Big mistakes in English. Do not say, I am difficult to find it. Say instead, it is difficult for me to find. Do not say, she is easy to bake a cake. Say instead, it is easy for her to bake a cake. Do not say, he is important to play. Say instead, it is important for him to play. Do not say, they are illegal to do that. Say instead, it is illegal for them to do that. Do not say, you are necessary to stop. Say instead, it is necessary for you to stop. Note, it's okay to say, I'm happy to be here. Or, she's expected to do that. What's the difference? The difference is focus. One sentence focuses on the person or subject. The other focuses on the activity or object. For example, we are happy to cook. That means we enjoy cooking. It is easy for us to cook. The focus is on the food or the activity of cooking. If you say, we are easy to cook. That means it's easy for someone to cook us. You don't want to say that. Another example, he is required to read those books. The focus is on the student. Those books are required for him to read. The focus is on the materials or the books. It is required for him or of him to read those books. To learn more about this topic, see video at link. Or, check on our websites for more free English learning resources. eslgold.com or freeenglishstudy.com


What's up everybody, Jason here for jasperyskatesrace.com. We just sold out 2022-23, Panini Contenders Optic Basketball. This is a five box break because he's number three. And again guys, you buy two or more teams to get a chance to win a free box. So again, one team unfortunately is not gonna get your chance to win a free box, but good luck. But if you buy two teams, that's one entry, four teams, two entries, six teams, three entries. We'll do that free box giveaway at the end guys. We'll alphabetize the names and check it out. Gotta go print it out from a different printer. You guys know how it is right now. But Ed got last one module spurs. There's everybody in the break. Here we go. All right, and remember I wrote down case three and four.  Ready or not? I have no idea what that is. For the left side guys, four, five, six, four. The right side, two, one, two, three. So this will here be for number four. All right, here we go guys. All right, so we got Tracy McGready-Yamming and a lottery ticket. First one, Shaden Sharp. Nice one for the troublemakers. Adam Kelly. What's up runtime, how you doing buddy? How you doing today man? Do I see gold? Do I see gold? I think I see gold. Kevin Durant, and it is a DeMar DeRosin gold. Season ticket for the Bulls. Nice, just off work man, awesome man. Thanks for getting those spots today. Yeah, time for some fun right? Six out of 10. Omar with the Bulls. Hang around with the gold. And another bad guys, we've even seen a lot of events in this. 11 out of 25, Dale Ellis. Nice orange though. For the Seattle SuperSonics, which is gonna go to the Oklahoma City Thunder, Adam Kelly. All right, Xbox. Like it says here, look for red cracked eyes, blue cracked eyes, green pulsar and gold and gold vinyl parallels. Definitely want to hit a gold vinyl. All right, oh bogey. That's a little cracked eyes feel. And playing the numbers game, red eyes. Fred Van Vleet for the Raptors. All right, it looks like another vet, Jesus. Or at least not a regular ticket. Now we got Josh Giddy, not numbered. For the Spurs, Devante Graham, that's a purple. Number to 15.  How's it going on here guys? Jesus Christ. Blazes. This could just be one of those cases guys, but I'm not giving up hope yet. So we have three more boxes here and then another five. And last but not least is that Devante Graham going to Ed. I know Ed, I freaking hate that too, man. Redemption. Ooh, is that the Black Pandora? Or is that just a base? It might be a base. And Marja, Buke Camp. Little ice for the bucks by Adam Kelly. Season ticket Jaylen Brown. We're going to go there and a redemption. Variation season ticket, carnival 31. Shed homegrown, nice. There's some OKC there. Adam Kelly. So that's going to be the variation season ticket for OKC. Dundara baby. All right, two more boxes guys. So that definitely kind of helps, but I want more. I want live too. I don't want redemptions. It's not your autographs, Chad. You've had time. Zach Levine uniformity with a blue ice lottery ticket, Jade and Ivy. 51 out of 75. Piston's going to have another redemption. What the hell's going on here? Jaylen Green, Drollin' Bead, blue. It's a color match though. Veteran ticket number two, RJ Barrett. For the New York Knicks, Matt L. Yeah, the lottery tickets do look nice when they're like the ice edition. All right guys, last box. I kind of still want to see what's hiding in the last five guys. I don't know. Chet's cool, variation ticket. Wasn't going to be a number one, just a base variation, but I feel like we're still missing a big wowser. Wowser rookie auto. Another redemption, Jesus Christ. Nobody wanted to sign in this year. Playing the numbers game and a sweet shot and the Edwards. Obagi Orange to 49. Tyler Hero and redemption is going to be the last card again. All right, last hit of the break, guys. Again, number four is down to like seven left. Let's get that done tonight, guys. Rookie season ticket, Green. What color is Green? Oh, you're cursing at her. Oh, let me see. Rookie season ticket. Green's out of 75. Card number one, 11. And it's Jalen Durand. Little bit of a teaser for Detroit too, but I think he'll take that up. Maybe a Jaden Ivy hiding in the next five. But Jalen Durand there. Rookie season ticket, Green. That should be out of 75. And Detroit, with that one. Yeah, at this point, huh? All right, you guys. Well, again, did finally see more rookies in this half, but again, more redemptions, man. Come on, gotta give us something live to get a check home variation, though. But like I said, I would love to try to see what's hiding in the last five boxes, guys, in single digits. And we're gonna get wind of the box, right? Just like we are right now, so give it a shot, guys. Let's switch scenes and let's do that box giveaway now. So alphabetize it. And that's six for Adam, so that's three. Brian with one. Ed, you have three, so that's just one entry, man. But good luck. Mark with four, it's two entries. Oh, okay. So yeah, it seems like some of the bigger players might be redemptions then, unfortunately, but I feel like live is just so much more exciting. So yeah, Matt got six, and then Michael two each. Peter two, Shane two, and then Wen Shun with two. All right, so out of the possible 15, it's gonna be 14. Roll two and a five, seven times. Good luck. One, two, three, four, five, six, and seven. Seven times, seven, seven. Mark, congratulations, buddy. There you go, man.  Thank you. Now again, we have one more. We have a lot of contenders optic in the store there. If you guys wanna try to run it back, it is down to five now. So let's try to get that one rolling, guys. When I get back, jaspyscasebreaks.com.


