as we discussed reaching across the aisle without getting a backache to try to develop a bipartisan consensus for demilitarization. And tonight we're very proud to have with us, well on video will be Kelly Vlahos who's the editorial director for the Quincy Institute's Publication and Responsible Statecraft and Mark Perry who's a senior analyst at the Quincy Institute. Before we do that though we're gonna take a moment to update the events that are happening around the world and honey, why don't you start? Sure, thank you so much, Marcy and good evening everyone. My name is honey, I do that Barnes, with some delegates and allies and I co-host the code pink calls with Marcy Vanagrad and media Benjamin gladly every Tuesday evening. Yeah, I'd like to give some updates on what Secretary Blinken has been up to in terms of Guantanamo Bay. So Secretary of State, Anthony Blinken said on Monday that the Biden administration is actively looking into recreating the position of the State Department Envoy for the closure of the prison at the Guantanamo Bay. Naval Base in Cuba, you may recall this was one of the demands we send during our previous Code Pink Congress Capitol Hill calling an emailing party. So these calls do work greatly, I'm glad to say. Overall about 800 detainees have been held at the US military prison. Many tortured, most never charged with a crime. Now about 40 remain and nine of those have been recommended for transfer to another country. And I know Marcy that Code Pink has been leading on this effort for a long time as well as Muslim delegates and allies. We also put together a petition on this with Nadi Ahmed, so. Yes, thank you, honey. And thank you to Roots Action and Progressive Democrats of America. Many of you are on this call for your leadership to close Guantanamo as well. Nothing can happen, I guess. That's what we heard from the ACLU when we featured one of their attorneys. Nothing can happen to close Guantanamo until we have a special envoy overseeing the entire process for resettlement. So hopefully something concrete will happen on that front. In terms of Palestine, Israel-Palestine, I just wanted to share two things. Some of you probably read that the parliament in Ireland voted unanimously to denounce Israel's annexation of Palestine. And this was significant in that Ireland was the first member of the European Union to do so. In Los Angeles, where I'm based part of the time, United Teachers of Los Angeles, which represents 35,000 teachers as the second largest school district, they will be taking up a resolution to support a boycott divestment and sanctions in September. And in the run-up to that, it's quite charged, quite heated with the, you know, the Israel lobby is working overtime to complain to the school board, to complain to schools where teachers are talking about this to try to essentially silence the debate and derail this resolution. It's a significant effort. It comes on the heels of San Francisco, the school district there, the teachers, also voting to support BDS. And I know we have, I'm sorry, RJ Thompson, who's with Code Pink, who's one of our experts, along with our co-founder, Jodi Evans. And don't let me forget to say that we love you, Medea. We know she's in Peru representing all of us beautifully. She's there for the elections and it's a tight race and some disagreement and charges of this and that, but she's there fighting for us. So RJ is going to update us on China and what's happening, what just happened in the Senate and what will be happening in the house. So we can unmute RJ, yeah. Yeah, all right. Thank you, Marcy. So the US Innovation and Competition Act of 2021, it started as some separate bills in the Senate like the Endless Frontiers Act, the Strategic Competition Act and the Meeting the China Challenge Act, and they were combined last month. Some of the worst aspects of the bill, it undermines John Kerry's climate agreement with China. It demonizes Chinese and Chinese American students with yellow peril and McCarthyism. It allocates 1.37 billion in military funding around China in the Indo-Pacific region, including 655 million for foreign military funding. It vests new unchecked emergency powers to the Secretary of Homeland Security and it calls on schools and state legislatures to identify and remain vigilant to the risk posed by the undue influence of the Chinese Communist Party in the US, that is a quote from it. It passed the Senate, unfortunately, just today by 68 to 32 vote. And so now it will be going to the house in the house. There is a companion bill proposed by Gregory Meeks, the Democrat from New York's Fifth District and Chairman of the House Foreign Affairs Committee. The bill is called the EGLE Act in the house and in its introduction, Gregory Meeks acknowledged a need for cooperation with China on some issues like climate and COVID-19, but also said that China was the biggest threat to the US. So it is yet to be voted on in the house and it's a place where we could perhaps impact some change. Thank you. Thank you very much, RJ. Yeah, we don't have the roll call vote yet so it'll be interesting to see who cast those no votes. A lot of problems with this bill that sailed through the Senate, it awards a lot of billions and upon billions of dollars for technology hubs. They're basically hubs of robotics and artificial intelligence, STEM programs, semiconductor industry, but sandwiched in between all of that and this 1,445 page bill is, as RJ mentioned, a lot of militarism centering our foreign policy on future of Taiwan. We'll see what happens in the house. I checked with the Progressive Caucus Center to see if they thought that the house would be voting on this bill or if they would vote separately on Meeks' bill which is called the EGLE Act and we're not clear on that. So tonight when we host our calling party we're gonna focus on two issues, one of which is Palestine and no money, no more money for the Israeli military, right? They won another billion dollars. They just received seven or got the green light for 735 million in weapons sales, but also to weigh in with our house members on this bill, the US Innovation and Competition Act and say vote no until we hear further on what the future of that bill is, we want them to study it and vote no. Meeks' bill is 450 pages, not over 1400 but still there are a lot of problems with that bill. All right. Marcy, thank you for the update and thank you RJ for the update really quickly. If you could all introduce yourselves in the chat, that'd be wonderful. We do ask that you keep yourselves on mute and post your questions in the chat for honorable speakers until the very end where we would unmute and say goodbye to our guests. Great, thank you. So we came up, we were talking about ideas for CodePin Congress and we thought, well, what about reaching across the aisle, building a bipartisan consensus? And at this point, that might be a joke, but maybe not, right? There is precedent for this. We saw this at the end of the Vietnam War when Congress defunded that war and then we saw it and even overrode Nixon's veto of that. And then we saw it again in 2019 with the war powers resolution to stop US complicity in the war on Yemen. Trump vetoed that and Congress did not override that veto. So what is the future? Is there a future for bipartisan consensus on demilitarization? We invited two wonderful speakers, those who have been in the trenches with both Democrats and Republicans, libertarians, fighting this ever-increasing militarization and increases in the Pentagon budget. So we're gonna start with Kelly Blajos and we have her on video and she is the editorial director for Responsible Statecraft, which is the publication of the Quincy Institute. She has had a long history with the conservatives in this country. She was formerly the executive editor of the American Conservative Magazine and Grace Yourself. She spent 15 years as an online political reporter for Fox News in Washington, DC. She was also the Washington correspondent for Homeland Security Today magazine, which I haven't read, but I get the picture. So at this point, we're going to cue it up to my interview with Kelly. She couldn't be with us tonight, it's her birthday. But she did do an interview with me earlier and I asked her about the background of the Quincy Institute, how it came to be in 2019, who's involved and her thoughts on bipartisan demilitarization efforts. So, Mary, if you could cue that up. We'll take a look. Don't fit. You know, there is such a, there's such enthusiasm out there for changing the way that we approach our role in the world, the wars, you know, the militarism, the military-industrial complex, but yet the two parties aren't doing it for us. And, you know, there's nobody in Washington because all the think tanks are funded by either the left or the right. And so they got their, they got their sticks. So it really was this idea that, oh, wow, we can find this common ground. And maybe if the both sides get together, we can really pack a punch. And so that's why it was real, really novel that you had George Soros on the left and the Charles Koch Institute on the right becoming the two major anchor funders for this. And, you know, people, you know, there were a lot of people who were nay saying, and, you know, because either they were on the right and they didn't want anything to do with George Soros or vice versa. But, you know, I feel like, you know, with the intellectual power that we have.  He's really the, he really started this thing.  