had met you well. Take note of that. You faith. He did not say you're crying, has met you well. He said, your faith has made you well. This means Jesus Christ can see you all the times, but when he sees you without faith, he sees you without healing. He sees you without a miracle. Hallelujah. yaofizi yafita wenda yuwa yaa imiti wa nafili kola nafili Jesus ukuwa yao bounds watu kupios aun maeku yao karDo kupandia yao maeku When the entire crowd was telling him to be quiet, you agree with me that Batimez was a man of vision, a man of faith. As a man of vision, as a man of faith, though he was blind physically, he had good spiritual eyesight. He could see what people with good eyesight could not see. Those with good spiritual eyesight see that beauty in Christ that will effectually draw them to run after him because in Christ Jesus nothing is lacking, why everything is necessary. Tell your neighbor, in Christ Jesus nothing is lacking, why everything is necessary. May today be the day you will receive direction, instruction and the revelation you need. Yes, the Bible says Batimez sad by the roadside. You who are sitting by the roadside saying, I am blind, I am blind, I am sick, I am poor, I have no job, I have no husband, I have no wife, I am depressed, does God not care about me? Why me of all this? Does God not care about me? Oh, is he just passing by? Job! Batimez Batimez cried out and the son of David stood still. May your crying out today make the son of David to stop in front of you. May you receive the same grace in Jesus name. Victory in Christ Jesus is victory indeed. Victory is in our faith, in our believing and in our conferencing. Let me take you to the book of Romans chapter 10. Let's take our reading from verse 8. But what does it say?  That is the word of faith, which we preach.  For with the hearts one believes unto righteousness and with the mouth confession is made unto salvation. For the scripture says, whoever believes on him will not be put to shame. Hallelujah. We can understand that man is what he is by faith. We are what we are because of our capacity to believe. In other words, God cannot work through us except through our capacity to believe. God cannot work through us except through our capacity to believe. What is possible for me as an individual depends on my capacity to believe. Two things are required as conditions of belief. One, openly professing one's relationship with Jesus Christ.  The profession of faith alone, the profession of faith with the mouth alone alone without the power of it in the heart is a mockery of the very fundamental article of the Christian faith. There must first be faith in the hearts before there can be an acceptable confession with the mouth. For it is with the heart one believes unto righteousness and with the mouth confession is made unto salvation. Faith is both. Faith is what? Both. Failure to give Christ His proper place, His actual place in our hearts is actually responsible for the crisis of our faith. To give Christ His proper place in our hearts is actually responsible for the crisis of our faith. Are you with me? Failure to give Christ His proper place in our hearts is actually responsible for the crisis of our faith. The management of the hearts and its thoughts is fundamental to our faith and holy living. The Bible advises us to give up our souls and our bodies. Advises us to give up to God our souls and our bodies. That is our souls in believing and our bodies in confessing the Lordship of Christ. Whosoever believes in Him shall never be put to shame. In Philippians 4 verse 13, when Apostle Paul said, I can do all things through Christ who strengthens me, he was equally saying that he had given up his soul to Christ in believing and his body in confessing the Lordship of Christ. That is the true sense of believing. That is the true sense of believing. Believing is the only condition for answered prayer. Our claims in Christ Jesus is our capacity to believe. Our capacity to believe must be strong enough to attract and accommodate all rights and privileges in Christ Jesus. If you realize that your capacity to believe, if you realize that your ability to believe is not enough, you can offer prayer of faith for it and Jesus Christ will enlarge your spiritual coasts. But remember prayer is not right if it does not spring from faith. The Bible says the very foundation for receiving answers to our prayers is to base our faith on the fact that Christ died to provide all we are asking for. What are you asking for? Healing? Deliverance? All of God's blessings? For Him who believes? Do you believe? Do you believe? If you believe, let me see your hand. People of God, we are therefore required to respond in faith to the gospel message by believing that God raised Jesus Christ from the dead. By His resurrection Jesus Christ has demonstrated that He is worthy of being the object of our faith. By His resurrection Jesus Christ has demonstrated that we can never be disappointed if we make Him the center of our belief. By His resurrection Jesus Christ has demonstrated that we can never be disappointed if we make Him the center of our own world. Jesus Christ is all the world to me.  He is my all. He is my strength from day to day. Without Him I will fall. When Jesus Christ said to the father of the demon possessed boy in map 9 verse 23, everything is possible for Him who believes. What does this mean? This simply means what is possible for me may not be possible for you. Why? It is possible for me because I have capacity to believe. What is possible for you may not be possible for me. Why? It is possible for you because you have capacity to believe. It is this belief and confession that brings about the power to do all things unto salvation. Miracles are wrote in the name of Jesus Christ not by repeating the name as a good luck charm but by believing in that name as a divine revelation of grace and good will to men. When Peter and John were brought before the judges in the Book of Acts the contention of the adversary was not whether there was a miracle or not but the legitimacy of their source of power. The elders asked Peter and John the apostles by what name or by what power did you do this? Peter said we are called to account this day for an act of kindness. It is by the name Jesus Christ that this man stand here before you healed. This means the name Jesus Christ has power indeed but only among those who are committed to the glory of God. Are you committed to the glory of God? If you are, listen when we learn to use the name Jesus Christ according to the word of God when we learn to use the name Jesus Christ according to the word of God in the power of the Holy Ghost we have the secret which shook the world through the apostles. I am here today to do what I am born for what I am living for and what I am going to die for. May God bless His word in your hearts. In Jesus name.