Hello, hello everyone! My name is Laura and this is my channel, Laura's Little Library, and today I'm coming at you with a fall recommendations video. The video is going to be some recommendations of books I think are perfect to read in the fall time. These will not include spooky books. One of them is a bit of a cozy mystery, but it's not like spooky, not like Halloween. That will be a separate video more towards the end. Otherwise if you want spooky content, I am doing my whole spooky reading extravaganza right now. Links to the videos explaining that are in the description, so feel free to check them out. And while you're down there, why don't you subscribe, hit the bell, like the video if you like fall, and comment down below if you have any recommendations for me for this fall season. So I tried to choose books from all different genres for any and all different types of readers, especially since I think that some books for some people scream fall, but for others may not. For me, fall is all about the coziness and the aesthetics. So anything for me that is like a cozy mystery or fairy tale, something kind of familiar, nostalgic, you know, that kind of thing. So let's just get into the recommendations, shall we? So the first book I'm going to recommend, I listened over audiobook over the summer, and that is Fat Chance Charlie Vega, and I loved this book. This book takes place at the beginning of the school year, which is why I think fall would be a good time, as it is kind of in the fall time of the year with school starting, and it's just such a sweet contemporary book. It follows Charlie Vega, who is learning to accept her plus size body as well as deal with her mom and other people not accepting her for who she is. So she has this hobby of writing, which writing is kind of a hobby in characters that seems very cozy to me, because I think of Nanorimo, which is in November, it's during fall time, and I love the idea of sitting inside on a rainy day next to a window and writing a novel or reading a novel. And also the cover is mostly orange. I will admit the cover played a little bit into it for this one recommendation, but not for all of them. So I would definitely recommend checking that one out. It's a little bit more of a slice of life. I didn't find like a super obvious overall plot, but I very much enjoyed it. I was constantly wanting to read more, so if you haven't, if you haven't checked it out yet, you should definitely do that. The next one I'm going to recommend is a historical fiction, and I talked about this a lot right after I read it, but it is Juliet, and this is by Anne Fortier, and this is partially a retelling, partially not. So it's the idea of Shakespeare's Romeo and Juliet. You go back and forth between what actually happened with Romeo and Juliet, what's different than the Shakespeare's version, and then it also follows Juliet's descendant from years, years, generations, generations later. She's uncovering the mysteries of what actually happened to Romeo and Juliet and how that is affecting her life in the present. So she travels to Italy and goes through this whole, not magical, but this whole adventure. And I think this is a great full-time read because it is that nostalgic Romeo and Juliet, and it's in a warm setting, which even though the fall is getting into a cooler season, I still think warm settings can be very cozy. And just all the little fun Italian influences just make me think of travel, and so I enjoyed reading this during the fall time. Then the next one I have to recommend is a fairy tale retelling. This is kind of a bigger type of book that I would be recommending, and that is Girl Sovereign Thorn by Melissa Baterados. And this is a Persian-inspired sleeping beauty type retelling. It's the idea where the princess is locked away because she is poisonous to the touch.  Not great for her. Not great for those people. Because this is mythology and Persian and it's a standalone which is also kind of nice. I thought that it has really cool adventurous cozy vibes. It's a very different kind of cozy. Like it's definitely much more a fantasy reader cozy as there's magic and there's this mythical flame. I really enjoyed this book and the cover itself looks more spring than fall, but I feel like the story could go either way. There's a huge emphasis on nature, which normally I would point towards spring for, but leaves are turning on trees so I might not give this a chance. Then the next one I'm going to recommend is actually one that is being adapted into a Netflix adaptation. I'm not super current on it, but because it is resurfacing in popular media I thought I would throw it in here. And that is The School for Good and Evil and this is by Sonan Jainani. And this is all the cozy vibes because it is academic. It is retellings. It is fairy tales. It is so sweet. I just I absolutely love to this. So it's the idea that there is a school for good and a school for evil and two kids are chosen from these villages every year to attend the appropriate school for them. And when they graduate they need their story becomes a fairy tale and it is written into books and that is what's passed along to the villages that these kids come from, but no one believes that they're one and the same. So and there's a little bit of like cozy mystery. It's then again it's the nostalgia fairy tale-esque cozy feelings that you definitely get from this book and it is the first in a series. I've only read this one and a little bit of the second one but I'm sure the rest of the series is just as cozy. Another this is a much more broader recommendation but if you are also one of those people that love fairy tale retelling nostalgic type I would recommend pretty much any and all of the Disney Twisted Tale books. I own all of them except for the one that just came out what once was mine the Rapunzel retelling but I own all the other ones and I've read about half of them. So at this point I should really do a reading vlog where I read the rest of them but um maybe maybe I'll do that November or something. Comment down below if that's something you'd be interested in seeing. It's a reading vlog of reading all of the Disney Twisted Tales that I have not yet read and then maybe I can rank them in my favorites. But anyway if you like Disney I would recommend choosing one or two of your favorite stories seeing if there has been a twisted tale book released with it and then read that again fairy tale nostalgic but with a twist so it's interesting. I would say go for it. I think it would be a lot of fun and the last recommendation that I have for you is very different from all the other ones. I've talked about it a little bit recently as the second book just came out and I loved it and that is The Inheritance Game and this is by Jennifer Lynn Barnes and this is definitely the cozy mystery type. So a lot of people describe it as like knives out meets something else I don't remember but it's because I didn't know what it was but I completely agree. So it's the idea that this girl who lives with her older sister who's kind of struggling through life doing her best to get good grades to get an education to get a good job uh all of a sudden gets a call and finds out that this billionaire down in Texas has left her everything so she she goes down there to attend the reading of the will and it's true this billionaire basically disinherited his entire family and has given everything to this seemingly random person on the condition that she lives in the house with the family for a year and the house is the best because it is all the cozy vibes of mysteries and puzzles and little games happening and try to figure out why she got all the money but at the same time there are secret passageways and oh my word the four grandsons. So this is definitely a very different kind of uh fall vibe but I think it's absolutely perfect. It's great if you don't like spooky books or you don't really want to read or are interested in reading like horror or thriller but you still kind of want to get into those mysterious vibes. I think this would be perfect for you to pick up and like I said the second book just came out like a month or two ago the Hawthorne Legacy and they are beautiful. All right those are all the fall recommendations I have for you guys thank you so much for watching this video again if you liked it give a thumbs up comment down below with any of your recommendations or if you have read any of these books I would love to chat with you about them and subscribe if you haven't already hit the bell so you get notified I post every Thursday and during the month of October I am posting bonus videos on Tuesday like this one as long as this one actually goes up on Tuesday I'm gonna try so hard um but yeah until I see you all in the next video I wish you happy reading


