On this show, the daily debrief, we have often talked about the rising tensions in the Korean Peninsula. Now, the region had been relatively peaceful for decades, but in recent times, tensions have arisen and trust has broken down on both sides. A key reason is South Korea's active participation in U.S. strategies and maneuvers in the region. Meanwhile, North Korea conducted its third round of missile tests in a week. We go to Anish for the latest. Anish, thanks for joining us. Let's first take a look at the immediate developments. How do you see these missile tests? What has been the response from South Korea? How do you also see some of the recent developments? These include decisions on the question of reunification itself, the institutions connected to it. So, what do you make of all this? Yes, Prashant. So, what we are looking at is the third such cruise missile test happening within less than a week, actually. And this is pretty much in line with the kind of tensions that have been escalating in the region, especially in the Korean Peninsula over the past few months now. The thing is that we have to obviously look at it in the larger context. But what we are looking at right now is that relations have really worsened to a point where we are looking at confrontations at every possible juncture. And these cruise missile tests are pretty much just a sign that things are not going to be the same it used to be. And there is going to be far more confrontations, especially from the North right now, because it has pretty much given up, so to say, on this entire thing of reunification, and this entire goal of reunification, which was at the foundations of any attempt of peace or negotiations between the two Koreas. So, right now, on Monday, the missile, the cruise missile that was launched was a submarine launch cruise missile. And it is pretty much a new brand of cruise missile that has been developed by North Korea. And this in itself has been a big matter of concern for the South, because obviously the development of new missile technology by the North has always been a matter of alarm for the South. And obviously it's ally, the United States, which holds a massive military presence in the region as well. So, in all in all word, we are looking at is like a very deliberate attempt to escalate tensions on the part of the North, but definitely something that has been happening for a while now. And it cannot be divorced or looked in isolation from what has been happening for the past few years now, especially from the South and the United States, the kind of provocations that have happened over the years, and which has led to the situation right now. Ranish, now stepping back a bit, what does this really imply for the region? We have actually talked about on this show quite often how this region has generally been quite peaceful, but now in recent times, tensions have really been escalating. So, how do you see the broader context? Tensions are nothing new between two Koreas Prashant. But what we are looking at right now is probably a point of low return has been reached. Recently, we have seen North Korean leader Kim Jong-un talk about and even pretty much stating that reunification is no longer a goal. It is not viable. It is not desirable and that it is going to treat the South Korea as an enemy state or an enemy entity and no longer part of Korea. And obviously, the ultimate goal would include reclaiming the entirety of the Korean Peninsula, but the language of reunification is pretty much absent. That also was coupled with calls by Kim to dismantle pretty much every attempt or any monument that existed, especially the arch of reunification in Pyongyang that has always been looked up as this monument for a future hope of reunified Korea, which apparently has been destroyed or demolished very recently between the 19th and the 23rd of this month. Obviously, this was not as widely reported, but there was indication that the North Korean leadership has wanted the arch to be demolished. But we are yet to get proper official confirmation from North Korean officials so far, but definitely multiple reports and satellite images have shown that the arch is missing right now. And that itself clearly shows that tensions, it's a symbolic act, but definitely what we are looking at is that without any talk or any idea of a reunification or possible reunification, peace talks become completely irrelevant in the case of inter-Korean relations. And that is pretty much the point where we are at. And this is dangerous because we must remember that just a couple of years ago, we were already talking about how the two Koreas came together for a declaration to end the Korean war, which is de facto in place even though and it's only ceasefire between the two sides that is holding any kind of hostilities from getting out of hand. And at this point in time, if these tensions continue, the war can be reactivated. It is no longer a very distant possibility. It is something that is pretty much at the horizon right now. And we need to wait and see how the South Korean administration, especially the conservative and the very hardliner UN government, which can be held responsible for the kind of provocations that have led to this situation where reunification or even for that matter peace talks have become completely irrelevant as far as North Korea is concerned, is how he is going to respond to all of this. There has been no statement so far. And which is kind of jarring considering how he had pretty much a statement or a provocative statement for pretty much anything that happened when it comes to North Korea. So this kind of silence right now, a very studied silence at a time when he's also beleaguered by his own failures in the domestic front pretty much shows that the southern side has taken it far more seriously than it. I mean like it is quite serious, but this is going to be bigger, like the gravity of it is going to be much bigger than what we could have thought of maybe say a couple of months ago. So things have really gone that far and we can really hope that there can be a reset to status quo ante. But definitely we are just not in a position to say that that would be possible, especially under current administration so far. And that is a big, big problem because as I keep saying, as we have kept saying in this show, this is a region which hasn't had a war for nearly three quarters of a century and that is something quite novel in the entirety of the modern world right now. So if war is something that is now quite a looming possibility, that should be a match of concern for everybody and not just the East Asians. It is pretty much something that can affect everybody around the world right now. Thanks so much Anish for joining us. Measles might not seem like an alarming disease to many of us, but it can have a serious impact on a person's health. In recent times, the World Health Organization has been sounding the alarm on a rise in Measles cases in many parts of Europe. Forcing countries even in other parts of the world to take notice and step up precautions. Where are these cases increasing and why is it happening? We are joined by Hannah. And on multiple episodes, we seem to be discussing diseases which are easily preventable but nonetheless are causing a great deal of alarm. So let's start with the WHO of course in a sounding alarm on the number of cases. So let's start with what is the spread, which are the countries which are really affected? Well, one of the most recent alarms was sounded in Europe and that's because there was around a 30-fold increase in the number of cases of measles in the European region last year compared to the data from the previous one. So while the most affected countries were in the East, including Russia, some of the news that made most headlines, not surprisingly, they were located in the European countries, including the UK. But what we are seeing is an overall trend and that's related partly at least in the decrease of the uptake of the vaccine. We need around 95% coverage with the MMR vaccine in order to have herd immunity. But over the years, these percentages have eroded in the UK as well as in the rest of Europe. And of course, you know, when the COVID-19 pandemic hit, then there was an additional hit on the public health services. Many people were not able to get their children to get the vaccines. So now we have a bigger population, which is essentially exposed to the effects of what we are seeing. But of course, we know that since the alarm has been sounded in Europe, other countries in other regions have also said they would be particularly careful. So we have seen health authorities in Korea, in the US, issuing warnings or expressing concern about what's being seen and asking people to be cautious and to return to the vaccines, to the vaccine campaigns that we had previously seen. And, you know, this is not just something to be taken very lightly because you said rightly that, you know, measles is something that we talk a lot about that has been on the public health agenda for a very long time. And some of the public health officials have also recognized that people have also become a bit accustomed to measles not being perceived as such a terrible disease. But we do know that it can have very serious side effects and it can cause very, very serious cases of pneumonia, meningitis, blindness, it can even cause that. So it's not something that people can discard and say, you know, it's okay to go through it. It's actually something that can be very serious and put kids' lives at risk. And in this context, what are the reasons that, you know, there is an increase in cases? You mentioned, of course, the question, the issue of vaccines, but how does it really play out the reason for hesitancy? What are some of the other factors contributing to this? Well, if, for example, and if we take the UK as a case study in this regard, there has been vaccine hesitancy since the late 1990s, and that is because, of course, you know, there were those discard, of course, allegations that the MMR vaccine was linked to autism. But now the public health authorities in the UK are warning that it's not only about that. So it's not, of course, people, you know, people in the past have reluctantly and maybe more cautiously approached vaccination campaigns for measles. Their numbers right now show that this situation has somewhat improved. So younger parents are more prone to get back on the vaccine train and actually get all the doses covered. But what we do see is that there's now a bigger population of younger adults, of those who haven't been vaccinated, who are now exposed to the disease or who can facilitate the spread. And then, of course, we do have a large number of kids who have not received vaccines either because of the COVID pandemic, but also because the public health services and particularly primary healthcare has been so weakened that they cannot actually access the vaccines. So it's not only, you know, about doing a very good public health campaign and showing to people that the vaccines work. It's also about making sure that the vaccines are there for people and that they're easily accessible. That's not the case in the UK right now. And I would say that it's probably not the case in the rest of Europe right now. So one of the big hurdles in the way of health ministries of those in charge of public health policies right now is to get a very rapid response. So to increase the number of vaccinations that we're seeing, but also to make sure that, you know, the health workers who are there delivering the vaccines, to make sure that the health services that we need to actually get those vaccines to the people are there and are properly funded. Thank you so much for that update. That's all we have in today's Daily Deep Brief. We'll be back with a fresh episode tomorrow. In the meanwhile, do visit our website peoplesdispatch.org and follow us on all the social media platforms. If you're watching this on YouTube, please hit that subscribe button. Thank you.


