All right, hello everyone. Great to be here today. So I want to open with a little story. It was almost a year ago exactly, November 30th last year, and I got a Slack at about 10 a.m. saying, hey, we're launching Chatabt today.  Expect this to be a low-key research preview. Shouldn't really impact the sales team. I thought, cool, all right, I don't have to worry about this. And then something started happening. We were picked up by media everywhere, The Guardian, New York Times had us on the front page. Just blew our minds. We printed it out and framed it. BBC and as Noah Trevor put it, our Chatbot went viral. So I had to deal with going from about 30 inbounds a week with my small team to 10,000 with three sales reps. So that was a really interesting month or two or three. So to take a step back, how did we get here? OpenAI started as a research lab in 2015 with the ultimate goal of creating safe, beneficial AGI. AGI essentially being an autonomous system that can perform work as well as humans. From there, we began releasing our research to the public. So our first state of the art model was GPT-3, which we released in 2020. We had four flavors of our model ranging from Ada, our most basic, good for categorization, classification, all the way up to DaVinci, which could start to do some real generative content generation. And we began to see this powering real apps out in the wild like Jasper and CopyAI. We released GPT-4 in March of this year. It is likely the most complex piece of software mankind has created. Really big moment for us at OpenAI is when GPT-4 finished training in August of last year was really exciting for us. We didn't know exactly how powerful this model was gonna be and it definitely exceeded our expectations. We did a demo for Bill Gates, and he said, you know, there have been two moments in my career where I thought the world was about to go through a paradigm shift. The first is when I saw the graphic user interface and the second was today when I saw GPT-4 perform on the biology Olympiad. Since then we have released a number of different API endpoints. We have Dali, our image model, released last summer. This was a really big deal. I know it feels old hat now with a lot of image models on the market. This was really exciting stuff. And frankly, it's what made me want to join OpenAI when I was interviewing about a year and a half ago. We also released Whisper, our ASR model, which we have available both open source and via managed API. We've recently released Voice and Vision and also introduced some orchestration capabilities with function calling and our new assistance API.  I get this question a lot is how do I get started? How should I think of building my app on OpenAI's models? So at the base layer, you have the intelligence, the foundation, our different API models, whether that's GPT-4, our new assistance API, vision, Dali, Whisper, et cetera. On top of that, there are different ways to give this intelligence layer access to your data and customize the experience. So the first is embeddings. This is often referred to as RAG, or retrieval augmented generation, where you're essentially vectorizing data and allowing GPT to search across it for the results. There's also fine tuning, where you give the model access to samples of inputs and outputs and actually alter the underlying weights in the models to customize it for your organization. And the final is this brand new functionality, the ability to call APIs, whether you're outputting in JSON or you're using our function calling tools, that allow you to pull in external data in your results. So we're really focusing more and more after we've generated this amazingly powerful model of GPT-4 to give you the ability to customize it for your app and your product. And then finally, I just get this question a lot. What should we do after that? Well, the advice I give is using GPT-4 or using a model at this point is not an advantage. It's a platform. So build a product that has real differentiation and a real niche use case and think about the market you're going after and how you're going to succeed there versus just leveraging AI as your advantage. So what are we seeing out in the wild? What are companies doing with us? Salesforce has launched Einstein GPT, which lets you generate content, surface insights and run queries conversationally. We've got Ironclad, a B2B SaaS tool that's used for blinding contracts and they have released AI Assist, which lets you automatically red line a document and then go through and approve or deny the suggested changes. This is really meant to streamline contract management for sales organizations. I use Ironclad heavily and this has been a great help for me. Mixpanel, which is a data analytics tool introduced a way to query data conversationally. So instead of going into Mixpanel and saying how many user signups did I get last week and creating a funnel manually or running a cohort analysis, you can now query data conversationally and even generate visualizations of that data within their chat bot.  So we've got hundreds of companies developing on our APIs at this point. It's been really exciting to see the proliferation of creativity across many organizations, whether that's giant companies like Morgan Stanley and Lowe's or tiny startups building AI native apps. So been really fun and exciting to watch this proliferation. So about two and a half months ago now, we released ChatGBT Enterprise. This is really exciting for us. I think this is also maybe a good moment to remind the audience that we never train on data sent to us via API. We also do not train on data sent to us in ChatGBT Enterprise. So this is our safe, private and fast way for organizations to leverage ChatGBT. Lot of fanfare when we announced this, we saw a lot of speculation. What does this mean for the future of work, for the future of the information worker? So ChatGBT Enterprise is essentially our internal productivity tool. It gives everyone in the organization a chief of staff, staff or an assistant, however you'd like to think of it, whether that's people in HR, data science, sales, PMs, project managers, your lawyers, everyone can now be more efficient and productive at their job. BCG ran a really great study. So they actually analyzed the use of AI across their consultants and found that on average when their consultants used AI in their day to day work, they finished their tasks 12% more quickly, I'm sorry, 12% more tasks, 25% more quickly with a 40% higher quality. So pretty impressive results using AI in your day to day work. So what else is in ChatGBT Enterprise? So this is my favorite tool that we have probably ever released. It's called advanced data analysis. Used to be called code interpreter. Same thing, we rebranded it. We thought code interpreter maybe was a little intimidating if you're not a developer. This essentially is a tool that's using Python to run queries for you. So you can ask a natural language questions about data and it will run Python, help perform math on that data set and even visualize it in different formats. So as an example, in this one, we're essentially saying create a scatter plot. You could create any sort of visualization bar chart, et cetera, you could compare different data sets and it will visualize it for you. It can also perform advanced math. So one interesting use case I like to tell is our finance team at OpenAI every month, they get a giant file with all the ChatGBT purchases and then they have their tax rates by municipality and they have to figure out how much tax do we owe? And the file for the ChatGBT purchases is so large that they can't open it in Excel, champagne problem I know. And so they were chunking it and opening in Excel one by one and taking hours and hours to run the report and they said, what if we just put this in ChatGBT? So they put this giant file in ChatGBT, they added in the municipality tax rates and within minutes it calculated how much tax they owe. So save them hours and hours of time. And we found that finance teams, investment teams are really relying heavily on advanced data analysis now in their day-to-day jobs to perform pretty rigorous mathematical operations. So I get asked a lot as a sales leader, how does my team use ChatGBT? How do we dog food our own products? And I think some of these are pretty obvious like generating emails and generating copy but I think advanced data analysis is actually the tool that I use the most for sales operations. As an example, when I needed to cut territories across my team, I had no RevOps or sales ops by the way, we hired our first RevOps person in August. Amen, hallelujah. But up until then I was doing a lot of this myself and advanced data analysis was really helpful for that. So instead of having to manually generate this in Excel, I just uploaded files of here's all of our customers, all our inbound leads, create territories and divide it by 10 reps or 20 reps. It could do it by geography, it could do it by alphabetical distribution, it could do it, you know, by round robin. But I basically wanted to say, here's the data about my companies and my inbound and I want you to generate territories for me and it was something that was very easy to do. Similarly, with rep performance, if I'm trying to understand how are my reps doing rather than having to run this analysis in Excel, I can just upload a file from Salesforce export and just say, hey, calculate performance, sales cycle, ASP, let me know which reps are performing well and who's not and run this all within ChatGBT with visuals so I can just put it in a deck to present to my executive team. You could also use it for coaching. So I upload transcripts of one-on-ones and ask ChatGBT, what could I do better? How could I be a better mentor or coach to my reps? And it can give me advice, like maybe you should give this feedback or maybe you should ask about this or you brought this up three weeks ago, you should probably follow up on it. So about 10 days ago, Sam Altman stood exactly right on this stage at our developer day conference, kind of a while to be back here 10 days later and announced GPTs, our big new functionality that essentially lets you customize your ChatGBT instance. So you can customize it using instructions. So essentially telling ChatGBT-4, what you would like to see in the output, give it access to expanded knowledge and actually take action using our new assistance API. So I wanted to walk you some examples of GPTs we've created internally and how we're using them. So one is a call summarizer and next steps so you can just dump in your raw notes from a conversation you had with the customer and it will automatically summarize that call and give you clear next steps that you can send to a customer to follow up email. So it makes it really easy to go from conversation to really great follow up. There's also the sales to CSM transition GPT. What this lets us do is when sales reps close deals they have to hand it off to a customer success manager. This lets them just put the notes from the, the raw notes from all their conversations with the customer and it formats it in our template that makes it really easy for the CSM to understand the different roles, the next steps and how to act upon that customer to help make them successful and on board them onto chat GPT. And then the final one, which is probably the most useful one we've created for the entire organization is our customer Playbook GPT. So this basically is like our giant FAQ that we've collected over the last couple of years. Every question a customer asks we put into this giant document which is like pretty unwieldy to search across. That's what I had been doing every time I got a question from a customer I didn't know the answer to. I'd go into this document and control app and try to find answers. Now I can just conversationally query this document. So as an example, I just threw in what encryption does our API use and I get back all traffic center API secured using TLS 1.2 encryption while in transit and AES 256 encryption while at rest. Great. So now I just have this GPT up all the time if I'm asked things while I'm on customer calls and I don't know the answers I can just quickly ask GPT and I can sound really smart on the phone. So where do we go from here? What does the future hold? Our ultimate goal is to create AGI or artificial general intelligence, autonomous systems that perform work as well or better than humans.  