Welcome to day 18 of our 30 day pants review series where we pick a notecard at random and help you study for the pants So today's notecard is PPD Interpretation otherwise known as the Manto test interpretation. That's where you get the little bleb the little little bubble Intradermal in your forearm usually and then you come back 48 hours to 36 hours Sorry 48 hours to 72 hours later and you get that interpreted and if it's red and indurated You know that it's a it's a positive depending on the size and if it's not then it's negative depending again on the size So that's a test you'll commonly see as a provider in your primary care office in your urgent care In your occupational medicine practices if you work in any of those But you need to know it for the pants and for your exam anyway, so you may as well learn it So ppd interpretation there are three sizes that you have to worry about three sizes of induration And i'm going to give you a few seconds to think about those three sizes and what they mean So ppd interpretation give me three different sizes of the possible area of induration and what it could mean okay Size number one is going to be over 15 millimeters. So over 15 millimeters of induration means a positive test a positive ppd for a low risk patient someone who does not work in health care Someone who is not homeless someone who is not an immigrant to the united states from an area where tuberculosis is endemic and someone who does not have history of IV drug abuse IV da sorry my handwriting is terrible on the snow card so again High risk is someone who is health care worker who was an immigrant from a country that has Tuberculosis is an endemic someone who is homeless someone who was an IV drug abuser Those are all high risk. So the first of the three sizes is 15 millimeters or more 15 millimeters or more of induration Following the tuberculosis test. It's positive for low risk patients That is patients that are not in any of those categories that i just told you about size number two Is going to be more than 10 millimeters and that is a positive test for anybody that is in one of those categories And then size number three is more than five millimeters and more than five millimeters is a positive test for someone who is immunocompromised Has a positive chest x-ray has recent steroid use or has recently Contacted somebody who is known positive for TB. So the way you could think about this is it's basically three different sizes for three different groups of people The first one the least um or better yet the The least restrictive the one that's the hardest to become positive is for low risk individuals People who do not fit into any of these categories of high risk individuals You have to be 15 millimeters or greater of induration to test positive on the t beats reading test The second group is folks who are high risk quote-unquote, uh, or I guess we can call a moderate risk And those people need more than a 10 millimeter Induration so smaller than the 15 10 millimeters of induration is positive for anyone who is a health care worker like myself Someone who is an immigrant from a country where there is, uh, tuberculosis is endemic Someone who is homeless or someone who has a history of IV drug abuse and then finally five millimeters the most The easiest way to test positive for TB is for the ultra high risk group Or I guess you can call it the high risk group and that is going to be the people who are immunocompromised So they have hiv aids. They are on an immunosuppressant something like that. They have a positive chest x-ray they have characteristic hyalur What is the hyalur masses or I forget what it's actually called But a positive chest x-ray indicating TB if that is positive and there are more than five millimeters. They are positive uh, recent steroid use which is sort of kind of uh, like being immunocompromised Because it's an immunosuppressant and also if they recently had a positive TB contact All they need is five millimeters of induration to be tested positive for TB


The birth of Jesus was actually a fulfillment of the plan and promise of God. Down through the years, God had assured His people that a Savior would come. He first gave the promise to Adam and Eve, later He gave the promise to Abraham and then to King David. The promise became more specific through the prophets of God. Jeremiah foretold that the Savior would come from the line of David and be the righteousness of God's people. Isaiah foretold that he would be born of a virgin, that he would be called the Immanuel, which means God is with us. We remember well the words of the great prophet. For to us a child is born, to us a son is given, and the government will be on his shoulders, and he will be called wonderful, counselor, Almighty God, everlasting Father, Prince of Peace. Even the place of the Savior's birth was foretold. It was the prophet Micah who told us that the city would be Bethlehem. In those days, Caesar Augustus issued a decree that a census should be taken of the entire Roman world. This was the first census that took place while Quirinius was governor of Syria. And everyone went to his own town to register. So Joseph also went up from the town of Nazareth in Galilee to Judea, to Bethlehem, the town of David, because he belonged to the house and line of David. He went there to register with Mary, who was pledged to be married to him and was expecting a child. While they were there, the time came for the baby to be born, and she gave birth to her firstborn son. She wrapped him in cloths and placed him in a manger, because there was no room for them in the inn. Luke 2 verses 1 through 7. There were shepherds living out in the fields nearby, keeping watch over their flocks at night. An angel of the Lord appeared to them, and the glory of the Lord shone around them, and they were terrified. But the angel said to them, Do not be afraid. I bring you good news of great joy that will be for all the people. Today, in the town of David, a Savior has been born to you. He is Christ the Lord. This will be a sign to you. You will find the baby wrapped in cloths and lying in a manger. Suddenly, a great company of the heavenly hosts appeared with the angel, praising God and saying, and left them and gone into heaven. The shepherds said to one another, Let us go to Bethlehem and see this thing that has happened, which the Lord has told us about. So they hurried off and found Mary and Joseph and the baby who was lying in a manger. Luke 2 verses 15 and 16. They had seen them. They spread the word concerning what had been told them about this child. Luke 2 verse 17. This was born in Bethlehem in Judea during the time of King Herod. Magi from the east came to Jerusalem and asked, Where is the one who has been born king of the Jews? We saw his star in the east and have come to worship him. Matthew 2 verses 1 and 2. Magi secretly and found out from them the exact time the star had appeared. He sent them to Bethlehem and said, Go and make a careful search for the child. As soon as you find him, report to me so that I too may go and worship him. After they had heard the king, they went on their way, and the star they had seen in the east went ahead of them until it stopped over the place where the child was. When they saw the star, they were overjoyed. On coming to the house, they saw the child with his mother, Mary, and they bowed down and worshiped him. They opened their treasures and presented him with gifts of gold, incense, and murmur. Matthew 2 verses 7 through 11. Notice the participation of angels and people, rich and poor, men, women, and children. The message is that Jesus came for everyone. The Bible says God was reconciling the world to himself in Christ. This is why we have brought our message outside of the church and into the community tonight. The good news of Christmas is for all people. The good news that a Savior has come, that he has bought us back from death and Satan by his own death on the cross and his resurrection at Easter is for everyone. May this good news bring you the same peace and joy experienced by those who worshiped the Christ child on that first Christmas. May the love of the Christ child live in you and through you, not only during Christmas, but throughout your life. For he lives, he really and truly lives. Please join us in singing one verse of joy to the world at this time. We would like to invite you into our school behind you for some light refreshments and fellowship. The next presentation will be in five minutes.