And straightened out to Adamaa State where the police command has confirmed the arrest of 25 persons involved in the activities of stealing food and non-food items in the government's warehouses. The police public relations officer, SP Suleiman Ungoruje, said the police and other security personnel are doing everything possible to retrieve the items stolen. He assured residents that the security agencies will obey the order of the state government and will not hesitate to arrest whoever violates their directives. On the part of the National Emergency Management Agency, NEMA, they express worry over the activities of the hoodlums. The report reaches the command earlier hours of today that some hoodlums have gone down to vandalize and loot some government and private warehouses that is located within the state capital. There and then the commissioner of police now raise the operational asset of the command and deploy them to go down to the ladder and prevent them from going ahead to vandalize and possibly loot the warehouses. So all of a sudden that instruction has been carried out and as I'm talking to you now, 25 male suspects were apprehended and some items that were looted from the warehouses. This is what? Secondly, the command has succeeded in preventing them from going beyond the face warehouse that was attacked. The one belonging to the NEMA was the first one that was attacked, but the command has succeeded in preventing them from attacking the one that is located at Newman Rott belonging to Ministry of Agriculture. They looted, they vandalized them and looked at the building, not even through the main gate or main door, they even had to push, destroy the wall to find themselves in. You can see that a lot of items, both food and non-food items have been cut away and looking at our vehicles, our armed vehicles have been vandalized, then the main office which we just came in, not quite two weeks ago, has been vandalized, all the items have been destroyed, some cut it away and it's a high level of criminality.


Live from Las Vegas, it's theCUBE, covering AWS Executive Summit, brought to you by Accenture. Welcome back everyone to theCUBE's live coverage of the Accenture Executive Summit here at AWS re-invent. I'm your host, Rebecca Knight. We have three guests for this segment. We have Fang Deng. She is the big data and advanced analytics program lead analytics COE at Novartis. Thank you so much for coming on the show. Thank you, Rebecca. We have Loic Giro. He is Novartis head of analytics COE. Thank you so much, Loic. Thank you. And Vika Sindhwani. He is applied intelligence delivery lead at Accenture. Thank you so much. Thank you, Rebecca. So I want to start with you, Loic. Novartis, of course, is a household name. It's one of the largest pharmaceutical companies in the world. But I'd love you to just walk our viewers a little bit through your business and sort of the pain points you were looking to solve with this journey to the cloud. Yeah, thank you, Rebecca. So I think if we look at the company, I think we realize that it is more and more difficult to bring new drugs to market. So it takes about 12 years and around $1.2 billion to find a new drug. So at the same time, we see that there's more and more patients that need access to medicine. So in the last two years, I think we tried to create a new strategy where we're trying to re-imagine medicine for the use of data and technology. So in 2018, we've recruited a new CDO that came and tried to build our digital ambition, which is around free pillars, which is the innovation, the operation, and the engagement. On the innovation, what we are trying to do is to find new compound or application of existing compounds into our business to make sure that I think our patients can get access to drug much faster and earlier on. In the operation, we are trying to optimize the backbone of our day-to-day processes, be it in the manufacturing or in the supply chain or in the commercialization, to ensure that the patient also get access to drug much faster. In the engagement, we are trying to help the HCP and the players and the patients to better understand the drugs we produce, as well as the medication they need to have to receive their treatment. So if you look at these free pillars, the cloud strategy is an essential portion of it, because in all of these processes, we have a lot of data. And through cloud, I think we can make use of this data to help to innovate, operate, and engage. So as you said, it's really about re-imagining medicine, from the drug discovery process to how it's helping patients live longer, healthier lives. Fang, so talk about the vision for the Formula One platform. Yeah, as Loike mentioned before, we're trying to re-imagine our products for the patient, and we're trying to use more and more our data, history data, and also the public data, try to support our products. And the Formula One is our future enterprise data and X platform for our Novartis. So our objective is trying to leverage all the new technology, and also trying to consolidate all the data in on the cloud, and build up this platform for the whole Novartis users to support our business to better products for the patient. So when it comes to these new platforms, new technologies that are being introduced, we know that oftentimes the technology is the easy part, or at least the more straightforward part, I should say, but it's sort of getting people on board, the change management. What are some of the challenges that you at Novartis faced in terms of the culture and the skills for your workforce? So if you look at it, our industry is very traditional in nature, and when we embark in the digital transformation, I think the first thing we had to change is the culture of the company. So when you listen to our CEO, I think he tried to promote this inverse culture, where all of us are servant leaders, and then we work as an organization where we try to help each other and more and more collaborate. When it comes to digital transformation, when we started this, having this period, we've realized actually that our workforce was not trained. So the first few things that we did is, it tried to hire a new workforce, but also tried to actually identify the advocate or ambassadors that could go and then go into the digital transformation early on to be able to help and to guide the others to get through that. So it's actually, it's probably a multi-year journey, and then we are now in the second year, and we've seen already a tremendous progress, right? Can you describe some of the changes that you've seen? I mean, I'm really interested in what you talk about, the ambassadors, the people who are going to spread the good word, what are some of the changes that you've seen in your workforce? Yeah, we can mention that is, like you mentioned before, like talking about regarding overall culture perspective, try to leverage new technology, like the delivery perspective, we're trying to do more automation, and one side is trying to get more efficiency, and also another side, try to ensure the end-to-end responsibility for one product to be produced, and also at the same time, leverage more automation to think about the security side, the company side, help us a lot, improve in that part also. Maybe I can compliment that, so I think if you look at it, when at the initial starting point of our journey, I think a lot of people were reluctant to go and then try to work on the cloud and to work with digital technology, so we found few projects where we felt there's a good value for money, and that we can deliver a fast impact, right? And a few things like, how do we engage with the HCPs? How do we make sure that when our field force goes and talk to the HCPs, they know what to talk about, and often, and in which format? We also look at how we can reduce costs internally, and for different projects and product that we've established, we build credibility within the organization, and that helps to disseminate the cultural transformation. So once others are seeing the benefits that are captured, they're more likely to feel good about the cloud work? Yeah, that's true. And also, those of the new things, like our teams, they're all interested in about that. You see more and more people talking about our driveway, and also talk about DevOps, and how can we improve delivery efficiency, and at the same time, come back to say that the teams think about how to make themself to be a product owner and product delivery. That's a good thing for the whole team. Vika, so I want to bring you in here a little bit. So talk to me about how Accenture is helping Novartis, particularly in this AWS cloud initiative. So Accenture is a leader in business and technical IT transformation programs. So what we are bringing on the table is the expertise with not only the technology and the AWS elements, but also the business and technical transformation expertise that we have over the years in the firm. And additionally, I think it's not only about technology change, as you mentioned, it's all a lot about change and operating model, and also kind of working with a very blended team across, so that expertise and experience is what we bring to the table. A blended team, culturally, regionally, functionally, all of it. All of that, so we've, I mean, just to give you an example, we are working across teams in roughly about six geographies from various cultures, various countries, and it's various time zones which makes it quite challenging to make it all work together. So we started that journey, I hope we'll succeed in it, and it's working well so far. So cloud is really a mega trend right now. What are the differences that you're seeing across regions, countries, industries? So I think there's many answers, many parts of the answers to the question. So I think