Okay. So again, good afternoon to everyone. Let's continue our discussion now with your ESR. So, ESR is also known as your erythrocyte sedimentation rate. So, ESR, I just want it to be very, very clear at this point of time ha, ESR is a non-specific marker of underlying inflammation. So, when I say non-specific, your ESR could be a screening test but never as a confirmatory test. So, a lot of different conditions in our body, both pathological and it is order and diseases, some type would have ESR that is abnormal. Okay. That is abnormal. So, ESR, as you can see, is the sedimentation rate. So, what do we mean by that? This is the rate of fall of every RBC that will now settle from the top of your tube going to the bottom of the tube. So, the sedimentation rate, please remember this, is directly proportional to the weight of the cell aggregate and inversely proportional to the surface area. Directly proportional to cell aggregate and inversely proportional to your surface area. So, why do we perform ESR? Okay. Why do we perform ESR? So, as you can see, ESR is a non-specific marker. So, when I say marker, an abnormal ESR result would actually signal that there is something abnormal inside your body. Okay. There is something going on in your body that is actually not aligned with the usual scenario or the usual pathophysiological processes in your body. Okay. In your body. So, with regards to ESR, you would hear it even in immunology. You would hear it in hemacology because it can actually give you a reflection of both anemia and also inflammation. But before we dig deeper into the different conditions and the different considerations in performing your erythrocytes sedimentation rate, let us first discuss the stages of your ESR, which are, number one, the log phase, the LAG phase. Or di ba parang yung growth lang ng ating mga bacteria during poulture, di ba? May log, may log, may platu, di ba? Same thing with erythrocytes, we also have different stages. Okay. The first one is the log phase, the decantation phase and the last phase would be the sedimentation phase na. Okay. So, the first phase, which is the log phase, happens in the first 10 minutes. Okay. And then the decantation phase happens in the next 40 minutes. And the last stage, which is the sedimentation phase, happens in the last 10 minutes. And if you're going to add all of this, ilang minutes lahat, this is 60 minutes for a total of one hour. Which would now lead me to the answer that into another point that I want to make, that your erythrocytes sedimentation rate is the rate of your RBC sedimenting within an hour. Within an hour. So, that is one hour. That's why, kapag sa laboratory, ESR cannot be considered or should not be stopped. Okay. Hindi pwede niya stat yung ESR. Ano to halogin mo? Bilisan nyo. Yung siya cheer up mo yung mga ESR. Okay. ESR, let's go. Let's do this. Let's do this under 30 minutes because doc will get mad. Hindi ganan nyo. Okay. You have to really wait for one hour. But later, as we go along, may isy-share ako sa inyo ng mga advances in ESR na dati one hour ngayon 45 minutes na lahat. So, moving forward, let's talk about the different stages. So the lab phase will now be the rollu formation. Hindi to rollu formation. What happened during rollu formation? Your RBC now will start to aggregate or at magdidikit-dikit na sila to one another. Okay. They will be joined together na. And then the decantation phase, which is the next 40 minutes, would be a more rapid and constant sedimentation. So meaning to say, after your RBC already have formed rollu, it would now be easier for them to fall down. Gravity. Okay. And then the last 10 minutes would now be a slow. Why? Why slow? Because almost all of the RBC have accumulated in the bottom of your tube already. Okay. Bottom of your tube already. So please take note that using a longer tube, okay. If you're using a longer tube, the longer the decantation phase would be. Okay. The longer the decantation phase would be. So those are the three. Lab, decantation, and sedimentation phase. Okay. Let us now move forward to the different factors that would affect your sedimentation rate. Okay. Your sedimentation rate. Let's now talk about the intrinsic first. When we say intrinsic, something is wrong in the RBC. Something is wrong with the blood or the plasma. That is the reason why there is an abnormal ESR. Okay. There's an abnormal ESR. So let's start with the intrinsic factor. So intrinsic factors are any inherent factors that comes along with your specimen, either your RBC or your plasma. So number one, okay, is the number of RBC per cubic millimeter. So this is inversely proportional to your ESR. Okay. RBC count down. Okay. What happened in your polycythemia vera? Increase, decrease, thumbs up, thumbs down. Increase or decrease RBC count in your polycythemia vera. Increase, decrease, increase, correct. Increase sa PV. In your anemia, it is decreased, obviously. Okay. So meaning to say, slower ang ESR, kapag polycythemia vera, the anemia is faster ESR. As you can see, kaya siya ang gamit natin adjective is either slower or faster because we're talking about rate. Okay. We're talking about the rate. Okay. Hindi ko sinatabin increase, decrease, because we're talking about rate. Okay. Mas mapilis, okay. Kung narin, pag sinabi natin faster, that would be around 40 millimeter per hour, ganon. Okay. So slower and faster yung parameter natin dito, ha? So in your RBC count, okay, the more RBC, the slower, which is, bakit ganon, sir? Okay. Bakit pag mas madami, mas mabagal? Kasi siyempre, siksikan sila, nisila agad makakababa. Unlike your anemia, okay. Parang mag-isa lang siya dun, babagsak talaga siya agad papunta sa baba. Okay. Papunta sa baba. So that is for your RBC number or RBC count. Okay. Let's talk about RBC size. Let's talk about RBC size. RBC size is directly proportional naman. Okay. Directly proportional with ESR. What do I mean? The bigger the cell, the faster the ESR. Okay. RBC ya. The bigger the RBC, the faster the ESR. The smaller the RBC, the slower the ESR. Bakit ako ko ha? The slower the ESR. Question. What parameter can I use to check if your cell are macrositic or mormositic or micrositic? What can I use to check if? Ay, mabigilis. Okay. It's your MCV. What is the upper limit? Okay. I can say it is macrositic. Kapag ilan? I may naglagay ng 100. Okay. The answer is? But why 100? Okay. May naglagay. May naglagay. Ataman ang pala. 100. Okay. Greater than 100. Okay. Greater than 100 femtoliter. Would mean it is macrositic. Okay. Normal yan. Normal yung less than 100. Okay. It should be greater than. Okay. Greater than 100 femtoliter. Pag less than 80 femtoliter. That is your microsity. Okay. Very good. So again ha, RBC size is inverse, is directly proportional. Mas malaki, mas mabilis. Mas maliit, mas mabagal. Bakit mas malaki? Di ba ang saka mabagakagad? So yan. Talk about RBC shapes. Okay. What do we call the variation in your RBC shape? What do we call the variation in your RBC shape? We call it shape? Okay. The answer is? Okay. Point kilo cytosis. Okay. Point kilo cytosis. Correct. Okay. Question. In the RBC indices. Okay. Tingan natin kung may nakakatanda pa. RDW would reflect A. Point kilo cytosis. B. Anisochromia. Or letter C. Anisocytosis. ABC. Dancer is? Okay. Ang sagot po ay? Anisocytosis. Okay. RDW, guys. Ayan. May very good. RDW, anisocytosis. Okay. Anisocytosis. Sir, ano yung anisochromia? Anisochromia. Difference in the color of your RBC. Okay. Difference in the color of your RBC. Tatang nang obatan na. What is the last stage capable of mitosis? Pero masado ng malayo. Okay. Bakit isumpan nyo nako ng turu yan? Okay, yung pro-base o poly-ortho natin palatandaan sa RBC maturation series. But let's go back here. Okay. In the shape of your RBC, any abnormal or irregular shape would hinder rollu-formation. So kapag pinigilan mo yung rollu-formation, matatagalan ka. Okay. So ibig sabihin any point kilo sites, any presence of point kilo cytosis would now cause a slower ESR rate. Okay. Slower ESR rate. Okay. Are we clear? So far? Clear? Clear, clear, clear? Okay. My next slide will be the marriage of clean chem and hematology somehow. Why? Okay. Your plasma proteins. Remember, your plasma proteins Okay. As you all know, sabi ko nga, your ESR are usually used to check inflammation. These are usually done. Your ESR is done to check the presence of inflammation. So as you can see in your plasma proteins, we have acute phase reactants. Okay. We have acute phase reactants.  