Welcome to this deeper dive into interaction experiments. Today, data from experiments on protein interactions are easily accessible, both from primary repositories, such as the INDAC database, and from secondary integrative databases, such as STREAM. If you're not already familiar with the STREAM database, I highly recommend that you go watch my brief introduction to the resource before continuing. In this presentation, I'll focus on different types of interactions, the types of experiments that they originate from, and finally, a bit on how to combine them. Starting with interaction types. What is an interaction? In STREAM, you have functional associations. You will also often encounter co-expression networks, but here I'll focus strictly on physical protein interactions. There are two definitions of what a physical protein interaction is. There's the strict definition, which is actual physical contact between two proteins, and there's the looser definition, namely the two proteins are part of the same complex. If you look at the 3D structure of a complex, the difference between the two is obvious. Not all subunits of this complex are in direct contact with each other. On top of this, you have to worry about the dynamics of interactions. You have stable complexes like the one I just showed, but you also have transient interactions between, for example, kinases in their substrates, and you have proteins that come in brief contact with each other, known as co-localization. This brings me to the topic of interaction essays. How do we in practice measure interactions? Ideally, we would always determine the 3D structures of the complexes. However, that's not possible because it's too low throughput. For this reason, we rely very much on high throughput essays instead. I'll start with the so-called binary essays, the most famous of which is the yeast to hybrid essay. The idea is that you have two proteins that you want to test the interaction of, the bait and the prey. You fuse the bait protein to a DNA binding domain and the prey protein to a transcription activating domain. If the bait and the prey bind to each other, you will reconstitute a transcription factor that can activate the transcription of a reporter gene. That way, you can read out that the two proteins did in fact interact. You also have the fragment complementation essay. Here you instead take the two proteins X and Y and you fuse them to the two halves of a split enzyme. If the two proteins interact, they will reconstitute the enzyme activity by bringing together the two halves of the split enzyme. Both of these essays measure direct protein interactions, but they have a higher error rate. Another very popular type of experiment is APMS, affinity purification followed by mass spectrometry. For this, it's important in the affinity step to get a very clean pull-down. And for this reason, people often use the tandem affinity purification approach. Here, you have a construct where the protein X, the bait, is fused to both a calmodulin binding protein, a teft cleavage site and protein A. This allows you to first do a pull-down with an antibody against protein A, then cleave off the construct, do a secondary pull-down using calmodulin, and then another washing step. This gives you very clean pull-downs that allows you to then do mass spectrometry and identify po-complex interactions. The problem is that this essay does not allow you to measure transient interactions since they will long have been lost in the two washing steps. Finally, there's proximity labeling. Most popular is the BioID approach. What you have is a reactive group that you can fuse to other proteins with an enzyme. So you fuse the enzyme to the protein of interest, and any protein that comes nearby will now get the BioID tag attached to them as a form of post-translational modification. This allows you to subsequently measure every protein that has been nearby the protein X. This allows you to identify transient interactions very well. The problem is that you get rather noisy data since sometimes proteins randomly get very close to each other, and they will be tagged too. So how do you go about integrating these experiments, and why would you? First off, you need to be aware that these different essays are not directly comparable. It's much better to think of them as being complementary, since they work well for differentiated proteins as shown in this plot. Here, I'm comparing yeast to a hybrid, fragment complementation assay, and APMS. As you can see, the fragment complementation assay works much better for transmembrane proteins than the two others, whereas the two others work better for nuclear proteins. There's thus no such thing as the perfect assay to get a good overview of all the interactions in a cell you have to combine several. To do that, you generally need to turn everything into binary interaction networks, which is trivial for most assays, like yeast to a hybrid and fragment complementation assays, since they are inherently binary. But it is a bit tricky when you want to do this for APMS data. Imagine that you have two complexes. You have ABC, and you have the alternative complex AB prime C. If you do a pull-down using A as the bait, you can represent it in two ways. The spoke representation, where you show that A pulls down B, B prime, and C, or the matrix representation, in which you link all four proteins to each other. Which one is the better? Ultimately, it's a trade-off between sensitivity and specificity. If you use the spoke representation, you leave out some correct interactions, for example between B and C and B prime and C. But if you use the matrix representation, you infer a wrong interaction between B and B prime. So it's not that one is better than the other, you have to pick what is more important for you. This is all I want to say about interaction experiments. If you want to also learn, or you can predict interactions, have a look at this presentation. Thanks for your attention.


More than 3.5 million people in Syria left their homes with fragile dreams. They had to take refuge in Turkey for a better life. They were not able to communicate with locals and neither did they have the ability to express themselves. As a telecommunication flag bearer, we developed an application that helped the communication needs of the refugees. Refugees in Turkey connected with the Turkish people and connected to life through Tüksel.


So guys there is a way to make your room of requirement a much much bigger area and today I will explain all So the room of requirement is your home within Hogwarts and well It's a place you'll come to an absolute tonne and while I've seen a lot of complaints of the place Just not being big enough I mean a lot of people want to put down multiple planting stations brewing stations Pulsion stations this and the other and while the actual main area just isn't big enough And yes, we know there is an off-room down there But did you guys know you can make this off-room much much bigger almost doubling size and today We'll explain all guys, but now I have your attention if you do enjoy this video leaving a like really helps out And if you like what you see I want to see more be sure to subscribe Okay, so as you can see this room is absolutely Humongous, but it doesn't start off this way. There's a way of making this room this big Okay, so we talk a little bit of figuring out because I didn't actually realize I knew the room was there But I never went down there and Just out of the blue. I just went down there guys and the room expanded and you're seeing this on screen now Now I've asked more people on my discord I've asked a few friends and we've come to the conclusion of how you actually get this room to open up much much bigger I thought it was tied to the beasts I thought at first it was tied to the phoenix Once you catch the phoenix for dick in a quest line for him that this room would open up But that isn't the case I've had people confirm that they've got the phoenix and that room isn't opened up I've got people confirm that the rooms opened up and I don't have the phoenix So it ain't tied to the phoenix rising quest line for dick.  I ain't 100 certain on this point But I do know completing the game will do this for you But I would like you guys to try and let me know if you've got a grapple on the grapple On comes from a mission called let me just go into my quest and all the actual part of that mission is The lord of the shore, but I'm pretty certain it is a part of The sand bakers trial. So within the sand bakers trial, you will need the grapple.  I put him in with my phoenix upstairs Try here try then see if this room opens for you after that point before you beat the last few missions of the game If not, then it's definitely tired to defeat in ramrock the last boss and completing in the shadow of the revelation But yes, this this room is absolutely staggeringly big. I mean you can put so much in here now It's easily the biggest space here. So yes, enjoy that guys But yes, if you need more space within your room of requirement This is what you've got to do now if you're just curious and watching this video because you want to know how to expand upon the room requirements in regards to Getting the fourth of areas and this and the other it's basically tied to deke now You'll first get a notification from professor weasley about the room requirement quest line Which you'll see right here And this is basically where you first get the room of requirement And I believe you first start doing main missions for deke Now these are all scrambled up. I don't know why they're all scrambled up I'd wish to wear in order be easy for me to find things But the room requirement is there so much you do this You'll get then get a few missions for deke And I believe the first one maybe the alpha nab sack and the loom where you help him Go out and battle against poachers and save beasts upon you doing this you come back to The room of requirement and he opens up your first for variant for you Upon doing this is a few more missions for him Phoenix rising I believe is the last one you do directly for him Which comes after I know the foul of the dead the foul of the dead Is one where you Go out and tame a couple of festivals and he teaches you to breed and all about that good stuff So yeah, I think that one is before the phoenix rising the phoenix rising is that the last one I believe you do for him and you go and rescue the phoenix you come back And you then opens up the fourth room for you So between the alpha nab sack and the loom and phoenix rising if you follow his quest line You will get all four for variants and well some of these quest lines are tied to the main story So if you've just finished one quest line for him and the other one hasn't popped up Just complete and keep getting on with the main quest line And also these things are tied to your level two So make sure you're leveling up at the same time and eventually guys deke will call you or leave You'll send you an outpost or You'll just get a notification within your quest that he's got another quest for you Come back to him speak to him and he should have more quest for you until you do phoenix rising And there it is guys. It really is as simple as that Well, yes, this is a room requirement and how you can expand up on it I'm not sure if that room down there at least anything it could do I'm not sure but we will see maybe if I fill up that room down there fill up this room here with more stations I just need money people. I need money But guys I appreciate you stopping by if you did leaving a like really helps Out If you like what you see you want to see more Hogwarts legacy be sure to subscribe and hopefully my beautiful people I will see you on that next one