if I talk about industries, so initially when cloud started, we had seen a major uptake of the cloud technology in the companies that manufactured the cloud technology and the telecommunications, and where all the infrastructure and technology aspects were. Whereas companies like healthcare and media and metals and mining were kind of behind the curve in adoption rates because of their respective concerns around compliance and security of data. But I think that trend is slowly shifting as companies are becoming more open. I think they've seen how the public cloud has matured, the security models are speaking for themselves. People can understand the benefits from moving to the cloud in terms of cost rationalization, from reducing maintenance costs and focusing their co-teams on things that they were not able to divert their core attention on. If I could add, I think I will say for me, and where I've seen a Novartis, I think it's access to innovation. So I think cloud brings a lot of innovation at a rapid pace, that's one hand, and also access to external collaboration. So when you're inner or inside focus, I think there's reluctance from others that wants to work and collaborate with you. But when you work on the cloud, everybody goes on the cloud. So that's really a streamline and facilitate the collaboration with external partners. So how is that changing the culture of Novartis itself in terms of there are more opportunities to collaborate and it also is maybe changing the kinds of workers you attract because it is the people who want to be doing that in their day to day. Yes, I feel if you look at it, in the past I think we used to have all our own workforce and then we tried to do a lot of things with our own workers. But I think in this environment, you work a lot for others. So we have more and more partnership being announced and this partnership has been used actually to help the company to reinvent themselves. So that's actually on one hand. On the other side, as you said, I think that to attract those talents, I think you also need to have a different culture, right? But you need also to be able to give them the flexibility to work and do the things they like and we have a context and a framework. One of the things that we hear about so much at these technology conferences, this buzzword of digital transformation and Novartis is obviously embarking on its own digital transformation as well as its journey to the cloud. They're powering each other, they're accelerating each other. How would you describe what is happening to the industry and to Novartis within the pharmaceutical industry? Yeah, I think based on our knowledge to see Novartis, maybe it's the first company currently trying to build this kind of enterprise level data and also analytics platform. And based on that, we will be able to consolidate all of the history data, internet data and public data and even industry data and they try to help us to produce the better products for the patient. At the same time, give also the team a chance as you mentioned before and look at more opportunities and trying to leverage a new technology put those together, yeah. It's also changed the way that we work every day. So if you look at it now, we work with virtual assistant. We, I think we use machine learning advanced analytics to be able to talk to our HCPs. We actually monitor our clinical trial real time. I think using common centers. So every single day, I think the use of digital artwork and atom is a common thing. And I think we have seen that the adoption has increased since we were able to launch successful products. And I think one of the things which I really like about working at Novartis is also, I think there's an ambition to drive business value quickly. So you take a very agile use case based approach on things rather than having to wait for very long periods of time. Plus the company kind of encourages a culture which is based on mutual cooperation and sharing knowledge, which is great. Because Novartis is really on the vanguard of companies in terms of how much it's embraced the cloud and how much it's using it. What do you think other companies, pharmaceutical companies but maybe even in other industries as well could learn from the Novartis example? I think one thing people really shy about is, when they move to the cloud is the security aspect. I think what people probably had failed to realize in the past that there's been so much developments on security in the public cloud, which has been one of the key focus areas. So I think Novartis has taken that challenge and has understood that very well. And I think companies can learn from all the different aspects of security that we've built into our entire transformation work, starting from ingesting data, the user management to access and all of that. So that's kind of one thing. Similarly, compliance related aspects as well. So we've, GXP compliance is at the core of, how we are building our solution. So I think, and if you understand how we build the rules around the compliance bit in architecture, I think companies can learn from that as well and build that as integral part of your, not only technology solution, but the process that goes along with it. Loic, we started our conversation talking about Novartis and its quest to reimagine medicine. How do you think that your industry is going to look five, 10 years from now? I mean, the drug discovery process is slow on purpose. I mean, we need to think of patient health and safety foremost. But how do you think it really could change the course of how we treat people? So if you look at it, there's more and more treatment that actually are used and required data as a service or are being actually processed through data. So when I, when we look at, I think, the way that the industry is changing, I think the times to develop drugs, yes, it takes longer, but I think for the use of the data that you have, I think you can try to reduce that cycle. So one of the objectives is to reduce the cycle by one third, which means that we could bring that there is a new drug to market in eight years versus 12 years today. The other thing is that with the use of data, you can monitor the patient and you can recommend the treatment. So 80% of our patients, they don't go and they don't finish the treatment. So I think if we can show the adherence to treatment, then there's a lower risk of readmissions to those diseases and sickness that they have. So it's not even not just Novartis seeing the value of the data, it's the patients themselves. The patients see and the payers see as well, right? Because I think if you, if obviously the patient is not sick, then I think the insurance doesn't have to pay. So I think all the value chains is being transformed. Well, Fang Loic, Vikas, thank you so much for coming on theCUBE. It's a really fascinating segment. Thank you so much, your Vikas. I'm Rebecca Knight, stay tuned for more of theCUBE's live coverage of the Accenture Executive Summit coming up in just a little bit.


Thank you very much for the invitation and for the next 30 minutes I'll be discussing the preoperative CT checklist for functional endoscopic sinus surgery. I want to acknowledge the following individuals for contributing to this talk. First of all, Varsha Joshi from India for some of the slides. And also I'll be heavily referencing this excellent paper by O'Brien it out, which was published in radiology, which is called title avoiding a close call with surgical complications. So in this paper, they fairly elegantly identified a preoperative checklist that's referred to as close C L O S E. In my practice, I think this is very helpful and what I've done is I've expanded this a little bit and called it closed. And the close for our checklist will be the cribiform plate, the lamina paprecia, the osteomatial unit, the anointy cell, the sphenoid sinus, the ethmoid diseases, excuse me, ethmoid sinuses, and then various diseases that can involve the perinatal sinuses. So first we'll start with the cribiform plate. We know that the cribiform plate is located in the anterior skull base, and it's a very thin bone with small perforations that allow the first nerve to provide its small little neuro fibrils to extend through the cribiform plate to innervate the nasal cavity. So when we look at the cribiform plate, it's important to understand the adjacent anatomy. So this area right here is the phobia ethmoidalis. This area laterally is called the lateral lamella. There's a small little defect here in the lateral lamella, which you will sometimes see and we'll discuss this later, which is the anterior ethmoidal artery. And then the floor of this is in the cribiform plate. And this is our crystal galley. Now, when we look at the cribiform plate, realize that there are various depths of the cribiform plate that can potentially come into play. And this has been categorized by the carous classification. So a carous one is when you have a depth of the cribiform plate, so basically the height of this from the lateral lamella is less than three millimeters. This is a type one. If it's between four and seven millimeters, it's a type two. And if it's between greater than seven millimeters, it's a type three. So I do not include the carous classification my report, but what I do do is it forces me to look at the anterior skull base, and specifically to look at the cribiform plate. So although I don't mention the carous classifications I specifically look at the anterior skull base. So here is normal on the left hand side and this is an example of a normal development variation involving the anterior skull base. Now this was just in this particular case, just a normal variant with a little bit of the gyrosis rectus extending inferiorly. Notice how the cribiform plate is intact. So in this case, this is