there's no one right way to go through grief. And for some people, a kind of withdrawal might be what they actually want to do. It sounds like what you're describing is maybe you wouldn't even have wanted the withdrawal, but you kind of felt like you needed to because you were afraid of your contagious emotions, negative emotions. But I do want to be clear like for anybody who's listening that there's no one right way to grieve and everybody's going to do it differently. So part of it is just figuring out what do you need at a given moment. I think it's also helpful for people to know there's research by George Banana at Columbia. He's a grief researcher. And he's actually found that humans really are way more emotionally resilient than we think we are. We have been bereaved for as long as we have existed. And so we kind of know how to do it. For most people, they may mourn their lost beloved forever, but they also move forward at the same time, ultimately. There is a subset of people who go through what he calls chronic grief, where it really doesn't subside at all. But for the vast majority of people, it does. There's a great formulation that comes from the writer Nora McKinnerney who lost her husband when she was still a young woman. She says that she kept feeling like she was getting this message from people around her that she should move on and get over it. Move on, move on, move on. But she came up with a different way of doing that, which was not to move on, but to move forward. And the distinction is she did go on to remarry and now has a blended family with the child she had had with her first husband and her new husband's child. But she says her lost husband is still with her and the person that she is today, she is who she is because of that relationship she had had. So she's not leaving behind that person. She's not leaving behind her grief. She's moving forward with it. And I think that that's a much more palatable way for most of us to handle our losses because it's getting away from the false dichotomy, and I think that our culture asks of us, which is like, detach completely, move on, be done. Instead, carry your past with you even as you're embracing the future. I think that's a healthier approach for most of us.


Like right now me and Tank is weird because he love me to death, he know I love him to death, but we don't talk every day how we used to. Nigga, it used to be a time where you ain't see me without Tank, or you ain't see Tank without me. But what happened was, what I think what happened was, he just like, damn bro, I feel like he look up to me so much, it's like I let him down. Cause he know, cause he's somebody that really know like what I can do and how good I am.


Work. Work is an important part of life in Australia. It will give you independence and a sense of purpose. It will also help you meet new people, feel part of the community and pay your bills. There are lots of different job opportunities in Australia. Finding a job. All Australians have to compete for jobs. You might not get a job in your field and you might need to study more before you can get your skills recognised in Australia. There are plenty of training opportunities and bridging courses you can do to help you get more qualified for work. These courses usually cost money. Dimpla has been in Australia for 12 years. Time management is quite challenging, especially the time management.  So my suggestion is that if you are a student, if you are working, you have to prepare to work hard. Many people need to start with casual or shift work before getting a full-time job. This will help you get experience and can be a step towards full-time work. Volunteering isn't paid work. It is a good way to get work experience which can help you get a job in the future. It can also help you make contacts in the community. You can find jobs advertised in newspapers, on the internet or through employment service organisations and you might also find out about employment opportunities through friends and other community members. Or at a Job Services Australia provider where you can use the Job Search website. Don't be afraid to ask for help finding a job. It can be challenging for everyone. Job Services Australia. Job Services Australia providers can help you find a job or employment and training programs. Your provider may develop an employment pathway plan for you which could include training, work experience and other help to find a job. It is important you attend everything they organise for you so you don't lose your Centrelink payments. You will be asked questions about your education, work history and ability to work. It is important to be honest about how much education you have completed and what jobs you have had in the past. When you have qualifications, there is a free service which helps you compare your qualifications to Australian qualifications. Ask your provider about this service. Resumes. When you apply for a job, you'll need a resume a document which explains the jobs you have had the education you have completed and how to contact you. Centalka works for a Job Services Australia provider. What you basically need when you apply for a job in Australia is you need to have a resume. Most important is the contact details should be in on the resume along with the education or qualifications that you have. Employment history, then you can put skills, then at the end you can put reference. After you have sent in a job application you may have to go to a job interview. Attending a job interview. Getting a job is very competitive in Australia and you will need to compete for the job with other candidates. Arrive on time, dress neatly and try to be confident during your interview. When you go to an interview, you will be asked lots of questions. It's hard to get a job in Australia but once you apply for the job you will be helped to prepare your resume because there is a process of applying job in Australia but once you apply for the job it's not that you get a job, you have to go through an interview process. Working in Australia. The Australian government sets laws and wages and working conditions and these will vary between jobs. Given the amount of pay, the hours to be worked and working conditions such as safety, holidays, allowances and training. If you are unsure about your rights at work talk to your settlement service provider. Robert is a legal aid lawyer. People have a right to be free from discrimination in all areas of life including in the workplace so if you are being discriminated against in the community or in the workplace then you've got rights and you should seek some legal help to get those rights respected. When you start working you will need to find out when you are expected to work. You need to go to work on time and if you are sick and can't work tell your employer.  Your employers will transfer your pay directly into your bank account. An amount of money will be deducted to pay tax to the government and for superannuation which is savings for when you retire from work.


Hello everyone, I'm Alicia Woodruff and welcome to the Fort Report. It's the night before Christmas and stockings are hung by the chimney with care, but will soon be greeted by a mile strum of torn packaging and wrapping paper filling the air.  In green over the holiday will keep you from seeing red when you get to the big clean-up. So we're running down the items you might not think of to help you waste less and recycle more. And we called on Fort Worth's resident recycling guru, Kim Moat, to help us out. First up, the tough customers, wrapping paper and greeting cards. Well, holiday wrapping papers can be problematic. So we encourage people to recycle the cardboard tube for the recycling and that works out very well, but for the paper, it has metallic components to it that make it difficult to recycle. Same thing with gift cards. With FedEx foil lining, please don't recycle it, but if it's just paper, let's go ahead and recycle it. It makes sense to do it that way. Next up, the packaging your gifts come in. For example, this cardboard box that's wrapped up has a soccer ball inside of it. Once you remove the soccer ball, you've got a cardboard box, just like any other cardboard you have throughout the year, fold it up, put it in your recycle bin and it's ready to recycle. Rigid plastic containers that are wrapped around a product. When you cut that out, I know very difficult to do, but remove the product and the rigid plastic in the recycle. Getting away from the toys, let's talk about the recyclables from your holiday meal. From the kitchen, there's an awful lot of things we do during the holiday period. Things such as eggnog, such as extra cream, things like that. The cartons can be rinsed out and tossed in the recycling bin. One of my holiday favorites is the cranberry sauce in the can with the ridges. But when you pull the canberry sauce out, recycle the can. Also cookies sometimes come in metal containers, also in plastic containers. They're generally recyclable for the rigid plastic, metal containers, when you're consuming the cookies. Put them in the recycle bin unless you intend to reuse them. Recycling some of the items we discussed here will help green your Christmas. But be sure to take a minute to look at what you're throwing away and see if there are any recyclables you might have missed. You can find a list of items accepted in Fort Worth's curbside recycling program at fortworthtexas.gov slash solid waste. We wrap up the year next week, but until then, Merry Christmas from the Fort Report and Fort Worth Television.


Well, the winter season is finally a wrap in high school sports with many great plays and great moments. It's tough to show them all, but here are the top 10. And let's start on the mats. Number 10, Bemidji beat number six Grand Rapids on the road. Chance Heinrichs, Caleb B, and they both helped with the victory there. Number nine in the pool, Brainer's Michael Bailander won a section title in three events. Also helped the Warriors to the team's seven section title in 12 years. Number eight, what a career on the court for Bemidji's Linnaeus Whiting, battled back from a leg injury, scored his 1,000th career point here against Duluth Ease. Number seven on the ice, Bernadale Falls girls hockey, their first ever section title in trip to state, triple overtime thriller here against rival Rozo. Number six to the court, what a historic season for Minaga girls basketball, 30 straight wins, first ever section title and trip to state in a win over BBE. Number five boy, Soops cast Lakebina, they finished fourth in class A, putting a double overtime thrill over Rushford Peterson, the go-ahead basket here by Raoul at Washington. Number four, Grand Rapids girls basketball, they finished third in class 3A, Stephen F. Austin signing Heaven Hamling, big reason why the program's all-time leading at score. Number three back to the ice, Warroad girls hockey, runners up in class A, Hannah Corneliusen, the sophomore, one of the breakout stars for the Warriors. Number two, Rozo girls basketball, the comeback kids, down by double digits in the state quarterfinals, come back and win. They finished runner-up though to sock center and number one, the top play boys Nordic skiing, Grand Rapids, Garrett Beckridge, the individual state champ, won the freestyle in the morning, seventh in the class, it combined for first overall, there's too many to show, but those things were pretty cool. That's quite a challenge to come up with just 10. It was fun to do, it was a fun season, a lot of success and keep it going here in the spring. All right, fun to watch, thanks Colin. If you enjoyed this segment of Lakeland News, please consider making a tax-deductible contribution to Lakeland PBS.