Question. Is albiumin a positive or a negative acute phase reactant? Positive or acute phase reactant? Okay. Negative. Okay. Correct. Ay. Nagaral na sila. Okay. Correct. Aside from aside from albiumin and transtyritin, what else is the negative acute phase reactant? Aside from pre-albiumin, aside from transtyritin, aside from pre-alb. Okay. It's your transferring. It is your transferring. Okay. Trilang po sila. Or tatlonga lang sila. Your pre-albiumin or transtyritin, albiumin in your transferring. Okay. So only three. So moving forward, okay. Moving forward with that. As you can see now here, guys, pag may inflammation, faster ang ating, okay. Pag may inflammation, faster ang ESR. Pag walang inflammation, normal yung ESR obviously. Okay. Normal yung ESR obviously. And as you can see, globulins faster. Why? Globulins in general are your alpha one, alpha two beta and your gamma. Your fibrinogen, which is abeta globulin also causes faster ESR. So nakikita ninyo ha that the positive acute phase reactant would increase your, would increase your ESR. Pwede paulit kong mabilis po kapag may inflammation. Um, your ESR rate is faster in the presence of inflammation. Okay. And siguro tatanungin ninyo ako. Sir, pano naman po naging mabilis dahil sa inflammation? At sasagutin ko kayo, this is because of the presence of your positive acute phase reactant. Make sense now? Okay. So at least alam yung ngayon na yung ESR mo mabilis dahil may inflammation. But what about that inflammation that increases my ESR? It is because of the presence of your acute phase reactant. Okay. It is because of the presence of your acute phase reactant. Am I clear now? Okay. Am I clear? Okay. Thank you. Okay. Okay. So those are the plasma proteins. So remember daloong plasma proteins lang ang nagpapabagal less citin and albumin. Okay. Let's move forward with the viscosity. Okay. Viscosity of your plasma is inversely proportional to your ESR. Again, your RBC viscosity is inversely proportional to your ESR. The more viscous, the slower the ESR. Paralang yang take for example water. Water would move faster in your capillary ang capillary motion ng less viscous natin would flow faster. Unlike in your unlike in your in a more viscous solution, mas mabagal magfuflo yan. Okay. Kasi nga viscous siya. Okay. So in your viscosity with regard to your viscosity inversely proportional sila. Wait, wait, wait. Parang ternosilanino. Ternosilani RBC count. Okay. Ni RBC count. Bakit? In polycythemia vera ladies and gentlemen, polycythemia vera is also characterized not only with increased RBC but also with increased blood viscosity. Okay. Okay. Okay. So polycythemia vera increase yung RBC mo increase pa yung viscosity. Okay. So moving forward. Okay. Kani nakapamooving forward, sir. Hindi ka naman nagmooving forward. Okay. So moving on. Okay. We also have extrinsic factors. Okay. Extrinsic and intrinsic factors. Children, magmarilito ha. Kasi last time yung pinagusapan natin intrinsic and extrinsic factors ng hemolysis. Iba ito sa ISR. Ha. Yung mga pinagusapan natin kanina intrinsic factors. RBC count, presence of plasma proteins, poikilosytosis, what else pa ba? Your the size of your cell and then we also included din sa discussion natin your viscosity. So all of those are intrinsic factors. Let's talk about extrinsic factors this time. Okay. When I say extrinsic factors, ito yung mga nagawa nung medtech habang pinapreform yung ISR. Ito yung nangayari sa tube. Ito yung manner ng collection. Okay. Number one. Okay. Extrinsic factors is the length of tube. Okay. The longer the tube, the faster the ISR. Okay. Again. The longer the tube, the faster the ISR. Okay. The faster the ISR. Sir, parang may naalala kung note mo kanina ba ba? Okay. The faster the ISR. When I say faster ISR, that's equivalent to elevated ISR. Pero why am I saying it again faster or slower? Because I'm talking about rate. Okay. So faster ISR. The longer the tube, the faster the ISR. Why? Because in this sense, okay, kung note, this one. Ayan. Ito mas mahaba. Kung note, the longer this is, puha tayo ng isa. Okay. This one. Can you see? Which will have a faster ISR based on length of tube? Okay. Is it the stabilo? Okay. Or the moody pen? Okay. The answer would be the moody pen. Mas matas yung ISR, mas faster yung ISR nya because it's longer compared to this one. Okay. What about the diameter? Okay. What about the diameter of the tube? Normal diameter of your tube should be 2mm to 3.75mm. Okay. 2mm to 3.75mm. Before I move forward, question. What should be the distance of your 30K from the site of the puncture site during flibotomy? What should be the distance of your 30K? It should be 3-4 inches. What should be next question? What should be the distance of the drop of blood from the label in your PBS? Okay. Answer. Okay. Good. 1cm. Correct. What should be the diameter of the drop of blood? What should be the diameter? What should be the angle? Okay. What should be the angle of your needle insertion during flibotomy? Aga-aganya sumagot. Okay. What should be the angle? Okay. 15-30 pag flibotomy. But that's correct. 30-45 kapag peripheral blood smear. Okay. Napag peripheral blood smear. Okay. Lesson patapusin ng tanong. Okay. So moving forward. Sayon ngan. Lesson natin dun patapusin ng tanong. And changing with you guys. Okay. What's happening right now is not your fate. Okay. That's just a chapter of the season in your life. So, won't niyong tapusin lahat ngayon. Okay. Moving forward, let's go to the diameter of your tube. The less if you have as a what do you call this? If you have a smaller, if you have a smaller diameter slower siya. Slower diameter slower smaller diameter, slower than ESR. And then if it is a if it is a greater, your diameter is big. Okay. It's big. And that would mean that your ESR would be faster. Your ESR would be faster. Okay. So diameter of the tube 2 to 3.75 millimeter less than 2 slower greater than 3.75 that would be a faster ESR. So nakikita nyo na kong paning exams? Yes, sir. Okay. So increase or decrease makaganyan lang yun. Okay. With regards to your temperature, okay. The optimum is 22 to 27. Sir, bakit 22 to 27? This is sure room temperature. Okay. Less than 22, babagal. Diba parang ikaw pag normal yung temperature you can freely move. Like us here in the Philippines. But for Alberto and Kosen na na sa states ngayon, the colder mas restricted yung movement nila. Okay. So the higher the temperature the faster the ESR. Directly proportional temperature and ESR rate. The higher the temperature, the faster the ESR. The lower the temperature the slower the ESR. I clear. Can I see a race of hatch if I'm clear so far with all the things that we're talking about? Okay. Before I proceed, let me just clarify this one. Milaya has a question Longer tube, sabi natin kain nila ba? Longer tube, faster ESR which is still correct. Pero ang point lang dun sa kanin ang pinakita ko is elevated or longer yung ano niya. Longer yung decantation face niya. Kasi mas mahaba yung remember, Milaya, mas mahaba yung itatravel ng RBC mo so mas mahaba yung decantation mo but it's still faster. In