grip for transitions But I like how the stock tires on this car react especially on the bank. I Can initiate in and kind of float the car up and I can kind of put the car where I want to put it But it also has a nice slide factor of I can slow down in the higher gears and Make the car run smoother now. I'm gonna actually redo that because that's a very bad example of that so The way I have my car set up It doesn't lose any type of power or grip on the entry Regardless of tires now with this I can enter in I can kind of put it on the wall and If I didn't scrape the wall, I would have Ran nice on it But you notice the slide factor is a lot easier to slide a lot longer distance that I can slide and it a lot slower Speeds because I'm not gripping up as fast on the side by this with the custom tires Now I probably could do some tire pressure changing and inflate tires a lot to get it to not grip like that, but When it comes to me tandeming I found that having the stock tires Allows me to get a lot closer In its hand them with those tires because I can hold the e-brake more I can feather on the brakes more and the car still stays sideways because it doesn't grip up So when I'm sliding if I'm chasing down a slower car, I Don't have to worry about the car gripping up and stop sliding because of the low grip in the rear with the stock tires But you do have to make sure if you are running stock tires you anticipate where the car's gonna go and exactly how it's gonna move because you don't have that Lateral side bite as you would say running custom necks and tires and stuff like that Because of the quick transitions you don't have the side bike so a Little quick explanation on why I run those tires instead of running full custom tires all the way around I just find my car handles a lot better that way and personally I just enjoy it we're gonna actually hit this tournament and hopefully we can Come out with a win if it'll actually even let me go into the tournament I keep moving my finger and it keeps negating my activation So we are gonna enter with our e46 Here on tunnel edge Hopefully we can get some people to run with us We're gonna get some a little bit of practice going on right now though While we wait for other competitors You 46 one of my favorite cars my e21 is becoming closely second right now Was we banging the wall on our practice run? So if you guys are running stock tires in the back, I'd be very curious to what you guys Why you're running them on the rear? I know it's a lot easier for when it comes to tire wear rather than having to buy a bunch of tires Now I did find I could run stock tires in the front but the The transitioning speed and how quickly I can snap car back and forth was not there because the grip was not there So that is why we are running custom in the rear or a custom in the front and stocks in the rear on my e46 Because it just it it's dialed and I enjoy how it dries I've gotten a lot of more higher scores on this setup than I have when I was running full custom car tires But keep hitting the same spot hopefully we get some people to Go against us so we can actually have a tournament here for today So as always like thank you guys for watching come back and appreciate all support Make sure you follow me on Instagram and Twitter looks like we are gonna get into a tournament here here on Hakone skyline Hakone, hopefully we can do this 46 justice not get knocked out right away But who knows we could hit the wall like we tend to do a lot So a tournament here for today for you guys on this torque drift explaining why I'm running the tires I run People may think I'm crazy and that what I'm saying is actually stupid But you know that's what I find works for me some things may not work for you But they work for me, so this is just a little explanation for you guys So once we get into our grid in 30 seconds, I'll be back with you guys And we're gonna hit the Hakone skyline tunnel edge course and Have a little fun with it and see if we can't come home with a win in this tournament All right, so we are just in a great eight and there it looks like there's a copper drift guy down there Who is Miller is gonna be our first guy that we're gonna be going against in this tournament like I said, hopefully we don't You know wreck out right away looks like he's running a Kristoff's blue she's E92 Eurofighter So hopefully we can make a good solid run here anything you 46 and come out with a win In the first round nice initiation on the wall quick snap Kind of right on the wall didn't want to take it into the wall. It's a little bit Gensler run it like this so we can