The Cavalcade of America DuPont, one of America's oldest industries, presents the Cavalcade of America, a series of episodes from American history. Stories showing the qualities of mind and spirits that have made America and the American people what they are today. Distinguished educators, prominence in the American Historical Association, have cooperated in this series to achieve historical accuracy. Throughout this pageant of American life, listeners will find the inspiration that accounts for the forward march of American industry, agriculture, science and art. In the realm of research chemistry, where the name of DuPont is known the world over, the will to achieve, to build and rebuild, to produce better things for better living, is but a reflection of traditional American spirit. Tonight we are pleased to announce as our star player a favorite of the stage and screen, a man who is not only an actor but a distinguished playwright and director, Mr. Frank Craven, who will be heard in the first episode as Josiah Quimby, a resident of Sacramento, and in the second as Henry Fowler, a western farmer of the present day. Tonight the cavalcade of America recreates two outstanding examples of the will to rebuild, events characteristic of thousands of similar happenings in American history. The spotlight swings back through the mists of time, back through 83 years. Our cavalcade orchestra takes its way to California in the early years of the Gold Reich, with the 1849 overture. November 1852. Four years have passed since the cry of gold, gold went ringing round the world, but still the mad rush to California continues. On the Sacramento River stands a flourishing young town, the town of Sacramento. On this day of November 1852, a newcomer in front of the Avalanche Hotel stares curiously at the curb stones along the main street. What's the idea of curb stones as high as a man's head? Well, that's to keep the water from washing the buildings away. Huh? A little spring of tea, these streets here is all rivers. Them dusty rivers? I know you don't believe me, but it's right. You go look in the backyards of all the houses along here. You'll find a rowboat in every one of them, ready and waiting. Well, well, now listen, that's too much to swallow. I don't know, I laughed like that myself when I first came here. I didn't think it was so funny the next spring, though, when I seen my tent from a bed and all my worldly goods go disappearing downstream with me or following on a prank. You mean to tell me that... All I know is that when the spring rain commenced and the snows began to note in the mountains, the old Sacramento just naturally forgot she ever had any banks. This wasn't a city anymore, just a great sea of muddy water, full of debris and cattle and struggling people. Are there rows right over these buildings? No, not these buildings. These are all new buildings. Now, sir, we had more sense that time. We didn't build them out of dopey, we built them out of wood, and we built them higher up in the banks, too. And built curb stone six foot high. Yes, we built more than that. We built a levee, a $250,000 levee. I don't know how we ever managed to raise the money with half the folks in town ruined, but we did, somehow. Well, at least now you don't fear any more floods. Well, we've taken all the precautions, we know how. There's no telling, though. I said there was a boat in every backyard, didn't I? I'm surprised that anybody stays here at all, if that's the case.  Only gets the dander up, makes the place grow. Oh, we've got great plans for Sacramento. We're gonna lay out parks here one of these days, build schools... And there goes the school bell now. Oh, that's no school bell. That's the fire bell. Fire? I can see it. Look, now the school starts to be up. They're boring this way, too, right across the town. Quick, come on, let's go. Powers they struggled against the devastating flames. Building after building fell to the ground in spite of their efforts. Josiah Quimby and the others stood watching Sacramento become a mass of smoldering ruins. There goes the last block of buildings while we stand here watching. There's nothing else we can do. Yeah, there's plenty we can do. We could be making plans. Plans? Plans for rebuilding the town. It might be a good idea to let the fire burn itself out, mightn't it? Before we start talking about rebuilding, if we rebuild at all... What do you mean, Jim Hapsgood, if we rebuild? Of course we're going to. This ain't the first time that Sacramento's been destroyed. Twice already, the town's been wiped out by floods. And now comes this fire. Well, Jim, sometimes the Lord has a way of trying our souls to see what stuff we're made of. And he's going to find out, too, pronto. He's going to see the city of Sacramento rise up out of these ashes, bigger and finer and stronger than ever. Well, we've got no time to lose. Cold weather will be on us before we know it. We ought to start rebuilding just as fast as we can get the debris cleared away. Well, we can get a lumber up here from San Francisco in a couple of weeks. Yeah, we'll need more than lumber than San Francisco has got for a build all of Sacramento. Well, there's big supplies of stuff in Mary'sville, Nevada City. We'll need all of them. All the lumber we can lay our hands on. Hundreds of thousands of feet of it. Hundreds of thousands? That's $70 a thousand? That's the price they're asking in the market now. But just let them hear