The study found that the anxiety levels of breast cancer patients undergoing chemotherapy during the COVID-19 pandemic vary with experienced and inexperienced chemo cycles, and hospitals should improve their professional services to assess the anxiety of these patients. This article was authored by Fadilla Fadilla and Sangati Sangati.


The last thing I want to add to all of these, and I am running out of color. What color do I make this? Maybe bright pink. Sure, that's good enough. The last thing I want to add is the, no, it has to be green, I'm sorry. We've got priorities, it must be green. And that is the most important thing for me to like start talking about right now. There are four cranial nerves that carry visceral motor fibers. And that means that they are doing something unconscious. They are innervating some smooth muscle, cardiac muscle, or glands. Let's note who those guys are. Ready? Three, let's make a big like woof woof around them. Visceral motor, facial, seven, nine glossopharyngeal, and 10.  It means visceral motor fibers are there. Now, we have to get out of here, because I don't have enough room, I have to write down what they do. You are not going to forget that they also have other jobs. But who are they again? Cranial nerve three, who is three? Oculomotor, oculomotor, cranial nerve seven, who's that? Rock in the Facial House, cranial nerve nine, you know nine, I was just trying to get out of the picture there. Glossopharyngeal, and cranial nerve 10, V1, and only, Vegas. What do they do? Oculomotor, remember that guy was motored of four eye muscles. Also is motor, visceral motor, to pupil constriction. Now, pupil constriction, so there are smooth muscles surrounding your pupil that when they contract, they cause your eye to constrict, your pupil to constrict. And that's a visceral motor action, smooth muscle, because visceral motor, not conscious, and oculomotor is the one who's saying, go ahead and do that. Facial, facial does visceral motor to salivary glands. And I want to say also to tears. Facial makes you want to cry and drool. If you are drooling, you will also cry. However, glossopharyngeal is also salivary. In fact, it's the parotid gland. Oh my gosh, we could totally do external brain question. I hope somebody remembers to tell me that I said this, because you could do submandibular and sublingual. Those are my two salivary glands that are innervated by the facial nerve, and I could totally give you like some crazy fun gleeking question. Which cranial nerve enables me to be a masterful gleeker? And then you would say, we're rocking the submandibular gland. Thank you very much, Facial Nerve. The Facial Nerve allowed me to take revenge on my friend who I believe he's now my friend. I don't know if I told you his name last time, but I probably shouldn't tell you his name on YouTube. All right, Vegas, dude, visceral motor to everything. What? True story.  Vegas is everywhere. What stays in Vegas does not, whatever, stop.


You can 3D-print a holiday-inspired tree with Neopixel LEDs in Adafruit's Feather RP-2040 Scorpio. This project uses 8 Neopixel LED strips to make a festive display that cycles through different animations. The tree structure is 3D-printed and measures to a half a meter tall with a base diameter of 30 centimeters. This Feather features the RP-2040 chip, 8 megabytes of flash, and 8 consecutive GPIO outputs with 5 volts level-shifting for Neopixel driving. This project keeps it simple with just 8 strips of 30 LEDs, but it can be scaled up to a larger tree thanks to the RP-2040's PIO peripheral. It can control thousands of Neopixel LEDs. This project can be powered off a 5-volt USB power supply and uses an Adafruit Permaprotoboard with cables for easily connecting the Neopixel LED strips. If you're adding more LEDs or brighter animations, it's easy to adapt it to power the pixel separately from a beefy 5-volt power supply. An IDC cable plugs directly into the headers on the Feather Scorpio for plug-and-play style wiring. This project uses the LED animation library for Circuit Python to create animation sequences. The demo code uses the Neopixel 8 library to make use of the fast and buttery smooth animations with the LED animation library. The effects are easily customizable and each LED strip can be set to use a different animation along with different speed and colors. To build your own, be sure to check out the step-by-step tutorial on the Adafruit learning system. We hope this inspires you to build advanced LED art projects with Circuit Python and Adafruit's Feather RP-2040 Scorpio.