And so marrying that impulse with, you know, really a number of scholars on regional issues like China and Middle East, Afghanistan, we have a grand strategy program or we have a Russia expert, you know. So we got the intellectual foundation for why we're arguing for the things we are, you know, matched with a real advocacy so we can take that and then go on the hill and talk directly to members of Congress and even the White House and say, you know, this is how we should be talking about this. This is how we can affect change. And look, this isn't just fly by night, you know, advice. You know, this is stuff that's really rooted in some serious scholarship and research. And then I'm running the magazine Responsible Statecraft, which is sort of like a, it's an online magazine that takes outside contributors, as well as staff and our fellows and talking about restraint and talking about non-intervention and talking about how the military industrial complex is sort of like this self-licking ice cream cone that only benefits the defense industry and the politicians and has been screwing us for the last several decades and getting us into these wars and taking money, you know, from real domestic needs. So that is sort of our front-facing. So, you know, put that all together and I think we're making an impact because you got the blobby, you know, establishment people actually paying attention to what we have to say. They don't always agree, but then they're like, oh, because, you know, you got these smart people or saying things and they're real scholars with PhDs and so they can't just be dismissed as cranks or whatever. You know, so we're kind of making impact. And like I said, we're actually affecting policy by having these relationships with members of Congress. Now, right now it's kind of easy because you have the Democrats are in charge, you've got a Democrat in the White House. So they're a little more open, but, you know, I think we're making some strides on the Republican side too. It might be a little more difficult, you know, in terms of like building a consensus, you know, on the right, but, you know, with that advocacy role, I think that that's actually having an impact. So you see the impact, what in the withdrawal from Afghanistan with the reversal of the criminalization of those who cooperate with the ICC and extension of start? Yeah, I mean, specifically the Afghanistan issue, we actually brought together a campaign with both left and right nonprofits and other think tanks and action tanks. A few months ago, I'd say about one, I wanna say three or four months ago in earnest. And basically saying, okay, we're gonna do stuff on Twitter, we're gonna do op-eds, we're going to have letters and have them signed and delivered to the White House and to, you know, specific targeted members of Congress and we're gonna do videos and we're just gonna nail this issue. We had events, you know, panel discussions, we just did not let up. And it started with, you know, basically saying, hey, Trump did one thing right. He signed this Doha agreement. He wanted to get us out of Afghanistan. The Pentagon slow walked it, but now we have a deadline and it was May 1st. And so for months, we were saying, get out by May 1st, get out.   Another 20 years. Yeah, exactly. And then, you know, Biden came out and he said, you know, obviously we're not leaving by May 1st, but he said, I'm getting us out by September 11th. And we said, you know, okay, we'll take it. I mean, but we're gonna make sure you actually stick to it. And so, you know, so we're, our latest campaign is we wanna see all those interpreters with people that worked with our troops there, get out if they have to because a lot of them are in danger right now. I mean, we're not Pollyannish. We know what's gonna happen. The Taliban is already making gains on the floor there, on the ground there. It's gonna be a real hard road, but we are not convinced that staying is gonna make it any better. It's either gonna prolong the inevitable or it will actually instigate more violence because we already made this agreement with the Taliban and we'd be seen as breaking it. The Afghan people, I believe in what I've read and with people who know much more than I do have said that Afghan people really do wanna take control of their own country. And it's just, we haven't been able to let them do that on so many levels. And so it has to happen. It has to be organic. And yeah, it's gonna be ugly. And I think that as long as we continue to work with the Afghans, keep the channels open, keep aid flowing if that's necessary, making sure that the aid actually gets to the right people and isn't corrupted and not just blow them off like we did the Iraqis. When we got out of Iraq, we left nothing there except for troops and then even they were gone until ISIS took over and we had to go back in. But we didn't leave a real strong diplomatic presence there. Kelly, two other issues before you leave us. Do you see any hope for changing Congress's support, blanket support, unconditional support for Israel? And what about Yemen? We had great hopes that Biden would enter office and he would immediately suspend those weapons shipments to Saudi Arabia and the UAE. We don't see that happening.  Children are dying every day in Yemen. When is this going to end? It's very disappointing because the president seemed to come on really strong about getting out of Yemen and ending our support to Saudi Arabia for their offensive operations. And that whole offensive operations has sort of been hanging there. Like what does that even mean? Are there loopholes that we're not seeing and have we actually ended that assistance? And the more that the administration has been pressed on this, the less information we have. So we don't know what's going on there. As you mentioned, we suspended the arms sales to the Saudis, but it's still pending. And as far as UAE, we are selling them all of that high tech weaponry, including F-35s and bombs and drones, even though they're still involved in Yemen, even though they say they aren't. And they're responsible for all sorts of human rights violations in their own country in Libya. They're supporting, they're breaking an arms embargo there. I mean, it's very disappointing. We've given more weapons to Israel, I mean, Egypt. And then the big question, of course, is Israel. I'm heartened because there was a movement by Democrats to cut off the aid or at least, you know, there's some that want to cut it off, but after what happened in Gaza while it was going on, they said, can we at least suspend the $735 million worth of, you know, precision guided missiles you're gonna send them? And there was some hope there. Unfortunately, I think the Biden administration is just letting that those weapons flow in there. But the fact that people are rising up and feeling emboldened to question the $3.8 billion of aid that we give, the relative blank check that we give Israel with nothing in return. I mean, they've abandoned the two-state solution. They've abandoned the peace process. They've expanded the settlements. They've done everything to thwart peace, but yet we still keep giving them money and there's just no sense of any leverage. And I think people questioning that for the first time is was refreshing because as you know, it's been a third rail in Washington politics to even speak ill of that relationship. And now they want another billion dollars for the Iron Dome. So that's another struggle. Kelly, thank you so much for joining us on Code Pink Congress. Kelly Garner is the editorial director for Responsible Statecraft at the Quincy Institute and a senior advisor as well, working night and day to try to change US foreign policy. Thanks, Susan. Oh, thank you so much, Marcy. All right, back we are. So that was Kelly as you heard the editorial director for Responsible Statecraft, which is an excellent publication, check it out online. And now we have Mark Perry with us and Hania is going to introduce Mark. Yeah, it's such an honor and a great pleasure, Marcy. When I was reading Mark's bio, I kept getting chills. So what an accomplished guest speaker. Mark Perry is a senior analyst at the Quincy Institute. He is a widely published military and foreign affairs reporter and analyst. He is the author of 10 books, including the Pentagon's Wars, the military's undeclared war against America's president, the most dangerous man in America, the making of Douglas MacArthur, the Boston Globe named this book on General MacArthur, the best nonfiction work of 2014. Mark served as a senior foreign policy analyst and political director for Vietnam Veterans of America Foundation, which founded the international campaign to ban landmines, which won 1997 Nobel Peace Prize. It's a great honor to have you, Mark, and please take it away. Thank you very much. And thank you all for being here. I'm honored to be here. I'm a little bit intimidated by the numbers of people that this conference is attracted and impressed. You should be proud of the work you've done. And I agree with Kelly about reaching across the aisle. I know it's difficult. There is an emerging kind of libertarian Republican conservatism that is rearing its head. Now, reaching across the aisle is always difficult with that political party given its recent history. But I think we're gonna see more of this emerging libertarianism. And with that libertarianism comes cuts to the US budget and especially the defense budget. There are few and far between now, but there are going to be a lot more. But I wanna take a little different tact than Kelly took about reaching across the aisle and talk about reaching across cultures. And to do this, I'm gonna tell you a story. Back in the 1990s, I was a political director for Vietnam Veterans of America Foundation, which founded the international campaign to ban landmines. And it was a terrific initiative and very successful. We worked with Human Rights Watch and a number of other organizations. We signed up over 135 countries for a ban on landmines, but we didn't sign up the United States. So I got together with the Leader of Vietnam Veterans of America Foundation. We decided that what we would do is reach across cultures, not the aisle, but reach across the culture. Cultures in America and recruit military officers who would agree to a landmine ban. It seemed that we would never find any of them. We wrote a letter to the president that they would sign and we sent out the letter to West Point graduates and senior military officers. This is April, 1996, October, 1996. And waited and waited and waited and finally I received a phone call from General Volney Warner, who said, you wanna ban landmines? I said, yes, sir. He said, and what does Vietnam Veterans of America Foundation do? I said, well, we run clinics that puts legs on people overseas. He said, including Vietnam? I said, yes. He said, anyone who wants to help the Vietnamese people, I'll help. So you can sign me up. And we got 14 senior military officers, Norman Schwartzkoff, Volney Warner, former chairman of the Joint Chiefs of Staff, David Jones, signed this letter. We published it in the New York Times and it changed everything. It worked. So my appeal here now is much the same. I think Code Pink, certainly the Quincy Institute, that's why they brought me aboard, can reach across cultures to appeal to the military on the defense budget. Now it's kind of a default position of the US military that they'll always support increased defense spending. And everyone seems to think that's the way they think. But there are many military officers I know who are beginning to question the utility of more money that buys less defense, which is what's happening. And we all know it. And the particular focus of many officers now with the current Biden defense budget, which is a disappointment, but the focus of many military officers now is on nuclear weapons. I know Marcy has written about this for a responsible statecraft, but I appeal to all of you to kind of back