That means it needs to be able to see, hear, speak have memory and who even knows what else we joke internally and say it needs to be able to smell and taste as well. So we'll figure those out. But in the meantime, we have released a lot of new functionality really just over the last couple of weeks. Some of that is the first one is speech. So you can now talk to chat, you can open up your app and your iPhone and you can have a conversation with GPT without having to type it in. Similarly, we have our new text to speech model so you can get output invoice of six different voices you can choose from. They sound very natural using both of those modalities of text to speech and whisper. You can now actually have a conversation with chat GPT. This is really great if you're like driving and you don't have that you don't wanna take out your phone and use it you can use the voice modalities. We also introduced vision. I think this is probably the coolest most underestimated thing we've released in a while. We have it in chat GPT it'll be coming to API soon. I'm so excited to see the creativity of the world as they start to have access to GPTV. This essentially is giving GPT for eyes. So think it's just analyzing an image it's not just OCR it's reasoning about the image it's seeing. It's making sense of the image. In this example, we give it a baseball diamond and we say, explain to me what these different positions are and also how does this game work? And we say, hey put it in a table format while you're at it. So you can see this is leveraging advanced data analysis GPT forward a reason about the image in front of it advanced data analysis to create a table output of it and then also explaining me how the game works. You can imagine with vision there's so many potential use cases. Some of the interesting things I've heard recently is insurance companies using this where you can take a picture of a car accident and we'll auto describe the accident and come up with the claim. Retailers wanna use this to say, upload a dress and accessorize it for me. You can imagine any sort of marketplace where you're uploading images of houses or anything you're selling it can automatically describe that for you. From a support perspective you could just take a screenshot and share that and then GPTV could analyze everything happening in the screenshot to try to debug an issue without having to go back and forth with a user and ask them a million questions about what they're seeing on their screen. So this is a really fascinating new modality really excited about it and excited to see what people build with it. And then finally we've got Dolly three. So we released our image model last summer and this is our next version of Dolly. You can see it's a lot better at hands and faces which I know it was notoriously not great at. It can do words. So showcasing some of those features here and what's really cool if you haven't tried it yet in chat GPT is we're leveraging GPT-4 to help the prompt. So before with Dolly you had to think, okay I have to describe an image in a certain way. I don't really understand what I want to see. I don't know the different types of ways to talk about artwork and photo reality. So what we're doing now is in chat GPT if you put in something that says you know generate a woman image of a woman making a heart with her hands. GPT-4 will create four different prompts and so you'll get four different images that are all slightly different. So we're actually leveraging GPT-4 to improve the inputs for the Dolly outputs. And then finally we've released Browse with Bing. So I know it's really frustrating and annoying when you ask chat GPT a question and it says I'm sorry my training cutoff is used to be August 2021, it's a little bit sooner now but still you would prefer for it to have access to real-time data, give you results that are real-time. Now you can do that by leveraging Browse with Bing. It will essentially browse the internet for you, come back and give you information. And this is really cool when paired with advanced data analysis. This is what we're showing in this example. You can say show me the top ski resorts in Vermont besides Killington, give me a quick summary and create a funny nickname while you're at it. You can see it goes and searches the web, it finds all of the resorts, creates summary, gives us a funny nickname and puts it in a nice table format. All right, so I love this quote. Sam said this exactly 10 days ago, stay up on the stage right here. This will all look quaint in a year from now. We're just getting started. Thank you.


For more videos on people's struggles, please subscribe to our YouTube channel. The beginning of the new year has brought with it some hope, as different countries have started administering vaccinations against COVID-19. This has been the fastest development of a vaccine ever within the number of research collaborations to make this feat possible. A number of these vaccines have also gotten approval by regulatory agencies. The main ones include vaccines developed by Oxford University in AstraZeneca, Pfizer and BioNTech, Moderna in collaboration with the National Institute of Allergent Infectious Diseases in the US, the Sputnik 5 vaccine developed by Rasheer's Gamalaya Institute, the vaccine developed by Sinofarm Group, a Chinese government-owned pharmaceutical company. Dozens of nations have started administering shots of these vaccines to their populations starting with the elderly and healthcare workers. The United Kingdom was the first to start the rollout of the Pfizer-BioNTech vaccine on 8 December. It also became the first to start inoculating people with the Oxford-AstraZeneca vaccine on 4 January. The US has so far administered over 4.6 million shots using the Pfizer and the Moderna vaccines. The Pfizer vaccine is also being used in Canada, Germany, Spain, Mexico, among other countries. The Sputnik 5 vaccine has been approved in Argentina, Bolivia, Serbia, Venezuela, Belarus, among other places. Russia has been administering this vaccine since September last year. Meanwhile, thousands of Chinese citizens, including frontline health workers, teachers and public transport workers, have already received a Sinofarm vaccine under an emergency use authorization. This vaccine has also received emergency use authorization in the UAE and Bahrain. So why are there so many vaccines and how are they different from each other? Given how dangerous the novel coronavirus has turned out to be, governments, usage organizations and pharmaceuticals across the world have been trying to develop a vaccine that can work against it. The general sense behind this is that the more vaccines we have to deploy, the better. All these vaccines have displayed varying rates of effectiveness, but all of them are much above the 50% rate mandated by the FTA for emergency use for vaccines. These vaccines also employ different methodologies for building immunity against the virus. For instance, both the Pfizer-BioNTech and the Moderna vaccines rely on genetic instructions known as messenger RNA or mRNA. This prompt cells to make a protein that can train the immune system to recognize SARS-CoV-2 virus. This is the first time mRNA vaccines have been approved for any disease. Whereas the AstraZeneca-Oxford vaccine works using a virus that causes the common cold in chimpanzees. This virus is modified so it cannot spread and cause disease in the body. It is then loaded up with a gene for the coronavirus spike protein. When this vaccine is injected in the human body, it starts to produce the spike protein. The immune system detects this protein and produces active bodies. These active bodies would also then be effective against the real coronavirus should the person get infected. Russia's Sputnik 5 vaccine also uses this adenovirus vector method. This is the more conventional approach of producing vaccines. Other vaccines are also taking such conventional approaches. The Sinopharm vaccine contains a chemically inactivated version of the entire virus. The vaccine developed in India-Babharat biotech called Covaxin also works in a similar manner. At the moment, the Pfizer vaccine is being used in the most countries. However, it requires to be stored in ultra-freezing temperatures, making it deliberately expensive and difficult in remote areas. At $20 to $25, the Moderna and Pfizer vaccines are also priced much higher than the Oxford AstraZeneca vaccine, which costs $3 to $4 a shot. The Oxford vaccine can also be stored in normal refrigerators for six months, making it the cheaper and more convenient option. The vaccines approved until now require the administration of two shots within a gap of a few weeks. Several countries are now debating whether to give just one shot for now in order to provide some immunity to a greater number of people. The UK for instance has approved delaying the second shot of the vaccine to 12 weeks after the first one. The WHO has called this a risky move, saying there is no scientific evidence for a delay of more than six weeks in administering the second dose of the Pfizer-BioNTech vaccine. In India as well health, authorities are in a rush. The indigenously developed vaccine called Covaxin has been approved without data available on its effectiveness. Scientists are worried that this disregard of scientific and regulatory processes will dilute the overall potency of the vaccinations and also feed into anti-vaccine anxieties. Vaccines also still remain inaccessible from many countries. Apart from a few rich nations and countries with indigenous capabilities, most others may not be able to significantly vaccinate their populations until the next couple of years. So while there is some hope that we may start to recover and protect ourselves from this virus, many challenges remain for this immunity to reach all people.