Birth in human, first the contents, gestation period, parturation, relaxing hormone, adenocortic trophic hormone stimulation, oxytocin, birth and after birth, stages of labour and parturation. First the gestation period. So gestation period is actually the time span which an embryo or the fetus spans in the mother's body. Simply we can say that after fertilization, the zygote becomes burnt and the process of embryo or the fetus that is in the mother's body is actually the gestation period. For humans, for example, it is the 40 weeks or 280 days. Similarly, for other animals, for different mammals, this gestation period varies. The longest gestation period is for the elephant which is about 22 months. The parturation. Parturation is basically the process of birth. So we can define that is the process by which the baby comes out from the uterus of mother or from the birth canal. So during parturation, the embryo, the fetus is actually present in the uterus. So at the time of birth, the baby comes out through birth canal, out of the mother and this whole process of coming out from the body of mother is actually the parturation process. So parturation or birth process is actually stimulated by different types of hormones. Different types of hormones start the birth process. If we look at it simply, in humans, when nine months are completed, that is 40 weeks. After 40 weeks, the birth process starts. To start the birth process, the different events. First of all, when it is almost 38 weeks before the birth, the fetus it attains its position. The fetus which is the birth of the young one, it will first attain its position. The pattern of the position is that the head has to come out first. So first of all, the head will be aligned in the uterus in such a way that when the birth starts, the head will come out first. The next one, after attaining the position, now there is the turn for hormones. Now what will the hormones do? They will play their role. The first hormone which is involved in the birth process, that is the relaxing hormone. Relaxing hormone is basically the pituitary gland of the mother. It's secret relaxing hormones. Relaxing hormones actually dilates the bones. So what it will do is that the bones, the pubic bones will dilate because of which the fetus or the new one, it can come out through the birth canal. Because if the bones will stay on their position, then in that situation, when the normal birth is not possible. In many cases, doctors operate, they do a common reason that the bones are not dislocated from their place, they are not relaxed. So it means that before birth, the pubic bones should not be dislocated or displaced. Its dislocation will be that when the bones will move back from their original position, then the space will be created. So the space created from here can come out through the birth canal. So the first hormone is the relaxation which actually dilates the bones or is dislocating it. The second important hormone is the adrenocotrophic hormone. Adrenocotrophic hormone is basically the fetus which releases the mother. So first of all, during the birth, the fetus's pituitary gland will release adrenocotrophic hormone. Adrenocotrophic hormone of this fetus will affect the adrenal glands. This fetus will affect the adrenal glands of the baby, because of which the adrenal glands will release the steroid hormones. These steroid hormones will stimulate the placenta to release the prostaglandins hormones. So if we look at the sequence, it means that the fetus site is also playing its role in the birth. How will the stimulation be? First of all, the fetus's pituitary gland will release the adrenocotrophic hormone, ACUTH. This adrenocotrophic hormone will come to the kidney of the young one. This fetus's kidney will stimulate the adrenal gland, which will produce the adrenal gland or steroid hormone. Then this steroid hormone will affect the placenta. This placenta will affect the placenta, and the placenta will produce the prostaglandins. Prostaglandins will play a role in the birth of oxytocin hormones. This is the second important hormone. Prostaglandins are being released from the placenta. Second one is the oxytocin hormone. Oxytocin hormone is released by the mother. When the fetus is in the mother's uterus, the fetus will create a stretch because of the pressure. Because of the stretch and pressure, the mother's pituitary gland will secrete oxytocin hormones. Oxytocin hormone, which is released from the pituitary gland in combination with the prostaglandins, will give powerful contraction to the uterus's walls. The walls of the uterus will have powerful contraction. When there is powerful contraction, the labor pain starts. After this, the powerful contraction may take from 1 hour to 7 hours. It can take 1 hour to 1 hour. With the passage of time, the muscle contraction will increase. The intensity of the contraction will increase. When the muscle contraction increases, the young one will come out of the birth canal. It takes almost 1 hour to 1 hour to 1 hour to 1 hour to 1 hour. After the muscle contraction starts, the birth process is completed. Once the babies have come out, the birth will start. The muscle contraction will continue. The placenta will also come out of the mother's body. After birth, the placenta will come out of the mother's body. Overall, we can divide the birth process into 3 stages. The first stage is the dilation stage. The first stage is the dilation stage in which the vagina will dilate. The pubic bones will be displaced. The second position pattern is the birth. The second position pattern is the birth. The fetus or the young one will come out. And the third one is actually the after birth during which the placenta will also come out from the body.


with the computation of, with the computation of the, of the degree over a Jacobian, a Jacobian, a generic Jacobian in, in A5. And I want to tell you just briefly about another curve, another, another fiber, sorry, another fiber coming from the modular space of cubic trifles, non-singular cubic trifles. So I defined yesterday, this is the, consider all the cubic trifles in P4, non-singular cubic trifles. This is modular space of dimension 10. So it's not so big inside of A5, but it's pretty interesting. We have a, a theoretical theorem that allows us to embed this in A5 by, by taking a cubic trifle associated to, it looks like an annotation from the other fiber, but is, is, is intermediate Jacobian. So I define intermediate Jacobian with the, from Hodge theory. We take the h12 group complex coefficients over the third homology group of x. So this has also is a lattice. This is a, a C5 vector space. This is a five-dimensional a brilliant variety, which a principal polarization coming from intersection the, the co-product in the homology, in the third homology. This is intermediate Jacobian. So it's, it's not so, for the, for the geometry is not, we are going to, not going to see much about that. We are going to all work with the cubic trifles. Okay, intermediate Jacobian. So