Dr. Larsen, if you ever happen to actually see this video, please know that I actually do like you and I'm a really big fan of all the stuff you do. Hello everyone, Dylan Schumacher, Citadel Defense, and we are back with another edition of Tactical Book Review. And today's book is the Smart Book, S Small Unit Tactics, S3, by Dr. Christopher Larsen and Norman Wade. I have reviewed one of Dr. Larsen's other books on this channel called Light Infantry Tactics. Long story short, I would direct you to that book over this one and we will talk about why here. So this book is titled Small Unit Tactics. Honestly, I think this book would be better titled something like Big Corporate Structure for the Army for Unit Commanders from Battalion Size and Smaller. And if you're like, geez, that's a really copy title, what does that mean? I would say that kind of encompasses this book in the sense that this is one of the driest books that I have yet reviewed on this channel. If you think about reading military manuals, right? Military manuals are manuals that are written for a corporate structure and that corporate structure is the Army. It'd be like going into an HVAC manufacturer and reading one of the manuals for one of their rooftop units, right? That's essentially kind of sort of what you're doing. And so often military manuals, and this one being the biggest violator, I have very dry language and it's communicated in this very academic and just, I guess, dry fashion be the best way to say it. And this one is probably the creme de creme of the driest reading I've done so far. And I really hate saying that because I really like Christopher Larson. I'm subscribed to his YouTube channel. I love light infantry tactics. I've been to one shepherd. Like, I'm a big fan of all he's doing over there, but I gotta be honest and I just think this book is a pass because look, if you're reading this book as an everyday American person, right? And you just want to learn more about small unit tactics and how to fight as a team and garner things that you can use to embrace your martial American heritage. This book ain't it because this book, like I said, it's really written in the context of that corporate American military structure and being able to communicate and follow all the procedures that they have in the giant U.S. military because when you're working with tens of thousands of guys trying to conduct a battle you have to have certain procedures in order for things to move visually. And this book will help guide you through on how to do that and help explain the different tasks and different attacks and defenses and whatever that you participate and then how to communicate that up to higher and take information down from higher and that whole rigmarole. As an everyday guy who just maybe has four, six, 10 friends, whatever, that you're getting together with to train and learn and read stuff on how to do, this book just, there's not that much to glean from here. Light Infantry Tactics by Larson. I would point you to that book. There's tons to glean. Super helpful book. But this one, not so much. And I'm just gonna blame it on this Norman Wade guy because I have no idea who he is and we'll just say he ruined the whole book. One of the things I do wanna be real with you about is this is my bookmark. So I only got about a third of the way through that book, if you can see that. I did not finish all of this book. I'll be completely honest. And so maybe it gets better but I really tried and I gave it multiple turns to come back and thought I was in a bad mood. Maybe I just didn't like it, whatever. But at the end of the day, I think just, I realized what it's addressing isn't what I need because it's really addressing that how to be a commander of men in the actual US Army and how to follow their procedures and do all their stuff and understand the language of what it is they're accomplishing there. And yeah, can you glean stuff for your everyday person? Yeah, probably. But there are much better books that I would point you to. So I hope that's helpful. I hope that gives you some ideas about where to spend your reading time. Again, check out Lighting for New Tactics by Christopher Larson. And Mr. Larson, if you ever see this, please know that I really do love you. I hope that's helpful. This is Smart Book, Small Unit Tactics, S3 by Dr. Christopher Larson and Norman M. Wade. Do brave deeds and endure.


Torifaction is a process which significantly increases the energy density of biomass, making it more suitable for use in existing thermal power plants. It also makes the biomass more resistant to weathering and biodegradation, allowing for outdoor storage and transport. Torifaction can be further improved by adding a binding agent such as lignin or biomass tar, which increases the durability of the pellets. Lignin byproducts from pulp and paper processing, biomass tar from biomass pyrolysis, tall oil pitch, and lime are all viable options for binding agents. This article was authored by James W. Butler, William Scriven, and Samira Lotfi.


Originally, I had a spot on my nose that had started to develop, and it was kind of started off as a little dry spot of skin. It would go away for a little bit. It would come back. In Dan's case, he noticed a spot that wasn't healing on his nose, and it became concerning, and it was even growing. At that point is when I knew I needed to go get it checked. The dermatologist generally does the biopsy of any suspicious lesion, and anything that requires surgical intervention then gets sent to a surgical subspecialist. And they got follow-up appointments scheduled, and got the biopsy done that first visit, and I believe the results I got back were within a day or two. Basil cell carcinoma is a very slow-growing cancer. However, the quicker we treat it, the better the treatment will ultimately be. I never felt when I was going to talk to nursing staff or doctors that it was something that couldn't be handled and taken care of. And so, his tumor had a chance to grow, encompassing about half of his nose, and we had to rebuild him that half of the nose and make it as natural appearing as possible. It was pretty overwhelming when I got the mirror for the first time before they actually relocated. It did the graft. And Dan and I sat down and discussed all possible reconstructions. And so, he knew exactly how we were going to fix it. He tells me that his colleagues professionally and his friends and family say that it looks amazing, and they don't even notice it. I think everybody that I've come into contact with Kaiser has been very nice to deal with. They're very knowledgeable about what the process for every step is. They're very good about getting you unplugged in with the right care that you need for the specific things that you need. And they take care of business.


So, this is a quick introduction about how can you do continuous delivery for databases, because usually databases seen as a slow thing, do not touch it unless you really need to. How can we break that assumption about that and it is a misconception, how can you break that? I am sharing my experiences with that and it is just a beginner level talk, there is a lot thing that can be done on this. So, I am trying to convey that it can be done and explore yourself and do it, that is the whole idea of the talk. Quick show of hands, how many of you are writing code on a daily basis, programmers for that matter and from this how many of you are managing databases, I mean managing the sense you interact, cool. So, I hope that will convey something to you, I will be able to convey something to you. So, just a quick introduction, I am a co-founder of a company called Yoga Tree, it is a digital marketing product for yoga studios. And as we started this few years back, one of the thing that I really struggle, I think if you have worked on a product company, especially a start-up company, is that it evolves. It is a evolvability, how do you support that to the product? You think that this is what the users want or you think that this is how users should be doing it, you go out to the market with that and see that is not how they are using it. Then you change sometimes slightly, sometimes a bigger change. So, how do you adapt to that and how do you support that, especially for database. If you have production, if you have users, live users, if you have to make a drastic change here to your product, how do you make sure that the slow in nature of database and high risk, anyone who has had a database outage, they do not want to have it that in your life anymore. But the solution to that is not to touch database, you have to come out of that fear and find out how can you make more changes to it, how can you make it less risky. And that is where the concept of refactoring is doing things in a small steps and then at the end of a series of small steps, you get a bigger change out. That is the concept of refactoring and the same refactoring concepts can be applied in database 2 and that is what is called database refactoring. Many of the concepts that I am talking about, the example, the concept that I am using in this presentation is there in the book called database refactoring. I highly recommend you to check that out. And what it does, database refactoring helps you to evolve or evolutionary, it suppose evolutionary architecture and it suppose continuous delivery because the steps are small.  So enough of talk, let us look at some examples. So these are real examples that I had done in the product. I reduced the scope of it so that it is easy to convey. So we have, this is a digital marketing product. So we have the concept of people taking memberships with yoga studios. So you join a yoga studio and you take a membership and it can be for 3 months, 6 months, you pay that and that they record in their system. So when we started off, we call it as billing cycles, we had these fees in the database. Then we realized after some time we got feedback from the customers that some members do not pay everything in one shot. They pay in installment, especially if it is a yearly subscription and then they pay it in installments. So this kind of a structure where you have all the payment details in one table, you need to have one cycle but multiple payments, that will not work in this case. So we had to split it and that is what called the split table refactoring that we are doing over here. So this is what it should be. We should have one to many relation between the cycles and the payments. So that we can record, this many payments happened for this particular thing and we can also find out what is the balance and stuff like that. So how do you do that in a continuous delivery fashion? So what we have to do is we have to split this table into multiple tables. But we do not want to do that in a big bang way because if something goes wrong, the entire data will be screwed up. So what we do is we have a parallel implementation. So we introduce the payments table but we do not delete the existing fields. And we copy the data like when we add a cycle, we store that data into the payments also. So we have to do that by using a database trigger or say your own ORM callbacks and stuff like that, whatever it is. That techniques does not matter much but the idea is that you have parallel. So the advantage with that is if you have a lot of downstream dependencies like if you have native apps for example, say mobile app, then the APIs of that needs do not have to change on day one. It is not a breaking change. You can change that over a period of time and then you can, that gives you enough conference that nothing has broken. So you do this, you have the split table but you have parallel implementation and after a while what is that time period where you have to have this parallel change is up to you. Especially depending on the downstream dependencies. And in the end you contract, you expand and then you