Ah, we went from a copyright claim to fully monetized removed copyright claim in just an hour after uploading our latest video about YouTube shorts. I will show you the email YouTube sent us from Amazon giving us the good news that they agreed to release our copyright claim because we made a successful dispute using fair use as an argument to release Amazon's copyright claim. Here is the fair use argument we made, which was an honest statement of what the video was about, education, what we did, used a few seconds of their, we live time, copyright content, but in a way to teach people about clips, which is a fair use argument. And it was successful. This will hopefully help you make successful fair use arguments when you have copyright claims in your YouTube studio that look like this where you're not making any money. All the revenues being redirected to the rights holder and converted to this. Here are all the details in this video. So first of all, I want to show you the video in question, which is right here. Let me roll it. I need her man that she loved was dying. And so her emotions erupted in a supernova of the one power which allowed her to heal him and all the other people who were dying. Okay, you get the idea. I am explaining using this wheel of time clip how moments work on heartbeat moments. And that was the core of my argument in the fair use reason that we used to dispute. Now, how do we dispute it? I'll show you in YouTube studio. Find the video that has the dispute. So this is a different video, but you'll get the idea. Here is the dispute. You have to click these three dots and choose dispute. Then YouTube will remind you what is disputable and what isn't. So if your dispute isn't based on any of these reasons, click continue. Then we chose the reason for us, which was copyright exception as fair use. But you choose what applies to your video specifically, then click continue. If you choose fair use, YouTube will give you a lot of additional context that you should read before claiming fair use. Now I read it and I believed we qualified. And then you explain what type of fair use argument you're making. In our case, it was an educational video. Then the reason that we used, I shared with you in the previous screenshot. Then I checked all these boxes, typed in my name, and then I clicked submit. After that, in a matter of less than one hour, we received this email from YouTube giving us the green light that Amazon agreed to release their copyright claim because of our fair use argument on our video. And so now we're back to monetizing our content. Now let me break down the reason because I think it's important for you to understand the key points. Key points are, I talk about, I am teaching YouTubers how to convert, oops, should probably be convert, spelling mistake George, YouTube shorts to regular videos. So again, I'm expressing that this is an educational video and how to create clips using heartbeat moments. And then I explain how I use their content. I featured a few seconds of a scene from the Wheel of Time. You be honest, admit what you're doing, don't try to hide it, say exactly what content you used from the rights holder and then explain why you used it during my educational tutorial, which I believe qualifies as fair use. And then I simply made a very honest and genuine request. Can you please release your content ID claim as I spent a lot of time and energy creating this video and every dollar counts to help create these videos? That's it guys. Did this help you? Did you successfully release content ID claims from your videos? Tell me down there in the comments below what worked for you and what didn't. So we can all learn from each other and help each other grow together as a family. Now this is heartbeat photos guys. And here is a pretty cool looking picture of a freedom shirt. First, what is heartbeat photos? It's a better way to view your photos. Look, I'm not clicking, I'm just hovering. And if I want to, I can zoom in. I wanted to actually zoom in to the good news which is here, no monetization. And there's no clicking. Now you can press Q to move the thumbnails around. You have this hamburger menu where you can look at all of your other galleries and you can click Home which shows you your galleries as well as everybody else's galleries. This is already being used. Over 2,000 photos have been uploaded to heartbeat photos and you can see all of the public photos here. If you upload a photo, it's by default unlisted. It will not appear here. You have to choose public in order to have your photos listed publicly. And I'll show you how to do that. So if I go back to the gallery I was at, which is YouTube Creators and let's say I want to make this entire gallery public, I just say visibility public. Now I have another one which is scams to learn from and this one I haven't made public and you can see it is unlisted. If I change it to public, suddenly it's visible on the home page. Look, I need to refresh and then it'll be visible on the home page. There it is. These are scams to learn from. Alright, I hope you find this helpful. I hope you try out heartbeat photos. It's just heartbeat dot photos. The link is down there in the description below. Let me just go and change that gallery back to unlisted because I didn't want it public. Alright, there we go. It's meant for a future video guys. I'll make it public when I make that video about scams to learn from for you. And we have another product called Heartbeat Moments. If you add it to your Chrome, this will say remove from Chrome, but to get this just go to heartbeatmoments.com and you'll be able to create moments from your YouTube videos. And finally we have our Viki, our video wiki which combines everything. Video moments with photos from heartbeat moments, heartbeat photos and blogging. So you've already seen a lot of this. Here is an example of a moment. Click. That was the moment I just showed you. Did you see I didn't have to seek? I just clicked this timecode in a blog and it jumped, say if I'm in a different part of the video for example here and I just click this button, it jumps to the right part of the video. That's the power of a Viki combining a video with a wiki which we are building. You actually cannot build wikis or vikis yet. That's because we haven't added it to heartbeat, but we will. And this is the current Heartbeat Moments website. You can just type heartbeat.love. It's for all the things you love. And you can see all the moments other people have created. Of course, your moments will come here as well if you build your heartbeat. Now here I'm not signed in, but if you sign in, you'll get to see all the photos, all the moments that you created using the Heartbeat Moments Chrome extension. Alright Freedom Family, I hope this helps. Check out all the links down there in the description below. I also hope you are learning from us on how to grow faster. And this shirt is from a freedom, loyal freedom partner. She is proudly wearing the freedom colors and her YouTube channel is NiaYT. Let's go check it out. YouTube.com slash at NiaYT. And here she is. So that article, that post was from her community tab that you can see right here. It's the same photo. And she has actually a lot of photos of her wearing the freedom colors, which is pretty cool. If you do this, if so, send us an email at support at freedom.tm or tell me down there in the comments below. And I'd love to feature you on The George Show, like we're featuring Nia. Alright Freedom Family, I think that's enough for this video. And yeah, let's keep helping each other grow together to make this happen for you. And we'll all build our career and video using Heartbeat and YouTube together. Heartbeat is our new platform. It will pay you a penny when you earn a penny, unlike YouTube. You will make money from the first piece of content you upload, unlike YouTube, with YouTube you have to reach a thousand subscribers. And you'll be able to monetize photos, writing and video clips, not just videos, but we're not a YouTube competitor. You still upload your videos to YouTube. You just use Heartbeat to create photos, moments and writing that you monetize as an additional revenue stream on Heartbeat from which we pay you that penny if you earn a penny and from your first piece of content. Right now you can go to heartbeat.love, heartbeat.photos and start uploading your photos and create your moments which you will soon see in your Heartbeat Studio. Heartbeat Studio isn't built yet guys, but we are building it. That's our next big feature to launch where you'll see all of your analytics, revenue and data just like on YouTube Studio. And once we build that, then you'll start earning money from everything you've posted or uploaded to Heartbeat Photos or Heartbeat Moments and soon Heartbeat Vicki. So get started guys. Right now we have 70 users. Look at this. 70 users on Heartbeat Moments Chrome extension. Last time I made a video, I think it was 53 or 57, something like that. It's growing now. When that reaches a few thousand, it's more bragging rights. 70 is still a very small number, I agree, but we're just getting started and we haven't even tried to market Heartbeat yet because we're just making these videos to get the initial wave of loyal fans who are a little tolerant of bugs because there still are some bugs that we're ironing out and we're missing features like Heartbeat Studio like being able to blog. So once we build Studio, blogging which is writing and the community features that allow everyone to contribute to everyone else's writing, WikiStyle, then we're going to be ready for our first big marketing push. In that number, I bet we'll read over 10,000 once we do that because this is a very useful product guys. We even have our first Heartbeat Superfan. He's already created 353 moments just by himself. And if you're interested in that video, click that eye to see Stunt Chicken. That's his name. Who is the first Heartbeat Superfan? Heartbeat Moment Superfan. Alright Freedom Family. Until the next episode, I've got my exercise yesterday, not today. Did you? Today I'm probably going to take a break. I'm a little tired from all the exercising, I must say.  Every day is a sunny day in Dubai, almost. That's one of the reasons we moved here. Almost no rain, sunny almost every day. And it's just a very good environment to raise kids. Okay, if you're interested in Dubai, click that eye to see my playlist of all the videos I made while in Dubai. It's called the Freedom Experience. I hope you'll join us in Dubai. If you do, let me know. Email support.freedom.tm. I'd love to meet you in person. Okay, who am I? I am George, CEO and founder of Freedom and Heartbeat. We'll see you on the next episode of... Who You Dreaming But Love Here. Click that eye to partner with Freedom and join the Freedom family so we can all grow together. You get many perks, like position music, you also get epidemic sound, a lot of other access to royalty free videos, sponsorships, and many things to help you grow. Just click the links down there in the description below to get involved in our community, our forums, our Discord chat servers, meet our graphics team, meet our community team, all of that on Discord and the forums. What are you waiting for? Get started. And we will grow together as a family because this is the Freedom family. You are part of it, we are all part of it, and we're all growing together. To get more George, click that big F. That will subscribe you to Freedom Central, home of The George Show. And PewDiePie gave one of you, Freedom Family, a big shout out. Click that video to see the shout out and to see our new 3D sets for you. And click that video to see what YouTube recommends you watch next.