Good morning everybody I'm Tommy O'Brien company live from T F N N 9 a.m. Eastern time Friday morning 30 minutes to go until that opening bell and hang on a second folks we're waiting for there it is NQs tick positive by two points I was waiting for it have some faith right have some faith in those NQs just like that we're now positive by five in the NQs trading at 10,732 S&Ps negative by just one point now two points at 3138 the Dow futures negative by 24 25,547 we're looking at a five minute bar the S&Ps let me back this out a little bit put it in some context of yesterday's acceleration lower from about 3170 we reach a low of 3105 overnight after the close we're up about 3155 we sell off to a low of about three in the morning in the market but check out the acceleration from about 810 this morning approaching the highs we had at about 840 S&Ps right now negative by just one point those NQs climbing towards the highs all time highs we had yesterday 10,774 NQs accelerating higher during the eight o'clock hour as well from a low of about 10,671 the high just recently 10,741 and climbing up to that level as we speak how about the Dow negative by just 13 points now a little bit of a different formation though is we're just kind of hanging at this lower end of the range and just like that the S&P is ticking positive as we speak crude oil catching a little bit of a bid with the market as well in the last hour from 3854 we're up almost a dollar off those lows at 3949 how about this market folks gold up about $10 at 1813 right now silver up 16 cents and notes and bonds we get the 10 year up a ticket 13917 we get the 30 year up 13 ticks at 1825 and checking in on where we were I believe you had that 10 year yield sitting at where are we on bonds point 596 ticking up a bit and yield as we pull back slightly terms of what else you have going on according to John Hopkins biggest day out there 63200 new coronavirus cases some stark statistics when you look at it here in terms of the US seven day average has hit a new record every day for more than two weeks I mean the seven day average it's an average it's climbing dramatically seven day average up 17.6 compared to a week ago there's your seven day average bar there's the 63,000 cases we just had stark stark numbers folks United they reached a deal with their union they're lower this morning mortgage bailout some good news falling by 435 people who are on that now at 4.41 million loans though still in that number and PPI data this morning falling falling point 2% stay tuned folks crazy market Larry Pes vento coming up live to break it all down for you we'll be right back


Yeah, so I was tasked a 30-minute presentation and wrote a eight-hour book It's somewhat challenging And since it's being videoed I have to thank my wife for her patience tolerance and acceptance With with my process.  What's wrong with this guy? but anyway, so this is gonna kind of be a three-parter and And Maybe what we're gonna cover is a clinical trial the design and the outcomes right so that's important So we'll kind of set the you know the facts of what we found in our one-year results We'll go through the components of the vert interventions really the pieces right that make it work everything that does the continuous care model On that side. We'll cover a little bit of nutritional ketosis. I think it's been covered in quite length I don't know that I could add anything new to the conversation that's either in the public or that we've Provided if you have ketosis questions, I'd be happy to answer them Then we'll go into you know I called it health coaching with purpose I figured I'd have about 15 minutes and health coaching literally could be a three-day seminar So I thought I'd pick one thing I find to as a practitioner be the most Meaningful to me personally, and I think also for a lot of people to be the most impactful really connecting with purpose and meaning in the deep sense of why for doing this and If you're not a practitioner, I think this really applies to anyone so I coach high school kids coach soccer and track It works there. I have kids I have family members that want to do any time anyone wants to make a behavior change or improve their life Anytime we can connect back to a purpose or a deep sense of meaning and why we're doing something I think that really sets us up to have the foundation to move forward so Okay, so the trial on a high level So I kind of talk with my hands so I'm kind of should have got a laser pointer, but On a high level here's what we saw and this is from two papers that we published this year So 60% of completing patients reverse diabetes, right? So that would be a 1c under 6.5% or glycemic control without the use of diabetes specific medications Okay, on average we had a 1.3 percent average reduction in HBA 1c with 70 percent of the people below 6.5 So the 70 and the 60 are a little different Some of the people are still on diabetes meds under 6.5 So we don't count that as you know full reversal yet and that so that's why those stats are a little different on Medication, you know really probably the most impactful 94% of insulin users reduced or eliminated dosages right and a lot of times very quickly I think we had a hundred percent reduction in sulfonioria use Over 50% DPP fours over 50% SGLT twos I cut that slide out just for time and I thought maybe it's not as technical a conference So it wouldn't be that interesting, but if you want the data obviously I can point you to the papers And show those slides with you to weight loss So we don't specifically market this as weight loss for it. It's diabetes reversal But people do lose weight and that is a goal Sometimes it's the main goal, but it is a goal So we saw a 12% average weight loss from start to day 365 across Population and that would have been an average of 30 pounds per patient. So it does work for weight loss as well I'll show a chart graph there The second paper we published was in cardiovascular Diabetology interesting word So we saw a cardiovascular risk improvement including dyslipidemia, right or cholesterol numbers being off So a 12% improvement in the 10-year ASCVD risk score I do have a chart that's going to kind of outline all the risk markers and all the improvements that we saw there, too So it's not gonna be a deep dive, but give you enough on that Okay, so trial design so this was done in conjunction with Indiana University Health System in Lafayette, Indiana, so it's a five-year non randomized perspective controlled study We recruited four hundred and sixty-five participants through August 2015 in March of 2016 So we're coming up on the three-year mark next year, okay? The active arm an end of 378 and we put these pictures of people up there And this is something that like I fall into the trap of doing is that I see an N number And I don't really think that these are actual human beings, right? You know, it's just like the end of ten thousand or the end of 368 and you know Really every one of those ends is a human with a story, right? Somebody trying to do something life was going on things happened On that side, so I fall in that trap So, you know anytime we can kind of think when we see a study that had humans doing something and then humans Caring for them. They just kind of gives a deeper underlying meaning to what it is 262 of our active arm were diagnosed with type 2 diabetes So we did have a percentage that were pre-diabetic Okay, so a 1c 5.7 up to the 6.5 the usual care arm So that would be your standard of care. We recruited 87 people who just continued whatever they were doing So we do have a comparison group in that side Mean age was 54. You know, these are averages Obviously, there's not probably one specific person in this study that actually is all these averages But they're meaningful for trials. So the mean age is 54 mean BMI of 40.3 weight starting weight 257 The average years of diagnosis for type 2 diabetes was 8.4 So we didn't go out and cherry-pick people who were newly diagnosed On that side and then it was 67 percent female All right, do patients stay engaged so that seems to be an issue with nutrition related trials right can people actually do it and Well, we found was yes. So 83 percent trial retention at the end of one year Obviously people drop out for many reasons could be health reasons. This is it This is a large commitment that they're making. All right. It's not just behavior change You know, they had to go to appointments and labs and see the physician And so it was a pretty large time commitment. So 83 percent of people were willing to stay engaged and continue through year one We are going to publish future papers as a huge priority for us, right? It's a five-year trial. We're not going to end here. I Can't give you the list off hand from memory But it's at least like 10 more papers that are coming out the gate here. Hopefully pretty soon All right, HBAC. So again, we had a 1.3 percent average reduction and 60 percent diabetes reversal So the average starting with 7.5. We have this number here It's 70 days because we did publish a 70-day paper to kind of get something out So even at 70 days the average got below 6.5 Then it comes down to 6.2 out at one year and then the gray line at the top Goes up actually and that would be our usual care arm So the people that just kept doing whatever they were doing and didn't make any changes It got a little worse not bad, but a little worse Okay, here's the weight change Graph so obviously started zero we get down to our 12 percent here The dash line is 5% and so that's what's considered statistically significant in a nutrition weight loss trial Okay, so anytime anyone does any intervention and gets better than 5% that's considered Excellent, so we got 12 86% of patients lost more than 5% and 61% of patients actually lost more than 10% And I don't have exact numbers, but we did have multiple patients lose over 50 and even a hundred pounds individually, right? Okay from the cardiovascular paper so examining all cardiovascular wrist bile markers that Are generally accepted as cardiovascular wrist bile markers. We saw improvement of 22 of 26 of them in the treatment Right, so that's one of the main kind of criticisms of low-carb or ketosis is yeah You can reverse diabetes, but you're gonna give them all heart disease Right and so we're showing that is not this not the case if you look at our usual care arm Zero improvement in any wrist biomarker So whatever biomarker risk or biomarker that you think is the motor most important for risk or your physician does your practitioner Philosophy does zero of them improved in the usual care All right, so what do we actually do so this will be more of the tactical X's and O's nuts and bolts Okay, so we have two sources of innovation so we have continuous remote care That's gonna be enabled through the technology. So I have a phone in my bag I can watch someone's glucose numbers ketone numbers and I can get messages from them pretty much 24 7 I do sleep right, but the system is watching them on the backside. The physician does the same thing So what we call it telemedicine platform in your pocket, right? It's personalized physician and coach care All right, obviously different than the traditional medical mark, right? Somebody goes into their doctor Make a change come back and maybe see us in a month. It's a large gap in care there So really we're using the technology to close that gap Then we have our clinical protocol. So this would be medication management, right? A lot of people are coming in on medications. They need to be monitored They need to be adjusted and then we have individual guidance including nutritional ketosis And I'll get into more we do provide guidance on other things besides just ketosis Okay, so here's how it looks So we have Wilma in the center Just she's fantastic. She's in some of our videos. I haven't got to meet her personally, but her personality is Just super super engaging and you know, I love watching all our videos So we have a biomarker tracking on the left, right?  