actually Run this full sweep on that handbrake That's where my stock tires come in Definitely into play because I'm able to handbrake longer through that section to link that in one Continue with sweep rather than having to do a quick little chicane switch We are gonna come across the line with a very solid run here in the first run 155 See what he can do and Kristoff blue she's E92 And he comes with a hundred thirty-one. So we have a decent Advantage lead going into our chase So let's uh See what we can do in the chase This E46 is probably my best chase car. We can initiate a little bit sooner And just not him Cut that really short long e-brakes throw just make sure we don't smack into him It looks like he's gonna run that sweep line as well Whoo, I thought we were gonna biff it into the wall and get spun out. We're able to hold that I'm not sure how luckily we were able to come out of that cleanly and Still come across the line with a very solid chase of 42 So hopefully that would give us enough to take that win here in the first round of this tournament Unless he came out cross with an amazing chase and he had a 43 But we had a better lead so we will come across one and nine to one seventy five We'll take that win in the first round that tournament gg to you sir. Who is Miller gg on that tournament run It's now we're going against South auto man in 42 seconds. It looks like we did have much higher score and we're already hopping into it All right second round shotgun in this tournament right now Great eight battle. We are in the final four so south auto man and a Supra I think I faced him before I recognize the paint So if you're watching this, I faced you before I believe and we've had some good battles So we got to make sure we get a solid lead And I like it last time. Oh, I thought we were gonna lose our cleanly already We did lose one clipping point. So we are at a little bit of a disadvantage right now, but at least we did not Wreck and lose our clean lead. I'm gonna try and stretch this out as much as we can transition this back out Try and bring this out to the wall get as much of those close call points as we can Look it back this way. There we go as close as we can Flick it and try to get all these last ones right on the wall with that problem still over 150 Lead so I will be happy with that, but he got a 200,000 point lead south auto man You are gonna be taking me out here in this tournament probably and GG to you sir 200,000. I thought my 150 was good, but we did lose one One of those points. So he's thrown in massive angle. I can see that already way more angle than I was throwing and Definitely not gonna be able to make this up in the chase But we are gonna do everything we can Oh, he's running that outside sweep right on that wall. That's where him and I definitely differed But nonetheless, we're gonna truck we're gonna go out with a bang and try and do our best here We biffed it in a wall so did he but he did not lose his points GG south auto man. Take me out in this tournament. So Unfortunately, we didn't get to take a win in this tournament But just wanted to bring you guys a little video with some little tandem and drifting action talking about why I run the tires I do and he had an amazing chase too. That man is probably gonna go on to take the win South auto man GG to you sir. So as always make sure you guys follow me on Instagram and Twitter all which found the description box below I appreciate you guys coming back guys have any more questions of why I tune the cars the way I do Let me know down in the comments I will try to address them in the next video I would like to do some more Q&A's some live Q&A's and stuff like that here on torque drift So look forward to me doing some more cute live Q&A's and stuff like that here on the game on the mobile platform the new update Coming out super excited getting a day six doing some tell food delivery So as always, I thank you guys for watching. I'm evil rabbit and we'll see you guys on the next one