contract. Contract to whatever schema change what you want to do. At that point of time only you delete the old data but you have already migrated that to the new tables. So when you first deploy, you take care of the migration and using callbacks or triggers, you make sure that the data that you are saving into the old fields you are also saving it to the new one. That can happen in the background. So this is the entire refactoring process. First you introduce the new changes. Then you have a transition period of migrating to new way of implementing it. Once you have completely transitioned it, you contract. And this is the crux of expand contract. And let us look at another example. This is called the split column. In this case, we are not migrating a new table. We are migrating, we are splitting an existing table into multiple. So in this example, the customers can book trial classes with yoga studios. They can say, so they do not want to join without evaluating how well the class is. That happens in many cases. So what they can do is they can book a trial and they can attend one or two classes depending upon how many trial classes each studio offer. And then in the end they can make a decision whether they want to join or not. So that we are recording in this table called trial bookings. So we have field code status that status can be of multiple things like whether they have attended, whether they have attended and joined. That is also important. That is the funnel. Or whether they have not attended. But then after a while we realize that too many things are being stored in that field. It is doing too many things. So we had to split that. So we need two kinds of data that is whether they have attended or whether they have joined, became a member. Because that is where the conversion reel happens. So the same way we implemented that too. That is we should not delete and add the new table in the same migration. We introduce the new fields. Have the migration script to migrate the data. Then also make the change to the code so that anytime there is a data added to that table make sure that it is added to the new fields also. And then in the end when you are completely transitioned then you contract it. It is the same refactoring process. So the idea over here is that any major change that you are making do it in real small steps so that you can observe and make changes. And you do not actually lose the data in this case because if you are deleting the table, if you are deleting a table or a field and if something goes wrong then the entire data then you have to go back and stuff like that. So that is a very high risk scenario. So and this is what the idea of expand contract that is you have parallel implementation. You have the earlier code as well as a new code and then you observe it for some time and then you make sure that all the dependencies are actually moved to the new way of implementing and then you contract to the new way of implementing. So what is required for this is a very simple concept but we cannot just do it just like that. There are some prerequisites for doing it. And what are the basics for that? One is that you should have versioning for all your database scripts so that you can identify each of them and make sure that the changes are like the code. You have to treat it like a code. And every change has to be in the version control and there should be a way to identify each of these migrations. So usually if you are working with any ORM software usually they will have a way to give a unique identifier to each script or you can use the timestamp in that way. If multiple teams or multiple people are working on database changes there should not be any clash between the unique identifier. So there are ways to do that but fundamentally what is required is you should have version for each of your database scripts so that it can be identified and in case you need to roll back you can roll back to a specific version of your database. That is basic and the next thing is automation. You will have to make sure that the testing and deployment automation to make sure that when the code actually migrates to production the database changes are also going in. And then also in case you need to have enough tests to make sure that nothing is broken. So that is a fundamental thing, it is not different for this but you have to also make sure that the migrations are executed rightly even as part of the deployments. And last bit is the strategy that you want to apply. This particular pattern even though it makes sense, it doesn't make sense even though it is useful it doesn't make sense to use it all the time. If the change is not that critical maybe you can just delete and add the column at the same time because it requires effort. The major problem with this kind of parallel implementation is that you expand but never contract then that creates technical debt. So as a team you have to have a strategy to make sure that what is the timeline? You cannot just blindly say within two weeks you have to contract. It depends on the size of the team, depends on the code base, depends on your downstream dependencies, depends on the criticality of the change that you are deploying. So many aspects are there. So how do you approach that and how do you make decisions? That is the strategy bit and you have to always evaluate what works and what doesn't work and you have to change it. And this is very critical because even though it is a good pattern if you don't have a good strategy it can create more issues than advantages for you. And this particular idea of parallel change is not just restricted to database. So the idea is coming from I think most of you are familiar with branch by abstraction. So this is the same implementation that if you are making a major change to your design or major design change or a framework change for that matter you may not have to do it as a big bang thing. You can do it in small steps. That's all idea of continuous delivery. So for example you have an existing implementation you have to change it rather than changing it across you introduce a new one then slowly you can change it. And in the end get rid of the old one. But there also the problem usually is that you have both implementation and you don't contract. That's the problem but as a team you have to have certain agreements or some guidelines to make sure that it doesn't happen. And when I have been giving this talk at multiple conferences most of the time the question comes up the idea makes sense who does it. I mean is it good for us? So I thought it's good to add some case studies to show that it's not like some pattern that I'm talking about it's actually being used. So in this article I'll share the slides so you can get the links separately. In this particular article they talk about how they release changes in Facebook and then they follow the same approach for that. And so I think it's not a recent article but I'm sure that they still follow that. Because of their database change they are making sure that it's always rolled back. You can always roll back your change. And then it doesn't and that the only way to do that in my opinion is making sure that you have parallel change. You support both earlier version and the current version and over a period you move to the new version. This is not about database change but the concept of the parallel change as a thing. So I'm sure almost all of you have used GitHub. And the main feature in GitHub or one of the things in GitHub is that when you submit a code it shows you what is the differences. And then so that you can see whether it can be merged or not. They had a problem with that merging library. And then they did that with parallel change. They observed and made sure that because a problem in that, a bug in that area will be a huge thing for GitHub. So to make sure that it's safer they did parallel change the branch by abstraction and then they did that and then observed they had it running it in background and then they changed to the new implementation. So without affecting any user base. So any major change should be taken in small steps. That's what the point is. Just to end, things will always go wrong. So you should make sure that you're making only small steps. And that's the reason why it's important to have very low risk releases and do things in small batches and continuously. And that can be done for database also with the small steps. And these are some of the references continuous delivery for sure but the patterns that I mentioned or the refactoring methods that I mentioned are from this book called Refactoring Databases. There are a lot of refactoring techniques that he talks about. I just took 203. So refer that in case you are interested to take this rule and links to the different case studies I used. So I think that's it. Okay, sure. Thank you. Thank you, Chad. Any questions? May be one or two questions. Hi. Hello. I am Karthik from Boeing. Actually, we have a situation like database migration or parallel database or refactoring. We feel that it will be like dangerous element sometimes. Sorry? It's a dangerous element when we attack with the databases because sometimes when we release on the production releases will happen. Database segment is a primary factor. Okay. When we start up with migration from small to as a parallel one, we actually found out it could means earlier old data also it was merging and new data was segmenting with different branches. So when we funneled down it was not happening properly. How well we can refactor this and get this back. Can you repeat? For us, parallel database did not work for us. Okay. So what is the best way, best method we can get out of it? We're doing road green deployments? Yes. Okay. Can you say when it didn't work out for parallel databases? See, our deployments will be like every like three weeks or four weeks and we started like migration. Slowly migration. But at one point of time we thought that it was not working because new databases were also new data sets were included into it. Tables were different table sets we created here different merge sets and the codes were different. Sequencing we could not match it actually. So that's a bit that I spoke about the strategy. You have to re-look at how you are actually deploying and then what is your strategy to make sure that the parallel implementation is done correctly. Is it because how can you capture these issues in the production even earlier? How can you simulate that even in environments, even in the development environment itself? Maybe it can be because of lack of automation or it can be because of not having enough strategy to say that how long it should be there and how do you make sure that the changes enough monitoring in the production or those kind of things. So we have to re-look at where exactly it is not working right. And then so I am afraid we will be able to give an answer in this maybe we can chat after that. Yeah. Yeah. It doesn't have to be tied up with toggles. I I am not sure. Only it to