a sense, it's still an elevated ESR. Okay. Hopefully I'm clear with that. Yung stage 2 lang yung decantation face yung mas mahaba, longer than 40 minutes. Okay. But of course yung ang mag-adjust dun silag at siyong dulong side. Okay. Okay. So that's with temperature 22-27. Ginito ang gagawin ninyo guys. Specifically in certain cases like temperature sizes, meron siyang optimum. So anything below the optimum and above the optimum dun maglalaro if it is faster or slower. Okay. So inclination of the tube. Okay. This is very important for you to remember because still think the tube is a straight ESR. Let me show you a picture of ESR. Parang kaya yung palang meron na kayong idea kong pano siya ginagawa. As you can see, lahat ng ESR straight. Okay. Lahat ng ESR straight siya vertical siya na oriented. Okay. Why? Because any tilt in your ESR any tilt dyan, any baliko any tilt in your ESR would cost what? Tilting or inclination of your tube would cost okay, an error up to 30%. Okay. Even a slide 3-degree angle tilt would now cost an error of 30% 30% error. Specifically, what error it would accelerate or faster yung ESR. Nakukukuha ko ba ako. Konwara, example normal naman yung normal siyong bang nan dito. Konwara si Davis na lang. Sanag ising Konwara ay yung ESR okay, this is your ESR tube ni Davis. Normal yung dogo ni Davis, wala siyang inflammation, wala siyang condition. Pero nung nilagay ni nilagay ni RG yung kanyang tube, baka pabalik ko sabihin, ah okay kaya kaya Davis naman niya nilagay niya lang nakakaslan. Eventually faster yung ESR ngayon ni ESR results would now be faster ay nanong ayong resonada napag faster, faster ESR would mean there is a presence of inflammation and there is a presence of inflammation. So tilting would would cost now would now cost would now cost unabnormal results of your ESR. So before I go ahead, before I move forward, siguro nagtataka kayo sir what is the normal ESR? It is actually 0 to 30 for male, 0 to 40 for women. 0 to 30, 0 to 40. So ibig sabihin sir pwede akong mag-ESR nilagay ko yan ng isang oras pero wala nang yayari pwede pero normal pa rin yung 0, 0 lang siya. Later papakita ko sa inyong kung paano siya binapasa. So let's move forward from those things. We still have this tree, last tree nalang to. So wet glassware. Take for example, this is your tube basayong luog, it will cause hemolysis, faster ESR. What about the presence of bubbles? Presence of bubbles meaning to siguro ibig sabihin pag may mga bubbles ka yan in between, konti lang yung dubo na nailagay mo. That's why it would also cost faster ESR. Sir paano naman po pag anticoagulant? Masyadong madami yung anticoagulant na nalagay ko na dilute ng anticoagulant yung blood what will happen? Faster ESR. Sir in what way? Remember this improper ratio of blood in anticoagulant would cost the shrinkage of your RBC. Meaning to say that is a poikilo, cytosis. In short, kapag meron kang kapag nag-crenate, wag hindi ko na tatawagin poikilosite. Kapag nag-crenate yung cells mo kapag nag-crenate yung cells mo or nag-rupture yung cells mo, it would also cause hemolysis. Therefore increase din yung ESR. Hindi ko na tatawagin poikilosites baka malito kayo kasi poikilosites is different, slower than ESR. Nag-gets ba ko? Higher concentration ng anticoagulant, lahat elevated or faster ESR. Delay in ESR, for example you did your ESR for more than 2 hours mag-suswell naman this time yung RBC mo. Mag-suswell yung RBC mo RBC would start to swell and remember when your RBC start to swell, when your RBC start to swell poikilositosis na ryan magiging spherosite sila magiging slower yung ESR. Slower yung ESR. Siguro what I want you to do then, I've seen some of your IG stories which I really want to upload. Some of you are summarizing my notes. Some of you are summarizing my notes tapos nakalagay yung names nila doon. Nakalagay yung mga names nila doon which I really... yun yung sinasabi ko sa batch ninyo, matagal na. Pagpatulin yung ganyan. Syempre, ganyan din naman sa men's school may mga talagang tagawa ng trance. Tapos trance nalang yung babasahin ang buong batch. Ayun nga, with regards to that I want you to make sure that you have a table. Kasi meron ng table, kagay nung pass, yung pressure, angle, speed, tapos yung eska nina yung eska nina sa ulo. Pagdating doon sa anan natin, pinagusapan natin yung tawag dito. Pinagusapan natin yung peripheral blood smear. Pass. Pressure ay halay yung utako na wawala na. Pressure, yung angle, yung size, size of the drop and speed. Okay. So moving forward, question. What color of test tube is being used for ESR? What color of tube is being used for ESR? Ay, very good. It is your may sumagot ng lavender, may sumagot ng black. The correct answer is both. Why? Because I did not specify what type of ESR method. What type of ESR method. You can use your purple, but never your light blue. Okay. Not your light blue. Okay. Not your light blue. You can use your purple. You can use your black, but never your light blue. Okay. Never your light blue. Not your light blue. Okay. So to be specific, okay.  Let us talk about those two. We have two types. We have your Westergren and we have your windthrobe. Okay. Your windthrobe and your lance bird, you have to read it after one hour. It uses a double oxalate as an anticoagilan. Okay. As an anticoagilan. Okay. As an anticoagilan. So these are the normal values for your ESR. Again, we have your windthrobe, windthrobe and lance bird. Okay. Windthrobe and lance bird.  Why? Because di ba orignally, you only have to read your ESR after one hour. ESR, take an extra lip. After one hour, hindi ka paulit ng isang oras. Okay. Two readings siya. I want you to remember that. Windthrobe, one reading, two readings. Two readings. In addition to that, your Westergren uses your 3.8 sodium citrate as an anticoagilan. Found in your black top tube. Found in your black top tube. Are we clear? Okay. Let me just talk about your windthrobe first. Your windthrobe, you can use double oxalate or you can use your EDTA on it. Your lavender. Your windthrobe in lance bird is actually we call the tube windthrobe tube. We call it windthrobe tube. And your windthrobe tube can be used into two tests. Your erythrocyte sedimentation rate, which is on the left side, the red one. Yung mga red graduation lines later I'll show you. And on the right side, the white increments would now be for hematocrit. But I want you guys to be specific because next meeting we will talk about hematocrit, hemoglobin, and RBC indices. But for now, I want you to remember that when using your windthrobe tube we are measuring the macro hematocrit. Macro hematocrit. And not the micro hemat. Di ba may ron tayong micro hematocrit tube? Your windthrobe tube is your macro hematocrit tube. Why? Obviously kasi mas malaki siya. So this is your windthrobe tube. The red one. The 0 to 10 that is for your ESR the white graduation from 10 to 0 that is for your macro hematocrit. That is for your hematocrit. Am I still clear? Am I still making sense with you guys? Ha? Pwag yung patsin yung mong gula kong hair. Wala mga upload to pero para lang mais yung aking anong. Are we clear? Clear ba tayo? Okay. Thank you, thank you. So again windthrobe tube. Okay. So this is how your ESR look like. Kumapapansin ninyo sir, ba thread kasi haimolais yung RBC haimolais, haimolais. This is etong number four number four, white turbidity sabi niya doon, leukocytosis doon. But for me nga, hindi pa nag-start na ano. Hindi pa nags-start na sa ano pa lang yan, nag-dedecant na lang. Number five ayan. So accelerated. Doon naman yellowish yung kanyang plasma. So most probably mayroon yung liver disease. Ayan. My liver disease ayan, ecteric. Liver disease, see you tomorrow. Clean chem. May clean chem nga ba tayo tomorrow? Ayan. So how do we read it? Ganito siya. Okay. So meaning to say, sabi nga natin kanina, your RBC would sediment. Okay. Would start to would start to form sediment below the tube. And this is how it would apply. Okay. So take for example, ayan. Ecto siya. Okay. It will go down down down down down. Okay. Papabasya ng pababa. So from zero to ayan, ecto ecto yung ano ha. This is wind throw. So sand ka titingin. Right or left? Right or left? Sa left. Ecto siya. So this is your wind throw. So kung makikita ninyo zero, we're going to count that. So yubibilangan mo yung distance already. So nandito na siya. So this is around 0.5 yun. 0.5. So 1, 2, 3. 