Hi, everybody. Happy new release day. We got another case of 2022 Bowman's best baseball coming at you. Eight box, pick your team number four, the full case right here. Big thanks to this group right here for getting into it on a Wednesday. If you got a rooftop next to your name, that means you won that team in the filler. If you got a star next to your name like Gilo does, that means he got last bot Mojo. Last bot Mojo, 70% of the time, hits 100% of the time. So they say. So let's see if it works out for Gabe tonight. I hope it does. Thanks, everyone.  You've been here. You've been hanging with us for a while, Gilo. I feel like you should have gotten some last bot Mojo at some point. Good luck. Hopefully it works out tonight. World baseball classic action happening here, ladies and gentlemen, Australia at Korea in Japan. Australia's up to nothing in the top of the fifth. They were big underdogs too at plus 450. I put half a unit on Australia plus 450. I'm trying out, I'm putting a little bit on a, every underdog in the group state. Let's see how that works out. I'm two for two so far. Small sample size. This game's not over yet, so we'll see. Courtney's asking any chasers from the Giants in Bowman's bed. Oh, you're Aaron. I don't know. How much were the Giants? I mean, I think the main chase is really just, you're kind of prospect hunting, and then the Mariners people, Mariners Rob is looking for Julio Rodriguez, and Tristan is looking for Wander Broncos, but I'm not sure if the Giants really have a particular chaser, but oh, look at this, Jordan Lawler and Julio Rodriguez UFO cards. 30 out of 50. That's gonna be for Ethan and the Diamondbacks, nice. And here's who, and I'll do an autograph recap and a Julio and Wander recap at the end. There's a Julio Rodriguez UFO insert refractor. These are pretty cool, these can be autographed too. And there's Brian Acunha. I think, is that the, I keep forgetting. Is that the youngest Acunha or is Luis Angel the youngest? Ronald's the oldest, but pretty talented baseball family here. This is gonna go to Minnesota. That'll be for Eric and the twins. Here's Ezekiel Tovar to 199. That'll be for the Cardinals. Cardinals, that's gonna be for Colorado. Connor with Colorado. Here's a Wander, just a base. Jordan Alvarez, the Atomic Refractors, not numbered. All card ship though. Here is Adrienne Placencia, Placencia. That goes to Rob and the Halos. Gonna try to shave a little time off this particular break now that I'm kinda used to what I'm looking for here.  Look at that. Global impact for Nando Datis Jr., three out of 25 on card. A lot of time insert autographs or die cut autographs to end up just being stickers, but this is an on card, nice. Padres, that goes to Darren in San Diego, nice. Got Jackson Cuyo to 150 for the Brew Crew, Henry, the Brewers. And Jayce Young, that's Josh's brother. This one's for the Tigers, Tristan. And Jayce is the Younger. Do you know who'd be happy with a Kwan UFO? Does he have a UFO card on the checklist? I should have a checklist up, but I don't. Tommy Edmond's Korean? Yeah, his mom's Korean. I had no idea. In 2023, Edmond was called to the South Korea National Baseball Team. He's playing second base right now. I saw Tommy Edmond, basically. And I was like, wait, what's he doing there? Edmond is the son of John Edmond Jr. and Maureen Kwak. He has Korean heritage from his mother's side. His father, John, played four years of college baseball at Williams College in Massachusetts, and is a teacher, varsity baseball coach at La Jolla Country Day School, Edmond's alma mater. His mother, Maureen, was born in South Korea, moved to the United States as a child. Edmond's older brother, John, works in research and development for the twins. Younger sister, Elise, played volleyball at Davis and College of Works as assistant engineer for the Cardinals. Where are they getting all this information? That's a, someone in the Edmond family like really, really making sure that Wikipedia page is filled out nicely. Here's Alan Serta. That'll be for DY and the Reds. Here's Yo'Kenzie Noel for Jilo and the Guardians. Gabe and the Guardians. Sounds like a band, Jilo. Hey, we're Gabe and the Guardians. And this is our song, Baseball. Last Bomb Mojo strikes again. There's Jeremy Pena at 250. That's for the Stroes, that'll be for Connor. Now, Brandon Marsh to 299. Mini Diamonds for the Phillies, that'll be for Tristan. We got a Norhei Vera, Tristan and the White Sox out of Bobby Whit Jr. for Joey and the Royals. Earth, Bobby Whit Jr., welcome to Earth. And we've got a Mason hour autograph and a red parallel. Are those out of five? Mason hour is for Tristan and Tampa Bay. We have here, oh, it's a rookie. Rookie red, Reed Detmerz. It's out of 10. So then what's out of five? I was thinking here, I'm always getting ready for a train whistle. I was ready to, ready to hit the bell, hit the train whistle. No, sad times. Reds out of 10, red lava is out of five. All right, fair enough. Okay, tops, okay. Thank you, Rob. Why can't they just make it consistent, Rob? Oh, I gotta mix things up like that. All right, so in case you're wondering, the parallels in Bowman's Best Baseball for 2022, your refractors, that's one per pack. Atomic is one