we, but we are identifying the, with the, with the, yeah, this is popularized, a video about it. Okay. Okay. How do you construct? How do you construct a covering in, in R6? So you, what you need, take a cubic trifle together with a line, a line inside it. Okay. And consider the projection. So the cubic trifle is inside before. So given this line, you can consider the projection over this line. It's a rational map into P2. Okay. This is a projection from the line projection from L. Okay. So this is not well-defined on the line, but you can always blow up the line x. And this is, this is now well, you get a well-defined map by, I'll call it pi also. And this pi turns out to be, is what we call a conic bundle of P2. This map is a conic bundle. So, but, but that I mean that the inverse image of a point in P, in P2, you take a point, you have two options. The fiber, the fiber, the fibers is one-dimensional fiber. And the fiber is either a conic or you have two options, a conic or two lines intersecting one point. So it's also degree two. So at the generic conic, two lines, the union of two lines, two lines. Let me put this. So conic or two lines. Okay. Of course. So we are going to do the same, the same idea as we did with the quintics. We consider the locus on P2 of the points where, where the conic degenerates. The conic degenerates. And this is the discriminant locus again. So the discriminant locus, locus of this, of this conic bundle is well, all the points in P2 such that this is this inverse, inverse image, a pair of lines, pair of lines. And let's call that C. And this C is again a quintic, a plain quintic. Quintic. Now, do you have a plain quintic in P2? Yeah. I like to draw P2 because the few things I can know how to draw, to draw. Then a quintic. And the quintic, you take the class of a line. Yes. It's a different line now. It intersects five points. And it turns out that that's right. I will tell you something about this, this, this line. The thing is, you can now define in the, okay, let me tell you something more. The funnel in the, in the space of all, all the lines, the funnel surface of lines of a cubic three-fold. Let's put it fx is the set of all lines inside of x. It's a line. So it's a surface, funnel surface of lines. And in this funnel surface of lines, you have in particular the, the fiber of the conic bundle over the discriminant blocks. Okay. So here I'm going to define the covering. So I'm going to define the covering C tilde over C as the set of the two lines, the lines in the funnel surface such that this line intersect. Okay. Now let me put names. I fix a line for the block. Let's call it this L0. Okay. L0. Maybe I can give a drawing here. So you have, you have L0.  This is somewhere there. And how do you project? So imagine that you are already in x tilde. Okay. And you are over, over a point on the discriminant locus. So the fiber of this discriminant locus is a pair of lines, but this pair of lines, since, since, since we are talking about the projection, this pair of lines lives in the, in the same plane generated by well, the pair of lines and this LC. So you have two pairs of lines intersect and L0. So let's call it L prime, L and L prime. Okay. And these two have the same image, the projection that goes to P. You project PL0, you go to P point in the, in the, in the corp C. Okay. Another color. And this is just two lines as the inverse image of this P. So by this procedure, I have, so I just can define C tilde as a set of lines in the final surface such that they intersect my given L0 line. So those are precisely the lines, the lines of, of, yeah, of the degenerated conics and the conic bond. Okay. And this is by construction, this is, well, I call it P is not, not a problem. And it's also a two one. And it comes with a natural involution, of course, Utah. And this is, this is the associated, you have a plane, Quintic. Okay. Quintic. And every double cover, a double covering comes from, comes from two torsion points. So this is related to a two torsion point on C. And it turns out that this two torsion points is an odd torsion point, odd in the sense that when you take the sections of the line bundle, it tensor with this L that I define here. So, yeah, well, okay, I say this is the line, but this is more precisely is, I should say is, so you call it that fee is the pullback of the class of a line. Okay. May I ask, so is this discriminant Quintic in general as well? Yes. Good question. It's in general smooth. Yes. That's true. That just has to be shown. Yes. You can, you can expect the, yes, general smooth. Thank you. Yes. I'm wondering about when this can degenerate. You don't have double lines as fibers. No, no, I don't have double lines as fibers. Precisely, because I wanted the anecdote over here. This is it. Yeah, they don't have ramification points. So in general, yeah, let me write it here. Smooth in general. And what I want to say is that it's all these, in the sense that this is always with the parity one. So the number of sections of this tensor, this tensor is, is even, is always odd, not odd number. Okay. That is, that is what they mean by the way. So that, that, that takes us in the, in the other component of the Quintile, of the coverings of the plain Quintics is of different nature. So, and moreover, well, okay, this is something I'm not going to prove. But this is my proposition to move in, I think, is that the prime of this constructed double covering is a somorphic to the intermediate jacob. This is a very beautiful. And, okay. So what they wanted to, I wanted to, to study now the fibers of over this, this, this, over this intermediate jacobian. Observe first that by construction, so to construct this double covering, what I need is a pair, is this pair, X and a line. So if X is fixed, if the intermediate jacobian is fixed, or the cubic threefold is fixed, you have such a double covering by the choice of lines. So in this sense, you can identify the fiber over any fixed intermediate jacobian with the surface of finalize. So it's two-dimensional. Just choose a line, choose the line inside of X where you want to project. Okay. So let's, let's look at them at the map. So you have, let's see, R6. Angela. Yes. It's obvious that if you change the line, then the, that the covering will change. Because you say isomorphic, so it's. You can identify. No, I agree with you. It's not adobius, but it's true. It's not, you get non-isomorphic coverings. Yes. Yes, yes. No, I am making a lot of shortcuts on this, but it's, yes. Yes, this is, maybe, maybe the construction will be more clear. A5. So this is P6. And now we are going to blow up on Rc. So Rc remember is the double coverings over being fixed with all theta, all theta torsion point, all theta torsion point. This is the old ones. And we blow up P6 over, over these locals. This is exceptional divisors. And the image, by this construction, the image is in, in the locals of intermediate Jacobians that I identified with the cubic leafels. Okay. So I blow up here. And this is still exceptional