normal gyros, but you have to realize you can have other masses that can arise in the olfactory groove in the olfactory sulcus that could potentially give you this regressive remodeling. So first of all, it forces you to look in this area. The only thing that it forces you to do is to look for any defects in the anterior skull base. So this is normal on the left hand side. But for instance, if you saw this mass here involving the right nasal cavity you may think it's polyporting because of thickening because there's disease adjacent to it. But by forcing you to look at the anterior skull base, you can see that there's a defect in the anterior skull base. And what we can see is that in this particular case, there is an encephaloscele that's extending through the anterior skull base into the nasal cavity. So certainly you do not want to send your surgeons in to resect in this case an encephaloscele. The next area when we talk about closed is the lamina perprecia. Now we're all familiar with the lamina perprecia. It's a very, very thin paper-like bone that forms the lateral wall of the ethmoid sinus and the medial wall of the orbit. Again, very, very thin bone. And it's important to look at this bone specifically to look for certain pathologies. So in this particular case, if the patient was pre-op for endoscopic sinus surgery, we would want to tell the ENT surgeons that there is a defect involving the lamina perprecia. And this is due to medial deviation. And in this case, prior fracture that has allowed for herniation of the fat and a little bit of the muscle into this defect. So this is a medial blowout fracture. And this would be part of our checklist when we evaluate the lamina perprecia. The next O that we talk about is the O for the osteomyatal unit. So let's go over the anatomy of the osteomyatal unit. So here's a normal maxillary sinus. Here's our alveolar recess. Here's our zygomatic recess. And here's our primary osteoma, the maxillary sinus. This is continuous with the ethmoidal infindibulum, which continues in superiorly. Eventually, it ends into the hiatus semulunaris, which runs from anterior to the posterior. The floor of the ethmoidal infindibulus formed by the unsinate process. Eventually, when the drainage gets right here to this hiatus semulunaris, it extends inferiorly into the middle meatus. And right above it is the middle turbinate and the middle concha. So the osteomyatal unit is formed by the primary osteoma and maxillary sinus, the ethmoidal infindibulum, the unsinate process, the middle meatus and the middle turbinate. And that is what's typically resected during a standard functional endoscopic sinus surgery. So on CT scan just to confirm. Here's the primary osteome. Here's our ethmoidal infindibulum. This is the unsinate process. This is the middle meatus. And here's our middle turbinate. So we have to evaluate the osteomyatal unit very closely in all of our studies. And we have to be aware of some of the normal variants that could potentially lead to narrowing of specifically the ethmoidal infindibulum and then potentially result in mucosal thickening. So this is an example here of multiple howler cells. What howler cells are are aerated in, I should say, formed in for orbital air cells that oftentimes track along the primary osteome and the ethmoidal infindibulum. This is the classic example of a concha bolosa. So here we have air involving both middle turbinates. This is these are concha bolosa. Occasionally we could have paradoxical rotations of the middle turbinates. So normally the middle turbinates or the inferior turbinates are typically extending outward, if you will. Here what we can see is that there's paradoxical rotation of these middle turbinates. So we want to comment here because if they are large enough. They can again push against the middle myatus or potentially have mass effect involved in the medial wall of the maxillary sinus and potentially impinge upon the ethmoidal infindibulum. And then finally, we always want to look for the integrity and the course of the normal nasal septum. So in this particular case we can see that there's a nasal septal deviation to the right and this is associated with the spur. Occasionally patients can, when they have the spur that abuts the middle turbinate, this can cause headaches. And this is sometimes referred to as sleuters headaches. And if we see this appearance in a patient that has the classic symptoms, then these can be treated by some type of nerve block or some type of anti inflammatory or a neuro, an agent that somehow blocks the plexus, the tyrogl-palatin fossa and sphenopalatin foramen. The next thing that we'll talk about are the onoity cells. So when we look at the onoity cells there are specific type of cells. So on the left hand side is the normally aerated sphenoid sinus and typically you can have some septations within the sphenoid sinus. On the right hand side, we can see a class of example of sphenoethmoidal air cells and these are referred to as the onoity air cells. Now the onoity air cells are referred to as sphenoethmoidal air cells and they are located superior lateral to the sphenoid air cells. So when we look at the sphenoid sinus, the SS here is a normal appearance of the sphenoid sinus and then just above it are other aerated air cells. And these are the posterior ethmoidal air cells and these are the onoity air cells as we see here. Notice the onoity air cells in this case are in close proximity to the optic nerves. In fact, the optic nerves are running through the superior lateral aspect of these air cells. Now during an endoscopic sinus surgery, it's important to make the surgeons aware that there are sphenoethmoidal air cells or otherwise known as the onoity air cells. Why? Because it's possible that the surgeon may confuse a sphenoid air cells with the onoity air cells and this predisposes these patients to optic nerve injuries. Another example here, this is a patient that has sphenoethmoidal air cells and when we look superiorly, we can see mucosal thickening here involving this superior air cells and this is complete opacification of an onoity air cells. And again, this can be very difficult to see. The surgeons typically comes through the sphenoethmoidal recess. They think that this is the roof of the sphenoid sinus. But in this case, there's a small onoity air cell that's completely opacified. So the next year that we'll talk about is the sphenoid sinus and the sphenoid bone. So the sphenoid bone really, it took me a while to figure this out, but the sphenoid bone has lesser and greater wings. It has a body and it has pterogoid plates. So again, when I grew up, I would always think about the sphenoid sinus in the axial plane, but we have to realize that the sphenoid sinus originally got its name by looking to this in the coronal plane. So the sphenoid bone is a wedged bone that is located between the clivus and other components of the central skull base. And when you look at the sphenoid sinus, you can almost make out that there's a wing here, a lesser wing, and there's a greater wing. So it sort of looks like a bird. On the other hand, there's a greater wing and there's a lesser wing. Here is the body of the bird or the sphenoid sinus. We have one foot here. This is the medial plate. Another foot here, which is a lateral plate. This area is a cell and here's a dorsum cell. So if you think of the sphenoid sinus as a bird, then for me, it made the sphenoid sinus seem a lot more simple. So when we look at the sphenoid sinus, this is what it looks like in the sagittal plane, and we know that the sphenoid bone has a sinus within it. So when we look at the sphenoid bone and the sphenoid sinus, here is our cell, here's the dorsal aspect, here's the anterior aspect, and there's where our pituitary gland lives. So when we look at the sphenoid sinus, it can have levels of progressive numinization. So in this particular case, this is anterior numinization of the sphenoid sinus. This is referred to as conchal numinization. It's the anterior third. Then you can have pre-cellar numinization. In this case, the numinization extends to the anterior aspect of the cell. And then you can have complete aeration of the cellar. Now this is important prior to endoscopic sinus surgery, but also if this patient did have a pituitary adenoma and the patient underwent a transfenoidal resection, it is important to comment on the level of aeration involving this sphenoid sinus, because this type of surgery would be much easier to get to the floor of the cellar. Similarly, once they got to the cellar, this would require much more packing to ensure that to prevent leaks here because this leak could go directly into that sphenoid sinus. The sphenoid sinus, once it is heavily pneumatized, it can put other neural and vascular structures at risk. This is an example of an incredibly well aerated sphenoid sinus.  