Welcome, folks. This is Tom O'Brien of TFNN. We have five days a week. We go seven and a half hours a day We go 24 hours a day on the internet at TFNN.com Always remember folks, whatever you think about you bring about whatever you focus on grows Hope everyone's having a great day safe day. It's a TGIF, folks Let's make it a great one and the market's a closed Monday, which is for all of us in the market. It's a beautiful thing Be impeccable with your word manifest your true intentions Regardless of what language you speak your intent will may be manifested through the word what you dream what you feel and what you really I'll be manifested to what you say each and every day Market wise. Let's take a look at it out here. We have the Dow industries down 89 Nasdaq is flat S&Ps off five and a half gold contract up six dollars and 80 cents trade in a 15 85 an ounce silver silver up 9 cents 17 dollars 71 cents an ounce light sweet crude up 61 cents 52 dollars three sets a barrel notes and bones you get the 10 year up seven ticks trade in 131 30 year up 17 ticks at 162 13 and King dollar King dollar up 57 ticks trade in 99 125 The euro is at 108 the pound is at 130 and the yen is at 109 point seven seven to one the US dollar iPhone numbers 877 9276 648 give us call folks one that's going on in your world and the world of the S&Ps Let's take a look at it. What do you have? We have another day. We have another week We have another all-time high inside the spy out here today what we did Actually, let's see the high yesterday was that 338 12 we got the 337 73, but I believe the cash actually went to a new high No, it didn't so just missed the new high So the high at thus far was going to be yesterday if we put this on a weekly basis what you're going to see out here as That the bottom line is that you're getting away from the breakout area in the in the cash S&P In the S&P in general the breakout area. There is a 33 37 right now We're 33 71 and the X 100 which continues to be the leader out here We take a look at the cues cues made of high today of a 234 86 That the high yesterday was 234 93 so There's no doubt that just about made it you can see if you happen to be watching Tiger TV You can see how this volume is contracting in a dramatic way What we did on Tuesday and the cues you did 30 million shares Wednesday It did 24 million Thursday it did 22 million and we'll see whether you can even get to 20 million today or it's 16 million So what what you do have as the bottom line is that you continue to push higher the volume continues to contract You know, I just put this on a Weekly and you can see on a weekly, you know, we had gone down slightly the that two weeks ago With 189 million we went up last week with 143 in this week. We're going to have about 120 and NVIDIA and VDA which is one of the ones that said wrote pushing the Ndx 100 higher today. This is a classic You know, if we were listening to the program yesterday, you're going to see was a confirmed ABC structure in the way up Bottom line is that we were talking about this last couple days Actually, it had taken the B point out of an ABC structure on the way up on Monday You got over the B point had the volume now your price projection on this which was so cool was $292 we up 19 bucks today or $294 now watch this. This is what's going to be intriguing here So if we put this on a weekly first what you're going to see is that you're coming into an over-the-high the high the last the all-time high Is 292 76 so in the weekly basis that had 53 million shares and you got to remember what we did and NVIDIA it was like a disaster this thing went from $292 straight down to 128 literally Three months later. Okay, so on the weekly basis, what are you doing? Well, you're coming up with tremendously higher higher volume 53 million was the number there. We're doing 74. So the bottom line don't even think this is Equity that is pushing into its highs with tremendously higher volume now in the monthly it's going to be a different animal So at the end of this month, we're going to be looking at okay Where is NVIDIA the reason being is that on a monthly basis? You're talking about 324 million and even with this acceleration up that we have This week you're only at 103. So that's telling me the most you're probably going to do is 200 million So the real kicker is going to be at the end of this month Can you and do you close over 292 because if you don't close over 292 you and your volume continues to basically drop off You're going to be in a consolidation, which it totally makes sense by the way Why because this was a one-way run which NVIDIA loves to do from a price point of $132 You know seven months ago hundred that we went from 132 took it all back to 294 And this is a hundred percent move of a move when you do a hundred percent move over move Meaning that you've gone down so many points you go all the way back up most of the time That is the end of that particular move It has to do something other than not to build more cause to get up and over that level If we go over to the NQ's the NDX in general and we take a look at that and the X what you're going to see as The move is out there. You got X B there at 11 and a half percent That's quite a move to and video is up six and a half percent You got a luminar up 2.8 percent and you got eBay up 2.5 percent The SMH is so let's take a look at the SMH is because the SMH is no doubt That's what drives the NBX 100 as well as driving the NASDAQ composite We have with the NBX 100 on a weekly basis. We got to a price point this week got over the highs We got to a price point of 150 to 62 a last high out here was 150 Bottom line on the weekly basis though you are over that and you have volume over that So let's say and that will get tested one more time on the monthly basis That's going to be the same setup that we're going to want to be looking at why because this monthly volume has been Contracting and a huge way when we do look at that SMH, you know, but thus far the bottom line It got into it on a weekly basis has some volume as we got into that area Some of the other higher volume stocks in this market out here today You got Ruku that came out with numbers last night. That's trading down eight dollars at 130 You get smile directors getting whacked That's down 250 at 12 dollars and 80 cents that stocks in big big trouble lift is down two bucks Inside the Dow industrials the strength versus the weakness inside the Dow industrials out here We have visa is the leader out here today. That's up 1% Putting 15 positive points home depots putting 10 American Express is putting seven taken away from it IBM negative 29 United Health negative 29 Boeing negative 22 Stay right there folks. We're gonna be coming back with our man. Mr. Bud Springs Bud is in the mortgage business. We're gonna be talking mortgages. We're gonna be talking of course Percentages, what's the 10 you're doing? What's the 30 you're doing? What can you get a mortgage for right now? What should you be getting prepared for if you are buying a house? We'll come right back


Cabbage is one of those ingredients that we love at our house, but we just don't eat it very often. And, you know, when you think of cabbage, a lot of times you'll think of coleslaw. And sometimes I like to grate it into a green salad, but typically it's one of those things I don't often pick up at the grocery store. Well, I did make colcan and potatoes over the weekend, and I had half a head of cabbage left. So I'm gonna show you a really quick and easy. It takes about five minutes to make this quick and easy cabbage stir fry. So I have my ingredients measured out and I've heated up about a tablespoon of coconut oil. I like coconut oil because it can really take high heat.  When the oil is nice and hot, you can add some cumin seeds, some brown mustard seeds, and then I have some fenugreek seeds. Fenugreek is used a lot in Indian cooking, but no worries if you don't have it. It's typically found in an Indian market. You can also use just some fennel seeds instead of the fenugreek, and that's really tasty too. Fenugreek is a pretty bitter seed, but it really gets a lot milder when you cook it. So I've got that, and as soon as these seeds start to sizzle and pop, I'm going to add my cabbage and some seasonings. I've got some turmeric powder. Turmeric is a little bit like nature's natural pain reliever. And now I'm adding the cabbage. And you can see that I've sliced it really, really thin. And you wanna use a nice deep pan. You could also use a wok if you have a wok. Just put it in, give it a nice little stir after cooking the cabbage for just a minute or two, add some coconut. I use unsweetened coconut and it's grated, so it's pretty fine. Just stir that in. And I like to add a little bit of curry powder too. And that is pretty optional. Just a little bit for some of that extra flavor that curry powder brings, that nice rich aroma and flavor. And basically you just wanna cook the cabbage until it's a little bit wilted. It'll be soft, but it'll still be crunchy when you eat it. Right at the end, I like to add a little bit of salt. And that's all there is to it. If you like a little bit of heat, don't be afraid to sprinkle on a little bit of crushed red pepper flakes. And that really kinda jazzes it up a little bit. So there you are, stir-fried cabbage. It's a great way to use that brain food. I'm Sue Dodin sharing good food for Goodlite 365.


Okay, so it's a real privilege to be asked to come and talk to the esteemed audience about an issue that I've actually grown to become interested in based on a couple of observations that we've made. My day-to-day practice is interesting. It's a combination of patients who have coronary blockages or valves or adult congenital heart disease, and you see differences between genders in many different ways. But there's a unique aspect of patients that I treat that have very end-stage disease of either the lungs or the heart. And in those cases, when we're talking about transplanting the organ and you have a donor and a recipient in the immune system, there we really start to see some very interesting differences in patients depending on the gender that they have. So I'm going to kind of highlight an overview of both my own personal experiences, as well as what's been published in the literature to give kind of a flavor of what the landscape is like when it comes to gender-related outcomes in heart and lung failure and mechanical support. So I'm going to start with a brief sketch on lung transplants. This is where I noticed something that was kind of interesting. So lung transplant happens the same way, whether it happens in females or in males. There's really no difference, although there are sometimes issues related to stature and average sizes and wanting to get the right size fit. But in general, the procedures perform the same way. One of the things that I was very interested in in Minnesota was looking at what determined whether some people did better or worse after a transplant. Because lung transplant, especially out of all thoracic organ transplants, has the Achilles' heel of rejection at about 10 years, 5 to 10 years that is about 50% at 5 years. So it's a big deal. So I did a study where we reviewed about 879 transplants at our center at the time. And it was actually looking at what was going to be determining a better or worse outcome. And I was kind of focused on the donor, the distance. I was focused on the recipient's level of illness, on comorbidities like coronary disease or different things that would probably make an impact. And what we found was there was only one factor that made a difference. And it was none of those. It was actually just the gender of the recipient that determined the longevity of the graft and how long people survived after a lung transplant or bilateral lung transplant. And this finding was pretty striking to us. It had been shown to some degree in other large-scale center studies using the UNOS database. But it was very striking in a large single-center experience. Whether we adjusted for all of the different things that the different individuals had or not, it was very clear, and maybe you'll be pleasantly surprised to know at the Women's Symposium that it was the females that did, by far, better than the males. So we had about 80% survival at 5 years for females, which is, like, you know, better than an aortic valve replacement. I mean, that's really, really a good outcome. And males did worse. So we looked at this in a couple of different ways, and whenever we