this effort. There's a lot of low-hanging fruit here. The F-35 doesn't work. We don't need another aircraft carrier. The army is too big. We're spending a lot on our overseas accounts for these useless losing wars. But the focus of many military officers I talked to has been on nuclear weapons because they are the most destabilizing part of our arsenal. I know many of you have done this before you've talked to military officers. You've appealed to senior officers. But I think if we have a singular focus, if the progressive movement in this country can have a singular focus on the nuclear issue, we can make real progress. As I saw this defense budget promoted by the Biden administration, I couldn't believe they basically kept the Trump nuclear upgrades the same. And I just, something tells me I just, I don't buy what they're trying to sell. And I'm not sure they're trying to sell it that hard. There are many members of Congress who we know who are gonna focus on this nuclear weapons upgrade. And I think the one low-hanging fruit, it's almost on the ground that bears our attention is the upgrades to the ICBM. The upgrade is called the Ground-Based Strategic Deterrent. And it would replace the ICBM Minuteman Three Missiles by 2029, it's money wasted. And it's dangerous and it's destabilizing. So in our work at the Quincy Institute, I've kind of urged people who are our coalition partners and the Pentagon budget coalition to focus on a nuclear weapons issue. We have lots of allies and we have military officers who are beginning to recruit who agree with us on the issue. And if you can get 15 or 16 U.S. Air Force officers retired, because nobody who's currently serving would ever step out of line. But if you can get 15 or 16 retired U.S. Air Force officers who would agree with cutting the Minuteman Three and oppose these upgrades and these billions of dollars of wasted money on nuclear weapons, including new two new types of tactical nuclear weapons, I think we can make an incredible progress. I know that Elizabeth Warren in the Senate is extremely interested in this issue. Barbara Lee and Ro Khanna and Mark Pocan in the house are extremely interested in this issue. So there's a lot of waste, I don't have to tell you all, there's a lot of waste depending on budget. But we're not gonna kill the F-35, we're just not gonna do it.  And we're not gonna kill, we're not gonna take 100,000 soldiers out of the Army and they could do with 100,000 fewer soldiers. That's not gonna work. But we, with the help of our allies in the Congress in both parties, and with the help of the military, including U.S. Air Force officers who don't believe in these systems and consider them dangerous, I think that this is something we can win if we will focus on it. So I'm happy to take your questions or your comments and I hope that my presentation has helped you. Thank you so much, Mark. Wonderful to have you with us tonight, Mark Perry, senior analyst with the Quincy Institute for Responsible Statecraft. I'll start off. So Mark, can you identify any Republican or independent? Well, not Bernie Sanders, we know he would not be supportive of increased militarism. But can you identify any Republicans in Congress who you think would join us in a call to cut, reduce the military budget and nix the ICBM replacement, the ground-based strategic deterrent? And aside from identifying those in Congress, can you identify any constituencies that might be attracted to those Republicans who would join us? I can name two or three variables and perhaps one Republican, but there will be more if one joins. Rand Paul has real doubts about the ICBM. We're not gonna get any member of Congress, Democrat or Republican, that's part of the missile caucus, the ICBM caucus. These, excuse me, these land-based systems are in North and South Dakota, Montana, Wyoming and the members of Congress and the Senate from those states view this as a jobs creator. So they're not gonna join us. Southern Democrats and Southern Republicans are probably not gonna join us. But I think we could probably pick off members of California Delegation Center and members of the House. I think we can pick off New Englanders, but we can pick off more if we have a retired lieutenant general, and I have one of mine I've been talking to, who will stand up in the Congress and testify and he have testimony that says I'm an Air Force officer and I think these things are dangerous. And let's not forget, we have former Secretary of Defense William Perry who's been on this and has been crusading on this and Daniel Ellsberg, but basically William Perry who has real stature on this issue who would join us and he talks to Republicans every day, they know this is a destabilizing weapon. What they're worried about is the jobs that would create the money that they get from defense contractors, let's not forget. Defense contractors have one lobbyist per member of Congress. We have one advocacy director at Quincy. So we're all gun and we're all spent, but on this issue, on this issue as a matter of principle, I think we have a shot, especially if we can get an Air Force officer who will walk in, if I walk into a senator's office, my name is Mark Perry, I'm at Quincy Institution, so that's great. Welcome to our discussion on national security. But if you have a lieutenant general in the Air Force walk in and say, we can get rid of these weapons, they're dangerous, that makes a huge difference. Thank you, Hania, would you like to read a question? Yeah, I definitely would. Now, how did we transition economically from our dependence on private military contractors and military spending in general? And what about the profit seeking motives of the current existing military industrial system and the people who run this system? De-coupling to our industrial base from military spending is the biggest obstacle we face. And I'll give you one example. Senator Sherrod Brown has voted for money for the M1A1 Abrams tanks, 2,000 of which are sitting in the California desert unused, because we don't need them. But year after year, he does this because there's 983 jobs out in Lima, Ohio that are dependent on tank manufacturing. And it's a disappointment. This is Sherrod Brown. This isn't, you know, Jim Imhoff. This is Sherrod Brown. So decoupling, you know, the industrial base from military spending is our, it's the one thing that we have got to figure out how to do, nobody's figured it out yet. Now, I've had discussions with people who thought long and hard about this and say, well, you do the green new deal. I just don't think that's gonna work. The idea here isn't to substitute new spending with more spending on different things. I want to cut the defense budget. And I would like to get rid of these weapons no matter what the cost. So I think, you know, some kind of industrial repurposing policy which happened in the 90s happened even in the midst of the Cold War during the Eisenhower administration. This is even at the Heritage Foundation to be blunt with you. There's real questions about whether we really need 495,000 soldiers in our army. There are military officers who are raising money for K through 12 education because there's not enough money in our budget but they won't cut the defense budget. So that decoupling is essential. I wish I had a simple answer on how to do it. When I come up with the answer, I'll give you all a call because this is, I think this is the hardest job we face. Thank you, Mark. I have a follow-up question. You said that you thought the low-hanging brute, so to speak, was the ground-based strategic deterrent. That's the replacement for the land-based intercontinental missiles. So you mentioned, I think, an ad that you had placed about land mines during Vietnam. What do you think about, do you think there's any point or that we would get mileage from Senator Warren, for example, holding Senate hearings on destabilizing impact of the land-based missiles? I think she'd be happy to do it. And I think the appeal to her is, your first witness is Secretary of Defense William Perry. No relation, by the way. And your second witness is a retired Lieutenant General Air Force officer, who I know. And let's blow up the balloon here. Let's get this a lot of attention. She was, when Kathleen Hicks, who's Lloyd Austin's deputy, was in her confirmation hearings, Elizabeth Warren asked her very specifically, now you're gonna review this nuclear posture review that the Trump administration brought out and you're gonna, and you're going to subject it to real criticism. Do I have your word on that, Kathleen Hicks said yes. Well, they didn't do that. They cut it a very fractional amount and they haven't reviewed it. Now, Lloyd Austin, the Secretary of Defense says he's gonna review it, but here we are, the first Biden budget would have been the perfect time to do it. I think that Biden is protecting himself on the infrastructure bill, all kinds of political reasons. And I'm sure he's got very good excuses that he can rattle off about why he did this, keep the military office back and all the rest of it. But at some point, he's going to have to face the music with somebody like Elizabeth Warren because they gave a pledge to her that they would take a hard look at this and that they just would not swallow what Trump was selling. They haven't done that. They've swallowed almost whole. Somebody posted in the chat, it was Obama that began this quote, nuclear modernization of what I call the armament program. And I read that the reason he made that promise was because he wanted Republicans on board to extend the start journey or to first start initially. But regardless, it was a Faustian bargain. And then Trump awarded the $13 billion sole source contract to Northrop Grumman to develop the ground-based strategic deterrent. So back to the hearings for a minute. So you feel that hearings are effective? Well, I think they're effective in kind of building support beyond the progressive left. You know, it's, you're not going to convince a guy like Jim Emhoff, but the hearings are effective because there are Republicans who are scratching their heads on this nuclear deterrence issue and wondering about it and they need to hear other voices. The other thing is, like, you know, looking back on Obama, I mean, there's a lot to regret about Obama and this nuclear posture review is one of the things we can get. And he did, you're right. He did trade, you know, upgrades and modernization in exchange for the start treaty. And it's possible that Biden will be doing the same when he talks to Putin. I mean, you know, Biden has a history here. When he talks to Putin, whenever it's going to be in next month, you know, he's going to be tough, the American elections and Ukraine and, but sooner or later, they're going to walk around the barn and get to strategic arm reductions. They're going to because it's in Biden's heart. Now, I know it's in Jake Sullivan's heart. I know it's in Tony Blinken's heart. They're going to get to it. And if they start cutting strategic warheads, not just warheads, but delivery systems, then the Minuteman III is going out the door. And Biden, if he does that, and there is some chance that he will, certainly I'm not a mind reader. He's going to need support in the progressive left, stand up and cheer, getting rid of these, you know, whatever they are, 480 missiles in the middle of the country, because they're there to be attacked. I mean, that's, that would be a huge victory for us. And I think it's, you know, all the things in the defense budget, that's the thing I look at that is very doable for us. Thank you, I appreciate your perspective. Somebody raised in the chat the question about China and where do you think this is all going? Earlier we gave an update on the Senate passing 68 to 32, the US Innovation and Competition Act of 2021, which is a recipe for war as far as I'm concerned, with China, of course we don't want that and we need to push back, but it looks like this is heading to the house and there's lots of bipartisan support. Your thoughts on China, US-China relations. Well, it's a disappointment.  