They're gonna test their ketones We send them a Cell phone connected scale. So they stand on it and automatically imports to the app, right? That's pretty cool If someone's on hypertensive medication, we'll send them a blood pressure cuff. We want to monitor that as well Okay, that all in real time from the dotted line at the top goes to the health coach So I can see all that right. I can see somebody's fasting glucose. I can see their post meal glucose I can see their ketones. I can see their weight this morning I can see it all in real time and then they get nice charts and graphs and we get nice charts and graphs So we can see trends, right? Especially when it comes to weight trend longer term trends are more important, right? I mean like I remember my experience doing this and every employee can can do it Like I gained two pounds today. Oh my god. It's like Okay, it's not the end of the world. So long-term trends there. So the health coach then we can communicate So there's the the chat stream the message We do also do phone calls and video calls, right? It's not all technology. You know, there's certain things that 500 text messages aren't going to do right but a 15 minute or a 30 minute phone call or a video call can be very impactful, right? information Hey coach, what do you think about this recipe text? Great? Hey, I lost my job today. That's a phone call On the back end of the loop we have health coach and physician communication obviously vitally important, you know for You know just caring for people on that side the physicians do communicate with the patients, right? So they do I Don't know if there's a routine cadence for video calls, but there are video calls so in the process when someone comes in they're gonna do a video kind of like History and physical and get to meet the physician and talk about everything they need so the physician has the background Physicians gonna monitor glucose and progress and make med changes, you know Just like I monitor glucose on that side and then at certain milestones or certain points during the process the Patient is going to do calls with the physician from the physician's request and every once in a while there are reasons, you know Good reasons that a physician needs to talk to their physician, right? It's like going to see your regular doctor So we want to make that available And then down here something we probably haven't talked a lot about Patient community. So this is actually why I started at Verda So the clinical trial was going on and the idea was we need a way for patients to interact with each other right I came out of addiction recovery, so kind of well-stepped in a 12-step model and You know really tried didn't use 12 steps, but really tried to model it off the Philosophy of sharing experience strength and hope right when we get in a room with other people That have suffered through the same thing that we've suffered with we have some kind of connection and affinity Right with them already Friendships fellowship those things build so we wanted to provide a place where people could interact with each other You know and share hey Awesome things that happen right and then also not so awesome things that happen right and have it be a safe place Where they could you know not be judged and be understood and share those things and get validation and also hear other people's stories and realize I'm not the only one right you know Health issues can be very socially isolating right on that side, so I came into Verda Started that up moderated it for a couple of years, and it's a really rewarding experience You know just seeing the friendships that developed Online and then my judge of a really successful community is that people actually started meeting in real life on Their own hey, we're gonna do a meet-up in Portland. Hey, let's get together for a lunch once a week In Indiana who likes to ride bikes who wants to do a walking club all those kind of things, right? So social media is kind of bridging that connection back into the real world You know where we see kind of it's divisive on one end. Here's a positive side of it on another And then we do have a resource center, right? Self-education is big Sometimes people don't want to ask the coach right it might be 1 a.m Well, hopefully they're sleeping, but it might be 1 a.m.  We have more articles on different topics You know it's pretty comprehensive, but then we also I think the biggest thing is recipes But that's all in there anything they want to know continuously building on that It's just a place they can go 24-7 on demand to get what they need Without any assistance on that side So the feedback loop so biomarkers, so here's what we're tracking so we have ketones Via blood so beta hydroxybutyrate. We use the precision extra meter I think we've been testing out the keto mojo maybe but we're gonna track blood glucose obviously weight mood Here's what we do on a so that's quantitative and then qualitatively mood and energy hunger and cravings So there's a one to scale one to four sliding scale the patient can check in with right So again, we're looking at trends right? Oh your moods been excellent four four four four four four four four now It's one well your numbers might be good, but that tells me something as a coach Something's going on with this person. I need to reach out same for energy right hunger cravings Those are all important kind of qualitative probably the question that I ask most often is How do you feel? How do you feel? I know what the numbers are I don't know why the numbers are that way I need context How do you feel okay? Do you feel okay great if the numbers are great and you feel great? You're doing great if the numbers are great, and you feel bad something's going on. Maybe that's an early sign Okay, numbers are bad, and you feel great. That's kind of odd And the numbers are bad, and you feel bad. All right. Well, that's that's a pretty good sign there Yeah, so why how do you feel very very important? So health coaches, so what do we do you know kind on a high level we focus on nutrition and behavior change So we have a multi-disciplinary team We wanted to make a wide range of practitioners, and so we have registered dietitians nurses clinical psychologists people of varied backgrounds education levels some of them have PhDs masters those kind of things Kind of goes into phases and these these overlap a little bit So in the early months, you know we're kind of in the reversal phase right so we could take Someone that comes in with a very limited nutrition knowledge, right? What do they need at the beginning? They need to know what to do Right, so they need the plan they need the information they need the education the system's gonna walk them through a set of educational videos Right, so they're gonna do some things on their own. We've got some little quizzes in there You know just to kind of assess how they're doing in the learning process The coach is going to be there to answer questions help them plan figure out what foods they like what foods They don't like you know really kind of set that structure Scaffolding that they can begin to work in the coach at the beginning is also going to work on Behavior change it's not just long-term right we have short-term behavior change. You know, how do we plan our day? How do we grocery shop right? What time do we get up? We might be make we might be cooking more food, right? Okay, we need a lot time for that. Maybe we need to adjust some priorities all those kind of things happen, so Nutritional guidance then on the medication side that's gonna be coming from the physician So like you saw with weight loss in the a1c drop if we take somebody on low-carbon ketosis And they're doing fairly well. They can have very rapid lowering in blood glucose, right? So we need to be really on reducing those medications and the physicians are on top of it And the coaches are communicating with them back and forth on that side and then troubleshooting It's kind of a catch-all. I mean it really could be anything right in the later months so say we have Somebody's getting it and they're doing fairly well They've got a routine down. They've got the basics. They're seeing some success So we kind of shift to long-term behavior change and then navigating life events, right? There might be a life event that happens a weekend, right? Trauma tragedy stress job loss I mean, we can't really predict those things But when we get out in the longer stage with behavior change in life events Probably the I mean the recurring one in a long term where we like people to stay at least a year as you get through every holiday Those are probably the most stressful Planned events or things that we know are gonna come up on the calendar And it's like if you can get a year through and we can get you through a Thanksgiving and a Christmas and an Easter and some birthday parties and birthday cake and You know all those kind of things and you've got some assistance and support that can be very helpful on that side The later months and again We also work with this in the earlier months because this is always important at every phase We do give personal always guidance on exercise sleep stress management and also support and you know Just dealing with body image and those kind of things So I got into ketosis because I was overweight I've lost 60 pounds doing it Elevated a 1c and there were definitely times That's five years ago, but there are definitely times in the weight loss process where I looked in the mirror and saw my old self Right, I think it was just really connected with this old image of myself and that self-esteem Level that I had then would come back right guilt shame Self-hates probably strong, but it's probably a good self-description at times, right? So we help people kind of navigate them and really just hold space Right and then you know let them kind of work through those things and you know really provide validation and reassurance and emotional support So that's a really big part of what coaches do It's not just all the technical X's and O's and meal planning all those things It's really being there for someone as another human being caring for them When we look at Behavioral change techniques, so these are official words So we've cognitive behavioral therapy right which kind of kind of be summed up with Why are you doing what you're doing? Let's be aware of that smart goals, so Measurable actionable Timely all those kind of things and then motivational interviewing which I like to sum up with as a long series of asking people why over and over again And I'll get kind of more into motivational interviewing because that's really the one I like the most And that's gonna