do studies in transplant, we also have to consider not only the gender of the recipient, but we have to consider the gender of the donor. And there are some notable differences when people get a gender-matched transplant versus a gender-mismatched transplant. And we know that especially in heart transplant. And I'll talk about that. So we had to explore that in this particular study as well. And what you see is what has been shown to be true over and over again that when you have a female donor to a male recipient, so a female donor to a male recipient, those seem to do the worst by far. That's the black line here. There's been the lowest survival out at 5 years than either the females in general, which did superior, or males that received male donors. Irrespective of this, females did better than males, but especially if the male received a female donor, then they did particularly worse. We also looked at rejection. So is there potentially some effect that's going on in the immune system, or females rejecting more or rejecting less, or males rejecting more? And what came out at 5 years was that males did worse in terms of freedom from rejection. So they had a much less chance at 5 years. They had about a 20% chance of being free from rejection compared to the females who had about a 40% chance, almost twice as much, twice as likely to be free from rejection. So why could this be, and why is this an issue? And by the way, this now has prompted, we're in the process of submitting NIH grants in collaboration here with Texas Heart, analyzing specimens from every transplant that we do to try to understand whether there are some immune, cytokine-related cell factors that are different in the recipients depending on the gender that could then allow us to offer the same benefits to any gender, irrespective. But there are clearly other differences. There are psychosocial factors that could play a role, access to care. There are hormonal differences for sure. There are also physiologic differences. And then there's thought to be immunologic differences that may be related to differences in the hormonal milieu of the recipient. Just to highlight a couple of potential things. It's been studied in kidney transplants, actually, a fair amount in animal models that looks like the kidney organ expresses a lot more HLA antigens. So they express a lot more antigens that could potentially cause the immune system to attack the organ. So they have to be immunosuppressed a little bit more than the male graphs do. And this is an animal model, and it's fairly well characterized. And when we look at animal models of female heart graphs, it seems that those actually do worse than males, and it's reversed by blocking the estrogen receptor. So one of the interesting theories is that when you have a lot of estrogen around the organ, the donor organ, it can actually stimulate the endothelial cells to recruit the immune system. So it can actually be a pro-inflammatory agent. So if you have more estrogen in the system, that can be pro-inflammatory. And monocytes in particular are cells that get triggered by estrogen and go to the graft. So blocking the estrogen receptor seems to improve this in animal models at least. When we look at primary graft dysfunction is a big problem, and you see here the lungs, you can barely see them. They're all white on both sides. They have oxygen in, and basically the organ just gets stunned after the transplant. It's not so much rejection. It just gets stunned from having no blood flow, being transported, and then transplanted. And in this large study that just came out actually in 2018 from the lung transplant outcomes group, they noticed that one of the biggest predictors for developing primary graft dysfunction was female status. So female status was associated with significantly greater incidents of graft dysfunction after transplant. Now that goes a little bit against what our observations were initially, but it tells you that the story is complicated, and the interactions between gender may be specific to anything from the disease process. If it's pulmonary hypertension might be different than if it's ILD or if it's COPD. And there might be differences in the whole immune milieu, et cetera, but there are clearly differences. One of the studies that we're starting here in February, which is going to allow us to fine tune this, is we're changing the way we're transporting organs. We're starting with lungs, and then we're going to move into hearts as well. Using a device that lets us evaluate and transport the organ and collect samples from the organ throughout transport and treat it and make it better. And it's called the organ care system, so we take this with us in flight. So we're not so much taking the organs on ice anymore. We're actually going to transport them in this device. What we're going to be doing is checking samples from, and we're establishing funding for this, checking samples from different genders to see if we can detect differences in the donor that come, and we think that this is going to give us some clues as to specific disease categories that do better for different genders and what the mechanisms of that might be. Switching gears to heart transplantation. Again, a heart transplant, we do about 2,500 heart transplants a year in the U.S., a similar number of lung transplants. And heart transplants are performed probably in the same way. Again, they're just like lungs, irrespective of gender. The donor organ is protected in the same way. So is there a difference between the outcomes of a heart transplant between females and recipients, and should there be? So a lot of people have looked into this, and there's been about two or three very large-scale registry databases that I want to highlight that have studied this question. And this one in particular by Cush and colleagues that was published in circulation looked at the influence of donor and recipient sex mismatch in heart transplant outcomes, analyzing the ISHLT registry. 6,584 heart transplants, which is incredible. Now this is worldwide. In this, they identified that male recipients of a female donor, not unlike what we had discussed earlier, male recipients of a female donor had a 10% increased chance of dying. So now that's after adjusting for other factors that could be related to this, they still had a 10% increased chance of dying. And when they look at the other way, female recipients of female donors, so females that were matched, female to female, had a 10% decrease in mortality. So I suppose if you had to choose, and if you had the luxury of choosing as a female recipient of a heart transplant, it would be nice if you got a female graft. Those seemed to do the best. Now it is interesting to also note that there are many more transplants done, at least in this era from 1990 to 2008 in males than in females. That's another interesting kind of discrepancy in the field of heart transplantation. And that is probably equalizing out now, but it's certainly notable here. That's a male combo is the most popular. And it does the best. So that's going to slant a lot of the data towards suggesting that maybe males do better with heart transplants. And in fact, that's what seems to be the case when you look at the largest registry. So it's almost opposite to what we saw in lung transplant. Now when we look at this, in this particular study, overall survival out to 20 years, which is great. So that means we have patients surviving very, very long with heart transplants. For males, on average, it was close to about 20, 25%. And females, it was about the same actually. But this just highlights the difference where if you were a male recipient of a female graft, you did worse. And if you were a male recipient of a male donor, you do better. And for females, it's the opposite. Now, could it be that cardiac allograft vasculopathy is at play? That's one of the biggest drivers for rejection or failure of the organ over time is that the coronary artery starts to get thick and narrowed. And this is a known phenomenon, unfortunately, that happens. So they looked at this in this large registry. And when they saw females that had female donors with male recipients, they had a pretty high rate of coronary artery obstruction in the donor. About 40%. So that was pretty high. But it was the same as male to male donor to recipient. So it's hard to say that that is the reason for why the grafts tend to fail afterwards. And it's not entirely clear from this particular study. Another study looked at 67,855 heart transplants by Kazmerik et al. They also identified in this particular study that males did better than females. And when they looked at male donors to male recipients, they had an 84% one-year survival compared to a 79% survival for male donors and female recipients. One thing that's interesting about heart transplanted was shown very nicely in this study is that the five-year survival was not different between genders if they survived beyond one year. So it's that first year that matters a lot when we look at discrepancies between female and male. It almost makes you wonder that, you know, it's that one year you really have to focus on. So anything that could contribute to worse outcomes such as being very sick, very ill at the time of transplant, anything you can possibly modify between genders, you want to do so. So if you're female, you want to get access to transplant centers early. You want to try to be in the best shape possible because if you make it through that first year, the outcomes are going to be the same. How about the waiting list? So this is another hot topic because in the waiting, there's a scarcity of organs. So unfortunately we can't really choose, you know, what we want. If we want a female or a male donor, you don't get that many choices. And hearts even worse than with lungs because with lungs you can get single rights or single lefts. In March it's even more rare. So 16% of patients die on the waiting list. That's a huge number. So 16% of people die. The chances of a female dying compared to a male is three to one. So females tend to have a much more likelihood on average of dying on the wait list, three to one. And this was a very good study looking at this in the Journal of Circulation this year. Sex differences in mortality based on the UNOS status while awaiting heart transplant. With risk adjustment, so trying to put all the comorbidities such as hypertension and diabetes together, female status was still a significant hazard for death, especially for UNO status one. So what is status one? So status one is the sickest of patients.  And it's unclear. We don't truly know why. We have no idea why. And you can see this here. You know status one A, females do worse than male. You know status one B, it was the same thing. But you know status two, which is a little more stable. And status three, it's the reverse. Females do better than males. So what it kind of drives you to think or postulate is that if you're female and have heart failure, first off you want to try to recognize it early, get treated early. And ideally you want to be on the wait list not when you're really sick, but when you're in better shape. Because then you'll do better on the wait list to be more likely to be transplanted. This was an interesting study, the new heart study that looked at EKG monitors for all new donors. And so they basically wanted to look to see if there were any subtle signals in the EKG that could predict whether a donor was going to reject or not. And it was a nice database and it was prospective and it allowed us to get other information. Several centers involved in this. There was a publication that really zoned in on the effects of gender on the donor graft and had a couple of interesting observations. When you compare females to males in this cohort, the male patients seem to be sicker. So in terms of the comorbidities, not so much their unostatus or their inter-max status, but they seem to have more comorbidities like diabetes, 42% versus 21% for females. Hypertension is 63% versus 49%. Dislipidemia, elevated cholesterol, 62% versus 45%. History is smoking way more likely, 52% versus 35%. 