out of every 12 packs, which I guess would be, my packs are in here. One per box, maybe six packs per mini box, so yeah. So Atomics are one per box. Mini diamonds are out of 2.99, one out of every 19 packs. Purple out of 2.50, one out of every 23. Aqua lava to 1.99, that's out of one out of every 29 packs. Blue to 1.50, one out of every 38 packs. Green to 1.99, one out of every 57 packs. These are just for base cards. Green mini diamonds to 99, gold lava to 75. Same odds, one out of every, or 76 packs. Gold to 50, one out of 113 packs. Orange to 25, one out of every 226 packs. And that red we just saw, red from the base set out of 10, one out of every 563 packs. Red lava to five, one out of every 1,128 packs. And a super, one of one. One out of every 5,667 packs. Bryson Stott on Gilo's radar, getting to learn from Trey Town. I feel like we have some Philly fans who are in the chat that are high on Bryson starting even from back to last year. Jordan Lawler, Ethan with the Diamondbacks. The Team USA lineup for the World Baseball plus six ridiculous. They're batting like JT Real Muto, like eighth, six or seven, there's something like that. And Trey Turner is batting like seven or eight. Here's a Refractor Julio Rodriguez. That's for you, Rob, Mariners. Another Julio Rodriguez, all of these add up. And your autograph is Danny De Andrade. Blue auto to 150, that will be for Eric Lille and the Minnesota Twins. That's some lava? Yeah, James Wood, ooh, piece of candy, to 50. There's Mookie Betts to 75 for the Dodgers. That's gonna go to Kevin and the Dodgers. James Wood goes to Jeff and the Nationals. Come on, Christian Vicarro. I gotta make better use of the canvas there. That goes to Jeff and the Nationals. He just needs a little work at Jaspy's Autograph Camp. Here's another Yonkenzie Noelle for Gilo and the Guardians. He is an outfielder, third baseman. First baseman could play corners or the outfield, six, three, two, 50. Kind of, that's a big size right there. It's like football player size. Yeah, he is number 20 on the top 30 Cleveland Guardians prospect list right there. Michael Z, do you have anything close to breaking that combined tonight? I don't know, Michael. I've been breaking this for the last 20 minutes. So I haven't looked at any orders or the website, but check out the website, jaskyscasebreaks.com and you can see spots left numbers. Last time I checked that Mosaic basketball choice edition was down to two teams when I started this break. I don't know if that's full or not, but that would break tonight if you grab those two teams. Yeah, six, three, two, 50. Cause that like defensive end size? Could play defensive end that size. Now remember, Michael, some of the main break that look like they're only a couple spots away, some of those may have like a filler break attached where we're giving away the remainder of those spots. Let's just keep that in mind too. I guess he's gonna be, that Noel kid is gonna be, it's supposed to maybe make his debut this year. He was, he didn't reach full season ball until four years later after being signed in 2017. He smashed 51 homers in 203 games in the next two seasons, ranking six in the minors with 32 at age 20 last year in 2022. He was in the futures game last year, last summer, Gilo, and then reached AAA in September. He has the best raw power in the system and some of the best in the minors. He has 40 homer upside, but could be undone by, you guessed it, the strikeouts without any adjustments, making him reminiscent of Framel Reyes. Raw power, that moves the needle in the hobby. There's James Wood, ooh, he's a candy. That goes to Darren and the Padres. We saw that Nationals card of his. I'll bet he was part of the Juan Soto deal. And we got Jose Ramos. That's for Kevin and the Dodgers. Kevin won that in the filler. There's Anthony Gutierrez to 250. Rangers, that'll be for Tristan. We've got Eric Brown Jr. for the Brew Crew, that's for Henry.  