be now So usually at this point in a presentation, I'm completely zoned out from staring at PowerPoints and not listening to the person anymore So I figured I'd at least put something up there You would like to stare at and zone out too if you're not paying attention, so and that's okay if you're not So really this is gonna be more on purpose and I did kind of draft some stuff So I'll take my notes out so that I don't kind of lose my my train of thought here on this I'm more of a rider than a presenter. I had this like extreme freak-out moment when they offered for me to do this I think neuroscience would describe that as an overactive amygdala Right, that's fine. I'll just throw this up here. So I've got my little support slides So this is gonna be a little more philosophical and when I could talk about health coaching literally could be three days So I think I'd pick the if I could pick the one thing that's the most meaningful to me and I pointed on that at the beginning It's really kind of like purpose and meaning and finding our deep why so for me as a coach It was really a formal exercise that was suggested to me to do this in my practice So if you're a practitioner or a care provider or really you care about people I think it's really worth going through this process of Outlining what our purpose and meaning and why it is we do what we do I think we generally have an idea in our head We want to help people Right, but I think going through this process and really outlining it can be very powerful I heard this podcast. I don't know if you guys are familiar with Jaco willing kind of Navy Seal guy. It's pretty good so podcast one two three he had on Marine Corporal Jake Schick and I had a real affinity for him he had PTSD addiction issues trauma loss all those kind of things I struggled with a lot of those things and he said this thing and it's not really new to me or probably new to any of us Very simple. He said we're here for two reasons to love and be loved everything else is filler, right and Our family we had recently gone through a tragedy. My wife lost her oldest son On May 2nd, which kind of made this trip a little challenging But I heard that sitting out in our yard like two weeks after that You know it's kind of Jaco's podcast is pretty heavy and I'm like, you know, I was searching for something it's you know some meaning something to grasp by that glimmer of hope right in the moment of tragedy and Corporal Schick goes through a story and it's very traumatic But here he is on the other side saying we're here for two reasons to love and be loved And so that really I think is really I kind of changed what I wanted to talk about today Actually, I'm like if I'm gonna fly to Montana in the midst of all this family stuff and be away Then I actually want to say something that's meaningful that you guys might get something out of I mean, I can read slides But I mean, I don't know. It's like I got a mic. I might as well use it So it kind of reconnected me with my purpose, right? And so my purpose is being of service to others with no expectations Okay, pretty simple. I also use that as my definition of love So when I look at my wife or my kids or anyone in the room or patients, you know be of service with no expectations Right. It is an extremely difficult practice especially with children You know Admittedly don't don't do that. Well, but I think it's worth the effort and having that as a foundation for life so I think of it as kind of a philosophy of life and a purpose and a meaning that on that I Underlies everything I do and I don't always succeed, right? But I build off that foundation from the bottom to the top If that resonates with you, you can obviously take it. I didn't invent it It's not an original thought. I don't think I've had an original thought I can claim If you're not feeling that that's awesome too I really the exercise is to sit down with pen and paper and outline a purpose statement for why we do what we do Right, and if you get deep enough to one that undergirds everything in life, I think you found something really solid there Here's how I got there Right, so I had a sponsor in recovery Pretty wise guy. I picked a guy who was very successful material is successful I'm like I want what he has and then he gave me something. I didn't know I wanted He just sat down and he suggested we don't give advice. We make suggestions He's like, yeah, you might want to sit down and write a purpose statement Really kind of think about it And that was really the spark that kind of kicked off this journey at the same time, you know things kind of intertwined I was studying Buddhism and training of meditation. We have a local monastery in St. Louis, right? And it came across Four qualities of love in Buddhism. They're called the four measurable minds They're basically loving kindness, which is really the desire to offer happiness to others Compassion joy and the equanimity, which is really the desire to accept everything, right? No expectations Everyone comes as they come we accept them how they are for how they've been what they're doing today and how they will be, right? No judgment So why did I decide to talk about this today? Well, others have been having this conversation Right, I think the more in coaching and health and wellness and medicine The conversation as a whole the collective we is going less from the prescriptive and the technical, right? To how do we actually help people do this? I Have one patient who cares about the biochemistry of ketosis One it's fun to geek out with him. No one else cares, right? They want to know how their life is going to get better, right? We still have to be competent in the technical aspects of coaching, right? The X's and O's we have to know what we're doing or we can't just run out with blind compassion and not know anything That's not gonna work And I look at that and really what attracted me to Phinean volux work I look at that as the art and science of coaching Right, they have the art and science of low-carb living and the art and science of low-carb performance This is really the art and science of coaching and the art and science of living, right? We have to have competence and we have to care The most meaningful thing and Maybe that's a strong statement But the thing I get maybe get the most pleasure out of working with a patient is helping them walk through this process of finding their purpose and meaning Developing a philosophy of life and their why a lot of times it's super easy, right? Yeah, people run in that. I love my family. I love my work. I love my community. I volunteer They haven't figured out generally they do really well with behavior change, right? They have something else to go to It's usually when we don't have a real connection with that sense that things get off kilter Patients come in motivated generally by fear and pain and suffering. It was a very strong motivation But it's temporary Okay, especially when they get better Right, and that's a very common thing Come in we're super motivated. We can do anything for one two three months, right? The pain and suffering so intense and this is the same thing that happens in addiction and they call it the pink cloud phase Rapid change everything's excellent. Life is great. There's never a problem. We hit our goals This is the new normal.  And so this is when I jump in as coach and see it as invaluable Information, I know what I should be doing and I'm not doing it. Okay. Let's reconnect with your purpose And when I do a video call, I see the eyes light up and then I know I've got something And if I'm on a phone call the tone changes people like talking about their purpose and meaning they want to connect with it They don't want another meal plan. They don't want to hear a biochemistry lecture, right? They want to be talked to as a person and really connect to and find a deep meaning in life So it kind of looks like this So we set a purpose Purpose for a living purpose for doing anything we're doing we set standards, right? No expectations and also no rules I coach high school kids. They like to break rules. Adults like to break rules, too. Okay So we set standards standards are positive. They're affirmative. There's something to aim for I've never heard someone say I want to break standards ever Right, we want to meet standards. Okay, and on top we set goals Goals change Sometimes we meet goals. Sometimes goals are unrealistic goals are not a stable place to put ourselves They need to be on the top And when you look in the technical side of the standards Yes, some of those standards with behavior are going to be related to goals and maybe I could have made this like a nice circle, but I tried to make this design myself like two days ago and realized I have third-grade capability and paint and so I kind of rushed and got it to our tech guys and they gave me this nice wonderful Design so I will continue to work on it and maybe evolve it some more So if you leave with one thing Purpose standards goals, right? We have to have a purpose for doing what we're doing and Oh Last slide more information So there's our website We have a Twitter account. I have a Twitter account. I read tweets every once in a while post a tweet I write a lot of tweets that I then delete and don't post Usually Arguments I don't need to involve myself in about nutrition There's my email address. We are hiring Maybe that's the takeaway message read your tweet twice before you post it It's like Job opportunities. Here's the actual links to the papers on that side And if you do have any questions really about anything with verta feel free to reach out to me while I'm here or afterwards I mean, I think one of the reasons we come to this thing is to connect with people, right? I mean, obviously it's going to be videotaped and all those kind of things, you know But we all made an effort to come here to meet real people and I like people still so And then Christ is here. She's in the back. She actually is volunteering here as well She works for verta, so she'd be happy to answer any questions that you guys have to so if you want to catch her if I'm not around Yeah, let's Q&A Okay, thank you very much so big hand We have a microphone over there on the right if people want to ask questions Please line up and use the mic since the questions are being videotaped You know me. Thank you Linda Doug. Thank you so much for coming Especially given what you've told us about what a challenge it was to be here. So These data are astonishing and so The obvious question is how does it get scaled and I'm curious about what kinds of conversations you're having at verta About how to have a larger impact and it also strikes me listening to you that you're clearly An extraordinary coach How do we get these results on a much larger scale? Are you guys talking to insurance companies? Are you talking to the Buffett Bezos? You know three employer Effort, how do we scale it? So I honestly I'm in the room for those conversations But what from I don't I mean, I don't know if somebody knows Bezos or not, but maybe we're talking to them I don't know Yeah, on an enterprise level we do work with corporations, right? We're offered as a benefit basically through the HR packages and that's that's a really good strategy for growth, right? Employers are bearing a huge cost of medical care for their employees and then we could throw on You know absenteeism lowered performance, right if we don't have a healthy employee how impactful they're being on our