what's happened. Let them find out that Sacramento's been destroyed by fire, that we need lumber the worst way in the world, no matter what it costs. Yeah, loud enough, and perhaps they will hear about it down in San Francisco. But keep quiet, till after we put our order through. How can you keep a thing like this quiet? The burning of one of the biggest cities in California. The news will travel like lightning. Do you know how slow the mails are? If we start out right now, tonight, and start for nothing, we ought to get to San Francisco and the rest of these places before anybody else traveling that way carries unusual. And if they do hear of it before you get there, then that'll be just one more piece of hard luck for Sacramento. Well, at least we can try. In the offices of Wilson and King, number merchant, San Francisco. There you are, Mr. Grimby. There's your order. It's the biggest order, I don't mind telling you, that we've had the pleasure of filling since we started our business here in San Francisco. And if you've had any more lumber, you could have sold me on a boat that too.  No, no, I'm just acting as agents. You mind telling me who? Some folks from Sacramento. That's funny. There's another fellow in town today, understand, from Sacramento, doing the same thing. The same thing? Buying lumber, ordered a raft of it from one of our rivalries. You don't say. You must have a lot of faith in the future of Sacramento. Did you figure on using all this stuff? Yes, we have. Well, I hope you don't get stuck with it. No, I don't think we will. Not now. Where is it? You want me to sign this order? Right there, where I made that pencil mark. I see. And your signature goes underneath. That's right. Yes, the $100,000 speed is $70,000. Yes. All right. There. There you are. I'll just give me the pen. I'll put my John Hancock under it. There you are. Hey, Mr. King. What's the idea of rushing in here like a wild boar, Tom? Anybody think the city was on fire? Well, it is. I mean, it has been. There has been a fire. What? No, not here. Sacramento's been destroyed. Burn to the ground. You're sure? Who told you? A couple of prospectors. The city's wiped out, they say. Not a house left standing. This gentleman here has just come from Sacramento. It's a thousand. Well, they're not buying it from us at any such price. This order's canceled, Mr. Quimby.  It's canceled, I tell ya. You've signed it. You've got me to sign it under false pre-centers. You didn't tell me what you wanted all that lumber for. Are you in the habit of making your customers tell you what they're going to do with the lumber that they buy from you? You took an unfair benefit of me. I didn't know what had happened. I didn't know Sacramento had burned. No, you didn't know that the city was destroyed, that its people were homeless, they owned, but now that you do know, you're going to try and profit by it. You're going to hit them when they're down. You're going to charge them an outrageous and exorbitant price for the lumber that they need so desperately to put roots over their heads. Well, we're not asking you to give us this lumber, Mr. King. We're only asking you to sell it to us at a fair price. Well, what do you think, Mr. King? Hmm. All right, Mr. Quimby. Your order stands through the years to the present day. Americans in many communities have demonstrated many times that the will to rebuild is a trait deep set in the American character. The American cavalcade moves onward. The will to rebuild is as strong today as it ever was. It is spring, 1935, and over the Great Plains region of America, for months no rain has fallen. Starved livestock grub the park's fields. Trees and grains choke for moisture. Farmers scan the skies carefully, hopeful that rain will soon come to end the rising dust. One afternoon in March of this year, Henry Fowler, played by Frank Craven, a farmer of the blighted region, and his small son, Jimmy, are making family purchases in a general store. Will it be anything else, Henry? No, I guess not, Tom.  Yes, but who said I could have a chocolate bar, Dad? So I did. Well, give the boy a chocolate bar, Tom. That's right, Jimmy.  Here you are. Thank you, Mr. Wilson. Be sure how it don't rain any more. Oh, it's bound to rain before long. I'm looking for a good year this year. Your father's optimistic, Jimmy. I don't know what folks will do. The dust don't let up pretty soon. One good rain will fix the dust. Here's your money, Tom. Come on, Jim. We've got to get us to home. So long, Tom. So long. Bye-bye, Jimmy. Bye, Mr. Wilson. Bye, little man. Hop in, Jimmy. He's getting just here the never. He's bad. What does he mean? What does who mean, Jimmy? Mr. Wilson in the store. When he said he didn't know what folks would do if the dust doesn't quit. Well, he meant it to be pretty bad for the crops if it just gets bad. Nothing will grow on our farm either? Well, none of it gets real bad. Oh, that's all right. We can buy stuff at the store. Can't we, Dad? Well, yes. Yes, sure, son. Yes, we can buy stuff at the store. What is dark? Bad? Quick. Look. What? What is it?  Maybe it's going to rain. Oh, no. No such luck, Jimmy. That's dust. Dust? Quick. Roll up that window. I'll turn on the lights. Wee. There's just like a light out. Now, don't get scared, son. We're almost home. I'm not scared, Dad. It's getting worse by the minute. Hold your cap for your face, Jimmy. All right, Dad. Are you scared, Dad? No. No, but we won't be able to see the road if I... I hope your mother... Of course, stop, Dad. I can't budge it. Can't stop by the dust. Well, it'll... I'll have to leave it here. Come on.  