And in Anthony Gutierrez, Gold Lava Autograph, Rangers, Tristan, and Texas, 15 out of 75. Nice. And an Orange Julio Rodriguez, 10 out of 25. That's for Rob and the Mariners. There you go, Rob. Getting close for maybe some lower numbers. Keep Ryan Hayes to 2.99 for the Pirates, that'll be for Michael. And a Bobby Wood Jr. base for the Royal, that'll be for Joey Pruitt. Yeah, what was the other one number two? We got the 10 out of 25 in this case. And what was the other one? The other Orange. Do you have the other break here? Nine out of 25. This one's 10 out of 25. It's kind of crazy to think about it. Like, we'll think about the odds of consecutive numbers being pulled in consecutive cases, right? All these are inserted and printed, are inserted after the printing, and then randomly put into packs and randomly put into boxes. And those cases are randomly, you know, I mean, they just end up on, they just put them on different pallets. It all gets mixed up by the time it gets to a warehouse. Mixed up again by the time they're all sent out, they're just grabbing them from a huge stack, right? Then think of that, and those two cases end up being delivered here, right? And then when we're checking them in, we're kind of picking them up, checking them in, restacking them in a different order, right? And then we put into our warehouse and I happen to grab one case and then another case right after that. Kind of crazy if you think about it. Maybe we should buy lottery tickets later tonight. All right, we got a Tyler Whitaker that goes to Connor and the Astros, Julio Bass. Korea just hit a three-run bomb to take a one-run lead. There's Juan Guerrero, who also needs to make use of the canvas. As Jilo was saying earlier, what is this guy, signing for ants? You're signing for humans. But still, a hit for Connor and the Rockies who won that spot in the filler. There's Peter Lonzo to 199 Aqua Lava for the Mets, Paul with the Mets. I guess this is why Australia was plus 450. All right, and we got a Dustin Harris. Dust in the wind, all we are are dust in the wind. That goes to Tristan and Texas. George Kirby, Speckle to 299. Mini Diamond to 299, that is. And we got Daryl Hernayas. That's better. It's better use of the canvas there. Henry with the Orioles. Korea has some legit sewer friends. They really do. Wonder how much a plane ticket is from Korea to Tokyo. Couldn't be that much. 109 out of 150, George Kirby for Robin Seattle.  Korea is only into three sports. Golf, baseball, and soccer. Probably in that order. Brandon, anything available football-wise? Absolutely. Check the website, jaskyscasegraves.com. Lots of things in the football section. Brandon Immaculate, some Phoenix football, football mixer. Gabe's saying Philippines is his homeland. They only like boxing and basketball, and the guys aren't even tall enough for basketball. I feel like Oliver was there recently. I think he said that there was a, there's a healthy golf scene there too. We got Juan, I might miss your autograph if I breeze through these cards too quickly. You gotta center that. I wanna put, if I had like virtual or real life Photoshop, I'd be able to do that. Slide that right there, click save. That'll be Connor and the Rockies. Gabe, I'll sleeve a Stephen Kwan for you. There he is. There's Yerlin Confidant. Everyone's signing down here. He's just poor designed by Tops and leading all these players to believe that they have to sign down there. Maybe just the big kind of wide-out area should tell people, I don't know. Confidant going to DUI and the Reds. And we got a Gavin Sheets. For Tristan and the White Sox, that's in 99. We got Denzer Guzman for the halos. That's gonna be for Rob. All cards shipped to you, Gila. We'll let you sleeve all the Kwan's. Really, we're only really supposed to be sleeveing Julio Rodriguez and, and no, not either, but Julio Rodriguez and Juan de Franco. There's Junior Perez, A's, that's for Steve Birch. Steve Birch and the A's. Christian Santana 250. Stephen Kwan's winning a batting title. I wonder what the batting title odds are. I don't even know if those props are, those kind of props even out yet. All right, second to last box. Right on top is A. Wander Franco. Rookie card for Tristan and Tampa Bay. Here's a warming Bernabelle. Not cooling, but warming. Connor with Colorado. Francisco Lindor, Mini Diamond to 2.99. And we got Simon Juan. Paul with the Metropolitan's. Ezekiel Tovar to 1.99. That's Connor. Got a Bobby Wood Jr. rookie card for Joey and then we got a Masterpieces insert. And we got a Felix Valerio. That'll be for Henry and Milwaukee. We got Ian Lewis for the fish. Rob with the Marlins. Christian Hernan is blue to 1.50. That's for Tristan and Chicago.  