business, right? So it's not just the ROI and the expense on the corporate side And I'm not anti-capitalist or corporate I mean, I have I have a tendency to believe in the good in people and I think most corporations do care about their people Obviously, that's not across the board But I like to come in with a positive aspect about everyone until I have evidence. It's different On that side generally think companies care about their people even if it is just you know, sometimes It does help the ROI and that's a that's a big point. So that's a big growth strategy I believe we are talking to insurers I think that would really open up that and then that's one problem with the current system is it's trapped by insurance Realistically and also the general public. We're just not used to paying for medical care, right? And that is changing You know, so the people that come and pay cash out of pocket they see the value, right? And maybe they also have the financial ability to make that though, right? And I think we really want to democratize health through the technology All right, we don't want this to be for the 1% all right. We want this to be for everyone on that side That kind of cover all of all the bases. Okay, okay Very impressive results that you got and I think one of the key elements was the continuous coaching model You're not sort of sporadic, but you're always there on top of it So you never let things go astray. So I have two questions about this study though I assume I'd like to know a little bit more how you recruited the patients. Was it voluntary where they selected? Did they come running to a site and how would this work in just a General population where you didn't have that voluntary sign up. The other is could you go beyond? Diabetics could you because the benefits here could apply more widely to cardiovascular benefits and and all the other benefits of ketosis So those two questions are Voluntary recruitment or you know, and then could you scale it to other conditions? Yeah, so on the recruiting that I Wasn't around at the beginning of the recruiting But I know the stories and that was a huge amount of work by our by our team to recruit I didn't realize the amount of work that went into trying to get people to sign up for a trial. It was voluntary.  We'd have little ads up I think they even ran thing ran actual TV or radio commercials Right, but those are motivated people then right so how would this apply to a group of people who weren't as motivated see? You have to be kind of motivated to get through the process to become a patient We're trying to make that easier, but there's a level of commitment, right? We do require You know, we are practicing medicine our physicians are practicing medicine. So if you go to a new doctor There's a level of effort just to go see a new doctor, right? You're gonna have to fill out the forms and you got to go and there's a level of commitment So we have the same thing here, you know, the process is really going to be they can sign up on the website You know anybody can sign up on the website But then you're gonna do a call with an intake specialist who's gonna explain the program, right? Make sure it's right for you on that side and then you got some forms to fill out We do ask people to get you know blood work done so we can baseline them if they haven't had updated labs, right? We want to track their progress There's multiple steps in the process to becoming a patient that if you're really just not that motivated and kicking the tires I don't think they're gonna make it through I would and then how about expanding beyond diabetes? Yeah so our corporate line is Safely and sustainably reverse type 2 diabetes and other chronic metabolic diseases Right, and I think I saw your talk and I think we all generally know that this works for some other things We want to be evidence-based So if sometimes maybe we get a little criticism for being a little slow into jumping into other things One we want to make sure that we build the structure correctly to do this first Right, if we do this correctly Then doing those just we've got the model. We've got the setup, right? Board we're definitely interested in those things and some of it's gonna be dependent on research that other groups do right? We could all speculate about what ketosis cures, but we are practicing medicine. So we want More evidence on some of those things, but when it comes out, I think we'll definitely be looking at those Yeah, good morning. My name is Christoph from South Africa and I'm also a health coach and I wanted to Know thank you. Firstly, I'm for the very very nice Insights and and sharing your purpose But I wanted to know how best to onboard some potential doctors Physicians, they might be referred to Very often by their patients Very often the patients say my doctor is not supporting this and is there any onboarding procedure or any Resources you have to share to get those doctors on board as well Okay, so we have a couple things so we only accept patients in the United States But we do have physician outreach Okay, so if you have a physician or you are a physician There is a page on the website. They can go fell out They kind of get on a mailing list, but that would give them the opportunity in Some cases to speak with some of our doctors right on that side if a doctor has a patient in our clinic Obviously our physician is talking with someone's primary care, right? We want to have an open line of communication I think that's the right thing to do for the patient Nothing more frustrating than when someone has four specialists and they don't Communicate I mean it just drives people nuts. I mean it's just it's not the right thing to do for people on that side So, you know, we want their primary care to know what they're doing on that side We do have a Facebook group for practitioners Nutritional ketosis for physicians and providers sponsored by Virta health I wrote that in the paper and I didn't say it because I didn't read it because I didn't want to read it but yeah, so we have over 800 people and Happy anybody that wants to join it's an open group on that side. So You


Good afternoon ladies and gentlemen, hopefully you can all see the screen and hear me loud and clear Welcome to this month's non-farm payrolls webinar on Friday the 4th of February With me Michael Houston. What I what I'm going to go through today Is some of the key chart points on the various? Markets whether it be for an exchange indices and commodities But also look at it in the context of this week's market price action, which has been Really really volatile and I think it makes it much more difficult to sometimes calibrate a direction When it comes to which way the mark is going we've seen significant pivots this week from the ECB yesterday and the Bank of England and that's prompted a significant recalibration of Potentially the direction of not only the US dollar which is on course for its biggest weekly decline since March 2020 But also I think in terms of overall Fed policy What we've seen over the course of the past week or so is Fed officials Try and dial back expectations from from March Fed rate hike and by that by that I mean is the dialing back expectations of a 50 basis point rate move We're still going to get 25 basis points. That's pretty much priced in I think the bigger question is Whether or not a Significant increase in inflation will prompt them to reverse that Patrick Harker of the Philadelphia Fed in the last few days Was basically pointed to today's payrolls report for January and Suggested Ultimately the feds not so concerned About a weak payrolls report and it's more concerned about inflation and we've seen that play out this week in The pivot that we've seen from the Bank of England not so much by virtue of the fact they hiked by 25 basis points But by the fact that four members voted for a 50 basis point rate hike now A week ago. We were concerned that the Federal Reserve Or markets were concerned that the Federal Reserve was going to hike by 50 basis points in March That expectation was dialed back By a number of Fed officials Once they came out of the quiet period, Mary Daly of the San Francisco Fed She dialed back on that Esther George dialed back on that expectation Patrick Harker as well. The Fed is concerned about inflation And so are other central banks and we saw that no better illustrated By Christine Lagarde at the ECB's press conference yesterday When she dialed back on her claim in December That she did not see the ECB raising rates this year. She refused to repeat that and then after the press conference we had a number of Solstice ECB officials suggesting that the ECB would recalibrate Their monetary policy stance in March Which prompted the big spike higher that we've seen in the euro now the bigger question for me is whether or not that signifies a significant Change of direction when it comes to the euro relative to the US dollar And more importantly for the US dollar in general well central bankers They are what I would call very Reluctant to give a significant steer one way or the other, but I think one thing we can deduce From the events of the past 24 hours Central bankers are now really worried about inflation They're worried that it's going to be a lot more persistent than was originally feared It's no surprise to me that The central banks are behind the curve And ultimately it really begs the question is today's payrolls report likely to be as important Or or is it going to be disregarded? Certainly the headline number. I'm not overly concerned about the Fed has already said that the They they think the US economy Is at maximum employment And really is a miss on the payrolls number as important When you consider that vacancies in the US economy are close to 11 million There's 11 million vacancies in the US economy So is a weak payrolls report likely to be a big significant driver when it comes to a fed Rate rise in March. No, it's not not really. I'm not concerned about a weak number I think What's more important is the participation rate Which Still shows um A significant fall from the 63.7 percent that we saw in February 2020 To where it is now 61.9 percent But wages, I think We heard it this morning from andrew bailier of the governor of the bank of england When and I had to really sort of Stop myself and listen twice When he suggested that people shouldn't ask for a pay rise Given the fact that we've got a cost of living squeeze coming over the course of the next few months I mean, seriously I mean this guy owns over half a million quid a year And he's saying don't ask for a pay rise because you'll exacerbate the wage price spiral Well, you know when energy prices are going up by 54 And tax rates are going up in april I think it sort of strains credibility to somewhat to suggest that people won't ask for a pay rise Particularly those who are most vulnerable To an energy price squeeze and you look at Brent crow prices. They're up seven weeks in a row so He's quite justifiably come under a little bit of stick for that So what am I looking for when it comes to today's? Key announcements. Well, let's look at the numbers. We've also got the canadian jobs report So that's going to be also quite important in the context of dollar cat But for me, it's really about this number here It's the average week. It's the average hourly earnings Which has gone up From 4.2 percent 4.7 percent in december And is expected to go up to 5.2 percent for january And the reason that average early earnings