I am Dr. Harish Babu Reddy, Consultant Gastroenterologist at Manipal Hospital, Malishparam and Jainagar, Bangalore. Today in this Facebook Live program, I will be talking about fatty liver in the next 15 to 20 minutes. I decided this topic of fatty liver as we are very commonly seen in the OPD day-to-day practice. One of the main patients come to us with the reports of fatty liver. So, we will be understanding about this fatty liver in the next 15 to 20 minutes under 4 or 5 subreddings, like as to know what is a fatty liver, what are the causes of fatty liver, who are the population at risk for developing this fatty liver and how this fatty liver progresses over a period of time to become what we call as cirrhosis and how does they present to us, like what are the problems which patients face from day-to-day with this fatty liver problems and what are the tests and what are the treatment options which were available. And more importantly, in the end, I will be discussing what are the preventive measures we can take in preventing this fatty liver and also progression of this fatty liver from stage 2 to stage 3 to become a cirrhosis. So, now coming to the first question, like what is fatty liver? As like it is there in the name, fatty liver means there is excess fat in the liver. It sets that according to our research, it is inside that more than 5% of hepatocytes filled, the hepatocytes are the liver cells filled with fat is called as, we call it as a fatty liver or even more than 5% of the dry weight of the liver whenever it is more than 5% fat content, we call it as a fatty liver. Coming to the types of fatty liver, the most commonly we have alcoholic related fatty liver and the second one broadly we classify as a non-alcoholic fatty liver disease. Alcoholic fatty liver is completely altogether a different topic which we will discuss in next sessions but today our discussion will limit it to the non-alcoholic fatty liver disease which is very, very common including even in children of late we are seeing this patients. Coming to this fatty liver, who are these people who come with fatty liver to us? These are the patients who are usually obese, who have diabetes, who have cholesterol issues, what we call as dysplopidemia and who are usually have this sedentary lifestyle. These are the patients, these are the people when they go for a routine ultrasound checkup or ultrasound is done for some other health issue, then they get this fatty liver report and then they usually come and see a gastroenterologist. So, this fatty liver over a period of time because of this global rise in epidemic of the obesity that is reflecting in the fatty liver also. This is the kind of a reflection of the obesity towards diabetes or towards hypertension it is same gastro component what we call as a fatty liver. And over a period of time especially in the European and American countries it has become a most common reason for chronic liver disease what we call as cirrhosis. Even in India also we can see that there is lot of increase in this fatty liver cases in the middle age group people and also we are seeing very commonly even in the children also because of this lifestyle and food habit changes. And over a period of time it can be a very big epidemic turning into you know progression into chronic liver disease. So, it is better that we understand it in the very early stages and try to prevent it from the progression or even revert it back to normal with all our lifestyle and food habit changes. So, if you see in the general population it is said that like 25% of the people out of 125 people are known to have fatty liver. And if you see in a patients who are obese and diabetic it can be as high as 45 to 50% of the people can have this fatty liver in one of the stages whatever the stages of the fatty liver it is. So, now coming to the stages of the fatty liver and how this fatty liver kind of progresses over a period of time. So, this fatty liver whatever we call the broadly word we use as N-A-F-L-D that is called non-alcoholic fatty liver disease. This non-alcoholic fatty liver disease basically has three stages. One of the first stage is fatty liver that is just there is a fat deposition in the liver but there is no any swelling of the liver or there is no any damage to liver cells or what we call as hepatocytes. But over a period of time because of this excess fat getting into the liver and deposition the liver will starts getting swollen. And along with that this fat will also keep on damaging the liver cells that we call as hepatocytes damage. So, along with this hepatocytes damage and the swollen liver what we call it as the N-A-F-L-D that is MASH. So, it means that non-alcoholic steatohepatitis. Steatohepatitis means because of the fat there is a damage to the liver cells leading to the inflammation within the liver. But one thing we should all know is liver is one beautiful organ where it has a lot of regeneration ability. So, whenever there is a damage by whatever mechanism it can be because of the fat or it can be because of alcohol or it can be because of the viruses still the liver always tries to kind of come back to its normal this normal capacity. But when this process becomes repetitive and chronic always then what happens will be repeated damage to the liver again and again so that leads to scarring. Once the scarring comes into the liver the liver will start becoming stiff the liver will start sunken in size and it might become even a nodules on the surface that's when we use that word as a cirrhosis. Once it goes to cirrhosis that is where it is difficult for a liver to come back. But whenever it is in the fatty liver stage or a non-alcoholic steatohepatitis phase it can usually come back to normal by the changes in the lifestyle and diet which I will be discussing with you in the later discussion. But once it becomes cirrhosis that is when there is a permanent scarring that means the liver has become stiff the liver has become decreased in size it cannot come back to its normal. So we should all take these preventive steps to prevent progression of fatty liver to the cirrhosis. Once it becomes cirrhosis it can be cirrhosis it will behave like the same way as alcoholic patients or it can be some viral related problem. So once cirrhosis happens it can progress to become what we call like we can have a decompensation of this by terms of blood omitting or jaundice or there will be fluid accumulation or what we call asitis in the abdomen and then further it can even lead to very rarely to even epitocellular carcinoma the liver cancer also to some place. So this we have to always target these patients very early and we need to understand this in the terms of fatty liver and NASH and try to prevent it from further progression to the further disease. So this is how the fatty liver progresses but it progresses over a long period of time. It takes around like 10 to 15 years if there are no further insults like further insult means if this patient starts taking alcohol then this progression can occur very fast. If this patient gets some viral infection this progression can happen in 5 to 10 years also but only fatty liver will take around 15 to 20 years. So as of now whenever we see a fatty liver patient who has progressed into cirrhosis they are usually in the older age like say 50 or in the 60s but because this fatty liver is now coming in the very early age group like the children and in the first to second decade itself these patients by the age of 40 to 50 when they are really economically and you know socially they are working they are really productive in that age group in that age group they start developing cirrhosis that's when it's going to have a big impact personally and also an economic impact towards on a larger scale towards the country also. So this is how the fatty liver kind of progresses. Now who are these people whom we should be worried about and like who are these patients we should be very careful to screen and like identify these high risk patients what we call and try to intervene as early as possible. So the first group of people is the obesity and obesity as you guys already know it is rising epidemic in this every part of the world and even in India also. So whenever we have like what we call as a body mass index for Saudi stations it is said that the ratio if it is more than 43.5 we call it as a obesity in those patients who are at high risk and the second group of patients are those who already have a type 2 diabetes that is a second component. Third patients are those who are already having cholesterol issues in terms of high total cholesterol or high triglyceride levels these are all the people who can have this at risk for developing high risk for developing the fatty liver. Next even some viral infections like our hepatitis C that can also kind of predispose to fat accumulation and one important thing is all of the people should watch on for what medicines you are taking and you should always discuss with your doctor or with whomever healthcare practitioner you are seeing what are its effects on the liver. Because liver is kind of it will face the brunt of all the medicines what we use in a day to day practice either it can be steroids it can be any other counter like when we take the over the counter medicine or alternative medicines even to some extent excess between A that also can cause like fat accumulation in the liver. So these are some of the risk groups but there are some even genetic predispositions also but these are the factors where we can identify this subgroup of people and educate them about this fatty liver and try to prevent it to further progression into the liver disease. Now coming to the clinical manifestations how do these patients usually get present to the OPD or how do they come to know that either they are having a fatty liver or not. Most of the times it is just asymptomatic. They don't have any issues because of the fat accumulation liver because it is such an ability for a liver to kind of carry on its functions with normalcy. So but once in a while we get to see people like have some mild discomfort below the right rib cage that is like the liver area or usually the patient will have either fatigue or some kind of lethargy. They don't know but they are not able to cope up with the normal work they get tired easily this is some of the presentations usually what we see. But once the fatty liver progresses to cirrhosis that what we call chronic liver disease or cirrhosis of the liver that will be same manifestations irrespective of whatever is the problem either it is because of alcohol or it is because of this non-alcoholic fatty liver disease or the virus infection doesn't matter if they develop have a jaundice they can have accumulation of fluid in the abdomen what we call as ascites they can have the blood omitting and they can have decreased concentration, altered sensorium and all these things. So these are the complete clinical manifestations wherein we kind of identify these patients and kind of intervene them very heavily. Why I am stressing on this NFLD too much is this has a lot of associated problems in the same patient like they can have diabetes they can have cholesterol issues they can have a heart problem or they can have a stroke problem or any of these problems they all are kind of associated in the same family. So this is the non-alcoholic fatty liver disease or fatty liver what I am talking today it is a component of that syndrome that we call as a metabolic syndrome it is a gastro manifestation of whatever the metabolic syndrome we call. So once we take care of fatty liver or once we take care of diabetes or cholesterol levels it is indirectly we are taking care of the complete body so it will help us to lead a better quality of life and at the end of the day we can try to decrease the doses of medicines required for your associated conditions. So now next coming to what are the impacts like how does this fatty liver is going to affect the people or the public in a day to day practice because once the liver becomes cirrhosis as I told you that can have its own complications which I already discussed but they are also at risk for cardiovascular complications what we call like a coronary artery disease or what we call heart attack or that kind of problems are more in this fatty liver patients. Actually the fatty liver patients most of the time they have a problem more of this coronary disease or heart disease rather than the fatty liver itself and these are the patients who are also at risk for like some of the malignancies. See once the liver becomes cirrhosis that carries itself the risk of carrying a developing a cancer at the rate of 1 to 4% over the decade for every patient but that we have a screening but also it can have