I don't think Biden wants a confrontation with China. I really don't. But these are easy votes to get in the House and Senate. And he can walk down the street, nobody says that guy is weak on China. So he's doing the typical kind of triangulation that sickened me by the Clinton administration that he protects his right and he harvests the votes of conservative Democrats by banging the table on China. So now the Lysol is dissipated and here's how the garbage smells. This is really dangerous. The Pentagon calls China a pacing threat. That means that China is matching our defense budget increases, but their defense budget is a quarter of ours. Their technical know-how, their fighter aircraft, their fighter bombers don't match ours. They have one aircraft carrier, it's lousy. They certainly don't have the heritage we do of interfering in foreign countries by dropping their military in the middle of it. But nevermind, they're a pacing threat. But what that means in reality is they're not a peer competitor, which is the military's term for somebody to be afraid of. The United States military is not afraid of China. They're using China as a way to build their budget. It's a dangerous thing to do. I would like to say we're not headed to war, but history shows us that increased defense budgets often lead military officers to the belief that they need to use what they build. And that's the danger here. I don't think that China's a peer competitor. They're certainly not a military peer competitor.  Mark, I've thought that we need to engage in outreach directly with the military on this to the rank and file military to say, we are sending you a letter and we do not want you to attack China. Because I feel as though we have mad men and women running our government when it comes to building up, weaponizing the Indo-Pacific, the South China Sea area. I'd like to ask you about three or four representatives and get your take. Adam Smith, so he's chair of the House Armed Services Committee from Washington. He's a hawk, although he is co-sponsoring the Snow First Strike Bill. He is facing a primary challenge from a teacher who has the backing, I believe, of the National Education Association, large organization, Cynthia Gallardo. I read something that Adam Smith had written recently in which he was defending, vigorously defending the, I don't call it the defense budget, the military budget and the US Space Force saying, absolutely we have to have both of these that Biden has supported trillions of dollars for relief for the suffering from COVID and the economy slow down. And all means we need this for our military, just adamant about that. So your take on Adam Smith, he also takes hundreds of thousands of dollars from military contractors, no shame there. So he's won. I'd also like your take on Senator Diane Feinstein. These would be the nuclear issue. We were out there, Code Pink recently. We held a rally, not a protest, a rally in front of her office, met with her, one of her representatives in DC who happens to be a, quote, defense fellow. I never knew there was such a thing where the Pentagon actually pays the salary of defense fellows that are embedded in the offices of senators, outrageous. We met with her urging Senator Feinstein who is the chair of the House of, of the Senate Appropriations Subcommittee over energy, the Department of Energy, which would be overseeing the development of the ground based strategic deterrent to say, hey, speak out, oppose this. Because I believe in 2014, she wrote an editorial for the Washington Post, an op-ed saying that our nuclear weapons program is unnecessary and unsustainable. So Diane Feinstein, bring back that, that Diane Feinstein. And the last person I wanna ask you about, so it's Adam Smith, Diane Feinstein. And lastly, Senator Patrick Leahy of Vermont. Now, he talks a good game often. And wasn't he involved in pushing for the ban on landmines? Yeah, no, for that. But he also escorted the F-35 into Burlington. I know Bernie supported it as well, but from those I've spoken to in Vermont, they really do blame Leahy for bringing the F-35 to the middle of Burlington, Vermont, at the airport there. He is chair of the Senate Appropriations Committee. So I would think that he would have a very powerful role to play in the military budget. Your take on those three. Yeah, I wish this was off the record, but there are so many people here. Adam Smith is probably the best, I understand the problem with Adam Smith. But Adam Smith is probably the best military thinker on the Hill. He really knows what he's doing, he does. And he has come out with statements over the last three or four months. This is the Lysol Spray game. He has come out with statements over the last three or four months talking about how the United States should not be seeking military hegemony or dominance in the Pacific, but parity, which is a lot different than what his colleagues are saying. I understand his voting record. I know where he is on military spending, but he's the one guy who understands these military systems and understands military strategy and talk to the military far better than anyone on the Hill, in my opinion. He's gettable, he's gettable. Before you go on to the others, has he come out against the ground base strategic deterrent? Well, he has not, and he's not likely to, but he's gettable. I'm not an expert on the Hill, so I'll leave Cynthia to you guys. Cynthia Gallardo, the primary challenge. I know her record, I'm not impressed. She says she's anti-imperialist, I like that.  I am not a big fan of the senator from California, and I think it's past time for her to retire. And I have seen over the years that she is easily swayed by conservative voices. One of the great secrets of the mid-90s was that Diane Feinstein listened to Trent Blatt a lot, which I found embarrassing for her. I just don't have much of a brief for her. Patrick Leahy, I know personally, and I have admiration for him. I hear he's gonna run for another term in the Senate. He loves his job. He's gettable. He doesn't really understand the military that well. It's not his thing, he's a judiciary guy. He's a court system guy, which he's very, very good. But his aides and his staff are first-rate on military issues, and they guide him, and he's very gettable. Mark, one last question. It's almost time for our Capitol Calling party. I ask everybody to stay. We'll be calling about Palestine and China today. Mark, here's the question. Can you talk about the disastrous plans for plutonium pits and how it impacts WIPV? Can this be a good bipartisan campaign? Also, can you touch on the proposed whole-tech nuclear waste facility? I can't, you know, honestly, I can't speak on any of those issues. I'm just not that familiar with them, and I'll leave that to your experts. But I wish you'd ask me the question you asked Kelly about the Israel-Palestinian issue. Okay, I'm asking. Because I worked in the West Bank Gaza in Israel for 20 years, and... What were you doing there? I was helping FATA, the mainline Palestinian organization, do politics. Not for pay. I lived in the Palestinian territory, I was ended up really having a love affair with the Palestinian people. Broken as they are, and for good reason. But I think that the recent conflict that we've seen there is different. And profoundly so, primarily because we now have an uprising, which is continuing, but not in the pages of the paper, but it's continuing inside of Israel itself where Arab Israelis are now in the streets and being rounded up in massive numbers, 1700 in jail in Israel. And this is new. It's, this is, this is Black Lives Matter comes to Israel, and it's about time. So this is a very sensitive issue that we can make progress on. There's real discomfort in the halls of Congress with what Israel is doing. Of course you get the standard, Israel is right to defend itself, we'll defend Israel no matter what. You get Americans who are more Israeli than the Israelis. But if you're around, and as old as I am on this issue, in the 80s and 90s, you couldn't mention the Palestinians in Washington, D.C. or in the national media without being criticized as some kind of anti-Semite or being anti-Israel. That has changed, and that's significant. And I hope that we can continue to press on that issue. Well, thank you so much, Mark Perry for joining us. Thank you all. Mark is a senior policy analyst for the Quincy Institute, writes for responsible statecraft, prolific author, and we are so grateful for your presence here tonight and has given us a lot to think about. Thank you Mark. Thank you, thank you very much. And Mark, before you go, I'd like to ask for our audience members before we go into our Capitol Hill calling party, please unmute yourselves, send your love to Mark, and let him know that we appreciate his presence here. And thank you for the time that you've spent educating us on this call. Thank you Mark, thank you so much. Thank you very much. Thank you. Thanks a lot, thanks a lot. Unless it's a happy birthday, let's say happy birthday to Kelly. She was with us earlier. Can we say happy birthday to Kelly? Happy birthday Kelly. Happy birthday Kelly. Happy birthday Kelly. Happy birthday Kelly. Want to meet us there? Mr. Church around the center. Thank you, thank you. Thank you so much. Thank you. Well, yeah, yeah, so if I can have you all, please mute yourselves again. This is where the action begins and we're very honored to have, how many people now on the call? We have about 105, so let's all stay these calls. Make a huge difference. So what we're gonna do today,