0.8. Okay. Na sa 0.8 na yung ano. This is actually 10. This is 8. Okay. So increment nyan 1. So 1 0, 1, 2, 3, 4, 5, 6, 7, 8, 9. 10 ito, 10. Unlike kasi sa wind throw, ayan kung makikita ninyo yung ano sa wind throw, 0 to 9, 0 to 20, 0 to 13. So 1 digit lang sila. Unlike the other ano na esr yung increments niya s by 10. So this one, bilangin natin. This is only 8. 8 millimeter per hour. So that is the value of your esr. So ganan yung siya ba basahin. Sir ganan din po ba sa ano, sa lab? Yes. May yung tub mo, kas ba basahin mo lang siya. Okay. So hopefully during your pre-internship ano, we will be able to do that. And so having said that now ako usually, siguro pag nasa ganagawin yung siyang practice na, pagdinig namin yung esr tube you would also ask for somebody else's opinion. Okay. Kung baga pa double check ninyo. Okay. So moving forward, ayan aside from Westergren, aside from your wind throw, we also have your Vesmatic. Your Vesmatic is a bench top analyzer for esr. So you can do 20 blood samples at once. Okay. So naka naka slant yung esr tube. Anong mga yari, pag naka slant yung esr tube? Faster or slower? Faster or slower? Ay, mga slow nang mga keyboard warriors. Okay. It is faster or slower. Faster. Okay. And having that in mind, di ba? That is the principle now that they use to hasten para pabilisin yung Westergren. So originally, di ba? Pansin ninyo, yung Westergren natin two hours, kasi this is the most sensitive. Two hours. One hour and then another hour. What they did is to slant the tube 18 degrees, which now would make it now. You would read the first instead now, one hour. You would now read it after 25 minutes. And then you would now in the second hour, you would read it after 45 minutes. So di ba ang galing na 25 and then 45. So instead na 1 and 2, 25 45. So how do we measure it? We measure the esr using your optoelectric sensors automatically that automatically reads your esr levels. So I am now down to the I'll give you a case study by the end of the day. Pero hindi nga naman nasasagotin na like in the TLC pa. Tasagotin din natin agan. So these are the different conditions. These are just the conditions. These are all on your notes na, ha, guys? So esr what are the things that would be increased? Your esr is increased in your inflammation, chronic in chronic acute what do you mean? Acute and chronic infections, rheumatic fever, rheumatoid arthritis, myocardial infarction, all of this increase yung esr. Siguro magtatangakayo sir in nephrosis isn't it sir that all of my almost all of my plasma proteins were out of my body because I have nephrotic syndrome. I have nephrosis. Question what would be the only plasma protein increase during nephrotic syndrome? What is the plasma protein increase during nephrotic syndrome, children? The answer is ala hindi ko makita yung chat. What is the answer? May sumagot? Ay, may nakita po kong albumin. May pre-albumin ako nakikita. May nakita kong macroalbumin. Anong macroalbumin? May tinuro ba ako sa inyong macroalbumin, ha? Okay. Hindi ko makita yung chat namin sa auto. Ayyan. May sagot na dito sa O2 at O1. Dito sa O3, O4. Okay. Anong sagot? The answer is it's your, ay may nakita ko beta 2, macroglobulin kontin-kontin na lang, but the answer is your alpha 2, macroglobulin. Okay. Alpha 2, AMG, right? Alpha 2, macroglobulin. Sir, anong beta 2, microglobulin is the plasma protein you see on the surface of the cell. Small shot, right? Microglobulin. Okay. Hindi siya prealbumin, ha? Hindi albumin. So in nephrotic syndrome, the only plasma protein increase is on the alpha 2 band which is your alpha 2, macroglobulin. Okay. Very good for those who answered correctly. Kaya, in nephrosis okay, elevated pa rin yung ESR. Bakit, sir? Because your alpha 2, macroglobulin is a positive acute phase reactor. Okay. Did it make sense? Okay, kung bakit sa nephrosis, wala man na akong natiti rang protein sa katawan. Matas pa rin yung ESR ko. Bakit? Kasi nga, isa sa mga rason, AMG mo, matas pa din. Well, aside from that, we can also attribute that to a lot of other things, like there is anemia due to chronic kidney disease. Okay, saan siya increase? Increase po siya. When I say increase gas, it's faster. Okay. Increase siya sa tuberculosis, ayat. Mwaldensthromacroglobulinemia, hepatitis, and the rest.  Bakit man dyan si spirocytosis? Bakit po siya kinoon si Dernay ESR is normal? Bakit siya kinoon si Dernay ESR is normal? Bakit siya kinoon si Dernay ESR is normal? Isabi nyo, sir, slower now. Mali si sir. Inakarekot si sir, paano niya papalitan yung sagot niya? Ano? Why? I would still stick up with my answer that it is slower in polycytemia vera, in your spirocytosis. Why? It's not about, inflammation faster. Inflammation in a cute face reaction, faster ESR. Why is it that in this such situations, normal yung ESR sabi ni sir, slower. Slower, pero within reference range. The answer is this. Very similar to what Jerry Cosette. Very similar to what Jerry Cosette. Remember, sa sobrang bagal niya, wala pa rin siya. Lumampating isang oras. Pwede na sa 0 pa rin siya. Or na nandun pa rin siya sa within the reference range. Gaya nang sabi ni Jerry. It's too slow. Na nandun pa rin siya sa 1R9 nakalipas. Hindi pa rin nagsediment yung RBC. Nakukuha ako. Kaya when I say slower, the slower things na sinabi ko kanina doon, still slower pa rin siya. Paglumalala bas yan in your results. It would appear as if it is normal. As if it is normal. And of course, for the last slide for today, for the last slide for today, we've been talking for 2 hours and 30 minutes na. So, guys, I want you to remember this. ESR, sabi natin kanina, that ESR is a nonspecific test. Nonspecific test siya. But there are two conditions. ESR is useful and is indicated in establishing the diagnosis and in the monitoring of two conditions, which is your polymyalgia, rheumatica, and temporal arteritis, where the rate of your ESR typically exceeds 90mm per hour. It's your polymyalgia, rheumatica, polymyalgia, rheumatica, and your temporal temporal arteritis. Temporal arteritis. Am I clear? Hello, guys. Are we clear? Can I see a raise of hands if I am clear? Okay, thank you so much. Okay, thank you, thank you. Now, for our um, for our case study. Case study number one. I want everybody to answer. I want everybody to answer. I will be calling I will be calling persons to answer. So, pag hindi alam, call a friend. So, ESR, because of lack of space in the laboratory, masikip kasi, the rack of sedimentation rate tubes was placed directly on top of a small refrigerator. What are the three possible effects on the ESR result? Will it be falsely decrease or slower, falsely increase or faster, or nothing at all? So, again, what are the three possible effects on ESR results? Based on everything that we talk about, both the intrinsic and the extrinsic, what could be the possible what could be the possible effects? So, una-una, will it be intrinsic or extrinsic? Intrinsic, extrinsic. Correct. So, let's take a look at the O1 and O2 if the answer is correct. It's extrinsic. Why extrinsic? It's not your problem. I'm the problem. Okay, sounds familiar. Okay, so extrinsic. So, now, what would be the effect in your ESR? Anyone who's the brave