increasing the risk of you know large intestine adenomas what we call polyps it can be more and even it can raise the incidence of large intestine cancer also sometimes and in females it has been linked with sometimes they can even also develop the breast carcinoma also in these patients so we should be very careful with respect to the management of obesity because that is going to affect the body from every like organ aspect and these patients have told you their increased risk for liver cancer their increased risk for coronary artery disease or what we call as heart attacks and also they can have increased risk for developing the brain stroke also. So after understanding how they present the clinical manifestations of these processes and address patients also now let us kind of learn about how to diagnose this fatty liver, how to diagnose and how to assess the severity also then we will discuss later after that the management. So coming to the diagnosis it is always as I told you this non-alcoholic fatty liver disease is in those patients who are taking alcohol less than 20 grams per day for less than 5 days a week. If these patients are consuming more alcohol then there can be both the components there can be component of the alcohol also and there can be component of the non-alcohol also otherwise it will be only the non-alcohol component along with that we always whenever the fatty liver patient comes we check for their thyroid, their diabetes their cholesterol issue and their deep blood pressure depending on the parameters we might even ask for a ECG and echo also to know the cardiac status but whenever we get this fatty liver patient we do the routine blood test what we call complete hemogram and more importantly what we are interested in the liver function test if the liver function test if the SGOT and SGPD what we call liver enzymes if that values are absolutely normal then means the liver the fatty liver is still in the stage one it has not started affecting the fatty liver so that is a very ideal time for people to learn about it and try to prevent it from further progress but if the liver enzyme starts rising what we call SGOT and SGPD if there are more than whatever the cutoff levels or whatever like less than 39 or more than 40 from the lab values and in some times females we consider lesser value also if that is there then it means that the fat has started affecting the liver so that means it has gone into the second stage that is non-alcoholic state of hepatitis once the patient goes into non-alcoholic state of hepatitis and this liver values have kind of started rising then we always check in all these patients for a viral marker that is we look for hepatitis B and hepatitis C test and depending upon the age group like and also for a female patient we always try to rule out the autoimmune hepatitis by doing some of the blood test and in some patients we also consider doing of the Wilson disease also but in Indian setting we should be aware that most of our people either from villages rural side or even from the urban also have an error like very much the liver the liver problem itself tell them to take kind of go on take some alternative medicines or over the counter medicines most of the time these medicines are always at risk of damaging the liver it should be very very careful when we are trying to take any medicine which is outside the description of a doctor and even with your doctor please always discuss what are its impacts on liver for any other medicine also so we always roll out viral markers we roll out autoimmune conditions in females and anger male patients also and we roll out this Wilson disease also and always all we ask for your any of the medicine whatever you are taking whatever the preparations you are taking you may not think you may think it is not a medicine but always tell your doctor that I am taking this and this supplement because whereas it is easier to identify and to further give to you know kind of either stop it or whether to is there any treatment we can give it on it will be easier job next coming to the imaging modalities imaging modalities we tell always about like ultrasound ultrasound is the easiest investigation because it is available across the country at even rural settings everywhere the ultrasound is present and it is a very simple investigation and very sensitive so it will diagnose fatty liver and it will tell us like there are even grades of fatty liver in the ultrasound the radiologist whenever they are telling they will try to you know based on their based on their appearance of the liver with respect to spleen and kidney the grade 1, grade 2 and grade 3 also then in some patients we also consider doing an MR elastography or even CT scan there also best modalities but MR elastography is something which will give us more information about the fat content also and also the liver stiffness so sometimes when we kind of we have very obese patients wherein we can't do this ultrasound or next what I will be discussing is the fibroscan investigation in them we ask them to go for a MR elastography wherein it will give us the exact information for us be how much is the fat accumulation in the liver and how much is the stiffness or how much the liver has become really stiff and how much the liver has functioned in size but offline the very recent advances in the science and technology we have got a machine called fibroscan because of fibroscan we are able to avoid very very like required cases of liver biopsy we are not at all doing liver biopsy in any of these patients unless and until it is really required because this fibroscan which is a simple machine which is similar to ultrasound and even easier than that to do it up so we just be keeping a probe on the liver by 10 times that machine will analyze the fat content as what we call CAP value that is controlled attenuation parameter and we also get LSM that is liver stiffness measurement based on these two values we can tell the patient about what stage of fatty liver they are in how much the liver has become stiff really then what are the treatment medicines which are available according to the whatever stage they are in and these values can be different with respect to the different etiology also like for a fatty liver it is a different cut-ups for alcoholics it is different for viral markers, viral diseases it is a different thing and for also for cholesterol what we call deep jaundice patient of this different cut-ups but once this liver stiffness measurement usually that value will be between 2 to 6 but once it starts going 7 and above then we call as it has gone into the f25 doses where it is really important and we need to pay more attention for it and liver biopsy usually we do not do it in a cases in a straightforward cases of fatty liver but whenever there is a diagnostic dilemma or we think that just a fatty liver is not explaining the blood reports and the scan reports then we might consider doing a liver biopsy that is a one day procedure where the patient gets admitted for a day in hospital and with the needle we just poke into the liver and remove a piece of tissue and send it for the microscope but routinely we do not do it now because of the availability of the fibroscan and MR-elastography but whenever there is a dilemma we are not able to explain especially in young patients or the values of the liver tests are very very high sometimes we do consider doing the liver biopsy so after understanding how do you diagnose and how we understood all about this clinical manifestation now the most important part let us come to how to treat it and more than important how to prevent it from the progression to the cirrhotic stage the first and foremost for all this what we call as a metabolic syndrome which includes everything which includes diabetes which includes cholesterol issues the bad cholesterol has been high or it can be even hypertension and even it can be fatty liver it is always going to be the dietary and the lifestyle changes the dietary changes with respect to the fatty liver is basically to target your weight loss at least like say 10% of your normal weight that should be done gradually for a period of 6 months so you need to cut down your fat content refined sugars those things have to be cut down cut down the red meat like you can have a white meat and also you can have the high protein like chicken and fish but you try to cut down the red meat and most important is the exercise it is with the research it has been recommended that every day 30 minutes of aerobic exercise aerobic exercises means it includes running it includes jogging it includes cycling this kind of swimming also these aerobic exercises we should be able to do it like 30 minutes every day for at least 5 days a week so it becomes 150 minutes of aerobic regular exercises per week has been documented to decrease the progression also and it helps in reversing the fatty liver also next most important is to cut down stop smoking and stop alcohol intake whoever patient is obtained from fatty liver and always try to associate with the manage the diabetic patients and also manage like this diabetes hypertension and cholesterol issues should be strictly monitored and all these patients this screen for cardiovascular what we call like do an ECG and echo and check for those complications also next coming to the medications we have some medicines which are already approved but there is a lot of research going on in this field the next probably in a year or two we will have very good molecules to treat these fatty liver patients so we still use some of the medicines and most importantly we use vitamin A so vitamin E vitamin E is something which is very very rich in antioxidants which will help in recovering the kind of stopping that inflammation or the damage which is already going on in the liver and also it helps to kind of revert back the liver to normal stages and some of the diabetic medicines like bioglitter zone and saroglitter also after doing all the blood tests and the scanning like the fibroscan and all we assess the stages of that and based on the stages we kind of pilot these medicines on a patient to patient basis and follow up them over a period of 3 months to 6 months and repeat the values then again check for them and try to target always to have a normal liver blood test and also to decrease to revert back the values what we have got in the fibroscan and some of the medicines as I told you there are obetapolic acid and some new medicines are there but still they are in research but they are not proved as of now for day to day usage of OBD next most important I told you to take care of all the comorbidities whatever we have told and most important next comes on to obesity obesity management is the cornerstone for all this like metabolic symptoms obesity management always starts within self with respect to the exercise and food management always but in case if your BMI is very high like say more than 40 or more than 35 with all other comorbidities like sugar, BP, cholesterol and up we do have some options for these patients to explain we can cut down their weight by decreasing the size of the stomach that we can do it either endoscopically also now or we can do it laparoscopically also endoscopy it is a very simple normal procedure like the way we do normal endoscopies but yeah it will be a procedure within we do not be doing any incision or any scar on your abdomen completely an endoscopy procedure we have balloons basically we can place a balloon inside the stomach where we can significantly decrease the patient's intake of food and we can reduce the size of the stomach by doing endoscopic sleeve gastroplasty which can also be done by laparoscopy also but endoscopy feasibility is much better for a patient for a tolerance so these are the 2-3 methods like sleeve surgery, reducing the size of the stomach or placing a balloon to kind of