Here's an example of v2s that impinge upon the superior lateral wall of the sphenoid sinus. Excuse me, sorry about that. Here's the v2 right here that's along the lateral wall of the sphenoid sinus. This little septation right here that sometimes you see in the sphenoid bone, this little septation often tells you where the carotid artery is. So in this particular case, I messed up a little bit. This little septation goes to the carotid artery, and right here is v2 on one side and there's v2 on the opposite side. Here's an example of carotid arteries that impinge in the posterior lateral aspect of the sphenoid sinus. We have to let our surgeons be aware of this because if this was disease and they were going in to do an endoscopic resection, a functional endoscopic sinus surgery into the sphenoid sinus, they would want to make sure that they're aware of the carotid artery impinging upon the posterior lateral walls of the sphenoid sinus. And in this particular case, this patient has optic nerve, the right optic nerve is actually extending inferiorly into that sphenoid sinus. So just to reiterate the anatomy very nicely seen here, this is Vidian's canal, this is v2, this is the superior orbital fissure, this is the lesser wing of the sphenoid sinus, and here's our optic nerve on the right and an optic nerve on the left. Well, the next thing that we'll talk about when we talk about closed is that we'll talk about the ethmoid sinuses. So the ethmoid sinuses are divided into anterior, middle, and posterior ethmoid air cells. In some textbooks, they combine the anterior and the middle ethmoid air cells into the anterior ethmoidal complex and the posterior ethmoidal complex. This lateral attachment involving the bone at the very posterior aspect of either this anterior ethmoidal complex or what I more commonly refer to as a posterior aspect of the middle ethmoidal air cell, this is what's referred to as the basal lamella. So here's the basal lamella on the patient's left and this is the basal lamella on the patient's right. When we look at the sagal images, you can see the basal lamella right here very nicely identified. Now there are a couple of unique air cells that we need to be aware of. The agronasi air cell is the most anterior ethmoid air cell, and it forms the anterior boundary of the frontal recess. So the agronasi air cell is an ethmoid air cell that extends anterior to the frontal recess, and we can see here that it's aerated. Occasionally the agronasi air cell can become enlarged or opacified, and this can obstruct the frontal recess. So the frontal recess is the primary drainage of the frontal sinus, and if this becomes obstructed, then this can result in narrowing and eventually result in mucosal thickening involving the frontal sinus. When we look at the ethmoid air cells, there are different types of frontal ethmoidal air cells. The type one air cell is just a standard frontal ethmoidal air cell that extends anterior to the frontal recess, so this is a type one. If you have multiple anterior ethmoid air cells, but they're still below the level of the frontal sinus, then this is referred to as a type two. A type three ethmoid air cell is when this agronasi air cell extends superiorly into the inferior portion of the frontal recess, and the type four is when this agronasi air cell or this ethmoid air cell extends and is isolated to the frontal recess. Now I have to admit I do not comment on these in my standard reports, but just for completion's sake, this is a complete evaluation of these frontal ethmoidal air cells. The next E that we talk about when we talk about closed is the ethmoidal artery. So when we look at the anterior skull base and we talked about this earlier just to review the normal anatomy. This is the phobia ethmoidalis, it's located here. This is our ladder lateral amela. This little defect right here is the groove for the anterior ethmoidal artery. Here's our cribiform plate. This is our crystal galley. And right where my arrow is is where the olfactory groove runs, and just above it is the gyrus rectus. So this agile images identifies the the anterior ethmoidal artery as it runs in the groove involving the anterior skull base. In the anterior case, this is a normal appearance. This is an example of air rated ethmoidal air cells extending along the phobia ethmoidalis, and we can see that it's actually impinging on the groove for the anterior ethmoidal artery. This would be important of these row pacified and the surgeons were trying to resect this, they would want to make sure that this is running in close proximity to the anterior ethmoidal air cells. The last thing that we typically talk about is the D, which is the disease. So it's important to be familiar with the various tips different types of diseases that can involve the sinuses. Now I'm just going to spend a couple of minutes on this because this really is on a checklist prior to functional endoscopic sinus surgery, but I will talk about a little bit of the different diseases. In this particular case, this patient had fever and had pain involving sinus and here we have an air fluid level. So this is an air fluid level involving the right maxillary sinus. Please do not call this acute sinusitis sinusitis is a clinical diagnosis, it is not a radiological diagnosis. So in this particular case, if you see an air fluid level what you can say, as these findings are consistent with the clinical diagnosis of acute sinusitis so this is the classical appearance radiologically of acute sinusitis, but realize that this again is a clinical diagnosis. Here's an example of a completely opacified maxillary sinus, and with a leap of faith you can see that there's thickening this is what we refer to as reactive osteitis, involving the posterior wall of the right maxillary sinus compared to the side on the opposite side So this is more consistent with chronic disease again, we can suggest it's chronic sinusitis but again it is a clinical diagnosis. So finally here's an example of chronic disease it's completely opacified, we can see the reactive hyperostosis, but we can also see that this sinus is small and it shrunken. So this is a hypoplastic maxillary sinus. These are oftentimes associated with enlargement of the orbit, and sometimes inferior displacement of the inferior wall of the orbit. And this is what we refer to as silent sinus disease. Here's an example of invasive fungal sinusitis. So we look at invasive fungal sinusitis. Sometimes this can be very tricky to see, but I'm going to point out a finding to you that hopefully you won't forget, because if you have someone that's at high risk, some that's diabetic, or other types of immunocompromised sometimes these sinuses are going to be completely well aerated. But where to look at is in the fat, either the fat anterior or posterior and specifically in this case, in the retro anthral fat. Notice how the retro anthral fat is not black as it is on the opposite side there's subtle areas of increased attenuation. This is early invasive fungal sinusitis this is the bad one this is mucormicosis or invasive fragilosis. Similarly anteriorly we can see subtle evidence of extension into the canine fossa, not as obvious as posterior, but please be sure to look at this when you're evaluating patients for sinus disease. This is an example of what looks relatively aggressive but the key thing here is this is a non contrast CT. And when you have a non contrast CT and you see areas of increased attenuation, purely on a non contrast study. This is allergic fungal sinusitis this is not invasive fungal sinus sinusitis this is allergic fungal sinusitis, and this can involve multiple perinazle sinuses, it can involve the nasal cavity. It can give you this bone erosion but this really is just benign disease. This can be resected. This can be easily the surgeons say that this almost has a peanut buttery or toothpaste consistency to it, and then patients are oftentimes treated with some type of mild anti fungal or steroids. And then we also want to be aware of incidental finding so this example was a small little assioma involved in the media aspect of the right frontal sinus. So what I tried to do over the last 25 minutes or so is talk about the checklist to evaluate patients prior to functional endoscopic sinus surgery. And I use the term close CL O O SED and just to reiterate the cribiform plate, specifically to look for encephaloceles lamina propretias specifically to look for herniation of fat into the nasal cavity. We always want to evaluate the osteomyatial unit. The onoity air cells can be a fuller because they can mimic the sphenoid sinus when the surgeons are performing endoscopic sinus surgery. We always want to talk about the sphenoid sinus talk about the ethmoid area including the ethmoid air cells and the ethmoid artery. And finally, to talk about various diseases involving the perinazle sciences. Thank you very much for your attention.


Today's Webmaster question was submitted by Jim from Vancouver in Washington. He asks, how often does Google re-index a website? It seems like it's much less often than it used to be. We add or remove pages from our site and it's weeks before those changes are reflected in Google search. You too might be wondering, how long does it take for Google to recognize bigger changes on a website? And from there, what can you do to speed that up? Looking at the whole website all at once or even within a short period of time can cause a significant load on a website. Googlebot tries to be polite and is limited to a certain number of pages every day. This number is automatically adjusted as we better recognize the limits of a website. Looking at portions of a website means that we have to prioritize how we crawl. So how does this work? In general, Googlebot tries to crawl important pages more frequently to make sure that most critical pages are covered. Often this will be a website's homepage or maybe higher level category pages. New content is often mentioned and linked from there so it's a great place for us to start. We'll re-crawl these pages frequently, maybe every few days, maybe even much more frequently depending on the website. Thank you for watching. Subscribe to the channel to be notified about our latest Webmaster videos.