Final box. All right, we need some giants to appear, says Courtney. Let's see what we got for you. Final box. Fingers crossed. Last four autos, ladies and gentlemen. Final mini box right here. Got more in the store, ladies and gentlemen. Jazzy'scaserates.com. Just kind of getting an idea of our time. If we hustle on another case, we can probably get one more done tonight, if you like. We got Ezekiel Tovar to 2.99, Mini Diamonds. And we got a Yasser Mercedes. Nice. That's some pretty cool penmanship there. I like that. Yas. I think this is one of the more of their highly-tied prospects. That's gonna go to Eric and the twins. And then we got a rookie, Gabriel Arias. Aqua Lava to 1.99. That's for Gabe and the Guardians. And we got another twin, Danny Dandrade. We saw that Mike Trout UFO autograph redemption in the previous case. So it's gonna look like this. Who was that? Was that for Rob, maybe? Yeah, I think it was for Rob. So Rob, I think he was in the chat earlier. It's gonna look like this, but with his autograph on it. And we got a Danier Cueva. And that is for Tristan and Texas. We got Miguel Cabrera, Miggy to 1.50 for the Tigers. That's also gonna be for Tristan. Got a Shoahio Tani, Global Impact, Die-Cut, another Julio Rodriguez. We have one more autograph, I think. We're close to being able to do a recap in just a second. And there's our last autograph. Luis Mesa, Gold Lava, Toronto, Rob, who won that team in the filler, gets the Luis Mesa, Gold Lava, 25 out of 75. And that's that, ladies and gentlemen. Nice, that was picker team four in the books. Jaspy's casebreaks.com. Here's a quick little recap. Another solid break in the books. Orange Julio Rodriguez, that's pretty strong. Julio Rodriguez, Refractor, the out of five Debtmers, or the out of 10 Debtmers, sorry, Red Lava is the out of five. The Global Impact, Die-Cut, Tatis Jr. autograph. That was a sharp-looking card. And the Jordan Lawler, UFO, Gold. There you go, gang. I'm Joe for Jaspy's casebreaks.com. That was picker team four. Next one is in the store. I'll see you next time for the next best. Bye-bye.


Hello, my name is Brian Kimmigan and thank you for having me. I'm going to share with you sulcus lens placement. So when you put the lens in the sulcus, obviously it's a less than ideal situation. And so you want to control as many variables as possible. And I'm not going to go into all those prerequisite steps, but as far as sulcus placement you want to create space in the sulcus with visco elastic and then you want to be able to put that lens into position. So let's go ahead and look at our video. Of course, the sulcus lens should be always be a three-piece lens. Please never ever ever put in a one-piece lens in the sulcus because that will cause problems like UGG syndrome. So this is a patient who had a very small pupil and a dense lens. I put iris hooks in and so now I'm going to fill the sulcus with a cohesive visco elastic and that will create space to be able to put the lens in the sulcus. So you can see me doing that here and you want to use a cohesive visco elastic because it'll be much easier to remove. I use a cannula to hold counter force as I push the lens in and as I dial the lens in you'll see the haptic come out and it comes out like this. You want to make sure it's planar with the sulcus space. So if this is the iris and this is a capsule you want that haptic to be facing the proper direction as you're seeing in the video and as you deliver the optic, oh, here a patient suddenly moved and you know, obviously you want to have exquisite control even when patients move. You want to use an instrument that's shaped like this. This is a maltzmann and you want to be able to get at the crotch of the haptic haptic junction and then push the trailing haptic into the sulcus. Now here it's very important that you place that lens the right way and you want to be able to use something like a maltzmann to push and pull so that you have the lens in proper position. As you can see here, sometimes if you have a tear in the capsular bag or something like that, you want to avoid placing the haptics in the direction of the of the damage and so you want to place the haptics perpendicular to an anterior capsule or a posterior capsule or tear. And of course when you hydrate your incisions be very careful that you don't cause the lens to move. So one, fill the sulcus space with cohesive viscoelastic to use an instrument such as a lester, a kuglen or a maltzmann to be able to push and pull the optic haptic junction to position the IOL into the sulcus. Remember, if you have an anterior post-capsular tear, you want to make sure the haptics are not facing in that direction. You want to make sure they're perpendicular and it's very important to make sure that position is proper. Rotate the lens into position. As I said, you want to close the main incision with a tenon on suture because if this is a complicated case, you don't want vitreous coming forward if the patient rubs their eyes at home. And lastly, don't hesitate to put subconjunctival antibiotics. Thank you for your attention. And again, my name is Brian Kim. I hope this video is helpful to you for your cases and I wish you the best. Good luck.