help the patient to decrease the food intake we can help them to cut down their weight over a period of next 3-6 months and it will reflect on management of all the other conditions also it will take care of his diabetes it will take care of his hypertension it will take care of obstructive sleep apnea and it will take care of his fatty liver also now most important is what are the safety measures this patient should take see once the patient develops fatty liver and progresses to have this NASH what we call non-alcoholic steatohepatitis or even a chronic liver disease always better to vaccinate these patients after testing for hepatitis B and also for we can give a routine vaccines what we give for flu and all because these patients immunity will be on a lesser side so it's always better to vaccinate them for influenza or even pneumococcal vaccines also and these patients should strictly advise them not to take any medicines without the prescription of a doctor and after learning from them that they don't have any side effects with respect to the liver please try to avoid the over the counter medications as much as possible and third thing is even whatever medicine you are taking please watch it take a decision from your doctor then only you take this medicines next the prevention from the beginning itself like say when the patients are already like when they are healthy and active in the age group of 20s and 30 it's always better to start adopting a good healthy practices in terms of regular exercise not gaining weight and also very nutritious diet including salads, fruits very good protein sources like chicken and fish if they are non vegetarian it's always better to kind of inculcate these habits from the beginning itself so that we don't even end up developing this fatty liver and its complications this fatty liver diagnosis or even a prevention is very important because all these patients who are in the age of 20, 30 or 40s in the next 15 to 20 years if they don't take care this can progress this can progress slowly in the background to become a chronic liver disease which is a very very bad thing this can have this can lead to very poor quality of life it will have an economic burden it will have a lot of social impact so understanding all these things I think we should be able to kind of take care of it from the beginning itself try to prevent it from even developing and if we have already fatty liver so that we adopt all this lifestyle and good habit and good exercise routine daily so that we can kind of further prevent it to progression to that worst possible things what I was telling you can be decompensation of liver disease where in ascites can be there they can have blood omitting they can have altered sensorium or agitated behavior they are not able to concentrate on a day to day they should not have this increased risk for heart attacks or stroke taking care of other complications also like other diseases like diabetes, cholesterol hypertension is the same lifestyle basically that will help you to even if you are already on these medicines this routine healthy things will help you to decrease the dosage or even you can kind of discuss with your physician to kind of decrease it or even sometimes you are able to stop the medicines with a very good healthy lifestyle and also we can develop we can prevent them from progression to other non-hypatic issues like polyps in the colon or this one so with this I will try to conclude my talk about the nature of whatever the fatty liver disease is what is fatty liver then how does it present what are the tests we can do then how to manage this mostly without medicines with medicines anyway there are options whenever required we give it and always what are the preventive and safety measures we take it that is more important if you ask me now looking at some of the questions from the audience Ayush has asked he is a non-alcoholic and his SGPT level is always 55 from 3 to 4 years but says that nothing to worry see Ayush once the value of SGPT is 55 it is usually the maximum range of SGPT value is 39 in means like less than 40 once it is 55 means it is in the second stage what we call as a non-alcoholic state of hepatitis so there is some damage has happening in the liver because of the excess fat but it is always better for you to kind of get the viral markers that is hepatitis B and hepatitis C test and also get a fibroscan then fibroscan will exactly give information about how much is the fat accumulation in the liver and how much the liver has become stiff over a period of time based on that you can decide you will be started on a medicine by whichever gastroenterologist you can see or else you can adopt a healthy lifestyle measures whatever I have discussed with you and you can relook these values after the duration of 3 or 6 months so that it will help you to kind of achieve but your target should be always this LFT should become normal and the fibroscan values whatever you are going to get it after that we can tell you what are the target levels you should be able to achieve thank you so much for this knowledge about very common and very much rising in incidence this fat liver in a general public I will be happy to take back any questions if anything you can post on our facebook web page thank you thank you anasad


Ukrainian forces forced Russian troops to withdraw from two positions near Avdeevka. The Ukrainian armed forces counterattacked north of the Avdeevka Koch and chemical plant and forced Russian forces to withdraw from two forward positions. The Washington-based Institute for the Study of War said this in a Russian offensive campaign assessment. According to analysts, Ukrainian forces counterattacked near Avdeevka and recently made a confirmed advance. Geolocated footage indicates that Ukrainian forces advanced east of a section of the railway line north of the Avdeevka Koch and chemical plant. Russian forces continued offensive operations near Avdeevka and made confirmed gains. Geolocated footage indicates that Russian forces advanced along a section of the railway line north of the Avdeevka Koch and chemical plant in northwestern Avdeevka. Additional geolocated footage indicates that Russian forces also advanced south of the Avdeevka Waste Heap. Russian mill bloggers claimed that positional fighting is ongoing near and that Russian forces resumed assaults near Novelsky. A Russian mill blogger claimed that Ukrainian forces are counterattacking near Stepov and are pressuring Russian defences from the direction of Novo Kalinov.


Just a quick thing before we start, if you want to see all of the b-roll footage from this video, you can over on my second channel and the link will be in the description. This big beauty is a cantaloupe and it cost me a whopping two quid. I don't think I've ever actually cut one up before. Don't be too surprised I'm not much of a melon fan, something about the texture and the wateriness of them just doesn't make me want to eat them. I'm kind of the same with cucumbers as well. Anyway, why am I cutting one up? Mrs Plainly isn't a fan of them either and our daughter prefers mango. Well this rather unassuming fruit would become the centre of one of the largest food contamination cases in recent US history and depending on who you ask it's either the worst or second worst. Who would have thought this unassuming fruit could be so deadly? Just a quick warning, before slicing this I went a little bit mad with the b-roll footage. Welcome to Plainly Of Cool, today we're looking at the United States 2011 Listeria outbreak. It is the 28th of August 2011 and the Colorado Department for Health and Environment has noticed a small spike in Listeriosis. The first patient had been taken to hospital on the 15th of August. Listeriosis is not uncommon with between 800 and 1600 cases reported per year throughout the United States but this little spike which by the 2nd of September was at 7 known cases hinted just slightly as a potential outbreak. The Colorado Department for Health and Environment reported this to the Centre for Disease Control. Now the next bit will quickly run over the days leading up to the CDC's announcement of the outbreak. This runs roughly day by day until the 12th of September 2011 and serves to show what happens behind the scenes before the public are made aware. The strains of Listeria the patients have been infected with are defined on the 6th of September. In doing so allowing the CDC to link any other infections to identify an outbreak. You see it's vital to find out if a person is part of an outbreak or just a single occurrence because an untracked outbreak can be pretty bad news. On the same day two more persons were identified one from Nebraska and another from Texas hinting at the outbreak becoming a multi-state affair. Seven of the patients were interviewed and asked what they had eaten. This is easier said than done as Listeria bacteria can take up to two months to cause symptoms in a victim. Each victim was given a standard CDC questionnaire. From this cantaloupes were identified and three of the questionnaires even gave the brand. Rocky Ford Cantaloupe. A day later on the 7th of September the CDC began a multi-state investigation and armed with this vital information they began to zero in on the outbreak cause. On the 8th of September the CDC issued a supplemental questionnaire created by the Colorado Department of Public Health and Environment to learn more about the cantaloupes eaten by the ill persons. At the same time cantaloupes had been gathered by Colorado officials at retail outlets across the state that the ill persons had shopped at for testing. On the 9th of September the FDA also collected cantaloupes from the same shops for Listeria testing. And the state of Colorado issued warnings to at-risk demographics to the risks of eating contaminated fruit. Just a day later on the 10th of September the FDA and Colorado Department of Public Health and Environment had zeroed in on a potential source of the cantaloupes gents and farms. On the same day gents and farms distributor issues a recall of all cantaloupes. On the 11th of September preliminary trace back investigations and cantaloupes samples collected by the CDPHE were contaminated with Listeria hinting that cantaloupes produced and packed at gents and farms marketed as rocky fort for the source of the outbreak. On the 12th of September the outbreak was officially announced to the public by the CDC stating that 15 people in four states have been infected and this number like most outbreaks would only be the tip of the deadly iceberg. The anachronym city of the CDC FDA and CDPHE had identified the source impressively quickly however the crop that had been identified as the epicenter was roughly a 300,000 cantaloupe and it doesn't need me to tell you that this is a loss of potential sickness bombs. On the 14th of September the FDA announced that gents and farms had issued a voluntary recall of all of their produce. But before we continue let's have a look at what Listeria is and how it can make you very ill and potentially kill you. Listeria. Listeria or more precisely for today's video Listeria monocytogenes is a species of pathogenic bacteria that causes the infection Listeriosis. It is named after Quaker, surgeon and absolute mad lad Joseph Lister. His name is also what has been lent to the mouthwash Listerine. Anywho, Listeria monocytogenes can grow on uncooked meats, uncooked vegetables, fruits, pasteurized or unpasteurized milk, foods made from milk and some processed foods. If contaminated food is consumed it can result in a condition called Listeriosis. This happens during digestion when the bacteria penetrates the intestinal tract to cause systemic infections. Listeriosis preys on people with weakened immune systems, the elderly or pregnant women. A person with Listeriosis will usually show a fever, muscle aches, preceded by diarrhea and other gastrointestinal