26% is schemic heart disease, so from coronary blockages versus 12%. So on the whole, and 35% more likely to have a ventricular assist device. So on paper you would think that the male's going to do worse with this particular cohort. Despite that, women had a greater episode of rejection than men did. Even though the men had more comorbidities and were sicker, women also had more hospitalizations in this cohort. Now thankfully there was no difference in mortality afterwards, but you have to assume it's a pretty small group. So I think that this probably was going to, if one group was going to do worse, it was going to be the males because they were very ill, they had assist supports, they had diabetes, cholesterol, etc. So the fact that they was equal suggests that there is some disparity there. And if you probably had more numbers, you would see what they saw in the larger databases, where males did a little bit better. A couple of different mechanisms that could be responsible. Cell death is a process that kind of involves the immune system, but also is a little bit irrespective of that. And it happens whenever you take any organ and you have it without blood and oxygen, and you transplant it and you give it brand new oxygen, the cells die, just like they die in a program fashion as people get older in life. But they die very fast from this brand new introduction of blood flow. It's called a schemia reperfusion. So this particular study looked at, it was kind of interesting, it took biopsies of every donor organ both before it was transplanted, when it was transplanted, and then a week after it was transplanted to see if they can detect differences between gender. So cell death happens in a very structured way, a very programmed manner. That's called apoptotic cell death. There's also a second type of cell death that's called necrotic cell death. This is from a publication I had just a few years ago that the mitochondria get kind of ravaged after 10, 20 minutes. You can see them very, very fragmented and burnt out by a lot of production of free radicals that happens when they're devoid of oxygen. So these are in cardiomyocytes. This is more of a necrotic cell death pattern as opposed to the program. In this study that analyzed the donor hearts, they found that females had significantly higher amounts of necrosis or evidence of necrosis based on the markers that they looked at in the donors. So after the donors were transplanted, they detected more necrosis, more of a necrotic pathway in those donors than the males did. And when they looked at the apoptotic, which is a more structured, more programmed cell death that's responsible for aging, for instance, in the apoptotic cell there was really no difference between the males and the females, although there was definitely more apoptosis one week after the transplant for both genders. So it tells us that necrotic cell death pathways may be accelerated in females compared to males. When they looked at other apoptotic cell death markers, there was really no difference between the genders. Switching gears for a moment now to mechanical support. So when we talk about transplant, a lot of times because there are so many deaths on the waiting list, we have people on mechanical support because there's just not enough donor organs to go around. So thankfully we have ventricular assist devices which were in many ways not only invented but tested and pioneered here at this very institution that we're talking in, which is phenomenal by our very own Dr. Frazier and colleagues. So this is a ventricular assist device. I'm sure many of you know what this looks like, but it takes blood away from the ventricle, pumps it into the aorta, and it works great. And we're using it more and more now for a variety of cases where we think that somebody maybe, even people might be too high risk for a certain operation, sometimes it will go straight to a ventricular assist device. Or if a person is waiting for a heart transplant or waiting for a long time and we think they'll do better with a ventricular assist device, we'll do that. Is it possible that there are differences though in outcomes for ventricular assist devices between females? And that was one of the tasks of this talk. But I looked into this and it seems like there are. So I'm going to take you through a couple of them. The most important, the most significant up front is bleeding. So bleeding complications are pretty important with ventricular assist devices because you have to be on a blood thinner. So you have to because it's a mechanical device. And if you stop the blood thinner, you can have a stroke.  And this particular publication at the end of last year by Yavar and colleagues, they found that the freedom from bleeding was significantly better if you were male compared to females. So females had a way greater chance of having bleeding with ventricular assist devices even when they controlled for other risk factors. This is the breakdown of the different causes for bleeding. Gynecologic was not an insignificant portion of the bleeding, but females had a greater amount of gynecological as well as nasal pharyngeal bleeding. And so they speculate that there might be something in the mucosa that is different between the genders that allows for more bleeding in females than in males. How about stroke? Stroke is another major comorbidity that we think about with ventricular assist devices because you have this pumping constantly into the aorta and that pumps to the head. So there is definitely a risk of stroke with any of these devices. And could there be a difference in the risk of stroke between genders? In this particular study published the end of last year, looked at the Intermax Analysis, which is our largest registry for ventricular assist devices and compared various risk factors and outcomes. They looked at 7,000 LVAD patients. There was a 10% stroke rate overall, which is very, really pretty high. Female sex was associated with a 50% increase in the rate of strokes with VADs compared to males, so 50% more likely to have a stroke. They didn't have obviously a clear explanation for that, but they hypothesized that maybe it's the endogenous estrogen production, which is a little bit more pro-thrombotic. And that could potentially be responsible for greater amount of clot formation, greater amount of stroke. Of course you could also hypothesize that maybe it's because they had so much more bleeding that stopping anticoagulation could lead to stroke. So it's unclear, but clearly there's a discrepancy in two very large scale databases in these two important morbidities. This study by Bloomer and colleagues published in last year looked at sex-specific outcome disparities in patients receiving continuous flow LVADs and reviewed a variety of different studies. Again, there was in this one a 90% increase in stroke risk for females compared to males. Females were also twice as likely to need a right ventricular assist device. So right ventricular assist device is what I consider probably the third most important, I hate to rank them, but the third most significant problem that we can have after an LVAD. The LVAD is by definition left ventricular support, so it relies on the right ventricle in order to function. So if the right ventricle fails, now we have a problem because you're going to need also a right ventricular support device. You're going to need both. So the fact that females were twice as likely to fail on the right side is very significant and important to note. They did have in this meta-analysis, which is pulling together all the studies together on average, they noticed the similarities in renal failure. They did not detect a difference in bleeding and infections were the same. There were similar mortality for both groups. In this study now looking at a different pump, this is one that's coming out now that we're analyzing here at the Texas Heart and a couple of other centers. This is a momentum three trial looking at the heart mate three, which is a smaller pump. So could it be that there are differences in pumps that relate to issues between genders much more so than the gender itself? It's possible. In this particular trial, the preliminary data that was released probably at the request of the FDA demonstrated that the outcomes for males and females in terms of predicted probability of death or stroke or re-operation was the same. So that's real good. It tells us that this particular device, the heart mate three thus far with the first couple of hundred patients functions the same irrespective of gender. How about a broader worldwide European VAD registry? So this looked at gender differences in the EuroMax, which is the European registry for patients with mechanical circulatory support. This was kind of neat because they highlighted all the individual differences in the types of patients, comorbidities and characteristics between males and females receiving a VAD in Europe. So they had 815 men compared to 151 women. So right away that tells you there's a little bit of a discrepancy there in terms of, and it's unclear why more men would be getting VADs than females, not unlike the story with heart transplants. When you look at the ages, they were about the same. Males were a little bit older. The amount of smoking was significantly higher in the males. Also the amount of cardiomyopathy was significantly higher in the males due to coronary blockages was significantly higher in the males and dilated cardiomyopathy was significantly higher in the males. The males had a little bit higher risk profile than the females did. This breaks down the differences in complications. So when they looked at ischemic strokes, the females had a 8% incidence of that, a 0.08% per month incidence of ischemic stroke compared to males, which was not significant. There was also no difference in bleeding in the brain. Major infection was the same. Renal dysfunction a little bit more with females than males. Pump thrombosis was about the same. RV failure was significantly, ribentricular failure was significantly greater in the females and in the males. That was consistent with the data that we had from Intermax in the U.S. Erythmias was also a little bit greater in females and major bleeding was greater than females. So the European data is sort of similar to the U.S. data. This just further clarifies that the events, the percent events per one month of ischemic strokes, about 1.55 in men compared to 2.5 in women. So even though it wasn't statistically significant, it's very possible that if they had more patients, they would have seen a difference with more strokes in females than in males. And this just kind of highlights this a little bit more. When they looked at survival probability, the chances of surviving was higher with males than it was with females. So in conclusion, there does seem to be differences for women and men in thoracic organ transplant. It seems like women do actually better with lung transplant than males do for reasons that are not entirely understood. Males seem to do a little better than females on average for heart transplants. Women do slightly worse with vans, and some of that seems to be due to bleeding, RV dysfunction, or strokes. These results likely can be improved with increased awareness, with restructuring or awareness of access to care for both genders, risk factor modifications, getting patients in earlier, making sure patients are being followed early with their primary care providers and cardiologists, and probably making some adjustments in anticoagulation regimens and immunosuppression, depending on the gender. There needs to be greater awareness of right ventricular dysfunction, I think, in females compared to males. It's a very important thing. But every time we go back to do an ILVAD, we think about what are the chances of them having our right ventricular dysfunction. My partner Dr. Morgan has come up with beautiful algorithms for determining that, but I think that we have to think more about the possibility of it happening in females and what we're going to do to adjust for that or to predict that. There needs to be further research into methods of gender-specific tailored regimens, and hopefully here with our study on blood-related factors between genders, we'll be able to find additional mechanisms that can help tailor our therapies further. So with that, I want to thank you again for letting me talk to you guys about this topic, and I'll take any questions.


What is the ugliest sneaker of all time? Foam runners.  Yeah, I'll feel you on that one. What is the ugliest shoe of all time? Hmm, I really... It's gonna have to be a dunk of some sort, I don't know. Alright. What is the ugliest sneaker of all time? Personally, the new ones that has dropped those cactus plant flea market grinches. People like shaving them stuff. I can't do those, bro. Yeah, I think I could pass on those too.