Toxoplasma is a protozoan parasite that causes disease in humans and animals. It has unique endocytic structures that are not found in other eukaryotes. These structures are composed of specific proteins and play a role in maintaining the integrity of the plasma membrane. The endocytic structures may have evolved as a result of the parasite's need for a more efficient way to absorb nutrients from its environment. This article was authored by Lou Deccourney, Brandon N. Mercedes of Adra, Kristen M. Klinger, and others.


Bradford City chipynnol i'r gwaith nawr i fi am hynny yn y dydy'r ysgrifennu gymryd Fynaeth. Mynd yn ysgrifennu am gynhyrchu. Fy renneddo'r ysgrifennu maen nhw'n clywed i'w gwirionedd mewn wneud oes maen nhw. Fy yn gweithio i fynd o'n gweithio nad y ddechrau yng Nghymru 19a maen y 15th gofynie. Os y 56th byddwn yn lle, a'r eu cyd-egisio ar y clwb, gallwn cystafel i fynd yn gwneud.  Rwy'n rwy'n cael ei wrth gweithio, rwy'n gweithio o'r 11 oed, oes i'r 11 olyf o'r chyfl o'r wyf. That night I don't know half 11-11 12 o'clock at night and through my bedroom walls just hearing him sob as he Retold the sights of that day and I'm going down the next day to Prairie with various police officers and I know that the sights of that day were just horrific We know that people have breath for the rally together in so many different ways a'r bwysig yn yn siŵr wedi gŵr i gael eich castingsiwyr ymlaen o'i cyffredinol oes iawn, i fi hynny'n ei ddaiff y bwysig oherwydd pobol yn gweithio arbennig i'w ceistio'r bwysig o'r parodd i fynd, mae'r brafford o'n bobl o'n bobl o'r bwysig, mae'n bobol o'r bobl o'r bobl o'r bobl i fynd hynny'n so many it young famlys in children decked out in their Brafford City kids to say that we will never forget we will always remember. As a club we do that today, we will never forget the 56 and the lives that were impacted that day. We want to think today particularly of those people that we've lost ourselves this year and we particularly want to remember Paul Firth, a fath ymwneud y Brathfodd Brathford Cityfanym, gan rhai'r rhan o'r fawr o'r ddechrau'r ystod o'r gweithio'r dda, ddim yn 4 oed o'ch rhan oherol, ac mynd i chi'n ddod. Rwy'n ddod yn rhan o'r 56 oed. Rwy'n ddod o'r ddod o'r ddod o'r gweithio, ac o'r ddod o'r ddod o'r ddod o'r ddod o'r gweithio'r ddod o'r rhan o'r gweithio'r ddod o'r gweithio. fel y gallai dysgu, ac yn ymdweud i gafodd yr hynny. Mae gennym征ur yn beth. Cymru.  Rhyw oddi'r y gallai bwysig o'i cyflawn. Mae'r amser yn gyhoeddwyr o'r rhai Cyfnod 36 y gyrfa. Mae'n rhaid i'r cyfnod i'r ffioedd i'r ffordd a rhaid i'r rhaid. Cs Lewis, o'r cyffredinol o'r ysgol, yn fywydled i'r llyfr o'r holl. Mae'r rhaid i'r llyfr o'r holl, mae'n cael ei ffyrdd, mae'n cael eu cyfrifio arall. For those who'll grieve every day brings countless small moments of remembrance. Birthdays, anniversaries, bring their own pwnianse. Our grief is not only for the lives lost, but for the other losses the tragedy brought. The loss of hope and the loss of future, the loss of promise. We inevitably ponder what might have been, but we also hold dear the relationships that we shared, and hopefully we can draw strength from that. Grow close to one another, as we normally would do on the 11th of May every year. Our pain isn't lessened, but we can take enormous comfort from being together in our sorrow. Even as we join together online, knowing we share a sense of loss, we will all hope bring some more solace to those who still live with the pain, and for those who still bear the scars. I was reminded recently that Her Majesty the Queen, who is now herself in the depth of loss, once spoke of grief as being a price we have to pay for love. There are two sides to the same coin. It's a bittersweet truth that we cannot have one without the other. So let us remember today 56 gentle people who were taken from us that afternoon. People who loved and were loved. People whose lives enriched ours. Let us remember all those who were injured. Those who cared for them, and those who were terribly affected by what they experienced. As we come together this morning, we remember all those we lost, but we also remember with gratitude the love and the joy they brought into our lives. The city of Bradford will keep on remembering and commemorating in our own way. A reading from Psalm 31. Take me out of the net that is hidden for me, for you are my refuge.  You have redeemed me, O Lord, faithful God. Blessed be the Lord, for he has wondrously shown his steadfast love to me when I was beset as a city under siege. I said in my alarm I am driven far from your sight, but you heard my supplication when I cried out to you for help. I'm standing in front of the Bradford Farm Memorial plaque in Bradford Cathedral, and it tells us two things about that day in May 1985. It tells us shockingly that 56 people lost their lives and that 300 were injured. But it also tells us that four and a quarter million pounds was raised to respond to an appeal. That's over 10 million in current money, and that that money went towards the Burns Unit at the Bradford Royal Infirmary. Loss and generosity, a sudden loss, unexpected loss. For some families they lost more than one family member. Generosity is often born out of wanting to reach out, to do something, to be compassionate in a situation, to respond to the needs of human beings. In this past year so many families have experienced sudden loss, not just in this country, but around the globe. And yet we've also seen this wonderful outpouring of generosity, of volunteers coming forward, giving their time generously, of those in our hospitals working sacrificial hours in order to cope with the demand. And of course the wonderful exploits of Captain Tom and others who've raised funds for the NHS. In the reading that we heard from Psalm 31, the writer is having a nerve-wracking time. We think that he's probably been under threat of death himself. And he talks about God as a rock, as a refuge, as a strong fortress. These are strong images of stability, of not being moved. And this is how he's experiencing God in this moment. And then we have this statement of trust in God, into your hands I commit my spirit. It's interesting that centuries later Jesus, as he is dying on the cross, uses the same words. But within the Christian tradition we know that those were not his last words. There was another word that was spoken. He is risen. Even in the face of tragedy there is a purpose in this life. There is a better word to offer. And under God that's all about living generously. At this place of enduring memorial, let us bring to God in whatever way we feel able our thoughts and feelings at this time. Let us pray. We remember the lives of all those who died in the fire of 1985. We give thanks to God for all they meant to us, and for the ways in which their lives enriched our lives. We also give to God all that might have been, and our continuing sense of loss. We pray for all those caught up in the disaster all those years ago, who still carry the scars in their bodies and minds. We pray for those who were bereaved, and all those struggling with sorrow. Praying that each person might know the lights of God's presence, peace and hope. We give thanks for the medical developments that grew out of the tragedy. And continue to pray for the daily work of the burns unit, the paramedics, the police and the club staff. We pray for those who take part in sport and all who support them. And pray for their safety and protection in both this country and around the world. We give thanks for the people of Bradford, and especially for the community that live around the stadium and who opened their doors in compassion and service that day. We give thanks for the city of Lincoln.  