are going up is simply because u.s. employers can't fill The positions and if you look at amazon's numbers Last night, which saw a big market reaction after hours amazon recruited an extra 140 000 people In the fourth quarter of in their most recent quarter in the fourth quarter of last year And they wanted to recruit 150 000. They weren't able to recruit As many people as they would have liked Despite the fact that they've been paying signing on bonuses And what have you and been paying over and above what they would normally pay So the cost is going up quite significantly Now the reason the the headline number today is likely to be A fairly weak one is for any number of reasons. Obviously the omicron variant Has prompted an awful lot of people to stay at home We've also seen weekly jobless claims rise from a low of 188 000 in early december To 290 000 at the beginning of this month So we've seen a hundred we've seen an over 100 000 jump in weekly jobless claims as people stayed at home Due to sickness or absences due to people isolating through through exposure to an infected person Also the savings rate in the us People have been reluctant to go back because they needed to sort out childcare or what have you So those are the some of the reasons why You're probably going to see a little bit of a slowdown in hiring in January the big question is whether or not that sustained into february march and april and i don't think that it well Is the weather warms up people's savings run down And they're forced back in to the labor force. So that's why the headline number is not that important And that's why we didn't see a disappointing reaction on um Wednesday when adp came in at minus 300 000 even though we're expecting a plus number so for me the It's it's it's the it's the wages numbers and the participation rate, but ultimately when you've got cpi next week Um, which is likely to go from seven percent us cpi is likely to increase from seven percent to seven point three percent And the fed says it's more focused on that Then I think it's unlikely that we're going to see an outsized reaction to A disappointing us payrolls report Given some of the volatility that we've already seen this week When we saw a 26 decline in meta facebook's meta biggest one day for ever In a us big cap I mean you've got us big caps trading like penny stocks so it's you know, it really does make it very very difficult to Determine with any degree of certainty Where the mark is going to go to next? but one thing I have noted and Those of you who are regular attendees of my webinars will know I trade very much on a technical basis I look at markets on very much a technical standpoint And what we've seen in euro-dollar over the course of the past couple of days is quite significant Now this high here is quite important for me and the big question I think we need to ask ourselves with respect to this break higher in euro-dollar Is how much of it is people who are caught offside by The very sudden pivot Of the eCB and how likely is it that we'll see a rate hike from the eCB between now and the middle of the summer the eCB is clearly spooked by The inflation really I can't understand why it's such a surprise to them The eCB has as a mandate to basically target cpi at 2% Which is fine except for the fact that while German inflation or French inflation may French inflation is around about 3.8 cpi German inflation is around about 5.1 Inflation cpi in the Baltic states, Lithuania, Latvia is over 10% So how you can have a single Interest rate targeting a 2% cpi When you've got inflation at 10% in one part of the euro area and 3.8% in the other an 8.5% in Belgium and 4.5 or 6% in in the Netherlands Really highlights the challenges That are being faced by the eCB Nonetheless the northern core call the shots And we've seen a significant pivot verbally from the eCB The bigger question is whether or not we see the Deeds match the words and we're going to have to wait till March for that Meanwhile, the Federal Reserve is still Tapering they're still adding to their balance sheet But the bond markets have already made up their minds and you can certainly see that being played out in the German two-year yield here which Has absolutely surged But it's still negative I mean it's still negative, but at the beginning Of or the end of January. It was at minus six minus 0.65 percent. It's now minus two 0.29 and this is Over one year. This is over five years Okay, so over the last five years We are now trading at five year highs for German yields, and they're still negative on the two year 10 year has just gone into positive territory If you look at Italian yields Here The spread differential between German 10 year And Italian 10 year has blown out to its widest level in nearly a year So that tells you that The eCB is playing with fire a little bit in terms of the borrowing costs for the weaker European nations so We're seeing a move higher in euro dollar the big test for me today will be whether or not we break above 11480 It's significant that we weren't able to take out that previous high So today's payrolls report could be the catalyst That weakens the dollar further and pushes euro dollar up away from this What looks like A short-term base And if we do break above it, then we could see stops triggered All the way back to 116. So at a key level on euro dollar at this point in time So really strong wages number Could give the dollar a little bit of a kick Going forward and we could see the euro drift back down again A weak wages number could push euro dollar higher So the wages number, I think for me is the more important of the data points along with the unemployment rate, of course In terms of the s&p 500 what we're seeing with respect to the s&p is the weakness that we've seen over the course of the past Couple of days is threatening to unwind the rally that we've seen off the lows of the end of january And we're also Trending back towards the 200 day moving average that we've broken above So we're at a very key juncture with respect to the s&p 500 So i'll be interested to see whether or not the the move that we're seeing towards the downside Breaks back below the 200 day moving average. What's particularly important Very is the behavior of the nasdaq Because we haven't Broken through the 200 day moving average on the nasdaq And that's making things very very complicated when it comes to trying to determine an overall direction for us markets and it's you know i i This is the most difficult market that i've ever had to look at over the course of the past five to ten years Because of the volatility alone. I mean when you get the seven percent down move in amazon One day and then you get a 15 up move in after hours These are huge price swings Which means that in terms of the overall long-term direction It's very very difficult. What I would say is while we're below 15 500 I'm still of the opinion that we're selling the rally on the nasdaq Because we're getting lower highs and we're getting lower lows How you trade that in between is very very difficult Which means that levels are even more important now than they ever have been before so If we do get a rebound back to 15 500 on the nasdaq You've got to be a little bit suspicious as to whether or not we can sustain that given the fact that momentum Is starting to roll over you're getting as I say you're getting lower highs and you're getting lower lows So we need to first and foremost take out this high here We also have to take out that resistance here on the nasdaq and given that we've got what have I done? Goodness gracious me. I've just moved away from it. There it is So so basically give it given where we are at the moment given the fact that We've got significant inflationary pressures coming through Investors are becoming increasingly nervous about the ability of companies to keep Generating the types of profits that they have been generating over the course of the past two years Um, so that's the nasdaq now before we get to the numbers And here they come now the unemployment rates ticked up to 4% And the headline number has come in Let's just 4% let's get rid of that minus 200 000 Forecast well that's interesting. That's can I that's canada to get rid of that 5.7% on average earnings which was Which was much bigger than expected. That's a big big jump and 467 on the headline number Yeah, I mean this is This is absolutely amazing number For the payrolls number because we've gone completely the opposite direction to ADP Coming at 467 Well above expectations and the wages number has gone up to 5.7% We're expecting 5.2. So very much a dollar positive number I lost track of time there. So I do apologize for that And as we've seen we've seen a positive dollar move towards The upside and there we go So the likelihood is we'll probably track back down to the support level around about 1412 Unemployment rates risen to 4%. Let's look at the reason for the rise in the unemployment rate I'm checking the participation rate The participation rates jumped up from 61.9 to 62.2 So that's why the unemployment rates edged up a little bit. So that's not necessarily a bad thing It basically means that Starting to see more and more people And come back into the workforce and start looking for work So move higher in the unemployment rate is not something to be overly concerned about So the knee jerk reaction is to push the push the euro lower And the likelihood is that we'll see probably another Another retest of these highs here But I would suggest that we've probably seen the highs for the week for euro dollar on the back of those numbers there I wanted to go through the rest of the indices numbers on the back of that But certainly we're starting to see wage pressure building in the u.s economy so Good payrolls number Rising wage pressure the participation rate is risen And the unemployment rate has risen. So It's not a bad payrolls report. It's a really good payrolls report and it also feeds into a narrative To the fact that potentially you'll start you probably will start to hear more chatter About a potential 0.5 percent move in the fed funds rate in march The chatter that an awful lot of fed policy makers started to dial back on You could start to see come back into the overall discourse. Why? Because you've got the ecb and you've got the bank of england potentially talking about Attightening a policy going forward and this is really what it's all about. It's the ebb and flow And now suddenly they've changed The number what is going on there? Let me just double check my Reuters not my Reuters my Bloomberg because My Reuters has just changed to 3.4 and now they've changed the payrolls number. What is going on? All right, bear with me Reuters have given me completely wrong numbers on this So Bloomberg, let's go let's go again This is embarrassing and I apologize because the Reuters data on my platform is basically changed Recap 467 Bloomberg for non-farm payrolls. That was the initial correct number For some reason it changed. I have I do for not for whatever reason. I do not know The original numbers it appears do look as if they are correct And the payrolls The wages numbers were correct in the first place. So for whatever reason best known to Reuters they pushed through Changes to the numbers which weren't right. So my apologies for that the initial numbers were correct I don't know why the numbers changed and we're back to where we were. So it says you work Do you does anyone have any questions? On anything that I haven't