Hey, Bola buddies. Thanks for watching. I have Moonstone. I can't figure out which way to point when it's Moonstone Mama's here and She is gonna share with us her knowledge on these gemstones that I'm Going to unbag and this is her second time here so if you guys missed the first show go back and check it out on my playlist because She's got some knowledge. All right. I'm gonna pull up her YouTube channel just to show you guys And it is Moonstone Mama, so please go over and subscribe I'm gonna link it down in the description of the video like I always do and let's show her some Support and how I met her was is she commented on my video where I was asking about the green stone necklace And I was like, you know what? I'm gonna reach out to her and see if she wants to come on because she has a YouTube channel Well excited to be here Yes, so You went I know you did it in the last video But if you kind of want to tell people about your channel and kind of what you do on it First thing here, that'd be awesome. No problem. I primarily do jewelry unboxings I buy from shop Goodwill. I buy from thrift stores. I thrift to sell. I have an Etsy I have a eBay. I have a Poff mark. I'm not a big fan of jewelry I never have been but my favorite part is the detective work I don't really like jewelry, but that's what I do Easy for me to part with stuff People are like, how can you get rid of this? I'm like, well I like to sell it. I don't like to wear it. There it is Okay, so and you guys can find her Etsy on her her YouTube channel and so your mom does it with you once a week. Is that right? Yes? I have live jewelry auctions. I have one on Monday So, okay. Okay. Awesome fun This piece here just looks like a little stretch bracelet I'm trying to figure out what's going on here. Like maybe you can A style of bracelet. I know that sounds like but it really is some people collect kind of style And it's adjustable that little one up top can go down and make it smaller or bigger Okay, but it escapes my this moment, but it's not a slide I don't make any But it's not the slide the slide bracelets go like this. They pull this one's different, right? Right exactly. Okay. So, okay All right. Let me figure out you wanted me to shrink you I can't remember how I did that so you can see the stuff better. Oh That's not right. Whoops Now, I think I think this is tiger's eye Yes, it is. Okay. Now, what are these? Are these just standard beads? Those could be seed beads seed beads come in a variety of size Very expensive so Because I just sold a ton of seed beads on posh mark and they sold super fast I picked them up at a garage sale And they were from gem moons moon. I know gemstone mountain Yeah, that's a good place. Yeah, that's a good Undersold them because they sold the next day. Oh, well, yeah cheap So fun to pick those up See beads. Yeah, I sold. I mean I'm talking some poundage. I had to pay overage. It was over five pounds Holy smokes. I know I probably messed up. They bought them so quick This little bracelet had I think you call it a toggle. Yes, and it's just I Don't know to me. This is really boring, but you what do you think because you can see on the larger two? Rectangular stones that there's beautiful matrixing Possibly be an ocean Jasper a picture Jasper Stunning So you think this is really nice, but yes, yes, okay. It's beautiful. All of that is really Cheap to me though. Does it pick up on a magnet? No So hold on Yeah, uh Not the stone thing or not the bead but the Is there maybe a wire on the inside? Um, yes quite possibly you Know that's plastic it's sticking to Yeah, I think it's sticking. Yeah So it's it could just be a costume piece, but those stones really Set it off. I'd say minimum $15 on it. So would you call this just a stone toggle bracelet? I would call it a Jasper because it is a Jasper stone Now what if I sell something and somebody's like that's not Jasper like once I sell it I would always disclose I'm not a gemologist. I don't know I encourage you doing research on every item.  Because you never know someone's always gonna have an opinion on what they think it is, right? Yeah, and I could be right and they could I could be like oh But always just natural stone bracelet This is really long. Oh Holy smokes That's a long end and it's really pretty and it's got a toggle and it's like a heart toggle Let me get it on this My gosh That's gotta be like 60 inches long. It's really long That right there looks like it's it screams fall to me. So right there It's beautiful stunning. You have it looks like you have some carnelian pieces in there some carnelian chip What is it called? carnelian I wonder if we're out of our houses by fall It's stunning and it looks like the larger stones are like a banded agate Okay I'm getting to know agate. I'm like now. How do you say that? Do you say it agate or? She's like agate. I'm like Remember what I called it a got I think I said a got My my viewers know how ridiculous I am now. You know what this is same glass Hmm on that on that white one. Hmm It looks like a stone Glass and stones are tricky sometimes Now the little ones are going past Yes, and this one went way past this one's so the further it goes. Does that mean it's harder? Mmm. I don't know. I don't own a presidium gem tester. I'm gonna tell is scratching it on glass So maybe these bigger ones aren't and the rest are could that be quite possibly, huh? Okay The little ones for sure I can tell you their chips. They're pretty common But right what the thing is gonna make that like a moneymaker piece is the length There's a lot of carrots of natural stone chips on there. So 18 Minimum 22 26. It's a lot a lot a lot of stone. I mean it's cool Yeah, it's cool But it would be cooler if like I think this is a stone, but this one. I'm not sure Maybe it's it says glass, but maybe it's plastic. I Don't know what plastic does when it hits on the thing. Okay, these might be more of those pearls Whoa Long one So they have a really shiny iridescence to them so it doesn't appear to look like Tahitian pearls Rub a rubber rubber rubber them together and see if they're real. They feel gritty. Okay, but It it let it got chalky. Oh, I don't think the other one did that. No Probably not Yeah, it's a It's a gosh, let me see if I can show you what it looks like It's like into it. Yeah, it has probably some kind of coating on it. Okay. Yeah, so it's just junk No, if it feels gritty and they look like pearls, then it's pearls They're just lower-end pearls and someone decided to cover them to make them look like Tahitian pearls But their imitation, but they're still pearls nonetheless. I Want to look at that one from the other video we did because I have it sitting right here, and I want to compare it Because we thought that that one was legit, right? Yes, I do believe so. Oh Yeah, they look totally different. I don't know if you guys you'll be able to tell on the screen You can tell just the shininess of the larger one just in comparison to the other one that I do believe is Tahitian pearls They almost see the quality. Yeah, they look totally different Okay Good to know. Yeah, those just seem cheaper Okay, now this reminds me of that necklace that I sent you a picture of Mm-hmm, but this is not carved it's just But it's got that pinkish Let me try the white it might show up. It's got like pink and gray It's really pretty there. You can see it better. Yes. Yeah, that's rhodonite It's it's a pink stone with black and gray matrixing stunning and It is knotted in between and I'll tell you what here what it says It goes It's in the quartz amethyst in citrine And it's also hitting the jadeite in the spinal or spinal Now there's Places that are like chalky like maybe where the clear coat didn't go on super well Normally if a stone has been tumbled and polished there would just be so is it like Matt or yeah It's like Matt in some areas like it didn't get polished That's that's pretty normal Especially with wear of something the break down the oils on your skin can take away the the polishing effect of the stone It's only in one area So maybe they wore it like this all the time. Yep quite possibly so now. Do you think that's vintage because it has no class It's hard to say the knotting I Don't I don't know. I'm not a hundred percent certain, but it's Okay, this It just looks like a normal class. It doesn't look vintage Looks like a nice costume piece you have some dyed Magnesite So that is Magnesite Magnesite. Yeah, so it's it's another stone that is easily dyed So it's manufactured Mask produced because it's easily surfaced guide and they look like turquoise, but that's different than this or is it yet? Yes, the one the larger oval one is dyed how light that one because it has more dark black Matrixing okay, so I'm gonna give them a close-up so they can learn with me so they can See the difference in the like they both have that What do you call that? The black and the gray or whatever it would make a crackles. Yes, but they do have a very different look to them. Yes Okay, awesome this right guys is Shell such as I don't know. I thought maybe it was shell, but they look like little rocks Hmm, I think they're rocks of some sort a Great way to tell if something is dyed or not, especially having a piece like that is literally Like pulling it apart a little bit if the hole where it has been drilled has any kind of white Look to it. It's died because most the time any kind of stone that has been dyed is just Surfaced died so the center is still the natural color of the stone It looks like it's the same in the middle So either that piece hasn't been worn that much But looking at it in the vibrancy of the blue. It's either it's I'm pretty certain. It's a dyed piece It looks like that piece up close that I just showed you it's kind of got those different Hues to it. You know what I mean like the browns mixed in So it's just a toggle Bracelet stone My if I put this stuff on Etsy, everybody's gonna be like this girl's clueless. I'm looking at her store. They'll be like Okay, so this piece has some carved stones Can you see the carvings yes They're beautiful and it does look it has the What do you call that a pinch slide clasp a pinch slide clasp and It has one well it has a couple beads, but not many But yeah, so it's got some carved That's beautiful um They're very shiny. Um, not shiny really no It has a sheen to it, but it's not like super shiny. It's going up to the jadeite and the Final spinals But it's blue yes, I Personally have never seen blue jade. I don't know if blue jade even exists. I'm sure it doesn't I'm sure This gemstone tester. I'm not gonna be a salesman for it because I don't understand it It's a really good way to narrow things down if you have an idea of what group it is that I do believe is It's coming off pink it over. So it's rose quartz That's a great one The metaphysical properties are all about love on that one. It's a very popular Stone to sell for me. So rose quartz Don't have to watch the video back as I'm listing and be like, okay, this one is Okay, so rose quartz does it have a clasp no so a lot of times they'll be on like a Illusion wire and a lot of those stones can either be worn But I think they're primarily made to be resold and used as chips or like crafts or something So it's like a double-purpose kind of thing. Okay. It is going past the quartz Hmm. I really don't know how Accurate that thing is you know what I mean and I wonder if the size of the stone also Affects how it Reads, you know what I mean? Yeah, I'm I like I said, I don't have a pristine investor I don't know. I've heard really good things about it Well, I'm sure it's really good if you know what you're doing, but for someone like me that doesn't You'll be there. So this is a barrel So it looks like you have some Like shell beads and spacers in between Okay, I believe I've had a necklace similar to this and I do believe that that's died. How light Does that give you is it better on white? Yes Sometimes Differentiating between died. How light and turquoise is pretty difficult. I haven't been doing it for too long But I still get stopped now it has Ooh, this is really interesting Interesting Gosh, I don't even know how to describe it. I wish I knew It's almost has like pits that are metallicy. Oh Does that make sense Yeah, this is really interesting. Let me see if I can I really want you to see this And I know it's gonna be really hard to Can you see that at all? Yes It's like a and in some you know how like if you break a rock and it's like crystallized on the inside Interesting. Okay. Yeah, right there. It has some like a juicy effect to it. Yeah That's very interesting. Um, wow That to me most that that's interesting, but I think it's a died piece for sure Okay, trying to be imitation turquoise or trying to be turquoise This is another one of those just Love that that is Amazonite and spell it Amazon night like Amazon night Amazonite now you just know that because of the color. Mm-hmm. Huh. Okay. Is that a type of quartz? Um, it's a stone all on its own Um, it's a it's a type of a and a green stone when they're light and hue like that It could either be a venturing or amazonite But either way they'll stretch bracelets are they are really good sellers for me stretch bracelets.  