divisor. Okay. So as I said, this is called dimension five. This is small. This is called dimension three. Okay. So you have two-dimensional fibers. So here is a P2 bundle. And this is P1 bundle. Oh, P4, sorry. P4. That's right. And then there is, so I just giving you the result, but it's very, it's very, it's not so difficult to do. It's purely geometric. The description of of this map P6 at the, at the level of exceptional divisors. So what is the point here? So a point here. So what is this P2 bundle? Also, you can identify C eta L. Yeah. So you have a point C eta L in RC. It's still, and it's not here. This C is for, for, for, for cubic leafels, huh? Not for Cs. It should be like this. Okay. So this, this point is over the point C eta. And L, L is, is, what is it? C, C is a plane quintic. Eta gives, eta is the two torsion point that gives you the double covering connected, different from zero. And this is plane quintic. Quintic. So the L, the L is a line is, is the class of a line in the plane quintic. So you can write it as L in the dual line in P2. Every line in P2. And every line in P2 defined is degree, degree five, degree five line bundle with a, so I mean, then define the line with the line bundle. It's not such a great idea. But such that this is called. Okay. This is the one side. On the other side, a point here, what is a point here? Okay, is, you can identify with a cubic trifle together with hyperplane H. So let me write it here. X H in the section of the device or over, over the cubic trifles is X. So X, X is cubic threefold. And H is any hyperplane in P4. So which P4? The P4 where, this P4, where the X is, is in bed. Hyperplane. Okay. So these P4s are to each other. Okay. So what is the map? Yes. So the P, the P inverse tilde on the sectional device. So let me write E for the sectional devices of a point in C tilde. That should not be here. The inverse point. What is that? Okay. Let's look at, looking at our construction is, well, is, is on the, on this covering into, in order to give the double, double covering, we need a line where to project. So it's going to be a line. It's going to be the set of lines in the final surface. Yeah. With the property that this line belongs to the cubic trifle intersected with the hyperplane. That is the answer. So maybe it has to do with your question, Pavel, because so every line will give you a different, a different way of projecting. That's right. But I'm not considering all the lines, but only the lines in the intersection. And if, if you, you choose the X and H generally enough, this intersection is a smooth cubic surface for X and H general. Okay. So respect to have nice, nice intersection. And as it's a very well known fact that the every, every smooth cubic surface contain exactly 70, 70, 27 lines. Okay. So let me write it down because this is the whole point of this discussion. Every smooth cubic surface contains 27 lines. So the, the, the interesting part of this, looking at this fiber is that the 27, the lead already computed appears naturally. It has, it has some, some interpretation that this, and that was what Donaghi thought that this should be. It has to do with this, with this, with this cubic surface. Now, yes. So let's, let's, let's put it more concretely. So, so the cubic, so now this is not only about set 27 only, it's not only a number. It has to do the, the competent incidence corresponds to help with an incidence. For instance, we know that every line intersects in all the lines. Yes. So is, is this structure of the lines reflected in our fiber? That was the question. And at the time they, they, they knew the answer, that the degree is 27. They didn't know yet. So the, what was the, the relation between the, the incidence of the lines and, and, and, and the points on the, on a, on a fiber. Yeah. How. And this is when, when Donaghi come up with this tetragonal construction. It appears a little bit later. Okay. So I'm going to give you a recipe of how to, how to go from one tetragonal, double covering of a tetragonal and you get two orders. Okay. And this is, this is very, very similar to the trigonal construction. And maybe a probably Donaghi got the idea from there. You have two to one ethyl, double covering. And assume that this, this, this curve is tetragonal. Okay. I don't know if that could Okay. This is the drug. This is very general. Okay. Any, any genus, any genes for any genes. Okay. You can always. And now what do you do before this is so P1. So you have a pencil of G1s, G1 force. So the G14 is parametrized by P1. So for every point in P1, you have four points on the curve. So you can embed it, because before you can embed the G14 in the symmetric product of C four times. And you can define this associated P4 map from CT level in the way that you have a device or on the fiber here.  And over this point, you have the choice for every, every point you have two choices. You can choose to, I don't know. Pj, Ij, K, L, the others. Yeah. And every index can be one or two. So you have to, to, to play image of each point. So in general, you have two to the, two to the four times two. So this is a to one map. So let me put it clear. The inverse image of a point, P, you have two. So if P tilde one, P tilde two. Maybe the notation is not so sure. Anyways, and then you consider, you restricted that to the P1. And you call it X tilde. It's embedded here. So you take the restriction over P1. And it turns out that this is also curved, but this curve is disconnected, has two, two pieces. Let's call it to, let's call it C, C0 tilde union C1 tilde, which is the joint. They are really nothing to do. One nice to see each component is by defining a linear and equivalent relation on, on the set of, of the points of X tilde. So we will say, does D, you have two divisors, D, D prime in X tilde. So since in, since point here. So device of degree four and C tilde, we say that two, two of these divisors are equivalent, some, some, some, some relation, equivalent relation. If it only if they put, first they push down to the same divisor, push down to the same divisor in C4. So are in this fiber. Yes. And, and they share an even number of points. So this is a way of, of, of, of describing this linear, this linear equivalence of C, C, C tilde. And with this relation, so this, this relation comes from the monodrome. Okay. This is, you have to look at the monodrome around the branch, around the branch locus. What happened around the branch locus of, of F and how did it, it, it lead to the, to the monodrome into P4. Because you have to do careful. But this is the result. And, and it comes with a natural evolution, because this guy has an evolution. Let me see. I call it his sigma. Yes. And the sigma extends to the, to the device source of degree four. So you have an evolution here, just to change the two of them. And, and given this equivalent relation, in respect to this equivalent relation. Yeah. So each of this component comes with an evolution. And by definition, those are italic. So this is free, free of fixed points. So from each