soul this afternoon can see answers on the chat box. I want somebody who would volunteer themselves. So, everybody, lower down your hands. Okay, lower your hands. Okay. So, anyone who wants to answer, just raise your hand or acknowledge yourself na lang sa chat because hindi ko makita yung iba. Ay si Louie. Louie, unmute your mic. What what is the possible effect in your ESR? Louie, nagtaska ba ng kamay? Is Louie speaking? Wala ko marining. Wala pa. Okay, baka nakamali lang si Louie? Nahil dyan tatawagin natin si kung ako natatawag ng friend ni Louie. So, okay, any volunteer any volunteer who want to answer Miss Alberto. Unmute your mic, Danny. Ay na wala siya. Hello. Good morning, sir. Good morning, there. Good evening, sir. Good evening, sir. If it's on a refrigerator temperature on top of the refrigerator temperature would affect the the tube. Yeah. It would be well, it would accelerate or it would go faster because it's on top of a refrigerator to the temperature. Okay. So, thank you, Miss Alberto. Okay. Thank you, Danny. I'll thank you, Danny. So, that's correct, okay? That's one. Why? Because the tube is on top of the refrigerator, the monitor, the heat of the motor, the motor of your refrigerator would cause falsely increase or it would accelerate your ESR. Very good, Alberto. What else? I can see chats over here talking about optimal temperature. It's a very specific scenario. Hindi yung general na optimal temperature. I want what's happening on the case. Okay. That's correct for Alberto. That's very good. Aside from that, I still have toos and I'm still waiting for two answers. Iba naging English ay Rubigla kasi tagay us yung ka-usap. Okay. What else? Okay. Daniel, sir falsely increase ESR po due to vibrations po brought by the first motor of the refrigerator because some refrigerator tends to have vibrations and vibrations po brought by the opening and closing of the refrigerator switch parang tagito results to aggregation of the sedimentation rate po. Okay. Thank you, Daniel. Iba parang nakita nyo na yung case na nyo na binigay ko sa inyo. Okay. Thank you, Daniel. So, tama yung sinabi ni Daniel because of the vibration. It would now falsely increase. Parang ano yan, parang konorin nilagay mo dito. Yung pag-group mo, yung lamesa. So, what will happen faster? So, what else? Last one. Last one, guys. Last reasons. Let's go for Goree. I saw Goree raise her hand kanina. Jella, what's your answer? Go Jella. Falsely decrease po. Why? Because sir since it's on top of the refrigerator their tendencies mo di ba when we open the refrigerator. The temperature that's within the refrigerator parang ano siya there. Tama po ba? There's sa near sa area where the tube is placed. Therefore, may in KSR. Okay. Thank you Jella. Funny thing, nilagay ko pala tong case study na sa power point masinyan ko sa inyo. So, yan pala sa power point niya. So, the answers, thank you guys, Alberto Jella and Daniel. So, the answers are here. Okay, number one. Babak, it would cause a slower ESR because the air, the cold air rushing out from the refrigerator or freezer would actually slow down your ESR. It could also increase it in two ways. It can increase your ESR because of the vibration ng pag open and close ng refrigerator or the freezer. And aside from that, the motor, the heat ng motor released by your refrigerator. Okay. So, there's another question here. I think na figure out naman na Niazzy yung sagot sa tanong niya. Okay. So, yeah. So, that is it actually for today. Guys, thank you so much for intent in listening amidst my very, very long power point. So, thank you so much to you guys tomorrow for our discussion on our discussion on Glen Kim and also in Hima. So, you'll see me again, Hima Tamaro.


Welcome to Toffy TV, this is the Everton News Daily. Once again, Everton have been linked strongly with Norwich City, right back, Max Arans. Once again, Frabiano Romano has said that Bayern Munich are no longer interested. The £35m fee has scared them off and Everton are in for the player. He's saying that those sources have come from both ends, from the Norwich City end and from the Everton end.  Max Arans is someone we've been linked with since last summer, certainly someone Everton fans have wanted us to go after him and say to each other a new right back. He certainly seems to possess the attributes that we're looking for, a very modern right back that can get up and down the right hand side, who can be a defender but also can be someone in the shameless Coleman mould and can be a winger as well. So we'll have to wait and see. He certainly seems to fit the bill, whether he is, the player Everton are going to be after. We'll have to wait and see, but hell of a lot of links with the player in the last couple of weeks and certainly this week, so we'll have to see how that one develops over the next few months. Last year we were getting linked with Gabriel quite a lot as well, obviously he ended up going to Arsenal, but that one was in the pipeline for a very long time, it was only really Covid, that scuppered, that one. Pep Guardiola says he dreams of being Carlo Ancelotti, he says that Carlo Ancelotti is a Budde lifestyle, when it comes to football he doesn't really stress about things and he wishes he could have the same philosophy when it comes to football. Obviously a lot of that comes with I imagine experience and age and knowing when to calm down and focus on other things in your life, so it's very interesting to see that obviously people like Pep Guardiola look massively up with Carlo Ancelotti, sort of like the kind of manager who led the way for people like Pep Guardiola. So, high praise indeed from Pep Guardiola, hopefully Carlo Ancelotti will find himself in the same position Pep Guardiola is in in the next couple of years and then we'll see what the stressors like from Carlo Ancelotti. Everton have been linked today with Torino Cernabac, Gleeson Bremner, we've been linked to this player before, but according to media outlets in Italy, Everton and Liverpool are both looking at the player in the summer. As I said, we have been linked to them before and we do currently have four top centre backs and one alone at Blackburn in Giada Brantuit, so yeah, seems just an easy link for a player who obviously wants to get out of Torino. The head of the game on Monday against Southampton, Southampton have revealed that Minimino will be out and Romero will be out as well. He's apparently played his last game this season after breaking his ankle, so yeah, a bit more good news for Everton on the injury front, but obviously Everton have to turn up and do the job. They've run away speaking about the academy, spoken about the international affiliate programme and said it's a fantastic, fantastic scheme and who knows where it'll end up. He said basically it gives us Everton the opportunity to find players that maybe they wouldn't have found before and who knows maybe one of those players one day will turn up for Everton and there'll be somebody spotted that we wouldn't have spotted before. So there you go, there's more on that interview on Everton's website if you want to check that out. There you go, a bit of a quiet day with Carlo doing his press conference yesterday, but it'll be interesting to see how or if anything happens with Max Arans. Obviously we're not going to find out for a few months, but I want to keep an eye on that. There you go, no game obviously till Monday, so you can enjoy your weekend and enjoy this week as it continues after what has been a great week for Everton. So there you go, don't forget to give this video a like, subscribe if you haven't already and if you want more great videos, join us on Patreon, the link is in the description and it's on the screen. See you later.