you are looking for an INCREDIBLE tracking in skin next pre-farm and didn't get to use the boar farm, this video is for you. How's it going guys, my name's DPJ and if you enjoyed the video, leaving a like really helps out and if you like what you see and want to see more, be sure to subscribe. So this farm was shown to me by my pal mydolivecruises, whose channel you will find linked below. Check him out for those daily, new world videos. So this farm I will state, it isn't as good as the original boar farm pre-patch, but it is better than the post-patch boar farm, the farm we have in place now. Plus here the enemies are around level 49-50, so it's one higher leveled players can take advantage of and even earn great character XP at the same time as doing this. Also I apologise about the story footage, my OBS was being a biatch and I have no idea why. I do have GeForce experience installed, I have no idea why I haven't been using it, but that's going to change from now. This farm in spite is basically a cave located here and a map you can see me at, and this cave is full of wolves. Just like the boar farm, they just keep spawning. Now I will state, there is here enough about 3 high leveled players to make this efficient, or 4 or 5 lower leveled players to make this efficient. Also don't forget to make that campfire outside of here, because it is more or less as quick as you can skin them, they just respawn, I mean we ended up in a group of 5 here with a level, almost a level 60, the rest of us basically of 45-50s, and we were just obliterating them and there were more than enough wolves here to farm and skin, even though all of us had that 200 skinning and tracking staff that skill. There's also a name bus here called Artica, who also has some great loot you can drop at the same time, as well as giving you even extra XP, but yeah guys who need that tracking and skinning XP, I believe these wolves once you hit a level 100, you get between 600 and 800 skinning per wolf, so yeah guys I hope this helps you out, I mean the original boar farm also isn't too bad either, even after that nerf, so that's still an option too, but if you're a little too high for that, you won't gain XP out of killing them, you probably want to come here, so enjoy this, and on that note we have come to the end of the video, if you guys enjoyed it leaving a like really helps out, if you're new around here and want to see more be sure to subscribe, and if you never want to miss a video I upload you can turn notifications on, by hitting that bell button, but guys thanks as always for stopping by and hopefully I will see you on that next one


Good morning and welcome to our subspecialty round service. I want to congratulate all of you for planning for the weather. I also want to introduce a guest. This is a return international observer, Dr. Ikwesi Ahmed from CAATH in Ghana. Dr. Ahmed has finished a five month Retina Fellowship at Tilganga in Nepal. He will now be with us for one month and then he'll be working for one full year doing a Retina Fellowship with our partners at Erevent. And then he'll return to be the Retina Specialist for CAATH. So welcome. Would you like to say anything? You don't have to. All right, very good. We'll get you at the very end. With that, I'll turn the time over to Dr. Emmy Hartnett for our Retina subspecialty round. Thank you all for coming. I think it's an exciting time in Retina and genetics. And so we have a theme in this grand rounds where we'll have our experts present cases and then hear about some of the genetics from our genetic counselor, Emily Spoth, who I hope you all continue to use her expertise. So first, we're going to have Chris Kamansky, who's one of our first year fellows. And he's going to present a case of melanomelitic glaucoma and discussion of UVL melanoma genetics. Chris. All right, so this is an interesting case that I was able to see with Dr. Jacoby. And the history is that the patient came in complaining of floaters. He's a 69-year-old gentleman with a past medical history of diabetes, kidney stones, chronic kidney disease, stage three, who presented and complained of these new onset floaters in his right eye and denied any pain. He had a history of moderate myopia. He had a multifocal lens in his right eye that was positioned in the sulcus due to vitreous loss during surgery. His past medical history, as we talked about, CKD stage three, when I was looking at the chart initially thinking that was from diabetes, is actually due to severe and chronic nephrolithiasis. His diabetes was well-controlled with diet and physical activity. His hypothyroidism, hypertension, and hyperlipidemia had no family history of cancer. Married Liz at home with his wife. Medications were simple as the synthroids and the statin aspirin. And he was allergic to linoglyptin. His eye exam, his visual acuity, his hand motion in the right eye, 2020 in the left eye. His last refraction was actually done before he had cataract surgery in his right eye. And this is his refraction and vision. Pupils were normal, pressure normal, were unable to obtain visual fields in the right eye but normal in the left eye.  He also had, in his anterior chamber, two millimeters of a layered hyphaema with three plus-pigmented cell. Again, he had the multifocal sulcus lens. On dilated fundus exam, in the right eye he had a dense vitreous hemorrhage. He had no view posteriorly in that eye. The other eye was normal. So at this point, do we have any of the residents here? We have lots of them. Lots of them. Theresa, what's your differential for a diabetic with a vitreous hemorrhage? Perfect. Since he doesn't have diabetic retinopathy in these other eye, what other things would you think about? Yeah. So things that cause neobascularization, like ocular scumic syndrome. But what's probably most common in someone without diabetic retinopathy? So like retinal tear, hemorrhagic PVD, 69, retinal detachment. Because he didn't have diabetic retinopathy, and this is just kind of the complete differential on vitreous hemorrhage, we won't belabor it too much. But the general categories of the vitreo-retinal interface, which is most common at the top, then there's neobascularization due to retinal vascular disease, which you see the list there. You can have a RAM. Coroidal is interesting, because you can actually get vitreous hemorrhage from Coroidal neobascular membranes, but also Coroidal tumors. And then trauma, which he doesn't have a history of, blood disorders, and then some less common things than masquerades at the bottom. So additional testing, we did an ultrasound of the right eye, and the B-scan revealed this Coroidal mass, measuring 11 and 1 half millimeters with a thickness of a little over 11 millimeters. And the notes was medium reflectivity, 1 plus irregularity, and 3 plus vascularity. And this is a representative B diagnostic A-scan. So at this point, we have a patient we're diagnosing with Coroidal melanoma, with the right eye, and wanted to recommend an evaluation for brachytherapy with a radioactive plaque. And we wanted to perform genetics to give him a prognosis of this tumor, and then also get liver enzymes, chest and abdominal imaging. At this point, he elected to be referred to Philadelphia, where Dr. Shields performed his plaque treatment. This was this highlighting a classic case of Coroidal melanoma, and then we were just going to go through a discussion of Coroidal melanoma, and then of the genetics associated with it. So it's the most common primary malignancy of the globe. And the annual incidence is 1 per 200,000 people. You can have amelanotic melanoma, like you see here, or a classic ciliary body melanoma, extending underneath the retina and breaking through poox membrane, causing a vitreous hemorrhage and some pigment dispersion, or a super-tempo, this large, Coroidal melanoma. The demographics is pretty equal amongst men and women. Now, it's typical a disease of older people. However, it's arranged in this series with anyone from six years old to 100 years old. It's also a disease primarily of Caucasian people, with about 98% of these in the US being diagnosed in Caucasians. Interestingly, there's an elevated incidence of prior malignancy at 11%, but most of these people do not have a history of prior malignancy. In terms of tumor location, the majority of these are confined to the Coroid. And in this series of over 1,000 Coroidal melanoma, or UVL melanoma, is 65%. We're in the Coroid. 15%. We're in the ciliary body, or iris. And then the remainder were undetermined or not listed. So the treatment options for Coroidal melanoma, historically and still sometimes requires surgical resection, which is a nucleation. However, many of these eyes can be saved by the use of radiation therapy, most commonly brachytherapy, but also protein beam irradiation at some centers. And so quite brachytherapy, this is just a cartoon showing generally what is done. Pertimia is made. These radioactive seeds are placed by radiation oncology in this metallic plate, which is then sutured to the sclera and left there for about four days, then removed. And then the pertimia is repaired. So this is what it looks like when a plaque has been sent on to the sclera. As you can see from the trends in how UVL melanoma has been treated in the 70s, almost everyone was being eneupliated if this was diagnosed. However, through a lot of hard work and then the results of the comms study, it was shown that radiation treatment is actually very effective for Coroidal melanoma, and now it's become much more common. So the case continued. So the patient got his plaque and was doing very well under the care, co-managed between Dr. Shields and Dr. Jacoby. But 12 months after the plaque, he presented to the triage clinic at Moran, complaining of pain, photophobia, anterior, he was found to have an anterior chamber cell, vitreous cell, an ocular hypertension, his right eye was 26, left eye was 10. Dr. Harry was able to perform a B scan that day, and that revealed excellent tumor regression, so similar basal size as expected, but the thickness was previously 11.2 millimeters and now it's 5.3 millimeters, and we have a photo from around this time. And we can see this temporal mass with a little bit of overlying vitreous hemorrhage, and it's a little bit hard to see, but in the inferior vitreous, there's some vitreous pigment that you can see through the eyelashes. Those scars around the tumor actually laser that was performed by Dr. Shields to some non-perfuse retina in the hope of preventing neovascular glaucoma. What was interesting is then we expected this to probably be