already covered We're going to move on to cable now because one of the things that We've seen over the course of the past few days is that the pound has weakened quite significantly and one of the things that I have noticed is that There's significant resistance around about the 200 day moving average Now if we draw the line on this chart here The weakness in the pound does worry me a little bit relative to the euro because it does suggest That perhaps the dynamics are changing in euro sterling And it's certainly borne out by the fact that we haven't been able to sustain a move above 136 Now there we go. We've got it confirmed on my Bloomberg there 467 so all of that that data that came out later was just complete nonsense Just clear that there So it looks to me as if we're getting a bit of a rebound back in the dollar Move back down to potentially the 50 day moving average And euro sterling looks as if we're probably going to see a move higher On on that particular number there Getting a little bit of weakness in equity markets as well Which is not really surprising when you consider the strength of that payroll's report Because it's going to feed into potentially a much firmer US bond market. Let's have a look at the reaction In the US bond market in terms of the the us2 year Because that was already starting to trade higher on the back Of potentially firmer number and we're now on nine basis points up on the day 128 57 So we've moved even higher on the back of that payroll's report And we'll be able to see how that's played out There so the strong payroll's number has seen a big spike up in US treasury yields from around about 122 to 126 on the back of those wages numbers So again, that's why we're seeing the move higher in the dollar Markets are starting to price in potentially a much more aggressive fed in march So all that damage limitation that we saw at the beginning of the week From Fed officials is now starting to unwind again And now the 50 basis point rate hike that have been taken taken off the table At the beginning of the week is now starting to make itself felt In the short end of the us yield curve And we're seeing it playing out in the NASDAQ here because we're now falling back again on There you go there So it's high yields Weak in NASDAQ And it's playing out quite nicely On the futures as we get ready for the us open All right any questions on anything that I haven't covered. I'm going to go into natural gas now In response to a question that I just got there now. This is interesting because This suggests that we've seen the top in us natural gas If we look at the reaction here and compare the reaction here They do have startling similarities And that would suggest that perhaps We're probably going to start to see natural gas in the us start to track lower the next key support Based on the technicals for natural gas it's going to be Through these lows around about 484 Let's drill down into that slightly more detail And there we have it there this looks like potentially a little bit of a head and shoulders On the alley chart So you could draw a potential neckline through these lows through here With a potential break So that's your left shoulder. This is your head It's forming a bit of a right shoulder through here and as long as we stay below these peaks around about 520 And break below here. We could get a measured move from the highs Down through here to around about the lows all the way back here on 390 so on a technical basis on the alley charts you could potentially see Further weakness in us natural gas prices if we get a break below this series of lows through 480 So does that sort of make sense? I'm hoping it does but from a technical that's from a technical basis. That's probably potentially How I would look for a natural gas setup either a rebound back Above this five dollar five five ten area here for a move back down Or a potential break lower With a measured move down from Here to around about 420 on the natural gas So hopefully that makes sense from a technical point of view on the natural gas prices Looking at Brent crude I think potentially we're on a bit of a one-way trip towards 95 and potentially 100 dollars a barrel On this technical breakout that we've seen here So if natural even if natural gas prices start to drift off The fact that we've broken higher on Brent crude And we're we're up to seven weeks in a row Suggests we're probably going to continue to edge higher over the course Of the next few days now. That's not to say that we can't see a pullback towards 90 dollars a barrel but If you look at it on the daily charts We've seen the impulsive moves through the recent highs And we're continuing to track higher above the previous highs from Back in October And we haven't really seen much of a pullback in the interim and it's hard to see how OPEC Or anyone else for that matter Can stem the move higher unless of course we get an element of demand destruction And demand starts to drop off and the only the only way you're going to see that Is if the economy starts to snow slow significantly As we head towards the end of q1 and the beginning of q2 and that is quite like that that is a possibility obviously So that's something that we do need to be aware of But on a technical basis Brent crude does appear to be breaking out towards the upside Any other questions ladies and gents? A bit short on the questions front at the moment Does anyone have anything any particular interest in a particular market? Over the course of This this particular This particular presentation How low will the Aussie go? Oh, well That's a that's a very decent question. I suppose it really depends on whether or not you think that The dovish bias of the rba can hold There's the key support level thomas And if we drill all the way back You can see where the big big chart point is it's 69 90 I would be very very surprised If we get a break below 69 90 For me the the risky side for the Australian dollar Is towards the upside why do I say that because I do not see how the rba can continue to ignore The risk of higher inflation I currently it's got fairly what I would call fairly dovish bias But at some point they will have to bow to the inevitable in the same way that the ecb is And bring forward expectations for a rate hike into this year We're getting a bit of a pullback at the moment We've seen this bullish reversal on the dailies here So for me Given how the importance of this These 2020 lows I would suggest that The downside risk is limited now obviously if we break below 69 90 I changed my mind And then I rethink My stance But at the moment despite the fact that this is clearly in a downtrend On the balance of risks Yes, there will be big stops below 69 80 So if we go through 69 80, you're going to get a big correction to the downside But as long as 69 90 holds Then I think for me the risk is For a return to 72 70 72 80 so I'm still of the opinion that the the risk trade Is buying the dip with a stop below 69 80 on the ozzie dollar So hopefully that answers your question on that Do I see gold rising with the inflation situation? um In short, no I don't um We are currently with respect to Gold very much In a sideways consolidation We can see that here. There's pretty solid support around about 17 60 What i'm struck by is the fact that Even though we've seen a big big move higher in yields Gold prices have managed To be fairly restrained in their decline So that would suggest to me that the downside is limited to properly round about This area of support all the way through here And if we do get a move to the downside, it's likely to be constrained by either this line here or this line here We're in a range for gold And I really don't see that changing if you look at where yields have gone And what gold has done Gold has been fairly well behaved Relative to the move higher in yields. So I while I see some downside in gold I don't see it Going down too far, but at the same time I don't see it rising too far either You know, it's in a range and you can basically define that range by these two blue lines here And trade that range accordingly so So that for me, I think is You know the the key component here when it comes to the gold market now the asex 200 Let's see and find the australian index here So This is a very interesting chart I haven't done an awful lot of analysis on it, but What I can do Is basically do No, that's not particularly good line that This however is Probably a better one I think if you've got weakness in equity markets more broadly the asex is not going to be immune to that You You've got to really Get back above 7200 why because it was a fairly decent support level all the way through there And as such it's trading in a similar way I would argue to pretty much every other index Um, you look at the nasdaq you look at the s and p 500 You get a really strong rally off the lows We're starting to roll back again On the back of the weakness that we've been seeing more broadly so You know while while you trade the ozzy I think what you're doing in terms of the ozzy dollar is you're trading interest rate expectations on the back of the rba You know, I don't think you can really sort of link the ozzy and the asex to the same To the same level as as previously you've got to basically Compartmentalize them You know and for me with respect to the asex It's going to struggle to get back above this this resistance level here While you've got the weakness more broadly In all the other equity markets worldwide I don't think there is um You know what I would call A Correlation between the two that's the word I was looking for was looking for the word correlation between the two That makes sense. So, um I was very much by the dip in the australian dollar On the basis of a hawkish shift by the rba And basically trade the asex in the same way That I would trade the nasdaq and the s&p Because the charts aren't completely dissimilar over the course of the past couple of weeks. We look at the s&p here We've seen the big rebound off the lows and now we're starting to roll over again And now we're retesting the 200 day moving average So hopefully that answers your question Any other questions ladies and gents? On this play rolls friday So just to recap Let's keep an eye on the inflation numbers Next week out of the u.s economy on the 10th We're expecting headline cpi To move up from 7 percent to 7.3 and core prices to rise from 5.5 to 5.9 Beware of a six-handle there Because then once again We'll get increased chatter About the risks Of the fed going slightly bigger I mean who would have thought that the bank of england We were four four bank of england policymakers would vote for 50 basis points So I think it gives you an indication of how spooked central bankers are and when you hear Andrew Bailey talk about Not asking for pay rises and then you see U.s average hourly earnings Jump from 4.7 to 5.7 percent That gives you an indication Of the mindset that central bankers Um are going through and they will be speaking to each other so You know, we're talking one month from now or six weeks from now because the next fed meeting is mid-march Which is another payrolls report Between now and mid-march Then of course you've got the bank of canada as well the bank of canada could well raise rates at their next meeting um, which comes over the course of the next Four to five weeks It comes before the fed meeting So keep an eye on 128 on dollar cad. That's a big big level there We saw a big move higher there on the basis of a poor canada report and a weak Poor canada report and a strong A strong u.s dollar report As we can see there, but 128 is the big level on dollar cad So keep an eye on that um And obviously we've also got Um some fairly decent we've got got some important numbers coming from bp Which will basically feed into the oil story But also we've got unilever glaxo smith kline astrazeneca and Pfizer next week. So there'll be a pharma story as well um, so I think that's it for this week unless anyone has got any other questions. They'd like me to address otherwise, um I'll um, wish you all a great weekend And we'll pick this up same time same place next month when we come to visit the february payrolls report Um, when we'll have another look At the wages numbers and see whether or not the upward pressure in inflation repressures for wages has continued And say the u.s economy is 5.7 percent now Will we move up to six because it would appear that wages are now starting to play catch up When it comes to the inflationary narrative. So Thanks very much for listening guys. Hope you all have a great weekend Speak to you all same time same place next month and um, sorry for the data Anomalies there, which shouldn't have happened and which may have um Muddied muddied the messaging if you like