So there's also an option that you can where you can click and it says install dependencies It's always easier to click back, you know, check it out because then you would you don't have to worry You would install all the packages that are required by that package So once you've done that you should be able to type library some are and it should not give you an error Maybe we'll give you something like a loading library input Because it needs it for me. It's already loaded because I've loaded some are before so it doesn't give me the message anymore Okay, everyone still waiting for it to download or waiting for someone to come see you. Okay It's all right. If you if you haven't managed to load it. You can stay here for lunch and Have a couple of hours to do it Yeah Everything When you love the package it will it will give you an error if something's missing So when you load the package, you will contain all the functions all the data that are needed all the instructions So it's just like just just like our but it's a smaller version that only Contains what you need Yes, you could but you need to you need to download the source code Which is of course available because it's free right so you can unlock the source and you can edit any of the files You can change it you can modify it to suit your needs of course you need to know a little bit more to do that But it's fairly easy. There's a lot of documentation on how to do it So in my group we've got we've created, you know dozens of packages that are available and things It's very easy to do Yeah, you can it's it's all of it is open source open access you can Yeah, so when you don't know the package is going to download the binary for your computer like for windows You can download the binary and things but the places where it gets the package There's always this the source code and you can download the source code and look at the code into everything Yeah, it will give you the instructions, but you won't look I mean you Well, you can you can look at the source of art But you won't get all the details because it's hiding some things from you because you don't need to see them Okay, so we're just gonna take a few minutes to Just talk a little bit about our programming So I wanted to say that ours a true programming language So even though we haven't looked at that yet. So you have if statements you've got four and while loops Just like any programming language And I think it's a good time to take a break because this is where we take too long and we'll look at that after lunch And we don't have too much on the our basics after that So we'll be able to move on very quickly into the exploratory data analysis Which will be slightly more interesting because we look at a few things and you'll see the power of our very quickly Any questions before? We go for lunch Okay, so we're gonna start again Before we start is there any questions? So I know this morning's been a bit slow, you know, we're going slowly through all the things We're gonna finish that so we're gonna talk a little bit more about the our Programming language and then we're gonna move on into application the exploratory data analysis We're gonna see some real data sets how to visualize these things and so forth. So hopefully there will be more interaction afterwards Okay You're late Francis so we've seen we've so we've seen the basics of The the all language but in fact are is really a full programming software So this means that you can write your own functions to do things done and not really available in our So let's say you've got a special data set that you wanted to something That's very particular for that data set that is not building into our well You can go ahead and write your own function to do it Not only you can write your own script But then you can create functions that you can reuse in the future that will be adapted to various things So this is what I mean by a true programming language So one of the first thing you use in programming is called the if statement So typically you will have executions and things that depend on what? what the variable is or The value of the variable and so forth So it's very important to have this if statement that will be sort of conditional on something else So here's an example So I've cut it something very simple here if you look at this What do you think this is doing? Well, it's saying if X is greater than zero print X else print minus X What do you think this is doing? Absolute value right because if X is positive then you just print X if it's negative You take the negative sign of that which would be positive All right, so when you take the absolute value of X in our this is just what it's doing It's just looking at the value of X if it's greater than zero It just returns that if it's not it returns the negative of it. Okay, so let's look at that example X is minus two Okay, and we're gonna do this little exercise to do that Since it's minus two the absolute value is two and therefore it's printing two Okay, so you need this sort of if statements in order to know what to do depending on the value you're looking at You can have if and else if statements so could be if X is greater than zero Otherwise if it's zero and then else something else So you could have different cases that you can play with okay So you can divide it and put as many else health as you want. So you could have if X is greater than zero if it's one if it's two and then you could have different cases So this is that this is the exact same thing, right? But if X is zero then we know it's just you know, it's just to show you an example another thing That's very important when you do Programming so what is the goal of programming is to let the computer do things that? Either you couldn't do by hand or would take too long or needs to be repeated many times So that the computer can do that really silly right right by hand We can do it But it's gonna take us a long time to repeat an addition on a million numbers, right? But for the computer it's very easy and in order to do things automatically and repeat things We need what we call for or wide loops. So this will just try to Repeat something many many times or on a vector or something like that So let's look at an example to understand so let's say and here is a million Okay What we're going to do with the second comment and we're gonna see sign next so I'm not going to And just to explain that in great details, but basically what this does is that it will generate And random numbers from a normal distribution with mean 10 and start at aviation one So this is just a way to generate some random numbers And I'm not going to show X because there's a million number, but we can look at the first 10 numbers Okay, so you can see that it's close to 10 because the mean is 10 But of course, there's some noise there's some variability because of sound deviation is one R is vectorize so we know that we can take the square of X And what this will do is that it will apply the square function to each element of the vector X This is what we've seen earlier another way to do it will will be to say Okay, we've got a vector So what don't we loop for each element of X? I'm going to take the square and I'm going to assign that to a value of my vector So what I can do is that I? Can generate a vector of zero of length n that is a million So this is just a vector of zero Okay, the length of Y is just n which is the million Okay, and what I'm going to do is that I'm going to loop over all the elements of X and Every time I have a new value to take the square and I'm going to put it into the vector Y So this is what you do with a for loop So this says for each I going from one to n I'm going to Replace the value of the if element of the height element of Y with the square root of X of I Okay, so