symptoms. Symptoms can onset as late as two months post exposure and the disease has a mortality rate of around 25%. It is usually treated in the form of antibiotics, most particularly ampicillin. Death toll rises. On the 16th of September a sample of cantaloupe collected by the CDPHE from two retail locations stores supplied by Jensen farms shows an outbreak strain of Listeria and just a few days later the same strain was shown on samples taken from the farm directly. A report was released by the CDC on the 21st of September bringing a number of deaths to 13 and a number of confirmed cases to 72. The next day the FDA assisted by Colorado State and local officials begins environmental assessments at Jensen farms. By the end of September the cases number had risen to 84, the number of deaths had grown to 15 and the number of states involved was 19. The numbers of infected would continue to increase. Remember that it can take up to two months from infection to onset of illness. The CDC would continue updating the public all the way until August 2012, a full year after the initial cases. This is because linking deaths and sickness to the outbreak takes time, where blood samples need to be taken and the L monocytogenes be cultured from it. The final numbers of infected were 147 cases with 33 deaths. Fatalities occurred in the following states, Colorado, Indiana, Kansas, Louisiana, Maryland, Missouri, Montana, Nebraska, New Mexico, New York, Oklahoma, Texas and Wyoming. Among the persons who died, ages ranged between under one to over 96 years. Sadly, on top of this, one woman who was pregnant at the time of illness had a miscarriage. But how did L monocytogenes make its way into the food chain in the first place? Well, spoiler alert, it would be Jensen farms fault. The investigation. Now the FDA knew Jensen farms was the cause for their extensive patient sample and onsite testing. But that's not the end of the story. You see cantaloupes aren't the most common source of an outbreak. Usually it's unpasteurized milk and certain cheeses. The FDA found four separate Listeria monocytogenes strains in the cantaloupe crop, which they thought was rather unusual. During their investigation on Jensen farms packing sites, they found Listeria on rusty machinery. It was later discovered that much of the equipment had been bought recently second hand from a potato farm. Standing water inside the packing plant was also found to contain Listeria, and had been tracked about facility by staff on their shoes. Infected water was also found on the conveyor belts that had transported the cantaloupes. But although the bacteria was found onsite, the FDA weren't certain as to how it had reached it. Listeria is known to be found in soil, but samples taken from the farm came back clear, which again was pretty strange. Eric and Ryan Jensen, the brothers who owned Jensen farms in Colorado, were interviewed by the FDA, but Jensen's were in charge of maintaining equipment that would wash cantaloupes with antibacterial solutions to sufficiently combat contamination. However, it was found that the Jensen's did not outfit their conveyor systems with a chlorine spray, instead opting to wash the cantaloupes with city water for a longer period of time. This was the first year that they had used the second hand X potato farm equipment, and the FDA had clearly seen that it had not been properly maintained or cleaned. It was also found that the machinery was difficult to clean as well, with many places being hard to reach. It was found that Jensen farms also did not pre-call the cantaloup before putting it into cold storage. By not removing the field heat, it created condensation, creating an ideal condition full of growth of listeria. Jensen farms filed for bankruptcy in 2012, and shortly after criminal charges came unknocking. The charges were for the apparent negligence in equipment maintenance, both brothers pled guilty. They were sentenced to five years probation, six months home detention, and $150,000 each in restitution fees to the victims. Now the disaster, I'm going to rate as a bad day at the office, mainly because the Jensen's weren't intentionally negligent, however, still, quite a few people died. And I'm going to give this disaster a six on my legacy scale. This is a plain default production. All videos on the channel are creative commons, attribution, share or light licensed. The plain default videos are produced by me in a currently just a bit gray and boring corner of southern London, UK. I'd like to thank my Patreons and YouTube members for your financial support, and the rest of you for tuning in every week for your dose of random videos. I have Instagram, so check that out if you want to see random pictures. I also have Twitter. And if you're enjoying this outro song, please feel free to check out my second channel made by John. And all that's left to say is thank you for watching and MrMusic, play us out please.


Please remain standing for the singing of the national anthem of the Philippines and the United States. Additionally, construction projects are already underway with the Philippines' U.S. organization Building. A big round of applause to you. We request that the principal on stage for the picture taking will be the Balicadabra planet. We'll be the crossing of hands as you hold the hands of the persons beside you. We just call we have a shape way. Thank you. Second post will be the crossing of hands as you hold the hands of the persons beside you. We just call we have a shape way.


All right, guys, today we're talking about StackStorm. Thank you for coming here and hearing about what is the if, this, then that for DevOps Automation. And we only have 20 minutes to cover what is StackStorm, show some use cases, and tell you about what is the current state of StackStorm and what's coming next. So what is the StackStorm? Well, we build something which is a very generic event driven automation platform. And this thing is very difficult to explain. So to explain that simply, we're usually trying to say what StackStorm is like. And StackStorm is like if, this, then that, but for DevOps. And like in this, then that, something happens and then you take some action. Just like in this, because it is for DevOps, in DevOps, all the artifacts are code. It is exactly like that. There is a trigger, something happens, maybe sensor or Nuggets when handler. Here is a criteria, the pattern match. Here is an action, take some remediation things. Of course, we have a nice UI that we hammer home the same point. StackStorm is, if this happens, run this action. And I think at this point, we're done.   So the main ingredients of StackStorm is that's again, there's an open source platform that sits on top of your existing infrastructure.  You have a lot of your scripts. You have the business things like Slack or JIRA or GitHub. And on top of that, we have the sensors that are responsible for inbound integrations. That means something happens. It might be a monitoring event, or it might be the change in the temperature in this room. Or it might be someone came by the StackStorm booth and tweeted about StackStorm. And then it goes into the rules when this happens, what kind of action do we take? And then it takes the actions. And actions are usually simple and atomic. And to stitch them all together, you require the workflows. We use Mistral as a workflow engine. We actually, one of the Mistral contributors. And then the actions, again, we have a bunch of actions out there on the StackStorm exchange. They are ready for you, but it takes only few lines of metadata to turn your existing script into the action. You tell the StackStorm that these are the positional arguments. These are the key well arguments. And then you run StackStorm action create and your existing scripts is now in action and it has an API. It has the UI. And it can be stitched with other actions with the workflow. So canonical example, a monitoring thing. You know, like we, for instance, we have a service. When we have a monitoring system, by the sense we're not use, something happens. The sensor goes to StackStorm and says, well, there's a problem. We are running out of disk space. The automation checks if it is something that we can fix. And if it is, we fix that. If it is something that requires human intervention, we call the platform maybe VictorObsware or PagerDuty and like wake up body, you need to take a look at that. And these, the simplest thing, the outer mediation, you know, takes wonders. Now, what can be automated? StackStorm is pretty generic and like I got a hammer, I probably can automate everything. So the right question is what have been, what we should automate? And we should automate things within the reason. And as the book, the kind of practice of cloud automation system says, we need to automate the irritating things which irritate us too often. You know, things that are easy to automate and then happens often. And what has been automated with StackStorm? In fact, a lot of things. We, StackStorm team are supporting the OpenStack platform and we promote some of the use cases like outer mediation, network automation, but there is a number of things that community is doing with StackStorm. And I'll just highlight a few of them. Outer mediation probably is the biggest one. You know, of all the outer mediation tool, Facebook's F-bar is probably the most notorious and it is notorious because they outer mediate 94% of the incidents. And what they say is it is still a lot. Like for the record, they're not using StackStorm, but we are friends and we inspire each other architecture. And on the other hand, StackStorm has been used for out remediating OpenStack installations. Last year in Barcelona, Mirantis presented using StackStorm to out remediate the semantic cloud. The most well-known example of StackStorm based on the remediation is Netflix. They have Winston, which is the application on top of StackStorm, they put some specific on that. And they really hammer home on why outer mediation is better. It compresses the time, it reduces the burnout on the people, and it has the kind of overall positive impact. And sometimes it avoids the accidents all together because the things are remediated at computer time, not at the human time. Network automation. We are part of the bracket. And of course we're doing network automation and not only with the network, bracket network, we recently launched the integration with Napalm. And Napalm is the similar thing that is the cloud leap for cloud computing that enables you to automate a number of the network operation systems. And we introduced the automation pack, integration pack for Napalm. And people right now are using StackStorm to automate a variety of networking devices. Of course, when it comes to bracket and working devices, we are doing even more. Integration. Automation switch, sorry. Integration. One of our partner dimensional data put up this slide. They're using StackStorm to deal with what we call an integration spaghetti. You know that every monitor and tool has an ability to launch the script. And everything nowadays have an ability to receive the webhooks and shoot the webhooks. And once you begin to integrate one thing to another, another thing to another, soon you have a picture like that. And these guys actually got into this mess. The way out of that is like, and the problem with this is once things go south, you want to turn off your automation sometimes. And where exactly do you turn it off here? And using StackStorm to integrate a variety of IT systems is one of the big use case. And there is more to that. People are using StackStorm, dimensional data specifically, doing some security automation. They're replacing the legacy runbook systems, Microsoft System Center Orchestrator with StackStorm and say that delivers a lot of kind of DevOps goodies like infrastructure and code and others. And the guys also the contributors, they