Hello, my name is Roger Watson and I'm the Editor-in-Chief of North Education and Practice, which is published by Elsevier. I want to talk to you today briefly about what editors are looking for when a manuscript is submitted. Make sure that you follow international standards for publication of particular types of article. For example, if you're publishing a systematic review or an experimental study, make sure, if the journal requests it, that you follow the appropriate equator guidance for that kind of submission. So, for example, in a systematic review, we expect to see a Prisma checklist and we expect to see a Prisma flowchart, and likewise for other types of studies. That's by no means exhaustive, there are copious guidance available on the equator website. Most journals will point you to the equator website and probably provide a link to the specific guidance that you need to follow for that kind of article, and will also require that you use the latest versions of that guidance. So make sure that you've followed international conventions if the journal as indeed most will requests that you do. Beyond that, superficial things, again, like getting the spelling correct and using English properly, are very important. You'll already know that the vast majority of scientific journals are published in English. English is the language of science. So it doesn't matter what your own linguistic background or cultural background, whether English is your own first language, you have to present the article in passable, if not perfect English. This is not easy, of course, for people whose first language is not English, but in fact there's not really any excuse and journals don't really make much accommodation if the English is not correct. And I would strongly advise you if your English is not very good, is to make use of perhaps a professional editing service. Of course these do cost money or a translation service. But if you need to do that, or even if your English is quite good, I would always advise you before submission to try and find a native English speaker and allow them to take a look at your article. Don't expect them to write it for you, don't expect them to edit it for you, don't expect them necessarily to be expert in the subject material, but at least let them tell you if you're not using English as it is used by native English speakers. So do get the English right in the article. And again I would say especially get the English right in the title to the article and in the abstract. If that's all that the editor reads and you get it wrong there, then your paper won't go any further. But of course it's very important to get it right throughout the manuscript.


What's up y'all? It's your girl Kenzie here from Layton Sports Cards and I'm ripping 2023 Bowman Baseball Hobby 12 box case prank number eight, Random Teams. Again, here's our random result list. You can always find this on our website anytime, LaytonSportsCards.com under the results tab. Links right in chat for you too. All righty. Here we go. Good luck. See a big orange. This is too heavy to do so now. Good luck. I'm gonna open all the packs in each individual box and then go through them that way. Again, y'all, no paper-based ships out of this. It gets donated. You will get all your chrome, any hits, and any numbered paper, of course. Some Martinez, Blaze, Lunar Glow, first of Adeliel. I said I'm gonna open up all the packs first, didn't I? Hope everyone's off to a good start to their Thursday. Again, I always appreciate all the support y'all show. Here at LSC, watching the stream, hopping into breaks, popping in, staying high. Always a good time. We like the jeopardy music playing in the background while I open up all the packs. Here's the link for the next break, y'all, down to six. Very nice. Again, that's an eight box full case break of Bowman's Best Baseball. You got rookies, prospects, vet hits out of that.  All right, here we go. Cheerio sites on September. Los Santos, a little Watson, top 100. Nido. We've got Marcelo Meyer on the Refractor, 375-499, Red Sox. Hot Light Rookie of Brad Beanie for the Metz. Rookie of the Year favorites, Corbin Carroll. Spencer Jones, Chrome first. Dela Santos. Rozo Jacob Berry. Colas. Dela Cruz. We've got Lunar Glow of Manuel Beltre. Prospects, Oscar Colas. Deradriguez first. Moreno, Rookie of the Year favorites. Ray Clifford Bishop. Trey Sweeney, top 100. Bowen Simon. Omos Zavala. Volpe sites on September. Julian Perez. Benzcom, Lara. Luis Angelicunha. Charles, we've got Atomic Chase the Lotter for the Guardians. Stores. Sanchez, Figuero. Rookie of the Year, Langlears. Prospects, Blaze. De Leon, Martin Gonzalez first. Christian Hernandez. We've got Sky Blue Paper, 499. Chris Atheon-Vacarro. Washington. The Lotter, Chrome. Paper. Still looking for our auto here. De Jesus, Brady House. Matt McLean. Luis Garcia first. Corona. And here it is. Nice. Blue Jays. How about a Gabriel Martinez on the base first auto. Go Toronto. Gabriel Martinez. That's young. We've got Prospects, Chirillo. Lazardo Montez and Virgola. Alright, here we are. Really hoping for a big orange. If you can't pull an orange, let's pull a super. Alright, good logic there. Can you all match currently live over on the LSE Baseball Channel 2 with some Pick Your Team and Random Team style breaks? We're looking for some different baseball besides Bowman's Best that we've got coming up next. He'll be live for a bit over there. I've seen a lot of that, yeah. Yeah, I've seen. I saw someone pull a yellow Drew Jones. Jones Drew. Drew Jones. I had a 75 on one of those. I never have luck finding any decent retail products in the store. It's always like old stuff or hockey or soccer that I just don't collect, you know. Those were a hundred bucks for me. They were a lot. Oh yeah? I'm sure they're sold out right now, right? I'd take a chance for a hundred bucks for one of those. Heck yeah. Alright, here we go. Box two. Lawler. Prospects, Raffa Leone. Jorge Valera. Juan Rodriguez. We've got a spotlight for the Rangers there. Anthony Gutierrez. Javina Acuña. Okay, not bad. Nice, Eric. There you go. You're going to rip it or hold it. Lee Brock Jones on the first. Rosa Mason-Winn. We have Purple Joshua Bias to $199 on the Purple Border. Luciano on the Lunar Glow. Mejia Prospects. Elijah Green. Mingas. Kara Mitchell, Rookie of the Year. Tina's Young. Team Rip All Day. Love it. Nice. Y'all have to let us know what you hit. Jackson Jew. Sang Wagner. Tina's first. Addy, Rookie of the Year, favorite. Carol Rada. Prospects, Bias. Bias. Blake Cromes face. Davis. Top 100. Bastina, Simon Leuven. Burgos Boyd. Kumar Rocker. We have a Jace Bowen for the Pirates on the Refractor. First out of $4.99. The Pirates. Nice looking out of there. $4.35 of $4.99. Roman Anthony. Zalas. Blue Shimmer. It's going to be a Christian Serda first. B-backs, $124.150. And a Lunar Glow of Marcello Meyer. Baskin Robbins for the...nice. Keegan Murray, yeah. That'd be a nice hit. Munoz, that'd be a fun rip. Some baseball and basketball. James Almonte. Curtis Mead. Isaac Paper Base there, that flew off. Bias. Holiday Base. Ellie Gela Cruz, top 100. Tomic is going to be a Henry Davis for the Pirates. Nice Pittsburgh box here. Drew Jones, Chrome First, and Michael Arroyo. Alrighty, that'll do it for box two. Number three here. Definitely cheaper than last year. I think what, they were at like 500 last year or something? Last six. Remember, it's kind of crazy how the prices fluctuate so much. But I mean, that's good. It's good that it's blowing this year. So like, next year's football products. All those quarterbacks. Yeah, that doesn't move on. It chased up. For basketball too, but where may I get all the kids? And y'all, Bowman's Best Baseball up next. It's going to be an eight box full case break. Take your team style. All remaining teams are on sale. Last time we checked, I believe there were six to go. I'm going to save him some boxes instead of one. How you change the trash in here? Well, switch them. I'm going to take that next. Two quick places. How was your ripping day due again? Fun. Yeah, tuned in a little bit. It would be Bowman too. There wasn't a lot of Bowman. It was only two cases. Yeah, that's not too bad though. No, I would have preferred eight cases of Bowman. Yeah, Couser. We've got Black to 15 there. Kenny Gomez. There you go, Astros. I have not seen this one yet. That's a sharp looking card. Seven out of 15 there. He goes Stroze. Yeah, it's really sharp. I like that. Crossfix, holiday. Camarino base first. Colson Montgomery top 100. Wagner. I like rookie for the Red Sox cosses. Tina. Nice. There you go. That's awesome. Yeah, my niece who is 15 just got her first job a couple weeks ago. Gorman. Loving it. Loving the kind of, you know, earning the money, being able to spend it. How she wants Justin Crawford base first. So yeah, she is definitely enjoying that. Johnson. That's weird. No, you can work Brewster's hires at 14. It's very hard unless you know someone. Yeah. Decent on the first Lunar Glow. They like cruise prospects. There's so many laws set in place, you know, for minors. They wouldn't let me work until I was 15. Oh yeah. They were straight back. I mean, even still at 15, that's a great job. But looks is a good place to work at. Bush top 100. We have Aqua shimmer first of a marion boy. That is 90 of 125. They go Phillies. Gilbert's Dominguez. Costas, we're getting your favorites. Gomez, Marvis. Crossback, Sean Lawler. Watson, Mejia. The Carol top 100. Mar-Johnson, Blais. Royal, Arroyo. That's what we were talking about. Freilich, Cousin Cabrera first. We have for the twins, it's going to be orange first of Kyler Fedko. Wow. There you go, Minnesota. Big orange there. Kingsley W. Very nice. 13 of 25. Heck yeah. That's awesome. We'll get that in a mag for you. Congrats on that one. We'll get that in a mag. Serta, Blake. Paper, Westburg. That's awesome. Lunar glow first of Jorge Ruiz. Angels. Prospects, Simon Juan. Ruiz, Acunha. Luciano. Susak Brown. Luciano. Perosa. Cole Young top 100. Fernandez, Atomic first of De Leon. Another Red Sox hit there. Solid Fox 3 there for sure. Cardshop near me. That's awesome. Yeah, that wouldn't that be a first job? That's awesome. That is awesome. Do they do any brakes on or is it just like wax and singles and stuff?  