this is So here I wanted to do the square sorry Doesn't really matter Just an example Okay, and we're going to take the square of that So this is going to do exactly the same thing Okay, and if you look at Y from one to ten It's going to be the square of each of the values Okay, is it clear what this statement is doing? Okay, just for each I in one to n you're going to do that Okay, so this is slightly more advanced don't read too much We're not going to play with programming too much, but I wanted to show you that R is a fully Programming language you can and you can do your own scripts and things hopefully Soon enough, you know once you'll play with R you will have more experience with it You will be able to write little scripts that can do things for you in a more efficient way But one thing that I wanted to bring up is that So I said you could do it this way Can take Y and you take the square of X It's vectorized or we could do it You know almost manually tell the computer exactly what to do loop over all the element and say for each element Take the square of it. So what's the difference? That's a lot slower right so if we loop over all the elements And it's going to be very slow compared to do the operation and the vector Well, you need you don't have to initialize But you need to tell him how big Y will be because if you don't do that You won't know that Y is a vector. In fact, you won't even know what Y is so you need to Specify Y before and in fact the way you do that in R you need to initialize because when you create a vector It will always be initialized So the actual value of Y So here I could have put one for example or minus 10 or whatever It wouldn't really matter because I will just overwrite that but what I need is to create a vector of lens and okay, so The point of this exercise as you can see it's it's very challenging and intellectually it's very interesting But it's really to show you that if you do a for loop and it's going to be a lot slower than just doing X squared Right, it's because R is vectorized So one of the default of arts that it can be slightly slow sometimes And in order to be efficient you need to work with vectors Okay, do things on vectors directly do not loop over all the elements because it's lower because are the way I was designed If you tell him if you give him a vector and you say this is going to be an operation on the vector It's going to be a lot more efficient because it's going to know what to do a lot more efficiently so this is just For you to tell you to be a little bit careful about these loops that can be very slow in R Another way to do a loop is with what we call the wild loop So for the for loop we tell him exactly from which Element to which element would go and we're going to loop for each eye from one to end But we could just do we could loop Until a condition is satisfied and here we could have a counter that's a we start in one until it lets We're called an end which is going to loop and do the same thing and we're going to take the square root Or let's say the square here to be consistent We're going to take the square of that element and once you've done it you Increase the counter and then you keep on going until you are less than we call them in so it's the exact same thing We'll give you the exact same answer But it's just it's a different way to do it and it's also a different way to do things because you can't have Conditional statements depending on other values and so forth So I will show you a more advanced example of that later on is this sort of clear what the idea of this is Counter is just it's just counting where you are So you're looping over the vector you start at one and you say okay if it's counter is less We call them and I'm going to increase the counter and I'm going to take this You just increase it until you've done it for the end elements Okay So we've done that just to show you that you can do lots of things you can script you can loop over things So for example, you can apply the square root to a vector x and When you compare the execution speed it's going to be a lot faster when you do it on the vector directly So as I said you can also create your own function So when we look at the absolute value of x right we've got the if x is positive return x Else return minus x it will be nice to write a function that would do that In fact, there's one in arts called apps for absolute value But you can create your own function to do things so that every time you're going to apply that function to a new value You don't have to recopy everything right you can just apply that function to that value So here's a nice a very nice function that I'm sure you're going to use a lot It's called my first function and it takes a few arguments. So the first one is your name Which is a character first one is my name and there's a default value And then there's a number and depending on the number what it will do if number is zero it will return your name Else it will return my name It's a great function Decided to write a package and I'm going to submit it to r so Okay, so we're going to copy and paste that function Okay, and then r knows it's a function so it's going to be like the other functions we we're using r You can just apply that to Um The variables you have so here, you know, your name is francis number is one So we're going to try that Because number was one is going to speed up my name If you try zero Okay, it's francis if you use something else That's going to output that name So the beauty of a function is that you don't have to Recopy and paste the function every time you're using it You can just Modify the arguments that you want Also, something I wanted to show you is that when you write a function You can have variables that have defaults like this one is a default of raffael and this This one is a default of zero. So you don't have to specify these two You don't want to Okay Here's a more advanced example here Okay And I call that function My square root So if we apply that to 81 It's nine So forth, okay So What is this function doing it's actually computing the square root of a number using an algorithm called newton raphson So i'm not going to go into the details But in fact, this is exactly what r uses to compute the square root of a number Because there's no magic magic formula for the square root of a number, right? You know it by hand for by head for some numbers or you can do some calculation But you cannot just guess the square root of a number. It's not like doing an addition Or multiplication, right? So you need something that will be able to know. Well The square root of a number is that if I square that number obtained the number you gave me But you can actually do something that will try to Calculate numerically the square root of a number And this is one way to do it. So in r there's a function that does it and someone has cut it what I cut it just right here Okay, of course, it's a bit more efficient and it's better in orbit just to Show you an example that we can do very fancy things with with functions Say that again Oh, so you're asking if if I could do this for example Bring the product functions That's when you have to change off line after a break. Yes Can you Will definitely need the same line you you could but there's a couple of reasons why you shouldn't do that The first one is that because it's going to be very hard to read any code If you put everything on the same line, right? You can have a line with a bit on characters So it's not very pretty to look at especially when you write a lot of code You need to be very careful about the sort of things you do Typically, you also need to indent your code to make it easy so that you know, there's a jump every time there's a new A new thing you