neovascular glaucoma and expected to treat with anti-vegeta therapy. However, on gonioscopy, there was no neovascularization. There was dense pigment within the angle, as you see in this excellent goniofoto. And this raised some concerns for us. Is this tumor actually seeding the vitreous and now we're getting infiltration of the angle? Or could this be something else? So we sent these images to Dr. Shields and she decided she wanted to see the patient, saw the patient three days later. We started the patient on Prid Forte and Timo on the meantime. By the time the patient followed up with Dr. Shields, the pressure had normalized. The eye was feeling comfortable to the patient and he was feeling back to baseline. She assessed it and determined that this was likely just from tumor necrosis and that this is pigment being dispersed into the vitreous and then being ending up into the angle of the trabecular mesh work. But this is something we're gonna be watching very carefully over the next few months. Does the patient have translimination defects? In the eyes? Because I think there's only really one kind of multifocal you can say, but the rest are all gonna be single piece and that could be complicating the issue with. Absolutely, I think that's a great point. The patient was dilated when I saw him and I did not notice translimination defects, but it's something I might wanna go back and look. Look and see if it's a single piece or a three piece. If it's a single piece then. Then that could be a, yeah. Absolutely. Thank you for that. And what we're most concerned with is that. This shows the issue sometimes in the front of the eye forgets there's a back of the eye, the back of the eye be able to find out. Absolutely. It's just a clear window, right? So, we really wanna focus on that in cordial melanoma we're treating more than just the eye and we're treating the patient and that's because this is a disease with significant mortality. Despite advancements in the treatment of cordial melanoma, this mortality has been about 20% over five years and that hasn't changed over the last 40 years. And as you talked about there's the comm study which showed that radioactive therapy was safe and effective and this is the main result from that which this is death for many cause of the brachytherapy group versus the nucleation group in medium size tumors. You can see through 12 years there's no difference in survival. This is also true if you look at the results looking at only metastasis free survival. But there's also a lot of interesting data that was gained in the study. There are things that will put patients at risk for mortality and metastasis. And two of the biggest things I identified in this study was age. So if patients were over the age of 60 they were more likely to die from any cause but they're also more likely to develop metastasis. And if the tumor had a greater mean basal diameter of 11 millimeters. So after the completion of comms there's a number of people who looked at a lot of these risk factors to come up with predictors of metastatic disease. So hopefully we can identify these high risk patients and start learning of ways to help hopefully treat them. And this was mostly done looking at a nucleated eyes and they would calculate the largest basal tumor diameter the presence of different histologic results like closed loops, epithelial and cellularity, the metotic rate and then whether or not there was metonic spread. And this could be put into essentially a risk calculator that would hopefully predict how likely metastasis would be to happen. But what became clear to the oncologist is that this wasn't very good at doing that. And so the next step in trying to figure out uveal melanoma metastatic risk it was really to focus on genetics and how genetics could help us figure this out. There are two real main schools of thought and that was chromosomal analysis, DNA analysis which is led in Philadelphia and then gene expression profiling which is mRNA analysis which has really been at the forefront or been led by a big group down in Miami. And so we'll talk about each of these approaches. So there's some chromosomal changes that really have been linked to metastatic disease and melanoma and I'll talk about two of them. There really are three chromosomes involved. Chromosome three is probably one of the most important predictors of metastatic disease. And this is important to note this is the genetics of the tumor, this is not the patient, this is the tumor's genetics. And if you have a normal chromosome three you have relatively low incidence of metastasis three survival. However, if you lose one of your chromosomes three to an osomy of chromosome three there's high risk of metastatic disease. There's a similar story but somewhat flipped for chromosome eight Q in that if you gain chromosome eight Q you're having this increased risk of a metastatic disease. And what this study was looking at some of those basic characteristics of the tumor that you can get from ultrasound or from the biopsy and then looking at chromosomes three and chromosomes eight Q. And what I wanna show is that these the hazard ratios and what you can see is that the hazard ratios are elevated for some of these characteristics that have been shown in other studies to predict metastatic disease but when you look at the magnitude of the hazard ratio these chromosomal changes are much, much more important to predicting metastatic disease. And there's a really a similar story that's told when looking at gene expression profiles and metastatic risk. This is Dr. Harvey in South Florida. He had two major studies that looked at this concept of just breaking down tumors into either class one tumors, low risk tumors for metastatic disease and class two tumors which would be high risk for metastatic disease. And the initial study was only 26 patients and they actually identified 3,000 genes that were linked to risk of metastasis. And it's a busy slide but when you look in the molecular class which is not for right, you can see that class two tumors as determined by these 3,000 genes had a much higher incidence of metastatic disease and in the small sample size, a lot of the other things that were known to affect it weren't, they weren't able to determine that and then some of the things that shouldn't affect it like gender, there was no effect. This was then followed up eight years later a much more detailed study looking at 459 patients and to make this a more achievable test they truncated it from 3,000 genes to 12 genes and looked at the gene expression of those and they confirmed some of the things we know that age has an increased risk of metastatic disease, thecillary body's involved, it's an increased risk, a bigger tumor has an increased risk but when you get down to the bottom two graphs you really see that if you have minus only three, absolutely that increases your risk of metastatic disease but even more so than that they would argue this class two tumor as determined by these 12 genes has an increased risk of metastatic disease. Just to talk about one of the more recent findings that a lot of people are talking about is this BAP-1 mutation. We've already talked a lot about chromosome three, well on chromosome three is this BAP-1 gene and what it's been found is that this is very often in almost all metastatic melanominal or UVL melanoma cases that there is loss of expression of this and so whether that's because you have a chromosomal deletion or you get somatic mutations if you are not expressing BAP-1 you have a very high likelihood of developing metastatic disease so thought it's maybe we should assess directly for BAP-1 but that's still being debated. So our patient was in Philadelphia so they got the chromosomal studies and this is essentially the breakdown of the main findings of those chromosomal studies so two of the chromosomal changes in this patient gave them elevated risk. Dr. Shields published just a few years ago essentially a giant table that you can go through the matrix and find where your patient is based on all these chromosomal changes and what they found is that or you can look up is this patient has a five year risk of the test disease of about 33% which is very high and now we have to consider if we wanna refer him to some of the clinical trials that are looking at prophylactic therapy to try to prevent metastatic disease. Look at the huge odds ratio on that though. Yep. You gotta be very careful of telling people I mean the spread on that or your standard deviation we wanna call it is huge. Is massive. The reason is that out of the 1059 patients with UVL melanoma that they did this study with only six had this specific break. Precisely. And so how predicted is that? Well single patient who's dramatically different is gonna dramatically change that and that's what that's why we often look at these average ratios and we get the one the spread is huge let's be a little bit cautious about acting with patients like this is deterministic. And I completely agree. And especially since the treatments that are being looked at as prophylactic therapy are not benign. There are certainly risk associated with it. So we have this really interesting patient with melanoma-elitic glaucoma which we'll be following and hopefully we'll do well with topical therapy. And I think it was one interesting case we got to learn about melanoma-elitic glaucoma that hopefully this is either chafing an OGG syndrome or this is this pigment being dispersed from the tumor or and hopefully he remains metastasize-free. Here are my references and this one I'd like to open it up for further discussion about the genetics. And yeah, so I'd like to introduce Emily Spolt who's our genetic counselor. She can talk a little bit about her service. I have a terrific presentation. Thank you. And my role today is to be the official genetic peanut gallery for these cases. But in general what I do here is I see folks with either suspicion of or confirmed genetic condition view that an inherited retinal dystrophy kind of runs the gamut. That's mostly what I do. For this case, if you noticed on the BAP1 slide there is a subsection of folks that have an identified germline BAP1 mutation. So this is always interesting. BAP1 is one, so this is essentially a hereditary predisposition to uveoloma melanoma as well as molybdenum mesothelioma, clear cell renal cancer, utaneous melanoma. So worthwhile, I think, if you have a uveoloma patient to just ask about family history. Because this is one of these dominant tumor suppressor to hit hypothesis predisposition. So I'll be quick, that's all. Well, and please, Emily does a lot of different helps with a lot of diagnoses as well as management of patients so you can consult her. Okay, thank you.