one, you can define italic over covering. I call it P0. And then each of them maps to P1, 4 to 1. So very simple recipe. Very important. So you have, if you start with a triple like this, a double covering and let's call it here, F0 and F1, you, the tetragonal construction. So the only, the only thing that you require is that this guy is tetra, is the tetragonal. Yeah. You can always construct two older one ramified double coverings with that tetragonal map. This is very, very nice. And this is so called, is so called triality. And I think it's very interesting to know. So why, why this, okay, why this thing works? Why this is triality? So the reality is, is an ocean in group theory or, or yeah, algebra, the algebras. So you have a description of all the little algebras depending on the thinking diagram and so on. So when you look, when you look at the monotomy of this tower. So the tower corresponds to a monotomy corresponds. So what is the monotomy? So it's a representation or, or a map from the fundamental group of P1 minus the branch locus. So how do you describe this, this, this tower? So you have to give a map into which group, the group that you are using for the monotomy is the bi-group of D4. So I will come back with the D4 again, but so D4 has a thinking diagram like this. It's generated by four roots. So it's rank four to the thinking diagram. And it's associated to some Lie algebra. And so the automorphism of this Lie algebra corresponds or the outer automorphism of this Lie algebra corresponds to the automorphism of the thinking diagram. And this thinking diagram has an action of, of S3. Oops, this is not this. S3 acts on this thinking diagram. Yes, by, by moving, by moving this, this root. This is the, the reality that it was told. This is someone non-concept in, and also in representation theory. So, so that means also that every, every representation of the group W, the bi-group D4 comes in package of three. You have always these three, maybe because you have this outer automorphism that moves one, one representation into the other. So this, this fact of going to, when you come in package of three, you see it in, in this three, threeality of tetragonal double covariance. This is like the reason, the deep reason behind of the construction, this group theory. Okay. And this is very, so I just learned recently that WD4, it has this property. Essentially, it's the only, only group with has automorphism, outer automorphism, isomorphic to S3. They are very few who has no trivial automorphism, outer automorphisms. Yes, let me write it down. This is outer automorphisms. And, and so you cannot expect to have this for other groups, all the type of construction. So in this, for the same reason. Yeah. Okay. Yeah. Okay. So this is the tetragonal construction. That's right. So a small remark, you have time to, to elaborate, but just to tell you that the trigonal construction is at the generation of this one, of the tetragonal. You can see it like this. Okay. Now, let's not with, with this tetragonal in mind, let's do it geometrically. Now let's do it geometrically in the case of the cubic drift. So you have, let's see, start with a cubic three-fold in P4, smooth, three-fold, and align. I don't know, I want to, yeah, I fix the line. So I can construct the, the canonical, the conic, conic bundle, PL, into, into P2. You have the, the restriction to the, to the, to the discriminant locus is a, it's a double covering. Okay. And now choose, choose a plane, a plane in P4 that cuts the meeting, meeting the line where you're projecting and towards. Okay. So a intersection X is three lines. So this is where the, you can, the tetragonal cost is, you can see it geometrically because, so the first, the first, the first double covering, it, it was, you, you, you got it by, by, by projection with the line L. But when you project with the other two lines, you get other different, two different coverings. Okay. So you get three different, three different double coverings. So you get three quintics, quintics, C, C prime, C D prime, and then each one comes with a double cover. Okay. And this is what the, the comment of Pavel that you will have to show that these are not isomorphic, non-isomorphic as double coverings. Now observe. Okay. Where is the tetragonal map? Observe that when you project, okay, you have the line and this line is contained in a plane A and you have, so this, this, these three lines is the intersection with A. And when you project, when you project with PL from this line, okay, it's not good. You end up in P2. But the projection of these two lines is a point. Yeah, because they, they, they all live in the same plane. So it's a point here. And once you fix a point in the quintic, you are in a quintic. So you can project from this point. Yes. And when you project from this point, you get a G14. So I project from here and essentially you take all the lines going to this point like this. So in general, she's just as a quintic, the lines intersect while you don't see it from my drawing. But then, then you get the projection from P, gives you from P, keeps you a G14 on C. Okay, that's the G14 that associated to L. So when, when, by doing this procedure to get here, also, sorry, they all come with a four to one. And this is the tetragonal construction, geometrically. So the, the, again, the, the tetragonal map is given by the image of the other two lines. So they are related. And, and the three objects are the trigonally related is what they said. So, and, and these three objects, C tilde, C, F, C0, C0, F0. This is F0, F1, F. Oh, I changed my notation. Sorry. Let's do it all with primes are tetragonally related. So I can go from one to the other by the tetragonal construction. So this is F, F, F prime, FB prime. Okay. But moreover, these three maps can be realized simultaneously by, by the following construction, construction. So you take the A is given, you have this A here, a P2. Then consider once, once you fix a plane in P4, you define a pencil of hyperplanes, hyperplanes, let's call it C, equality of T alpha. So they are parameterized by P1, the hyperplanes in P4. So they are all P3s that containing, containing, containing A. So this is a pencil. And when you move the pencil, you can, you have also a pencil of cubic surface by intersecting with, with X. Yeah. So it's parameterized by this is cubic three four, cubic three four, cubic surface, cubic surface. Yes. And in the genetic, the genetic, the genetic, in the genetic element of the pencil, this cubic surface is going to be smooth. So don't worry. So, but you see, and every cubic surface comes with 27 lines, but you are moving this 27 lines along this pencil. And when you move the 27 lines along this pencil, you get, you get the lines in the different C-tildes. And that's how you can see that, that the tetragonal construction is very much related to the incidence of these lines, how we want one from the other. Okay. Let's say, so, so here is, here is the theorem. This is Donaghi. First book with Donaghi. I have time. That the