We will be entering escrow next week for the final purchase of the hospital and closing all transactions by August 31st and turning the ownership of the hospital to the Paro Valley Healthcare District to the hospital to them on September 1. So very exciting news after a lot of effort over the past year. Can go to the next slide. So just to give a little bit of background, the Paro Valley Healthcare District project, this is a non-profit of which the county, the city of Watsonville, Salud Padlajente, Paro Valley Community Health Trust are all members of, was formed in November of 2021 to purchase the hospital and return it to community ownership and operation. In December, Watsonville Community Hospital declared bankruptcy and so not worn notices. February 2022, the bankruptcy court approved the Paro Valley Health District project that is the non-profit, which I am a member as the lead bidder and finalized the sale. That was a very big moment that we were able to finalize that sale agreement. And then urgency legislation was approved to form the Paro Valley Healthcare District. Thank you to especially Senator Laird and Assemblymember Rivas for leading that effort. Truly a remarkable effort to do such a quick turn around on that legislation. In March, the county board of supervisors established the Paro Valley Healthcare District and you appointed five district members and they have had, they have had a very robust schedule. I've already had 15 meetings to date. The Santa Cruz County, we are providing the staffing to that district. We are, we have fully stood it up, including providing the legal work, the accounting work and then all of course, all of the staffing work. So there's probably around 15 to 20 staff that have been working a lot on standing up this healthcare district in such a short time period. So the project and the district has developed a business plan with a number of very well thought of consulting firms to turn around the hospital in the next one to two years. That there's been a great deal of work in turn making sure that there's a viable and sustainable path forward for the hospital. It is going to be very difficult. It's a very difficult healthcare environment statewide, nationwide, but we have a plan that we think is going to be successful and it's the best plan that we could have developed and the county has contributed to that as of other community partners. On August 31, as I mentioned, the bankruptcy court has established the date to close the sale. We will be entering escrow, we believe next week and then the close will happen on the 31st. Go ahead and next slide. The hospital, we have set a goal of $67 million, which includes the acquisition price as well as the operating capital needs for the hospital for the first year of operation. The Potter Valley Health District project and other partners have come together and we have raised $60 million to date. This includes $25 million in a delayed state grant award, which is the subject of our meeting today, that $25 million. There's a $6 million remaining funding gap. This is mainly the operating capital needs. We do have the funds sufficient to close the acquisition and complete the purchase. So we anticipate getting the additional $6 million to cover the operating reserve by the end of September. And to come around to come together around the $25 million delayed state grant community and city partners have come together to create to create these loan agreements to serve as a bridge loan to get the money to the hospital. Next slide. So we have requested various city and community partners to lend the county $25 million each. We will guarantee those loans and then in return, we will turn those funds over to the health care district project to finalize the purchase of the hospital and return it to local ownership. The $25 million from the state grant, this was secured due to the efforts of Senator Laird and Assemblymember Rebus. There were some drafting errors when state budget staff wrote this up in the state budget in such that it is going to have to be amended the language in a trailer bill, which will not be approved until we think August 31st, at which point the governor will sign it. We have been touched with the administration. They said that they can get us the money within two weeks of the budget being approved, so that would be mid-September. The problem is, is the $25 million is crucial to the final purchase of the hospital. We have to have it before August 31st or before mid-September is when the money will come. So that is why we have asked our community partners and city partners who all have a key stake in keeping the hospital open and sustainable. The entire community does, and I'm really grateful for each of them stepping up and agreeing to do this. They each provide short-term loans of 60 days or less. They will charge a very low or no interest. The interest will be the local area investment fund rate, which is a state fund that most of them invested, which is about 1.2% right now. We could have gone out and got a private sector loan from a private bank, but the cost estimates were in the excess of a quarter million dollars for up to 60-day loan for $25 million. So that would have been really tragic to have to spend that kind of money just because of some errors at the state level with regard to how the language is written. So that's why we've done this. It'll be a very minimal cost and we'll be able to get the $25 million into escrow. Next slide. So this is our recommendation that the board approve these five million-dollar short-term loan agreements between the county and city and community partners to provide bridge funding for the purchase of Watsonville Hospital and that you authorize minor changes to be made to the cost and administrative provisions of the agreements with the approval of the county administrative officer and county council in order to accommodate any special requests from our partners and that you also approve the transfer of the loan funds to escrow to the escrow account established to close the sale of the hospital to the Bonneville Health Care District by August 31st. That concludes my staff report. Thank you very much. Thank you, CAO Palacios. Are there any questions or comments from members of the board? All right, seeing none. Is there any member of the public that wishes to address us on this item? Seeing no hands raised, if you do wish to make a comment, click the raise hand button at the bottom of the Zoom screen. All right, seeing no member of the public that wishes to comment, I'll return to the board for action. Mr. Chair, I'll move the recommended actions as you know, nothing that really matters in life is particularly easy. And I think that this is is a challenging situation. But I think we're doing everything we can to ensure the health access for our entire county for not just actually our county, but even Monterey County be preserved. So I'll move the recommended actions. And I believe Supervisor Caput seconded it. You bet. The only comment I'll make is if we take out the loan, five million dollars each, twenty five million total, everything looks good to me. But you also have to look at what if the deal falls through? What if we don't get the twenty five million, you know, what would happen then? Yeah, so the money has been approved in the state budget and signed by the governor. So it's there. It's just they made a minor drafting error in writing up the language at the state level, the state budget staff. And so they have committed to us that they're going to correct that language. And so I think this is about as low risk as you can get. There's always a risk, but, you know, it's less than one percent, that's a for sure. And I think we will have the money by mid September. Yeah, but to any time you're dealing with money, there's a better risk versus a better show. Thank you. All right. We have a motion by Supervisor Friend and a second by Supervisor Caput to accept the staff recommendations. Any further discussion? Most important health care issue we can address in Santa Cruz County. Congratulations and a big thanks to those who participated. Yeah, I'll also extend my thanks to staff for just constant level of creativity and overcoming these challenges. There's been numerous, but keep keep getting us over them. And it looks like we're close to the end here. And having met the management team at Watsonville Hospital, Stephen Sawyer and crew, I mean, it's clear that we've got a good mix down there of experienced turnaround artists like Mr. Sawyer himself, as well as long time dedicated employees of the hospital that just really know the community and the operations there. And I think we've got a really great opportunity to turn the hospital around and I'm excited to finally get to the moment where we truly transfer this organization. Yeah, one one more quick question. There's still a six million dollar gap, right? Even after the 25 million and is there a deadline on that? Yes, we have we do have the secure. We have secured the funds to actually to complete the purchase. So the purchase is going to happen. The question is that we wanted to have at least 10 million dollars of operating capital for the hospital to get through the first year of operations to give them time to turn around their operations to be in the black. We are short about six million dollars for that goal where we've set in a self-imposed goal by the end of September, raising that last six million, and we believe we will be successful. It's amazing the amount of community partners and businesses and nonprofits and statewide and local businesses have and individuals have all come forward to help us and we're confident we'll get there and by the end of September. All right, if there's no further discussion, please call the roll. Your eyes are friend. All right, Coonerty. Hi, Caput. Hi, MacPherson. Hi, and Koenig. Hi, item passes unanimously. Thank you. And that brings us to the end of our special meeting agenda. The next regular meeting of the Board of Supervisors will be next Tuesday, August 23rd at 9 a.m. Thank you, everyone. Thank you, sir. Thank you, everyone. We'll see everybody to this. Thank you. Thank you. Recording stopped.