Hi everyone, Sean with jaspyscasebreaks.com here doing 2020 mosaic football 20 box blaster break pick your team number 18 No veteran common ship. These are 20 loose boxes directly how they were delivered to us from our distributor You can see them right here in rows of five four different columns five five deep And we're also giving away the bangles in the break So how to be entered into the break to get the bangles by two or more teams in this break get entered By two teams get one entry four teams two entries six teams three entries Etc. If you only buy one team you will not be entered into the break and some details about what we can pull from the break itself so Here is the list of customers Actually here Nick all the way down to you Nicholas You saw empty spot in there for where the bangles are So we're gonna do is we're gonna take that list copy it over here to this sheet and then alphabetize it So we can see how many spots each person got so Adam got to so one entry Christopher one entry Colin one entry Eric gets you one Glenn Gets one Mike Gets one Nicholas It's one Nick gets one Patrick gets one Ryan gets one Sean with four gets two and serenity gets one And Thomas gets one as well. There we go So we've got 14 spots total in here We're gonna copy that over to this list right here and Name on top after a six and a two eight times gets the bangles. Good luck one two three four five six Seven and eighth and final time congratulations to serenity You got yourself the bangles in this 20 box blaster break Congratulations So there you go. So let's print and rip. I'm gonna use the first part of this break to rip open all these boxes over here Louviano, how does which part of it work what we're doing or this break itself? So here is the Breaking sheet You'd see last spot mojo mark with the Detroit Lions on there and serenity love with the bangles spots You just won So I'm gonna pop back here for a couple minutes and rip these open To try to pull This part of it So no veteran commons ship in the break all inserts all color ships Obviously all rookies ship no matter what that's where the good stuff You know We're all chasing serenity now with the bangles She's chasing Joe Burrows. I'd love to find some Justin Herbert as a chargers fan. I like seeing Justin Herbert and getting his cards into the hands of other chargers fans or People are just taking the chance on the team. It's been a while since we've been wanted in the hobby Feels good to be wanted If you're wondering what that great show is on the background NYPD blue, I don't know if the show got better with time Or it's just much more entertaining now that I'm over but like all the cops shows and lawyer shows and stuff now couldn't get away with Bogey, you kidding me? You didn't know this movie. I'm a Die-hard chargers man season tickle order, buddy Glad I showed because there was one still in there. So we got that nice new stadium Then we're paying a dollar to play in every year. We didn't get to use it this year We said a whole dollar. I'll be honest before we drafted them. I was actually hoping we would not trap them 100% honesty So I'll give you guys I Did not want it. I Didn't think He was as good as people thought he was I Was hoping that if we were going to draft a quarterback, which I did not want to do So I wanted to keep Phillip Rivers I was hoping That we would actually have drafted Tula So that Phillip Rivers played another year or so and then like the year or two and two It could learn behind him and gotten healthy I thought that would have been awesome Didn't happen But and then as soon as we got rid of Rivers, I kind of knew they were going one way, but I was also hoping that they would give They would let Tyrod play but I also really like our backup quarterback Eastern stick He's a really good player from North Dakota Want a couple national championships there And I was hoping that he might be our future quarterback and in the meantime They let Tyrod play for the year or hour long until they realized he's Tyrod and he's not gonna win them games But he's also not gonna lose the games and our defense is supposed to be good enough When it's fully healthy that it could keep us engaged or win games for us Be the difference maker pretty much and none of that happens So I knew that I wanted us to Go I wanted them to pick Isaiah Simmons at six because He's supposed to be a generational athlete and talent, right? We have Derwin James already in our secondary So I thought if you were to put him in there as a linebacker And have him and Derwin James be able to kind of hate Derwin James be able to teach them Those two guys if you could pair them up together with how athletic each one of them is and how fast and strong they are I thought they would be the perfect combo for a defense Then we went Herbert and I was I'm not gonna lie. I was upset. I'm a little disappointed Because I wanted to strengthen our defense But that quickly turned around when we traded back into the first round And got Kenneth Murray Who is an absolute? Freakin nature in regards to he has Battery never runs out He hustles everywhere He has an absolute monster Us addressing our defense and getting a linebacker in the first round happened it anyways So then I was a little bit more, okay Happy with what happened because all we did was we ended up giving up a third round pick for it Even though we traded a second and a third Our second was early second round. So we moved up into the first round. So pretty much all we got what gave up was the Was the third round pick So That's what was That's how I ended up, you know being okay with it and now that he's playing Who was the quarterback before Herbert? Well, we had Philip Rivers For the last 15 years we drafted them in oh I think he started playing for us 05 Yeah, that sounds about right We had we had Drew Brees for four years a one or two or three or four I think we were started for this first time in 2005 for us played 14-15 years, so pretty much he's following in the footsteps of Philip Rivers 15-year quarterback with every career record for the Chargers. I wanted Philip Rivers to keep playing for us. I Even told Joe If you told me that the Chargers would resign Philip Rivers And we would go 0 and 16 and then he would retire as a Charger I said, I would I would be okay with that and the thing is to bogey Philip Rivers Never missed a start Entire time he was a Charger So from his first start in 2005 all the way through To his last last year with us. He never missed a single game So he was consistent. Oh, he was injured he Tours ACL or something Play I think he played on the tour torn MCL or ACL in in a playoff game against the dreaded Patriots back in I forget what year He played on it and we barely lost he wouldn't have been injured No What are you talking about? Oh, yeah, the thank you Joey. That's all that No problem. It was easy. I just have to request it I don't get to do that stuff. So I just let him send him a message. You may handle that for me We just got to run it up the chain Looks better in person not One day they'll understand you and they'll thank you for all of this boys girls Joey both Even the the boxy shit Is that we're saying Joey? I Did not Guys, I'm gonna take these last five boxes and move them over. You see me on camera Everything's staying on camera 2317 1610 Get a nice little spread out ages there, but no, I didn't see what cards were in the box Say what well, that's pretty cool Was that from what was that from Joey? Where did you get? Did you get that from us? Had to have gotten us from us, right? Was that out of It was out of the shoebox. Whoa, that's pretty cool. Yeah, I never even I never even looked in that. That's awesome Yeah, I saw the helmet, but I saw the message that was on there. I Didn't realize you had another thing in there God Love me some Cal Ruekin So you can see that there's 15 on the cart right behind me and the five boxes that I'm ripping here That'll make all 20 boxes guys Damn That's cool 20 box blaster Joey So lots of packaging or no, sorry PYT Joey bogey was in the chat He's across the pond so But what time is it for you there? Are you at you're at one one o'clock in the afternoon? 11 hours early free 11 hours difference So 115 for bogey over there Bogey, you're in England, right? Like oh 1115 so nine hours. Okay. Why did I think 11? 12 for you compared to Hawaii. I don't know why I thought it was 11 hours Austria There you go Yeah, he's talking do you not see it in the chat? Oh Exit and come back in Yeah, he's he's saying isn't he's in Austria unless he unless he he blocks you from seeing his chat Maybe maybe a bogey doesn't like you Joey Well, let's see if he if you chat some more if he's if he types more see if it comes in Sometimes the chat function can be weird. There you go What was the? What was the hit draft bogey that you did last time? What did we do? What's one was it? Cool, good luck everybody first box five here 15 here Odell green Pat Mahomes touchdown Masters going to the Chiefs Patrick Fernanda Chandler Jones green Terry McClure and silver Tom Brady green very nice Tampa Bay Nick Thornton, that's weird Joey Herman Moore green John L. Way Hall of Fame green Oh, it's just another exciting surprise for you bogey when you get in the mail Russell Wilson Pro Bowl silver mosaic Mike Allstock green Chase Claypool green for the Steelers Eric Ainge Jalen Hertz NFL debut for the Eagles Mike Brzezinski Brett Farve green Patrick Mahomes MVPs for the Chiefs Patrick Fernando and touchdown Masters silver mosaic for the Chiefs and Patrick Four nebulas nice. Oh bogey says he doesn't see you in the chat either Joey So it's got to be a problem with YouTube. So neither one of you guys can see chats John L. Way green Jordan love NFL debut for the Packers and Mike Brzezinski Luke Keekley silver Bo he says let's go Chiefs. That's because he's Patrick. That's his team in the on the break Marcus, Marriota green Emmett Smith Hall of Fame green Earl Thomas green Chase Claypool NFL debut For the Steelers Eric Ainge and Joe Namath silver mosaic Warren sap green AJ Dylan NFL debut green for the Packers and Mike Barry Sanders old-school green Boomeress science and green for the Bengals going to Serenity James Morgan rookie silver Going to the Jets and Eric Joe Burrow base for the Bengals Serenity in the spot. She won for having more than two teams Devin singletary green Got game drew lock green Chase Claypool NFL debut Steelers Eric Ainge Devonte Parker silver mosaic Kirk Cousins Pro Bowl green Patrick Mahomes base For the Chiefs Patrick Bogey Kevin King green Christian McCaffrey touchdown Masters silver mosaic Rob Gronkowski green You think they need the bench drew lock Joey What do you why do you think that? Not at all. Listen. I do not like the Broncos The best of them, but I think it would be a Big error to say that he sucks. You have a stained glass through lock very nice So I'm gonna bring over all the rest of them here Cool. Good luck. I'm gonna move the camera back over so we can see the whole table Where all the bright everything is Good luck. Jordan loves silver very nice Packers Mike Krasinski Clyde Edward Tulare NFL debut for the Chiefs Patrick Luke Keekley green Jalen Hertz Eagles Mike Krasinski Terry Bradshaw old-school green Barry Sanders green MVP's Patrick Mahomes green Bogey for the Chiefs Terry McClourin green Jared Cook green Cam