For mutual understanding to grow, so that burdens may be shared and our cities bound together as places of hope. We pray for one another, for the days that lie ahead of us, that we may use them wisely in the service of God's and others. Support us, dear God, each day of our lives, until the shadows lengthen and the evening comes. The busy world is hushed and the fever of life is over and our work is done. Then, God, grant us a safe lodging, a holy rest and peace at the last, through the love and mercy of God. Amen. We gather our thoughts and prayers together as we pray. Our Father, who art in heaven, hallowed be thy name. Thy kingdom come, thy will be done, on earth as it is in heaven. Give us this day our daily bread, and forgive us our trespasses, as we forgive those who trespass against us. And lead us not into temptation, but deliver us from evil. For thine is the kingdom, the power and the glory, for ever and ever. Amen. So, let us honour and pray for all those we remember this day, as we hold silence for a minute. Pest wishes to you all, as we remember 36 years since the dreadful Bradford fire on 11 May 1985, and the 56 people who died and the many injured. My husband Chris and I have been honoured to attend the Bradford Memorial Service for several years. I was very moved by the families and friends, they and flowers for their loved ones who will never be forgotten. And for the children, many of whom carried a single flower who will never be able to meet them. Lincoln football supporters still talk to me about the awful tragedy of the fire, of the loss of Bradford friends, and with the Stacey West stand, they continue to remember Bill Stacey and June West, who were lifelong fans of the Lincoln City football club. My prayers are with you all. I would like to thank the Deputy Lord Mayor of Bradford for their flowers for the people of Lincoln. Although the virus has kept us apart for another year, we very much hope that we will be with you again next year. The 11th of May 1985 should have gone down in history books as one of celebration and joy for the people of Bradford, and indeed Bradford City fans around the world. 36 years have now passed since 56 football fans sadly perished at Valley Parade football ground in a match between Bradford City and Lincoln City. This was a significant and poignant incident in the history of West Yorkshire Fire and Rescue Service, and we are still proud to this day of all the firefighters who tried in vain to fight that fire and ultimately serve lives on that tragic day. We should remember the bravery shown on the day by other emergency services too, the police, the ambulance, and indeed the humanity and heroism of other football fans on that day, along with club officials and players who tried desperately to help people. Once again we pay tribute to the 54 Bradford City fans and to Lincoln City fans who died that day, and we also remember the hundreds of supporters who were injured as a result of the fire. It is important to us as a fire service along with the people of Bradford that we keep the memories alive of the 56, and we continue to mark the occasion each year. I also feel it is important to remember that football grounds across the country and indeed the world are a much safer place now as a result of this tragedy. Just like last year, COVID has meant that we cannot come together as a city and pay tribute in the usual way, but I know people will still pay their respects in their own special way. I'd just like to finally say that today our thoughts and prayers are with the 56 fans who have lost their lives, their families, both football clubs and everybody affected by this tragedy. Thank you and take care. Hello, my name is Jane Whitehouse and I work for Yorkshire Ambulance Service as the group's daysum manager for Airdale, Bradford and Leeds. On behalf of everyone at the trust, we mark the anniversary of this tragedy by remembering the 56 people who lost their lives and the hundreds injured in the Bradford City fire 36 years ago. It was a devastating incident for the city and for British football. As an emergency service, our staff are used to responding to difficult incidents, but some of those remain vivid in the minds of those who attended and this is one of those incidents. We will never forget those who perished and our thoughts are with their families and all those affected by this disaster. Thank you. On 11 May 1985, 11,076 supporters travelled to Valley Parade. Fans were from Lincoln, fans were from Bradford, fans who never expected the day to end as it did. Now it should have been a day of celebration and instead, at 3.44pm, tragedy struck. Of the 11,000 people who went to watch a game of football, 265 received injuries, 56 never returned home. The Bradford fire is etched into the memory of the city and it's incumbent on us all to remember them and the fate they suffered that day. Now this has been a year of suffering, of turbulence and of tragedy but it's important that we take a moment to stop and to reflect the fate of those who left to watch it for a game of football and who never returned home. It's important that we pause to reflect on those who suffered physical or psychological injury and that we stop to give thanks to the selfless efforts of those heroes who put themselves in harm's way. The terrible events of that day will never be forgotten and our thoughts with those who are affected. Hello everyone, I'm Ajay Mahajan, Professor of Plastic Surgery and Director of Research at the Plastic Surgery and Burns Research Unit at the University of Bradford and Consultant Plastic Surgeon at Bradford Teaching Hospitals. The past year has been very challenging for all of us. Although we call the pandemic the Covid-19 pandemic, we're already in 2021 and unfortunately the effects of the pandemic are going to be felt for years to come. Ironically, this is very similar to the situation people had to face when the Bradford fire disaster happened. Although the immediate treatment for those affected was completed over the following months, the after effects continues to influence our lives to this day. We lost 56 lives that day but countless other lives were affected for years to come. We take this opportunity today to remember the hard times that the bantams have faced. We support them by being there for each other. We have kept the memories of those affected alive through the work we do at the Plastic Surgery and Burns Research Unit at the University of Bradford. During this last year, we paused our work in the labs in the University to provide the additional manpower, woman power that was needed at the Bradford Royal Infirmary to deal with the pandemic. We have, however, continued to keep the bantams' academic flag flying high by doing the academic work in whatever free time we had to complete various projects. We have published our work and continue to present our work at various international meetings in the virtual format. I'm very grateful to everyone who has supported our work through various fundraising activities in spite of the challenges that the pandemic has posed. We now look at the future with a renewed hope for better times. As we have done in the past together, we will get through this too. God bless and best wishes for the future. So let's receive God's blessing.   God bless this great and precious city. Bless Lincoln. Bless Ham. And those other places represented here virtually today with God's peace and prosperity. God bless all of you and all those whom you love, living and departed this day and always. Amen.