Practice sleeving and top loading stuff for sure. That's awesome. Yeah, that would be an ideal job. That would be awesome. They do brakes on Facebook. There you go. Yeah. I'm sure you've been around quite a bit here at LSD. I'm sure you have your brake knowledge and what not. You can definitely share that with them. That would be awesome. That's an interesting series. The mix and the heat. Right. Here we go. Box 4. Let's stretch my thumb there. Matto's top 100. Chariot Lunar Blow first of Luis Lara. Grurus. Prospects. Chariot. Drew Jones base first. Ariso. Calcer. Carrot, Radda. Fulminarans. Bastidas. Atomic first of Yenir Fernandez. Dodgers. Yeah, there you go. Get some experience now. Working in the car show. Yeah, for real. Garcia. Gliers. Burgos. We've got Lava to 399 to Mar Johnson. Aricio top 100. Radda. Ariso. Luciano. Gilbert. And we have Astros on the blue. Crater to 150. Ryan Clifford. Astros doing well. A nice 15 to 15 paper. And I'm a Clifford on the blue to 150. Bishop. Marcello Meyer. Got Lunar Blow first. Jayce Bowen. Got the auto there. Red Sox also doing well. Coloss. Ramos. Ricky to your favorites. Moreno. Wagner. Osunia. Arias. Alexander Ramirez. We've got Skyblue first of 499. Logan Wagner. Dodgers. Oh man. Let's see if we can do that for you. Henry Davis sites on September. Rodriguez. Prospects. De Los Santos. Youblee. The one negative thing I'll say about working at a card shop is most of your money may go towards the cards and the breaks that you see go through there. Brock Jones first. You always want to buy. You get so tempted seeing some sweet cards come through. Braves rookie Michael Harris is second on the spotlight. So I definitely got to pace yourself. Corbin Carroll. Rodriguez. Bias. Holliday and Trey Sweeney. We're looking on Bowman's bus. Again, y'all, one more baseball break after this. Then we've got football for the remainder. No one's checking out how we're looking on that. Five. Another team coming in. So five to go there. Those teams are remaining are on sale. It's a full case break. 32 autographs coming out of that. There is the link for you. You know, if you have any questions about that. 20. 20 something like that is expensive. Yeah. For that price though, buddy, you might be able to buy a couple of the cards you're looking for. Unless you're trying to get like some crazy low numbered burrow or Hertz or Herbert, you know. Excited to promote this year. Yeah, me too. I'm so excited. The way the Steelers draft it. I think we're going to have a great season. Hopefully Lunar Glow first. I'm Ronnie Simon. Rakes. Muñoz prospects. Brera Ponte. Cheerio sites on September. Serda first. Buero. De Pala first Chrome. Nido. Atomic coming up here. Atomic first of De Los Santos for the D-vax. We got yellow. Three of your favorites. Adley. We've got yellow paper Marcello Meyer. It's like the third numbered Marcello. We've seen a 75 there. Cruz Romero. Prospect Spience. Ray Solano. Rodriguez. Brito Clifford. Bowen Dominguez. Volpe. Saison September. We've got another orange coming up. Orange first. It's going to be a Osunia for the Rangers. 18-25. Alejandro Osuna. Second orange of the break. Nice. Their Rangers is going to be James J. Nice. And we have Tigers. How about a Gold Shimmer? Wow. Tigers. Kyle S. 49 out of 50. Heck yeah. Beautiful hit there. We'll get that one in a mag for you. What a box. An orange and a Gold Shimmer auto. Take those. Foscue. Aqua Shimmer first. Luis Rodriguez for the Carnals to 125. Lunar Glow. Prospects. Mejia for the box here. Rookie of the Year. Garrett Mitchell. Arias Crawford first. Face. Artega Fernandez. Paper. Artega top 100. It's just backwards. Tutor Jones back-to-back, right? Sounds like, wait, what are we? Seussac. Brown Beltray. Mariano Fernandez. Prospects. Rafaela. De Los Santos. Meyer. Kumar Rocker. Kenny Gomez. Mervis. Spotlight Rookie of Riley Green. Tigers. Watson and Isaac. Last couple here. Young. Johnson. Orange and a big gold shimmer auto. Heck yeah. Box 6. Yeah, Red Droom, my goodness. Seen a couple pull-ups so far, so that would be very hard car to pull, since there's probably only less than one handful. Well, obviously, because there's only a handful to start, but, yeah. What's up, Gucci? Hey, buddy. Welcome back. Eat some popcorn. I've heard of your popcorn stories recently. It's been going on. One or two. Yeah, that's what I'm saying a lot. Seen a few. Not many in existence. I don't think the super has been pulled yet. So that's all there. Oh, yeah. That would be a big, big car. Popcorn doesn't like you. Uh-oh. That doesn't sound good. I know you love your popcorn, bud. One second. Here's my hand there. Here we go. Come on. Let's see. Let's see your Red. Dylan laughing at me. Am I being... Oh, no. Better be careful. Charles Lunar Glow first of Montecino. Sanchez, Isaac. Robert Hassel cites on September. Sanchez. We have a Brock Jones to 125 on the...is that Aqua Lunar? Or Aqua Boulder? So many different parallels. Lunar Crater. Uh, Walner. Got Invicta a day on Draid for the twins. Not numbered on that one. Dyson. De La Cruz. Shaper. John Kensi Noelle. De Leon. Atomic of Mar- Marco Luciano. De La Cruz. Cosas. Henry Davis. De Jesus. Crossback. Jordan Lawler. García. We've got Dave Paula Crone first. De La Lasco. Corona Montecino. Base paper there. Lunar Crater. Peyton Graham. I always second guess myself. De La Cruz. De Leon Hernandez. We've got for the Cubbies a base first auto of Derniche Valdez. Chicago. Yeah. Gotta work on that a little bit bud. Tri. Kumar Rocker. Solano. Grayson Rodriguez. Top 100. For Lunar Glow first of Xavier Isaac for the Rates. Prospects. De La Cruz. Bowen and Perez Jr. Vargas. Simon. Paper. Tana Thomas. We've got Green Wanderer. Nice one there for the Rates. That's 53 of 399. It's weird not seeing a rookie next to his name or anything. Cunha. Spencer Jones first. Crohn. Prospects. Jackson Holiday. De Los Santos. Hernandez. Christian Hernandez. Top 100. Rozo. Paper. Alright Justin. We've got 6 more boxes to go. De La Cruz on the spotlight. Let's pull you one. Is that who you got? The Reds? It's a pretty darn good team for Camarino's not Reds. Ray's. Justin T. Yeah, that's a heck of a random there for you. A nice Wanderer paper too. Gorman. Fencegum and Meyer. What's up DJ? Here we go. Box 7. Fischli Halfway. Very solid first half to the break. Let's heat up on some autos here. The Big Gold Shimmer. Jace Young and a Orange. Auto is well first. Very solid first half. Oh. What's up Coochie? Oh yeah.  First I thought it was your dad for a second. That's like that. Lunar Glow first. Wilbur Sanchez. White Sauce. Prospects. Mimios. Spencer Jones. Chrome first. Sutter Strom. De Los Santos. Perrozo. Blaze. Williams. Curtis Mead. Got a few shoulda. 299. Alejandro Osunia on the paper first. Rangers. Montez. We've got First Atomic of Jorge Ruiz. Angels. Adley rookie of your favorites. Rez Benzcom. Prospects. Joshua Baez. Yada. Sanchez Sanchez. Veen. De Leon. De Lauder. Phone and iPad. We have For the Reds. Orange first. Cam. I can't find him. Hold on. Christopher S. Wow. 4 out of 25. What a case here. Big car. Wow, wow, wow. He was. That's why he tripped me up. Collier and Camarino. I got those two mixed up. Not a one-on-one, but we'll take an orange. That's a car. Wow. We'll take that. Gutierrez. Guero Lunar Glow first of Dylan Jorge. Mejia Prospects. Mitchell. Got Lugo. First speckle. We've got Elizardo Montez. Nice to 299 on the speckle first. You go Mariners. It's a nice hit, yeah. For real. Nice. Kyle hit the JC Young too. There you go. See what that's confident. I'm curious. At least 4 figures. Crawford top 100. Dylan Cruz. Romero. Maybe like 25 tops. I don't know.  I'm not as familiar with baseball comps. Valera. Brito Clifford. Rafaela. Bowen Muncie. William Stop 100. Simon Olmos. We've got Yankees Rookie Spotlight. Oswald Perosa. Santana. Ramos. Trebrillo. Nido and Arias. The last one was 35. 35. Wow. I was a little low on that. Very nice. Wow. That's awesome. Is this orange or true orange? True orange. Okay. Wow. Heck of a card. I have to save up quite a bit for that one Alon. Dylan just said the last comp was $3,500. That's awesome. It looked pretty clean too. It looked really good. Sometimes it's hard to tell centering on Bowen. Yeah, that looks good. Come on someone. 3750 and 3450. Yeah. Yeah, he is. I don't know if I pulled any out of him yet. Let's see. Priester. Top 100. We've got Lunar Glow of Yanquil Fernandez. We've got Blue. Border of Logan Ohapi. Ohio. Rookie for the Angels. That is 110 of 125. Prophex. Tamar Johnson. Vina Beltre. Montgomery Sites on September. Lee Brock Jones first. Prius Meyer. Payton. Foskew. James Atomic first of Daniel Susek. Oakland. Riga's Isaac. Brigadier of Favorites. Gunner Henderson. Holiday. Prospects. Christian Hernandez. Dario De La Cruz. Jarrillo. Top 100. Number one. Here's Jones first chrome. Vicaro. Henry Davis Sites on September. Show me orange. How about a speckle to 299? Junior Camarino. There you go, Justin. Wow. I guess you asked. Can you shall receive today? 299. There you go. Mag that one too. That's sick. I was about to say, if we pull another orange of like a huge player, this is just crazy. Juan de Polychrome first. What a case. Wow. Graham Lunar Glow first. Susek. A's again. Stella Meyer Prospects. Harrison Janelle. Brett Beatty. Rookie of the Year Favorite. Paper. Alonzo. Parada Top 100. Got orange shimmer. First for the Mariners. Come on Kyle. Axl Sanchez. We'll take an orange first all day. Very nice. Axl Sanchez 8 of 25. Very nice. It's kind of a cool name. Coleman Ares Prospects. Sang Thomas. Wagner Obsunia. Rangers Rookie. Josh Young on the spotlight. Bronco Jorge. Grisham. Cole Young. Rafaela Hernandez. Alright. Man, Justin must not be in chat. He'll have a nice recap or mail day if he doesn't rewatch this. Alright, box nine here. Let's check this next break real quick. Wait a minute. Rockies Tigers Giants. Three lefts. Tigers still up there. That's got Torque Rookies. And Autos. Rockies have quite a few. Don't they have... Burnabelle. And then who else did I say? Giants. It's an Artega. Ares Prospect in that, isn't it? Yeah. Yeah, Ramos. Yeah, still some great teams there. And that breaks next. Eight box full case break. 