Chancellor green Flea flicker Colts silver mosaic Carlos Hyde green Chase Claypool NFL debut green for the Steelers Eric Martian Lynch green Julio Jones green So is there an update Joey? Is that what it was? Patrick Mahomes for the Chiefs Lamar Jackson Pro Bowl Chiefs obviously Bogey Lamar Jackson's Ravens Adam Rosenstein T Higgins green going to the Bengals and Serenity the spot she won for having more than two spots Patrick Mahomes again for the Chiefs Bogey Teddy Bridgewater silver Kirk Cousins green Still nothing Joey. I don't know man. Maybe it's us. Maybe when we go off tonight. It'll go later, dude Have a good night Jason Whitten green Julian Edelman silver mosaic got game Martian Lynch green Chase Claypool NFL debut Steelers Eric Is this an orange? I think it is flea flicker Matthew Stafford orange fluorescent For the Lions five out of 25 Detroit Lions mark nation last spot mojo Patrick Mahomes Silver mosaic going to Bogey Congrats Bogey one of the last spots available and Joe burrow green For the Bengals Serenity the spot she won Tom Brady got game Buccaneers Nick Thornton Jalen Rago or NFL debut Green for the Eagles Mike Will to win Pat Mahomes bow and Bogey and the Chiefs Joe Mixon green Tyreek Hill green Marlon Mack silver And we got an auto a gold auto not numbered but very short prints parallel and it looks really nice with the New Orleans Saints Going to Thomas Machi Like I said, it's an unnumbered, but the gold parallel is very short print. So there you go, man. You got Thomas Jared Cook green Those are boxes six through ten Deandre swift green last spot mojo for the Lions and Mark Max Crosby green to Shawn Jackson green Ricky Williams green no number on which one Bogey on The auto there's no numbering on the gold autos now It's just it's just shorter print the bait the race regular auto is the oh We got a Genesis late in van der Ech The regular auto is the silver one Dallas Cowboys Davis Serta Genesis late in van der Ech for you. Congrats Calvin Ridley silver mosaic Sony Michelle green Pat Mahomes base for the Chiefs Patrick Larry Fitzgerald touchdown Masters silver mosaic Pat Mahomes MVP's green again for Bogey in the Chiefs Tom Brady touchdown Masters the Buccaneers and Nick Alvin Kamara silver Deandre swift NFL debut green last spot mojo Lions and Mark Patrick Mahomes green again for Bogey and the Chiefs Tom Brady Buccaneers and Nick Chris Godwin green Leviska Chanel Jr silver mosaic going to the Jags and Ryan Tiki Barber silver mosaic Zach Erts green Antonio Gandhi golden rookie green for Washington and Nicholas Derek Henry touchdown Masters green Aaron Jones green Lamar Jackson Pro Bowl for the Ravens and Adam That's what I'm saying Bogey. It's kind of always like that though So I feel like it's surprising that the Chiefs were still available Pro Bowl Lamar Jackson Ravens Adam Roger Staubach green Deandre swift NFL debut silver last spot mojo mark in the Lions. Oh How about another auto this one's Marcus Davenport again? And this one's the regular silver version. So you remember the last one was gold. This is the regular auto Marcus Davenport in the Saints For Thomas Maki Juju Swiss Schuster green Troy Aikman Hall of Fame green Touchdown Masters green Eli Manning Justin Herbert NFL debut for the Chargers and Sean Marquis Brown green Tom Brady base Buccaneers Nick a silver just a regular silver Let's see if we can find it. You have five boxes left. Why not? Justin Herbert base for the Chargers Sean Matic and Tom Brady green Buccaneers Nick Patrick Mahomes green for Bogey and the Chiefs Justin Herbert NFL debut for the Chargers and Sean Henry rugs NFL debut green for the Raiders and Christopher Dick Buck has silver Jerry Rice green Tua For the Dolphins and Sean Steve Young old-school silver mosaic Dwayne Haskins green KJ Hamler rookie silver very nice going to the Broncos and Christopher Terry Bradshaw green Jeff Saturday green Josh Jacobs got game green and Joe Neymar green Jalen rego or green for the Eagles Mike Krasinski Old-school Jerry Rice silver mosaic Cole Beasley green Derek Stidham green Steve Largent silver Steve Largent green Jeff Saturday silver mosaic Joe Burrow base serenity in the Bengals Congrats Miles Sanders green Josh Adams got game silver mosaic Jonathan Taylor NFL debut green for the Colts Nicholas Patrick Mahomes got game for Bogey and the Chiefs DJ Chark green Aaron Rodgers MVPs silver mosaic for the Packers and Mike Tiki Barbara green Jim Kelly Hall of Fame green carry on Johnson green and finishing it off with a got game silver mosaic juju Swiss Schuster For the Steelers hey guys that was the break Yeah, that was 2020 mosaic football 20 box blaster pick your team break number 18. I'm Sean Jaspis case breaks calm Thanks for hanging out. We'll see you next time


South African President Siri Ramaphosa says if wealthy nations take more than enough COVID-19 shots while millions in poor countries died waiting for them, it would amount to vaccine apartheid. South Africa and India have been pushing for a waiver on some intellectual property rights for vaccines and medicines at the World Trade Organization. South Africa's president has warned against wealthy nations hogging COVID-19 shots while millions in poor countries die in the queue waiting for them. That, Siri Ramaphosa said, would be tantamount to, quote, vaccine apartheid. Sub-Saharan Africa has administered the fewest vaccines relative to its population than any other region. Eight doses per 1,000 people compared to 150 per 1,000 globally, according to the World Health Organization. South Africa and India have been pushing for a waiver on some intellectual property rights for vaccines so they can be manufactured domestically. US President Joe Biden backed the proposal last week, though it could take months to reach a deal. In a newsletter, Ramaphosa called on South Africans to support the waiver, saying vaccines should be a global public good. It is about affirming our commitment to the advancement of equality and human rights, not just in our own country, but around the world, he wrote. Ramaphosa said South Africa was one of only five countries on the African continent able to manufacture vaccines, and that there was a need for new capacity to be built. Hello, hope you enjoyed the news. Please do subscribe to our YouTube channel, and don't forget to hit the notification button so you get notified about fresh news updates.


With the constant need for adopting more sustainable practices in order to stop damage happening to the environment, green buildings are something that have been largely overlooked in India. A green building is one which uses less water, optimizes energy efficiency, conserves natural resources, generates less waste and provides healthier space for occupants as compared to a conventional building. To bring the efforts of some of the top pioneers in limelight, here we are listing the top 10 green buildings in India. CII, Surabji Godrej Green Business Centre, Hyderabad. It is the world's best example of passive architectural design. It was the first building outside of the US which has been awarded LEED platinum rating at the time of its inauguration. The USB of this building is, it does not let out any waste and recycles it all within. Infinity Benchmark Kolkata. The major features of this building are, they are furnished with CO2 monitor sensors, rainwater harvesting and wastewater recycling system and humidification controls. The exterior of the building is made of brick wall block while the roof comprises of deck thick polyurethane foam of a better insulation. Sousalon 1 Earth Pune. This is one of the unique office which is located in Pune and is designed by Christopher Charles. Spread over 10 acres, this structure is one of the largest green building projects of the country and is also one of India's first buildings to be LEED, Leadership in Energy and Environmental Design Certified Renewable Resources. The campus has 18 hybrid wind turbines that fulfill 7% of the total energy consumption. The rest of the energy demand is met from off-site wind turbines. The structure is designed in a way to ensure maximum daylight exposure thereby reducing artificial lighting consumption. Infosys Limited Mysore. This awe-inspiring green building is located in the city of Palaces. The five-story structure has been built keeping in mind a holistic approach to sustainability in five key areas including sustainable site development, water savings, energy efficiency, material selection and indoor environmental quality. Ansel Essencia 67 Sector Burgaon. Indian architects have given another masterpiece that wants to be a part of the green eco revolution. The features of this building are viable sources of energy. All electronics are made for maximum energy conservation, splendid bicycle tracks, environment benches, bins, poles and bus stops and trot-resistance campus. Eyegate Knowledge Center, Noida. Next on the list of green building is Pakni Knowledge. It is designed in a way that it captures 73% of daylight within the office. Nearly 50% of land is covered with grass which doesn't let waste and sewage water go out. Olympia Tech Park Chennai. It is the largest and most sought-after IT park. It is worldwide famous for being the first green building of its size, 1.8 million square feet and has some of the best fortune, 100 companies operating in it. This tech park has the lowest energy consumption, high natural lighting systems, 100% water recycling and other environment-friendly practices. Bank of India, Goa. A world of eco-friendly lights and air-conditioning, intelligent glazing, modern capsule lifts and indoor fountains, this sums up this popular bank in Goa. The building uses nano-misty blue, softening-colored glass manufactured by Saint Gobind glass India for producing the cool effect and saving energy. Rajiv Gandhi International Airport, Hyderabad India's sixth busiest airport, Rajiv Gandhi International Airport sets a benchmark for the green buildings in India. The structure of the airport is designed in a way so as to consume less water, electricity and conserves natural resources. Within the campus of the airport, there is a green belt of 273 hectares with numerous plants. Biodiversity Conservation India Limited, Bangalore. In 1994, BCIL was established when green building concept was foreign to all of us and it was something one could not locate even with long-danged radar. The building was established with an aim of creating eco-friendly living habitats especially in urban space. It is a wonderful example of smart homes where one can turn lights off using mobile phones. The building makes use of the central reverse osmosis system to purify water without the use of chemicals. Studies say by 2030 the Indian building stock is expected to reach 100 billion square feet compared to the existing 25 billion square feet. Thanks for watching. Drop a like. Leave a comment. Please don't forget to subscribe our channel, Design Historics. Get more updated videos from now. Click on the bell button below to get notified. See you people in the next video. Till then, it's a bye from Design Historics team.


Hello everyone this is Ahmed Daan and you are watching one of my Australia travel videos. Today I will give you a quick downtown walking tour. Forget about subscribing this channel. Forget about liking this video. Thank you for watching and I will see you shortly.