PRIM, now when you take the PRIM of tetragonally related double coverings, they have all the same PRIM. And this is how we're interested that we are, we are finding the, the explicitly the 27 elements on the, on the file. The proof, well, the proof goes in, we can prove it by the generation as well. Let me just sketch. So what do we need to start with is a map. We have a map. You have, for instance, oh no, I see zero. Change my notation again. Well, okay, for instance, you can go from the tilde here. You can embed that in, in one of the others in four points of the order. And I will tell you how. This is, I think, the, the interesting part. You can always have a map from C tilde prime from one into four divisible. And from here, that's right. And then you apply the universal property of the PRIM. You can extend it to to the PRIM. And, okay, not, not here, but then you go to the big zero, C tilde. This goes from C four. That's a late P1. Sorry. Okay. What is interesting is this map. So you have, this map can be described as geometrically. So I'm using this, this description. So a line, a line in, a line, let's call it M, M in, in one of these, I put it while, ah, sorry. In one of the, this cubic surface that, that meets meeting the line L prime and is not, and not in A, also meets four of the other A lines of the A lines that they are in, in the cubic surface, but not in A. So A contains this three, but I'm considering the old meeting L and each, each in a co-planar one in each, each, however the time we are over time, one in each, one in each four co-planar plates. Let me, let me, let me draw that. So, okay, what they want to say that, that give you the map, you take the map M and then you send it, I don't know if it's an injection, but if you don't need an injection, you need a map in CT lab four for the other curve. You just to go into the four lines, four lines meeting L. Okay. Let me see if I did correct. So you have, I tried to draw it, but I'm not, so you have M for any M line in, in the cubic surface that, that meets L prime. So it's a, it's a line here. This is, that, this is the definition sort of to say that this is there. And they are exactly all their four lines meeting M and the, but they are not meeting A, A is somewhere else. So, and this, these all of them, they meet L. So I am sending, I am sending this M to the four lines meeting L. So four lines meeting L, they are, they are here, these those lines. Okay. And they are all co-planar, but this is, this is independent of L prime, L prime somewhere else. They don't intersect somewhere else. L, L, LB prime. Okay. That, that is, that is a construction coming from the geometry of the lines, these incidence lines of the, on the, on the cubic surface. So I want to stop here for the break and this is essentially what we have done for the triangle now. But they just want to say, how do you obtain a map from one curve into the, the divisors of the order in order to construct. Yes, in order to construct the, the isomorphism. There is any question? Is there any question? Okay. So let's do the five minutes break.


Hey everybody Dr. O here in this video we're going to talk about the larynx or your voice box then we will talk about the vocal cords as well so you can see here the larynx it actually connects the pharynx down down to the trachea and it helps to regulate how much air is going to enter and exit your your respiratory system your lungs it's primarily made of it's made of all cartilage but there's lots of different types of cartilages here there's three big ones as you can see those are the ones that are bolded on both of these images we have the epiglottis that's that elastic flap that covers like a lid covers the top of the glottis when you swallow so that food or drink doesn't go down the wrong pipe into your airways you have the thyroid cartilage on that forms the front of the larynx this is where the laryngeal prominence or your adam's apple is because it tends to be larger in men and you'll see how that also seems to play a role with sound production later then the cricoid cartilage is really just this ring around the edges not as big of a deal you can also see the let's see the arytenoid cartilage corniculate cartilage and the cuneiform cartilage these smaller cartilages they actually will attach to the muscles that control speech and sound production because of their link to the vocal cords so they're going to be pretty important in speech production not in sound production not really the structure here what else about this just those small spaces you see the cricothyroid ligament cricotracheal ligament especially that cricothyroid ligament that's going to be where tracheotomy would be performed so not a huge deal but just kind of interesting so those are the cartilages think of it being truly a box a box of cartilage with cartilage on the top front backs and the sides let's dive in though and see what it's actually protecting it's protecting the glottis which you see here which is the opening to the trachea so the glottis is really the opening but it's also you have the true vocal cords then you have what are called the vestibular folds or the false vocal cords so these are so that the white portion there are your actual vocal cords and because there's an opening between them there's a space that allows them to vibrate as sound travels through them so can so think about the vocal cords oscillating or vibrating being very similar to the sound you produce when you when you strum a guitar string something like that the size and thickness of these true vocal cords do play a big role in the pitch so the reason that people have different pitches or different make different sounds when when they speak is because of that that can also be altered because your vocal cords are attached to muscles so this is why some people are really good at impersonating other people they can they can manipulate these muscles better than the rest of us and they can change with their voice sounds we can all change how our voice sounds but some people are much better than others and then lastly because of the thickness and tension in these vocal cords generally men are going to have deeper voices because of the size of the larynx remember the larynx the cartilage is bigger in most men and that's where that deeper voice would come from all right so that is the larynx and your vocal cords and just basically sound production is going to be air being pushed out of this glottis and vibrating or oscillating these vocal cords now speech is going to involve lots of other structures the actual sound that comes out of your mouth will involve your sinuses your tongue and the rest of your mouth and lots of other structures as well so okay i hope this helps have a wonderful day be blessed