So this talk is going to be about telehealth platform. It's powered by Python and Django. It's a social network for doctors. Yeah, that's pretty cool. Yeah, so I can see the slides now. Remember, for everyone that is watching this talk, there is a Q&A button. You can click there and ask questions. And then at the end of the talk, I'm going to ask those questions to the speaker. So, okay, I think you're ready to go. Take over. Good luck. Thank you very much. Hi, today I'm going to talk about telehealth solution. And it's based on a polyglot microservice architecture. We use Python and Django. So it's a Python and Django platform. So what we have is a social network for doctors in the community. It's almost like a Facebook for doctors, where doctors can talk to each other. And also doctors can extend telehealth solution, right, as a medical practice for their clinics or polyclinics through different patients. And especially in COVID scenarios, right, and this telehealth solution has become very popular, as you all know, and it's catching up in the telehealth solution is being used in terms of not just for review consultation, but also for end-to-end, right? After the patient gets the prescription from the doctor, the patient takes the prescription, buys the medicines, right? Then the lab test needs to be done. It's going to go there, get the lab test done. And also the lab test gets integrated into the system back. So when I say end-to-end, all the healthcare ecosystem players are being integrated in a particular solution. So that's the beauty of telehealth. It's become really popular. And we also see why it's playing a big role in terms of voice assistants, digital assistants helping out. And also in terms of helping out the doctors, you are having a clinical assistant. So today we're going to look at what is a typical patient journey? And what do patients want, especially in this kind of scenario? And how does telehealth solution really help? What's the telehealth platform? How does it look like? And how does semantic analysis help? We talk about different patterns, voice assistants, they can speech processing, speaker recognition, speech types, speaker model, variations, speech engine, speech analytics, digital assistant. How does it help in taking modes? And a little bit on the technical architecture from looking at the solution. And what are the challenges that you are faced in a small demo I have? And what's next? How do you go about enhancing the telehealth platform? And what's coming up in the technology and healthcare? So let's look at the patient journey. The patient typically is having a fever, cold, cough, a specific problem. He wants to book an appointment with the doctor. He books the appointment and there's an appointment reminder which is created. And we can have schedule being tracked with both the patients and doctors. And if there are any delays coming in from the doctor friend, you have the delays being intimated. If there are any changes, you go about managing the appointment, rescheduling the appointment. And also after the appointment, there are any follow-ups required. If you have close appointment. So a very simple patient journey. I think everybody is familiar with this. Many of the times people would have gone to the hospital and seen at the help desk, receptionist and you would talk to them regarding appointment. So you envision yourself going into a hospital. The same journey you want to put that in an intelligent solution on the cloud, on your mobile application. And instead of receptionist, you take the same process and have a digital assistant, a voice assistant help out in this particular process. Now what do patients want? Let's take a step back from the technology. Typically patients want a doctor to know him or her. And they want the doctor to be competent. They want doctors to be caring about them and improving and curing and preventing their particular problems.  This is what a patient typically wants from the doctor. So how does the telehealth solution help? So from a technology point of view, we have a WebRPC based solution. And there's a deep learning based voice and also a little bit on historical data, patient's data and predicting identifying patterns. And we use neural network algorithms. And if you look at the solution, a lot of things which are happening, but there is a social community for doctors where we do take the feeds from internet data source and do the fact check, right? And have a CMS like WordPress and then publish blogs, publish feeds through mobile apps and web applications. And you have recommendation engine cases and knowledge engine insights and also a wallet and a payment gateway. Just in case you want to have what you call payments to process for the appointments, doctor appointments. And also you have transaction engine, loyalty management, curator. We're also enhancing for supporting IoT devices that's on the radio which is evolving. The platform has support for voice, video, SMS, also calls, service, and also insights. So if you look, look at the previous slide and current slide and basically on the left hand, right here, right? You have the historical data, the patient's data, the prediction, and different patterns which really helps for doctor to know the patients. And especially the voice assistance conversing with the user, right? Showing care, showing empathy, showing emotions, showing the symptoms, right? That really helps in terms of substituting a digital assistant to a nurse or a doctor, right? So how does the telehealth platform look like, right? In terms of different components of different persons getting involved? You have users, you have groups, you have content, right? And we look at audio and video chats which has an important component for telehealth platform. But you have notifications, you have discussions between the doctors, you have calls, you have social interactions, you have service, you have wallets, and also you have courses, events, news, career, written for the doctors and medical students. And you bring in employees, nurses and operational personnel, partners, vendors, and also customers who are the users. And there are groups created within doctors where you can have moderation with them, or you can have group discussions, or you can have case triage where two or three doctors discuss about the case. And you also can publish products, have product reviews, take it from doctors and healthcare personnel. And there is content related to feeds, news, recommendations and there are blogs and also services which are published through the content channel. The semantic analysis, like you were talking about where NLP plays a very important role, was one of the reasons why I had this session. Before we get into the NLP, the idea is to have understanding for the critical relationships between the words and phrases. So natural language processing which fits upon this. You have blogs, news, feeds. So there's a lot of text mining and text processing which happens behind, especially in the voice assistant or digital assistant or digital notes or prescriptions. And if you look at them, just giving a very simple example. John hit the ball. You have subject, verb, modifier in an object and you are trying to identify what are the entities here? What are the verbs here? What are the nouns here? Simple noun verb analysis helps. Or you have, you do entity extraction or parts of speech extraction and you try to identify the nouns and also sentiments. Is he talking about the ball being hit really hard or let's say John got hurt or the injury bad. So if you look at these particular objectives, you get the positive or negative sentiments. Typically you look at words like