want to do But you could but you have to be a little bit careful. So for example this one You could do x and add something else here If you want to put it on the same line you need to put a semi-colon here So it's better to put each operation on a separate line Yeah, yeah, so that's a good question. So typically It depends right if you want to if you use it a lot what you would want is that every time you load r You will know your functions, right? So what you could do is that you could create a new script Okay, let's say I'm going to create a new one here You don't have to do that. It's just to show you Okay, and I'm going to call that one test that r And I'm going to put it on my desktop Okay, then it contains my function then what I can do is that I can what we call source the file So it will actually execute everything that's in the file so that I don't have to copy and paste you will know the functions Still this is not really a nice way to do it because every time you're going to have to source the file The best way to do it will be to create your own package that contains the function You just type library my functions or whatever you call it and then every time you load the library You will know the functions you use and this is a very efficient way to do things Of course, sometimes I just test a few things and typically when I do that I just have my script. I put all my functions at the top of the bottom I copy them before and then I I execute what I want Okay, so when you just test some functions just need something very quickly I just write it somewhere on my script. I just copy and paste it and then r knows it I don't need to input that that function in more until I quit r and I relaunch it other the next time But in general once you you're starting to to be very comfortable with r we better to try to Create your own library that you can load every time you need it Yes, but at least you don't have to copy and paste all the functions. Everything is is Loaded when you type library Any other questions Yeah Say that again You mean always in like global or local is that okay So the question is Let's say in my function here. I create a variable. I actually let's try that Okay, I assign a variable in my function You can you can try the same so copy and paste that And then I'm going to execute that function And you would think that because I assign the value 3 to y then now y should be 3 It's not okay The reason it's because I assign the variable within the function And this is what we call a local assignment So it's only going to be known In the environment in which you do the assignment If you want to do a global assignment that is something that's going to be known in r everywhere you're working You can do like this so you put two Two less signs like that and this will be a global assignment and this will be known in r everywhere But this is a really bad idea. You should never do that because global assignments can be very very tricky Because then you will think that you've got a variable Everywhere, but then if you reassign a value you won't know it anymore. So it's it's typically a bad idea Never do global assignments So forgot I just said that You cannot do it Okay Okay, so we're seeing how to create a function Oh, yeah, there's yeah, go ahead That's a good question, but I They might be actually that's let's try So you you can You can lock some variables. So typically global Yes, typically global variables that are part of r would be locked out. That is you cannot overwrite these variables And in fact, you can even do that yourself when you do create a variable You could also lock it so that no one can modify the variable. But again, that's a really bad idea to do I mean, it's it's good for r because there's the core variables But let's say so there's the absolute value function right And here we had So I could do that, for example, could try to reassign absolute value to that function And we'll see what it's going to say Okay, if you don't give me if you don't like oh Actually here was a bad choice because there's already the absolute value here. So But it's uh, apparently you can do it, but it's a bad idea to do it. So I should have tried something else actually Yeah, so you Yeah, even still here. It doesn't really like it. So I guess It it's probably going to give you an error if you try to do that Okay, so we've seen how to write functions. Why don't you try to write a function? Um, and you can call it whatever you want That will create um, that will compute the inverse of a value x So your function should take one, uh input value, which is x and it should return the inverse of x Very very difficult function to write So try to do that. So just follow the the template that you have Take x compute the inverse and and return that I'm going to help you a bit. So this is what it should look like So let's put my inverse Should take a value x and it should return something you should do something inside Try to think about it So what you could do is okay, let's create a new variable one over x and then I return That value y If you really want to be explicit, you could type return y You you could do that. There's just I wanted to make it more explicit just to show you. Yeah. Yeah, you can exactly Which is in general, you know, you would want to make um some temporary assignments and then return that at the end Okay, so this should work and of course we'll return the inverse of x because you're just doing one over x Let's let me check whether x is there Yeah, so now we're going to try to check whether x is zero or not So we're going to use because dividing by zero is kind of a bad idea, right? In fact r knows how to how to deal with it If you divide by zero It will know that you know the limit is infinity and you will know how to deal with it Okay, but here we're going to do something like okay if x is uh Zero we're gonna We're going to print a warning okay And otherwise we're going to say it's fine And we can just return that Okay, so this will test if x is zero if it is it will print are you crazy And otherwise it will just return the value Okay, and this is your function. You watch fine any questions exactly Any number? I just want to Make a special check if if it is zero. I'm going to say be careful because you can divide by zero What is x Okay Okay, that's it's okay, so that's a good question. What if you input something that's not a number right for example like a character Well, you're going to be in trouble because you don't know what to do if it's a character And you're probably going to get an error in fact you can try so Something like that, right It's going to tell you it's not numerics. I don't know how to compute the the inverse of it, okay so something I should say is that One good thing about ours that it's what we call object oriented So you can define what we call class and methods So a method is a particular kind of function that we'll know what to do depending On the the kind of object your input So you could define various functions whether you've got a character whether it's zero whether it's positive Whether it's a matrix whether it's a vector and then Depending on the type of the input the function would know what to do Basically, you would have sub functions for each of these Each of these different cases and then The function will know which one to use at which time. So this is a beauty of r. It's that it's object oriented So you can do some very nice and easy programming that will take up all these special cases for you For example, uh, if you plot Let me give you an example Well, we'll see an example of that later When we'll look at the summary function Okay, so We know how to write a function. We've looked at That more advanced function, which is computing the square root