So, we will start this session on surgical treatment of locally advanced localized disease and locally advanced RCC. May I have my introduction slide, please? My introduction slide, please. How many surgeons have we got in the room? Quite a few. Great. May I have my slides? You just give us two minutes, please. We're just going to do your slides. Okay. Thank you. No, it's not this one. It's the other slide. It's introduction slide. This is the clinical cases at the end of the session. You have two set of slides. One is the introduction and the other is the clinical case. No? It's again, it's clinical case. So basically it was an introduction for seeing always in the audience surgeon, medical oncologist, nurses, pathologists, biologists, all over. And I wanted to show you some summary slide of clinical cases for having a vote before the presentation and a vote after. So we will go to the presentation. It doesn't work. No, it doesn't matter. Let's go on the first presentation. Okay. We're covering four subjects this afternoon in the surgical series. The first is a debate about robotics. Does it have to be robotics if you're doing partial refractomy? The second is on ablation. The third on the surgery for advanced disease and then Jean-Jacques clinical cases to close the surgical session. Without further ado then, I'd like to ask Christophe Fassan from Paris to come and make the case for everybody having a robot. Should I have a robot, partial refractomy?  May I have my slides, please? That's the most difficult step. So I must first thank the organizing committee for this invitation and to give me the opportunity to speak about this very exciting topic about robotic surgery. They completely changed the field of surgery in neurology and I think especially for the upper track. So can I have my slides? Okay. Okay. Thank you. If it works. So I think that first we will both admit the concept that partial refractomy must always remain the only goal of this surgery. And the way to do it will remain optional, of course. So for those who are not surgeons, this is what robotic surgery looks like. The surgeon is sitting in a console, he's moving the instrument with joystick. He has a 3D view so he's completely merged inside the patients. And on the other side, you have the patients with laparoscopic tubes that are moved by the surgeon. So in my institution, we have a 10-year experience on robotic surgery. We do right now for more than 400 cases a year. And kidney surgery represents close to 150 high cases per year concerning mostly partial nephrectomy but also some kind of very large radical nephrectomy or patients for a living donor nephrectomy. So which tumor will be accessible for this kind of surgery? Of course, the small localized peripheral tumor. But also some larger tumor that you can see here on the solitary kidney that will be done with a selective clamping or this very posterior tumor. And I like to do it in this case, laparoscopically, so you don't have to open the peritoneum. So this is how the surgery looks like very quickly. You have the external view and then we dissect the heel of the kidney so we can clamp the artery and the vein. And as soon as it is clamped, you can just remove the tumor. In this case, it was a 4.5 centimeter tumor. Then as soon as the tumor is, you can open, even open the cavity, in this case.  And then you can just repair the kidney to make hemostasis and to avoid any perspirative bleeding, which of course sometimes can occur. So as soon as the kidney is repaired, you will be declaim the kidney and be sure the hemostasis is correct. So this was our last data from last year. So as you see, I do both trans and retroparitoneal approach. If we compare tumor a little bit larger for transpiritoneal and smaller for a retrop, but we can go up to 8 centimeter depending on the patient. We always say that robotic surgery is longer. In fact, it's most of the time less than two hours and it's even quicker with the lomboscopic approach. With a very controlled warm ischemia, which is most of the time less than 15 minutes. And the hospital state, and we will see a little bit later, and that is the major advantage of robotic surgery is the hospital state. We've also a very well controlled oncological outcome with a positive margin of 1.6%. So we have, of course, observed a few complications. Most of those will be hematoma, postoperative hematomas. Most of them were just under surveillance, few transfusions, and just one patient needed embolization of this bleeding. We also had one patient with a urinoma. So in our institution, we did compare the robotic parachial nephrectomy and the open parachial nephrectomy. So on 100 consecutive patients, we saw that the mean tumor size were not different between those two groups. And the only difference were the high complexity score, which was a little bit higher in the open surgery group. So we compared the operative term, of course, which is almost the same between open and robotic parachial nephrectomy. Clamping time, 17.5 minutes. That was the first part of the experience. So it's why it's a little bit higher than the previous data that I've shown. So I think that right now, we go even faster with the robot but then in open surgery. So the main difference was the length of stay, which is 3.8 days for robotic surgery and 6.8 days in open surgery. So the robotic parachial nephrectomy was better than open parachial nephrectomy in terms of blood loss and hospital stay. And it has the same rate of complication, warm ischemia and impact on renal function. So we could say that robotic parachial nephrectomy is only accessible for small tumors. So in a survey in France, around 6 French academic centers between 2007 and 2011, we recorded 220 robotic parachial nephrectomy and 54 patients had a tumor over 4 cm. With intermediate and most of the patients had intermediate and high risk scorn nephrectomy. So as you can see, the warm ischemia is a little bit higher but we still have quite a normal operative time. It's a little bit higher also. It's turning around 3 hours and the warm ischemia is 23 minutes. Complication rates, of course, if you have a larger tumor, you must see some more complications. So we had 9 complications over 54 patients. Only 3 positive margins which makes the outcome, oncological outcomes quite similar to the open literature. So why robotic parachial nephrectomy is all gold standard at least in our department? Just because also we completely switch from open to parachial nephrectomy. This year, we are expecting to do more than 100 robotic parachels and only probably 15% of those will be open. We did 50 robotic parachial nephrectomy during the first month of this year and only 6 were open. So why also we choose to switch completely to robotic parachels? Because we've seen the same oncological outcomes. Short-term hospitals stay with a quicker recovery for the patient and less morbidity. When you see an open scar and you have complication of that open scar, most of the patients don't want to go for that kind of surgery anymore. But new front sparing surgery remains, I think, a challenging surgery, even open and of course it is robotically also. So I think it's the kind of surgery that should be done in a referring center with, I think, a high volume patient. Thank you. Thank you, Christo.