good, great, fantastic, excellent, friendly, awesome, spectacular, sometimes negative. You got hit badly. It was the worst shot. There was an issue here. There was something lost and awful, problem, bogus. These are negative sentiments. Now, like semantic analysis, the other key section is patterns. We identify patterns in historical data. So what has happened before in a patient's life? What have seen before? We also look at demographic. We also look at appearance, sounds, physical signs, smell, touch, feel, images, fluids, tissues. All these are different areas where patterns do the analysis and they're also mining, data mining which happens in the nodes or in the prescription or in the speech. When the patient is talking over to the doctor, there is a lot of discussion which happens and the patient tries to explain his physical condition or this condition and that's where all the patterns analysis really helps. Now we jump into voice systems and we have understood the semantic analysis and the patterns. There is a simple voice assistant like let's say it's on the Google Dialogflow and you want to look at the doctor looking at the patient's report and he wants to look at the patient. He sends a request and Dialogflow processes that particular simple command, voice command and sends the response back and shows the generator report saying that these are the list of patients. Similarly, a patient talking to a voice assistant is slightly complex and wants to know about COVID-19. So the Google Dialogflow provides capabilities like keywords like keyword search for example COVID or how does COVID affect the pets is having pets a bad situation during COVID or do you have vaccines for COVID? Do you have any medicines already identified? How do you go about preventing COVID? All these are simple voice commands like a keyword being sent as a request and Google Dialogflow provides to process them and sends the response back. Now how does the whole speech processing work? Let's take a step back from AI and look at the speech processing you look at speech coding so when the speech coding involves synthesis and recognition you also have a speaker model the speaker model consists of speaker identity and speech transcription the speech transcription basically is converting speech to text speaker identity is basically the speaker profile who is the speaker, where is he from which language he is talking what is his accent these are all demographics and these are all play a very important role in terms of creating a speaker model similarly speech type speech patterns you have derivation is also very important speech patterns there are many ways of saying the same thing in a hurry we say we show emotions when you are presenting formally the speech pattern might be very different when you are informal it might be completely different from the formal then given these challenges where there is speaker identity accent language and speech patterns how do you go about recognizing the speech there are various approaches you have template based word recognition continuous speech recognition neural network based recognition typically I have a template saying that it is going to be very structured where I have agenda I talk about what when how and last I talk about and then present it is very structured and you know what is going to come then recognition becomes much simpler let's say it is continuous speech like what we are discussing there will be a lot of questions and answers it is continuous the neural network based recognition is basically the next level it is not just template of continuous the neural network has capability of learning so you have feature instruction speech direction vocabulary and knowledge based acoustic model and you have analysis and feature instruction modeling and testing which is done to improve the neural network model what are the speech types in a speech you have isolated words you have connected words you have spontaneous speech let's take a simple sentence John is going to fall so when I say John is going to fall you see there are words which are broken John is going to fall let's take a complex sentence although John was wealthy it was very modest now you see in this particular speech especially after although you see a pause then John was wealthy then you say he was modest so there are connected words there are isolated words broken words and there is a spontaneous speech there are multiple types of speech which needs to be handled so what are the different speaker models we talked about speaker identity now let's look at speaker model where there is independent speaker model especially on zoom we are seeing at the bottom it is able to create subtitles independent of who the speaker is it doesn't know where I am from where I am from and in Euro-Python there will be speakers coming from various countries and it can detect so this model is basically independent it is able to detect the speech and then turn it into subtitles whereas you look at dependent model it is very specific to a particular speaker and that particular speaker notes my identity my background, demographics and there is a neural network engine which keeps on working in enhancing the cookbooks now what is derivation the derivation is if you look at speech being represented on a graphical node you see most of the time you record your speech there will be almost like a waveform where you see a cluster of waves with higher wavelength versus others which are white with a lower wavelength and break you break those down into different segments where there are broken vertical waves or there are pauses take those each segment translate the speech to text you get the transcription done so that is derivation now if you look at speech now you have looked at the various components of the speech if you look at speech engine you have audio and you have what you call the grammars and acoustic model written as test and you have an environment which is around and the channel speaker and you have style gender, age and speech speed and depicting on the demographics speech speed varies some people talk very fast some people talk very slow speech engine needs to have capability to handle both of them how about speech analytics so while doing the speech processing you prefer to look at emotions you prefer you have you look at periods of silence and also non-speech for example I think I am in the middle of the meeting I start thinking I need to start looking at the time also or let me take a step back and think about it and I pause do you see the pause there so even though it is a very simple sentence basically you look at the time and then I am in the middle of this but essentially it looks very fast but in this particular segment you break it down into different segments you see non-speech areas the speech analytics processes what are the periods of silence what are the non-speech areas and what are the emotions detected now let's look at digital assistants having looked at the speech recognition speech processing how does the speech processing really help in digital assistants or voice assistants now let's start looking at digital assistants this is where NLP and semantic analysis plays an important role helps in taking clinical notes retrieving cases processing commands sometimes speech voice commands updating prescriptions creating consultation appointments now let's look at the technical architecture where you have voice assistants digital assistants that's where speech processing speech engine, speech time really help this is a role of the processing Google Dialogflow they are using IBM Watson which is in terms of the speech processing capabilities