Okay, and it's kind of um, I would put that in a craft lot. Okay That's what I was thinking. No one's gonna want that craft lot from you. Somebody's gonna want it. Yes Um I don't know what this is Ooh Is it magnetic? Yes It is magnetite Okay So it is a man-made stone a man manufactured stone It's been but it's really good in the metaphysical properties for grounding Um, a lot of people like it if they're really spazzy. They like to wear it as calm and peace so So what do you think? What's that 15 so not really I'm like looking for the hundred dollar piece. Okay, so what happened here That is a craft 101 piece right there that looks like a more magnetite. Okay But that's still something somebody's crafted Okay purple amethyst and it has like some It's definitely got some different shades Get deeper the color of amethyst the more sought after it is but since it's chips Um, it's perfect. Someone is looking for a long amethyst strand necklace So what's like something value like for that? I would put that minimum $22 on my Etsy. Okay, and You feel confident saying amethyst Can you see it? That is amethyst. Okay. Cool. That's my burp stone Oh Okay, this is kind of a fun little piece. Oh, it's carved How fun beautiful, um On the back It's weird because they've got these two little dangle things on the back. That's interesting but it's uh Like a type of braid I wouldn't call it a braid. It doesn't look like a braid, but it's some sort of Somebody has you know probably handmade it, right? Yes. That for sure looks like an artisan piece to me Okay I'll stick the thing on it and see what it says Could it be citrine? Yes Did I just maybe get something right? Okay It could be citrine. It's kind of yellowish, right? Yes It could be citrine Um, it's one of those ones that it's weird to hold up in your hand, but it's better lay down on a bust Just like that. It's a stunning piece beautiful Okay, I feel like it's not really showing as cool as it really looks. Let me try it on the black Yeah, it's cool looking. I definitely think it's very cute Love that So cute Okay, I'm glad I've got this little black thing because I had the bust but So thank you to my subscriber who made me this it's perfect Okay, um, this is fun. It's a little uh stretch Oh, is it really glittery? Glittery glittery like looks like glitter Mm-hmm Uh, no, no interesting It it's got that, um Again, like it's it's a rock. You know, I mean it's got that rock Look where it's not polished in some areas Okay, pull it real close. Okay Let me try and put it on here Oh Um, well, how does it feel smooth? Is it ice cold or not? No, I don't think it's ice cold. It's not it may be See how that has like the Maybe a band. So what is it ag ag ag it? It may be agate. It may be jasper. It may be carnelian. It may be coral Um, you're this is kind of got a unique like little Yeah, I believe then that that is jasper Okay, it kind of reminds me of the one other one you called jasper. Now this one has this on it Yes, that's jasper. So I would call that a jasper Gemstone stretch bracelet. Yep. Okay Yeah, I key words are not my thing That's okay. The more you handle it the more familiar you get with it. Oh, how pretty that's definitely a courts So when I put that on there it should fall in the courts Should There's a difference between, you know looking at it on the screen touching it handling it You know, it hold it goes past it and then it settles back in at it You know, I mean, so I think sometimes it's how I'm holding the pin Like if I'm holding it at the wrong angle it shoots past and then when I get it like calm it goes back down So yeah courts. So this is a dyed quartz Just because normally Like is it worth anything? Absolutely. Um, some people want the really Really pretty purple colors the violent colors, I guess Okay, so this is tiger's eye and Magnetite is that what it's called? Let me see it Magnetite It's magnet. Yeah You got it Look at that guys. I'm learning All right, so it's got a barrel But that doesn't necessarily mean that it's vintage, right? Um, most likely it is especially you can tell some things vintage about the length of it People were a lot smaller back then. So they're so it's gonna be smaller When you say vintage are we talking like vintage vintage like 50s or are we talking like 70s or 70s probably passed 70s back Okay, because it doesn't look that old it still looks really clean and like fresh but now this one is a Kjk Ever heard of that? Nope So it's just costume It's signed jkj or something or wait. Oh, it's new yorking company So that's That's a junk, right Oh, no, no, no, no, no um New yorking company like the limited or whatever A lot of people like she goes is a really great reseller brand Yeah, I thought okay. We was a really great reseller brand in new york And why you know a really great reseller brand really? All right, I mean get your maximum resell value out of it I definitely put it in a bundle if I were you but nonetheless, it's a gemstone I mean, it's probably like 10 bucks, right if i'm looking Yeah, okay, so it's bread and butter Yep. Now here's a big cat's eye Yeah, that's a nice tiger's eye tigers. I'm not cat's eye That's okay Of course, I mess it up. I was like just so proud of myself. Okay So that's got a lot of Tigers eye on it. Yes sure does. That's kind of a statement piece, right? Yes statement piece 100 I like new statement piece in the title when I don't know what I'm talking about Yep Now, what do you think on that value wise? Well, tiger's eye is a little bit more Common of one so to me personally, I'd probably be like the lower end of the price range I would say 12 15 dollars. Yeah, okay This is just like stones Like they look like pebbles out of my yard Mm-hmm But you know what I mean? Yes, they're Tumbled stretch. They're not polled tumbled Tumbled stretch bracelet stones Huh any value? I would say 12 15 dollars really Now is that plus shipping or free shipping? I usually do free shipping on my Okay, so this is kind of this is interesting it toggles at the Oh, she's fancy. Yeah, it's kind of interesting Got beads at the top This is a very uh Like stone it's cratered That's It's great Aromatherapy volcano stone. Okay. You put a little essential oils. You put your perfume in it It's really gonna help you out throughout the day. Okay That to me Could be literally anything. Okay. It could be A dyed quartz. It could be a granite Um, it could be on both granite It's a stone. We'll just call it a stone And then in this right here, um that magnetite or whatever or is that could that be silver? It's not sticking It really looks like an artisan piece to me. Okay, like someone kind of put it together So the best way is to just do an acid test on it to see if it is or isn't Or just call it a artisan necklace Yep Yeah, I I can see like once people find me they'll be like i'm gonna go to that store that girl's glues um, so this says 399 on it Like it a crafters thing maybe So it's that's beautiful. That's sotolite. Is it a stretch? Yeah It's beautiful sotolite. Um There's a broken stone bummer Crafter This one is just a really pretty color It looks vintage for sure. It's very very vintage. Yes. Yes. Yes. Yes And it's very tiny. It's a choker or an inklet Okay, so I'm not getting it on there, right? So it's super cute. But do you know what it is? It's kind of like an orangish color. It's very interesting. Um Needed gemstone necklace put it in your gem tester. I'm curious to see what category it comes up as. Okay If it's even a gemstone, right? It might be glass I'm having a hard time getting it to It's glass So With it being such a vibrant color, I mean, it's not real cold So I would just call. I mean, it's really cool though. Mm-hmm. So just vintage glass beaded necklace. Yep choker style It says something on it Japan Okay. Yeah, that's a telltale for vintage. Yeah, it's super vintage. I love finding made in japan stuff Well, when it comes to not like necklaces, but Not really jewelry, but you know other stuff toys and That's more aware Okay Oh, okay. So to me that looks like carnelian Which is just like a Transparent with a brown glass. Mm-hmm So It's a good one. That's a sweater length one. It's pretty good. I would probably Now do you use sweater length in your title? um Like is that a descriptive word that you would recommend using or not? Definitely It gives people a general idea, especially on how to wear the piece if they don't know This is marked germany Oh um piece then I don't see anything else um, but it's Those are pretty common. Um, I've I've had a quite a few of those and those are just quartz Okay, gold tone um Just for fun Gives you practice with it too. Yeah, because when I if you tell me what it is and then I can So yeah, it's falling and it's hitting that black bar now It just seems really cheap like the The bracelet part but the part that hooks on to the stone that seems nice Yes, um, yes That is a pretty common bracelet. Oh, it's probably not I would more like probably bundle that with something to get your money back. No, this is weird I love weird. It's weird I'm trying to figure out what is happening in this picture Let me see if I can get you a better All right, can you see it at all?  I shouldn't say weird, but it is so cool I'll get better with this camera too. No worries. I want to say there's a dragon in there somewhere Yeah, um Yeah, but it's a weird-looking dragon it looks It's like a horse dragon or It looks asian inspired to me. That's really that is probably the best angle Yeah, that's what I'm seeing when I look at it Whoa um, that is some kind of carved ornamental Stunner of a piece It's a stone Mm-hmm. Here's the back. I would I would definitely yeah, that's dea dendric agate um Do what? I know I'm wearing my auctions too. People are like, um, could you spell that out for me? Yeah Okay, so Hand carved Yes So what would agate be on this thing anything it can fall under any category probably, right? I mean I don't know if that's a dragon or it looks like some sort of horse With like a dragon head either way it's pretty punk rock What do you think price wise price wise, um That's hard Because it's so you it's very hard Because if you could narrow down what you may think it is like if it's asian inspired or something that might give you a better clue This is just a this does not feel cold Um, it has no clasp Is it Seen through or is it opaque? I don't know what that means. Is it um solid black or is it translucent? Hold on. Let me stick this thing on it and that might give us a it's just It's Not registering. It's just showing glass Okay, it's showing glass Yeah I'm really bad at maybe holding it when they're tiny like this. It's just so hard Because that could either be smoky quartz or onyx Now it's not showing anything. Could it be plastic? Is it cold? It's not Heavy now it's on glass interesting No, not really heavy I mean, it's not light, but I mean, it's solid black. There's no To me it It looks like rocks It looks like onyx. Okay, so is How would I know for sure? Is there like a test or anything I can do for onyx? Um Onyx is usually solid black all the way through. You're not going to find any marks of Any other color in there It is solid solid solid black any kind of pitting in there is going to be black Yeah, this one you can see like it's a rough edge and it's just all black Yeah, most likely it's it's onyx, but it doesn't feel super cold I mean gemstones don't necessarily have to be super super cold. Okay It's just the weight you want to look at. Okay. Well, we have um another bag But we're gonna do it in another video because we're at 38 minutes and again, I'm gonna Pull up moonstone mamas and everyone. Please go subscribe and check out her channel. I think you're gonna love it And We'll be back for another video. So we're gonna work on one more tonight All right, you guys thanks for watching be sure to like comment subscribe and share and I'll see you guys soon You


USC and UCLA are heading to the Big Ten as early as 2024, Pac-12 and Big Ten have been sister conferences since 1990. Uh, something. It was over the Rose Bowl. Two pretty prominent schools in the Pac-12 heading towards the Big Ten. AJ Hawk as the most popular person from the most important school in the Big Ten. Sorry about it. Everybody else. How do you feel about the old conference realignment that's currently happening? I mean, there's definitely, yeah, I don't know what college football is going to be five years from now. It's going to look a lot different. I don't think any of us have any idea. No.