joke that StackStorm is like the duct tape for the data center. And once you have that, you find a lot of usage for that. Fun stuff. I mean, if you look at StackStorm Exchange, you will see that there is a variety of interesting packages here is, you know, the Tesla Park for StackStorm right now not only can honk the Tesla but does pretty advanced things with that. And do check out the booth show where our guys are using StackStorm to control their robotic arm as a response on your Twitter tweets about the StackStorm. So check it out. Serverless becomes a trend right now and it's right now more than a trend. It's actually delivers massive value. And this is a picture of OpenWisk. And if you screen a little bit and compare that with StackStorm, like we have events, triggers, rules, results, that's what we do in StackStorm. And now I'm actually, it's easy for me to explain what StackStorm is effectively. What is the Amazon Lambda and Amazon Step Functions? Lambda is actions and sensors and Step Functions is the initial workflow that we use. Exactly like that. So, and in fact, we are seeing people using StackStorm for the do-it-yourself serverless implementations. To more Wednesday 9 a.m., we have a session dedicated to StackStorm and serverless as it is related to OpenStack. So please check it out if you're interested, but this is a big and interesting trend. Like as I say, there is a variety of the use cases for StackStorm. We have a big platform and we support some of the use cases and we do invite people to try it out and see if it applies to their use cases as well and supply them and maintain them. So, when people look at the workflow-based solution and say, why don't I just, like now one is actually saying, why don't I do that manually? Everyone wants to automate stuff. But people are asking, why don't I, for instance, why don't I use scripts? Well, everyone is doing scripts. Like there are some problems with those. Like scripts are great. And StackStorm is not saying that scripts shouldn't be used. We're just placing them in the right place, which is your script is an action. However, stitching things together with scripts has drawbacks. The workflows are harder to write because we all know how to write scripts. Workflow is a little bit awkward, but workflow is superior in operations. Workflow is very reasonable. Yet it is transparent. It is not two-in-compliant language. It is just the serious events. And when something happens, you know that. I have a workflow that takes five steps. I'm on step three and I'm failing. Workflows are resilient. So if the system that runs your workflow goes down, workflow is resilient to continue execution when the system goes back up. And again, this is the virtue of StackStorm as a system, as a reliable system because some of the workflow tools out there cannot survive the failure as StackStorm can. And more interestingly, it can survive the failure of the environment. For instance, at the time of the call, the networking may be not available. And StackStorm is trying to reach out to there, but I cannot create the last VM out of the 100 and my workflow is failing. I don't want to start from the beginning. So we have an ability to restart the workflow from the point of failure. For instance, there is networking failure. You fix the networking, it's back. I just go and workflow continues to execute from this point. So workflows are superior in operations. StackStorm and the future. So first of all, we have, you know, it's a hundred million come through but it's 256. It's in binary form. So it's, but yeah, it's an active Apache to open source project. We're fortunate to have brocade support in this. And we have an active community on that. We have a lot of contributions on StackStorm. There is a commercial version of StackStorm to respect the fact that a number of companies has policies in place. They don't let them run anything in production that doesn't have a commercial support. But the open source StackStorm is fully functional not cripple, check it out. We have quite substantial user base. We have about 3000 installations a month. And the StackStorm exchange, the place where we have the integration box is filled up with integration with everything you can imagine. Again, full disclosure, some of these integrations are heavily used there for good. And some of them are just a folding on that. We don't have much of the test coverage on that. But the ones which have the test coverage has a special icon on that. So look at them. And each of them is represented by GitHub repository. And recently we introduced the community maintainers. Notably, there is an open stack back there that automates all open stack actions. So the takeaway here is, if you haven't heard about StackStorm, you just did. I invite you to try it out to use that and to contribute that because this is the community effort and without you, we cannot just bring that. We cannot integrate with everything. So please invite you to contribute. And when we say contribute, everything counts. You're trying out StackStorm, getting the S2 Vagrant and getting the top in 20 minutes or grabbing the StackStorm docker image and getting up and running in five minutes is the easiest thing. Try it out, read the documentation, try to do something with StackStorm. Tell us what doesn't work for you. We actually, we grow on negative feedback. Don't tell us what's good for you, we know. Tell us what doesn't work, help us improve. Commit the code. We have people who are contributing to the main code but we also inviting you to contribute to the integrations. You are using JIRA, help out to make the JIRA integration better. You're using kind of OpenStack, using some particular products, please do help us do that. And then spread the word. Like we have about 60 people here in the theater. If each of you will tweet about StackStorm, there will be someone who will know that StackStorm is an interesting project worth checking out these accounts and contribution as well. With that, thank you. And lastly, we are 50 stars away from crossing the 2000 stars on GitHub. Me, I rate my talks by the number of GitHub's I gather after the talk. So, if you don't mind, go to StackStorm, S2, and give me a star and I'll see how did I do. Thank you.


I'm a freighter business team and I'm running for business factory. I'm Alison Clarnan and I'm in the bachelor business programme. I'm running for business factory. My name is Michelle Hayden and I'm studying global business finance, EDF1 and I'm running for the position of business factory. My name is Noyle Beane and I'm studying counterfinancing with my second year ofları and I'm running for business. I would introduce that the standard of access for early C is nearly changed. Felly, dyma'r hwyl i'w fath yng ngôl yn ymgyrch i ddoeithio'r gwneud ar y ffygoid hygyrch, ond rydw i'n f krych o eich rhain, ac mae rydw i'n gair i gyrch i gael ffosème. Fy oedd y pethau gan ymdicol yw'r rhain yn gyd. Mae'r ddiwrnod o'r sphysgol fyddaeth heddiw gweld teithno dweud o'r onion. Rydyn i'r ddechrau i fynd yn ymhydrodd ac wedi'r fwy o'r grefio marchwyr. ..y'r ffordd ar ychydig, yn ymgyrch, ar y ddeud o'r llwyddiad hon. Rwy'n ei ffordd ar y dyfodol yng ngyfrannu'r ffordd.. ..y'n ymweld yn digwydd yn y ddeudol, mae'r ystyried yn aml yn cwrtho'r rai a'r ffordd yn y gyfrannu'r ffordd. Mae ydym yn ei ddweud o'r ddeudol yn y dyfodol ac yn ddweud o'r cyfrannu... ..y'n gweithio'r cyfrannu a'r ddeudol. One thing I really want to introduce into the business school in this year is a job and other support. This would give students an opportunity to see exactly what jobs are on offer at the moment, where companies can advertise positions. It's in the business school, it's easy to see and everyone knows exactly what's on offer for them. I would change the communication system that is between the class reps because I'd hope that the faculty that would have worn off this year will and that the class reps can't make it just be available and it's easy to reach. One thing that I want to introduce is the promotion of a business school. I've gone up to the best of my knowledge. There's only one from gone Ireland in the first year of business. So what I'd really like to do is campaign it for the north and to the south as well. One thing I would like to change is that I'd like to have more events, like faculty events, like business faculty ball and inter-class faculty events, and that's the everyone that's socialising to be okay with the class faculty. Where I'm focusing on this year is basically where students are having issues that are kind of a little bit of a dead end scenario to represent with the moment. If you are forced a recent exam from a Christmas exam and you are about to enter, you are locked out of the inter-system, students like this need support and opportunities and they also need people to explain exactly what's happened to them and how they can be helped because students who are suffering or struggling anyway are the ones we really need to focus on in this year at the moment. I am currently the first year of business class rep. I wasn't elected until the second semester because the class rep dropped out. So I have the experience of being a student and I know what it's like to be a student and not have to ask the class rep for help, but I also know what it's like for the class rep for the student to ask for help. I was on my student council when I was in secondary school for four years so I've all that experience as well. I've organised many events and run many campaigns with them. Well this is my fifth year of doing business. I did it at GCSE and A11. So it's something that I'm really familiar with. It's something that I'm comfortable with. So that's why I think I'd be good to represent people because I know a lot about business and I'm still learning. Well I've experienced of being a class rep for AVF-1 and I think I now would be asking a bit more in it that I was a class rep in comparison to find it was just a student in general so I think that this knowledge would be good because I'll have relevant contacts with relevant people. DCU so far I really got involved in all aspects. I was a first year class rep and I was actually awarded business rep in a year, two years ago. And since then I've been a treasurer of the Ruby Club, the account of finance society. I've been a share of the account of finance society this year and I've actually just this year I've actually helped set up the investment society in its first year. These skills I've learned and picked up along the way is what I've done for my event managing to how to actually get things done in a college. There's a lot different, I should just have my ideas and I think for myself I know exactly what I want to do and how are you going to do it? A few of the other candidates are in different years so I know that one of my candidates won't be going into his final year. I'd like to say that I wouldn't have as much pressure on me in my second year in business as someone with a final year. This is my third year in business so I have actually set up my own business so I'm used to being a leader so I'm used to being a leader but at the same time I'm going to take other people's opinions and work with different people from all sorts of different backgrounds so I think from that experience I would be able to work with a whole variety of students. Well I think that I'm a very determined person and I repeated my answer there to get my dream course which was India so with that determination I think I could be a great leader. The one thing I believe I can bring to Taylor is public experience. I've learned a lot in my few years here in DCU I've taken on board what some struggles students may have and I believe I know exactly how to tackle these and how to actually support students that perhaps are struggling in certain ways and also how to benefit students that are just going to remember their lives in DCU.