and then supports them on IBM blooms so from the technical architecture point of view the telecoms platform which we build has Android, iOS mobile clients it also has services layer built on Python, Zango PHP, Java and we have MySQL and MongoDB as the database MySQL is for relational and MongoDB is for NoSQL as a NoSQL database now what are the challenges in building this particular platform especially when you are building voice assistants digital assistants or a video platform you need to look at the browser's capability you need to look at the mobile OS dependency you have desktop OS issues you have speech hardware issues I don't know how many attendees had problems particularly when you get into any conferencing system most of the time you have challenges with the speech hardware it depends on whether you are using Windows 10, Mac OS it's just the incompatibility or the drivers which are challenging sometimes desktop OS let's say connected to this conference through mobile OS mobile OS has challenges in terms of providing audio and video capabilities so now let's look at the demo so I have so here I am signing up so I have the MySQL started I have started the Python Xambo server now I am signing up this is the doctor I am signing up I just put the doctor's name as Dr. John so now I log in after registration so this has feeds now let's look into the voice assistant so I say hi I try to start the recognition process I said hello we started detecting hello now I send the command hello so it comes back with the response now I started looking at corona I detected corona now I am sending that message I got the response so that was about the voice assistant now let's look at the clinical assistant now you are a doctor and you talk to a patient you want to so I have recommended and I am taking the notes now I want to have a video appointment with the doctor so I started the video now let's look at the other side there is a patient who wants to connect with the video system now here I am registering as a patient I go to the register so now I am a patient now patient.gmail.com so I am just simulating both the doctor and the patient for the demo now I log in as patient at gmail.com I go to video over here you see the person logging in and you see the person trying to call the connection gets established after accepting so when I go back over here I go to the doctor I completed the video session and I log out on both sides so that was the demo we looked at a demo which was powered by Python's A platform as my screen in HTML5 and I used the web RTC for the daily help and Google Dialogflow for voice assistants now many people ask in the conferences we talked about voice assistant, digital assistant daily health solution what is next what is next in the technology especially in healthcare or in radio mining with respect to AI so one of the things which are evolving is the biometrics and the other area is the language in another dimension we look at English and we have joining Europe from Dublin, Amsterdam France and many countries can I talk in French can we have doctor and patient relationship doctor being friends and patient being in India can we have multilingual speech and similarly can we have knowledge assistant which is learning has capability of self-learning which is updated itself and also can we have a connected system like we talked about pharmacy and labs diagnostics and pathology and clinics being connected hospitals being connected can we have all systems being connected integration is possible that's the next level now we go to the next level where we want to have dynamic program creation can we have a program being created in AI can we have AI coders can we create a program before normally we have code we used to have code generator now AI coder is intelligent in terms of having a neural network where you have neural sketch for different technology and neural sketch has capability of understanding the technology breaking down into various layers what is required for each and every day what are the domain what is the domain model also what is work created how does the process look like now next level from AI coder is what if I don't want the AI coder I'm a business user I'm aware of the process I'm aware of the domain I'm aware of the process steps in the workflow and you have various what you call users logging in and interacting at the process activity level can I have a no code automation platform where you can drag and drop and create a process and it deploys it on the cloud without any code being created yes and that's the no code automation platform which is up current so that was the brief presentation which is about telehealth colleague or microservices platform so any questions ideas one question regarding mobile app available on play store yes we have the mobile app available it's called white codes we have both what you call network app and also telehealth app for many of the donors we also have a clinic plus mobile app which is available also have a white light white label mobile app for your clinic so we have doctors community around 400k and we have nurses and medical professionals who use our system any other questions regarding the licensing model the doctors app is the network app where we have a social community is there is no licensing it's what you call you're a doctor you validate yourself with your medical certificate finding the payment model for the practice plus friend there are multiple packages which are available if you go for web model or if you go for mobile app model or if you go for white labelled app for your clinic there are various packages which are available online and it's called practice plus suit and you have multiple packages available can you as a patient just log on and see any doctor that needs the platform specific doctor it's a good question so in our platform we have our doctors who refer our patients and the patients will be able to go to a specific app on the play store install the app specific to that particular doctor okay so any other questions I think so people are asking about what about data privacy yeah that's a very good question we look at data privacy very carefully there are a lot of guidelines which are coming from telehealth and we also follow EPOS standards and also in terms of the data exchange we follow HL7 and here the fire FHIR support we have so we take data privacy very seriously especially in terms of the patient's data and doctors information okay so we still have a few minutes I mean how many countries is it used currently we are supporting within India so we have plans to go take it to the other countries so regarding the other countries the challenge is as you know right one is the telehealth guidelines that countries supports so we are looking at various countries within Asia okay perfect so I think there are some more questions so I'm going to say thank you very much for presenting on EuroPython we have to play some so we have some questions for you okay thank you very much that was very good there is a channel in this core so the name of the channel is talk telehealth so if someone wants to continue the discussion you can join that channel there it's in this core you have to go to the Brian breakout and then you have the discord channel for each talk and you can continue the discussion there or if anyone has more questions or they want to understand more about the project okay so I think that's all thank you thanks sir for giving an opportunity to talk about telehealth thank you for presenting speakers are the most important part of a conference so thank you very much have a good day and see you next time thank you