32 autographs coming out. Baseball is pretty darn hot. Let's say. I feel like a Trout or Otani coming out of that case. I don't know why. It's been a while. Some of the UFO ones that would be safe. Yeah. I pulled one of the Lava die cuts. Trout Redemption last year. It was a redemption. I was like, man, I wish I could see that car. And I love those Autos. I like Bowman's Best. They do a good job of kind of switching it up year by year. Yeah, for sure. They don't have the Lava this year, but they have the UFOs, which are really cool. I don't know which one I like better. I think both are very cool. It's very close. I don't know. We have the same car. You also have Forest Tonight starting at 5 with more group breaks. Again, he's got everything rippin' tonight. He's got Skybox Metal. He's got Hockey, Soccer, WWE, Basketball, and Football going tonight. So nice variety. What's tonight? Today is Thursday. Personals will be on the main channel here after group breaks. Kyle's on drip tomorrow and Saturday. Personal is on the main channel here tonight. Prospects, Brady House, Jesus, Garcia, Barraza, Garcia, Corona, Montesino, and Carcion. Pages, top 100. Graham Harrison, Hernandez, Rodriguez. Wolpe, top 100. We have to 199. Fuchsia, Boulder, Lunar Glow, 2199, Burgos. Artega on the Lunar Glow. There's Justin. There you go, Justin. Congrats, man. Heck of a hit. Heck of a hit. Elijah Green Prospects. That one's got to be close to four, too, huh? Maybe a little over a male. Colossovino, maybe like, I'm gonna say around 17 things. I think that might be, I guess, a little high, though. We've got Chirillo on the spotlight. Hi, there's a ton of them. Oh, okay, yeah, it was a bit off. Okay, still, at least saying. That's raw, too. That one looks pretty clean, too. Asunia Cross, yeah. Bit high there, Harris. I got excited because that was pretty close on the collier. We've got Lunar Glow, Colby Thomas for the ace. Yeah, it looks really good. Justin. Jorge. One more. Cruz. Perret. Oh, geez, aim bigger, let's go with red. We haven't seen a red yet, this case. If it's gonna, there's gonna be a case of the red. It's gonna be this one, though. Come on. Ramos top 100. I'm gonna see an atomic auto, too. Atomic Michelle Deeson for the Oats. Lee Virgola. Bradley Green working to your favorites. Brock Jones first, girl. Prius. Prospects, Drew Jones. James Lara. Alcantara. Regas, Baez. Holliday, Figueiredo. Lawler states on September. Chirillo, refractor out of 499, Martin Gonzalez for the Mariners. And it's base first auto, Lazaro Montez. Still another one, another one. Wow, congrats on that one. I think that was who, that was Kyle, right? Can I say Mariners? Yep, Kyle, there you go, man. Very nice, we'll mag that one. Juan, Drew Jones, prone first, and Martin Gonzalez. It's the second auto of him, right? Montez? Or did we pull the one? Oh, the, okay. Speckle. Wow, box 10, just super delayed. Oh, okay. Again, y'all, last time we checked, there were three teams left on the next break, Bowman's Best. All are on sale and I believe all were under about 65 bucks. Aki's 54, Tiger's 64, Giant's 54. So yeah, all teams remaining are under $64. Main site's on September. And that breaks right after this. Montez, Crom first. My chagrin, Rosa. Can you tweet that out for me? Just say whatever three teams are remaining. Priester, top 100. Rez, Benzcombe. Got spotlight of Adley. Rookie for the Orioles. Montez, Alvarez, we're here to hear. Sanchez, Sanchez. Gavin Cross, top 100. Santana Lunar Glow first of Glider Figiero. Arrangers, Prospects, House. She's on break. Oh, Trio, Nido. Cunha, Ramirez, Pfeiffer. Amador, Spencer Jones, Crom first. Rosa, Acunha. Riley Green, Rookie of the Year, favorites. Prospects, Drew Jones. Color coming up here, Gameral Gonzalez. Jackson, Holiday, top 100. C'mon, Rocker, we've got Purple Wei-Rae first of How You Lee out of 250. Phyllis, Lawler, Collier, Crom first. Montgomery, we have for Oakland, base first auto of Collin Pelluce. Space first, Sabino, Montez. Lunar Glow first, nice. Spencer Jones, there you go, Yankees. Prospects, Dylan Poirhe. Davis, DeJesus. Garcia, Blake, Ricky Tiedemann, top 100. Corona, A-Louise Garcia, first atomic. Blue Jace, Montezino, and Boyd. Box 11, c'mon, red. Food smells so good out there. Great. Pulling all this fire. Come on. Now one more baseball break up next, and then we're getting into football. Again, all football teams remaining are also on sale. We have After Bowman's Best is gonna be a four box Phoenix football. Pick your team break. And then ending the daytime with two half case, six box breaks of contenders football. And those are also five autographed box on average. So 30 autographs coming out of there. See an orange sitting right there. Let's see what it's gonna be. Pages. Brass, James. Prospects, Holiday. Where you guys, Laura Painter. Got fuchsia paper first. Lazaro Montez, 118 to 299. Montez coming out of this case. Love to see it. So we've got Cardinals rookie spotlight, Nolan Gorman. Trio, Piero, coming up here. Nolan Gorman, Drew Jones, first scroll. Is that Carol? Ooh. Rangers. Rangers is, I've got a couple of hits already this break. James J. See what we got here, James. 11 of 25, a Kumar rocker. Top 100, there you go. 72 out of 100. On the rocker orange. Congrats on that, James. Very nice. Salas first. Very forward top 100. Oh, young. Lunar glow first of Juan Olmos. Prospects, Deli de la Cruz. Vela Munoz. Frick of the Year, Vargas. Here at 75, a Luis Garcia. Nice on the Lunar. Folder glow. Regas Berrycrumb first. South Freilich, Avina, Yuli. Brock Jones first, Bergola. Casas rookie of your favorites. Barada, Montgomery. What's up, Manny? How's it going? Prospects, Loller. Like Abel top 100. We have to 175. Trey Ternick for the Phillies on the paper. Camarino first, Chrome. Andrew Painter, Wagner, Mesa. We have for the Reds, Carlos Jorge on the refractor. 481, 499. Nice big auto there. Yeah, that's awesome. There you go, Reds. Another nice hit coming your way. Sadie's Thomas. Big day at work. Nice. Well, that's good to hear, Manny. Glad that worked out for you. Some more pickups for the PC on eBay. Nice. What Giants cards you pick up now? Henry Davis. Lunar Blow first, Martin Gonzales. Man, Mariners having a great break, too. Simon Juan. Cedas. Rocker sites on September. Juan Vargas. Ramirez Wood. Drew Jones top 100. Jorge Atomic first, Kennedy Corona. Astros. Roman Anthony and Geno. One box left. One box left and then we will do a recap. And what a recap we have, Drew. Orange Taylor, can you say nice? Zebra. Nice. Wow, that sounds like some sweet stuff. That'll be a fun mail day. For sure. Number match auto. Sweet. Last box here. Come on, Red. I'll take another orange auto. How about a gold? Two. That's awesome. I think it's such an awesome feeling once you complete that rainbow for sure. I want platinum. Spider. What kind of parallel is that from? Maybe. Sounds interesting. Clearly. Spider? I have to see what that looks like. Total exclusive. From what product? You said clearly? I think so, yeah. Well, I'll see what that looks like. That sounds really cool. Those are sick. It's a long one. Oh, it's a one-on-one. It's a Sam Howl, kind of dark, but still the next spider web. Oh, that's cool. I like the look of that. That's sick. That is really cool. I didn't even know that was a thing. I didn't either. Fraylor. Vitega. Prospects, Colmenaris. Berry, chrome first. Royo top 100. Rossiano. Spotlight for the Yankees, Roderick Arias. Hernandez, Berkola. Oh, it was so much fun, Manny Grisham. It was a lot of fun. Had a great time. Comas. Mervis. Mervis, Mervis. We have Peyton Graham on the Luna Globe first. Detroit. Prospects, Marcella Meyer. Kimmerino, chrome first, Zavala. Brett Bady, rookie of the year. Wagner, Mesa. Thanks, Manny. How's the married life? Mercedes, Kross, Montgomery. Brooks Lee, Arias Crawford, Munoz. Connor Henderson, Rikki, to your favorites. Serta, Pueguero. Prospects, Christian Hernandez. Aloy, Wood. Marte top 100. Lugo, Giliarte. Paper, LaCruz, on. Soda, Strum Sites on September. Meryl O'Rei up here. Yankees, Refractor, Rookie Otto, 84 of 99. Oswald, Paraza. There you go, Yankees. Nice one there. 37 on the Bowman top 100. Nice, we'll end with a nice insert Otto there. Cowster, that's what I thought that Kumar Rocker was gonna be. I thought that was gonna be an Otto. Leroy Glow first, Jainer Hernandez. Dodgers, Prospects, to Mark Johnson. All right, last small stack here. Kallera, Ponte, we've got blue first paper of Yofri Solano, 49 of 150. Marlins, Couser, Gonzalez, James Wood. Got atomic first of Randy DeJesus and a blue way rave to 150 of Jordanie De Los Santos. And House. All right, wow, what a case we have here. What a case. One second here, we'll do a quick recap. Few oranges. We had the Axl Sanchez, Orange Shimmer to 25 Mariners. Orange Bowman top 100, number 72. Kumar Rocker to 25 Rangers. Orange Base to 25 Alejandro Osonia, Rangers. We had to 15 and Kenny Gomez on the black paper. Our autos, a Colton Palouse, Oakland. A Valdez, Cubs, Gabriel Martinez, Blue Jays, Refractor to 499. Jace Bowman Pirates and Carlos Jorge, Reds. Blue Crater to 150, Ryan Clifford Astros, Insert Auto, Bowman top 100 of Oswald Paraza. To 99, Yankees. And our Mags Cards. We had the Lazaro Montes. Lazaro Montes, Mariners. Speckle to 299, first of Junior Camarino for the Rays. That one was 237 of 299. The Gold Shimmer to 50, Jace Young, Tigers. And Orange to 25, Kyler Fedco. And probably card of the day, I would say here. 4 out of 25, Cam Collier for the Reds. Huge hit there. Thanks again, y'all. We've got Bowman's Best coming right up.