Come on. All right. See you, Dad. We'll be there in just a minute, son. Hang on. It's on tight now. We'll make it. In the road. Buddy. Come on, Spud. Come on, Spud. Come here. Come here. Come on, get up here. Come on. Come on. We'll carry you too. Don't be home. There's your mother in the window, son. We'll make it now. Mary. Mary. Open the door. Twenty-fifth. Twenty-sixth. Twenty-seventh. Twenty-eighth. March 29th. Five endless days and nights the dust storm rages. The worst in the history of the Southwest. Helpless to combat it. Unable to save the crops or livestock. The Fowler family puddle in the house. March 30th. Henry, what are we going to do? There's nothing we can do, Mary. Just sit and wait. That's all. That's all there is to do. As soon as the storm dies down. As soon as the storm dies down. Mary. I'm sorry, Henry. But I can't stand it much. You won't have to, Mary. Can't last forever, you know. Oh, I suppose not. Five days. Oh, look at this house. Dust. Dust. Dust everywhere. Comes in the windows even when they're open. Well, don't forget we're not the only ones. We've got a roof over our heads anyway. I feel sorry for the cat on the sink, and dogs are like spotty up there outside.  Oh, no.  I wish I could look out of the window. Oh, it's funny to have the lamp lit all the time. In the daytime even. Henry, do you think the farm's gone? No, don't be discouraged, Mary. I know it's bad. I'm sorry, Mary. I'm sorry, Mary. I know it's bad, but we've just got to make the best of it. But we had the crops all in. Well, we'll put them in again. Then if we get just one good soaking rain. If we get a good rain. Oh, if we could only have a little rain. Next morning, the wind has died a little, but the air is still loaded with soaking dust. There has been no dawn, no sun. Did you get any sweets, Mary? Yes, a little, Henry. It's so hard to breathe. You've got the wet paws out. Oh, I wish I could do it. Anything except dust this year. I can sleep out of a window. Oh, look at that cherry tree. The whole trunk is buried. Can I go to school today, Dad? School? Mary? That gives me an idea. What? Wait a minute. What's Tom's number? I know, I know. Hello? Central? Are the lines open? Good. Central. Call 7-4-RING-2. Yeah. Hello? Hello, Tom? This is Henry. Is anybody getting through to town? That's you, huh? Well, look. Can you be at the school house in two hours? Fine. Tom, phone some of the neighbors on your lines, and I'll call the folks around here. Tell them to be at the school house in two hours. Well, tell them to get through somehow. I'll see you later. Oh, but you can't do it, Henry. You know the car is broken down. Well, then I'll make it on foot. Hello? Central? 8-7-RING-1. There's plenty of the here, Tom. About 25, I reckon. See, the lights wester here is all down, Central told me. I couldn't get a soul wester here. What's the matter with the lights? All the lights in the village went bust two days ago. I brought some candles from the store. Here, I'll get them lit up. You got a match, Henry? Well, what's the idea, Henry? What's the good of a meeting? Listen, you men. I can't see you much, but I think I know who most of you are, even with those dust-mass sons. Listen, I was sick and tired sitting in the house, helpers. I know you are, too. I saw that we got together. We'd find out who needs help the most. I thought it might give us courage to go on if we decided to do something about this thing. I'd done mine this morning. I shot forehead of the finest cattle ever raised. Starvin' it was. I seen the wind blow seas right out of my land. What can you do about that?  We was brining sand in the flower. I know what I'm gonna do.  The dust has cut my farm. It's in keeping. Well, where will you go? Well, there's no dust further north of here, they tell me. John, there's been 18 million acres of land in the Southwest hit by dust storms in the last two years. Anyway, any place else from here is not our country, John. Well, I guess that's right. Our homes are here. It's where we were born and raised, most of us. Yes, and it's good land, dust to no dust. We'd fight, wouldn't we, if anybody tried to drive us out? Oh, that's what the dust is trying to do. Well, are we going to let it? Are we going to let a few days of a dust storm make quitters out of us?  Are we gonna let it beat us? You bet we're not. But what we want to do now, boys, is to check up the damage that's been done. Some of us have been hardy-hitting others, and we've got to pick in and help them first. That's right. Well, now you see, the wind died down last night. In a few weeks, we've been... What's the matter? Look, it's getting lighter outside. It's coming out. It's coming out. So, on the morning of March 30th, hope comes to the stricken country. But for two months more, the dust clouds continue. Not until May does rain bring a release.  And so, one day this fall, Henry Fowler and Jimmy are jogging again over the same road toward the general store. You're not forgetting you promised me a chocolate bar, are you? Oh, no. No, I won't forget, Jimmy. Remember the time when you bought me one just before the dust storm came up? Uh-huh. I'm glad we didn't move away, aren't you? You bet I am. I want to find some day when I grow up. Of course you will. Just like your grandpa and me. Over to these dust storms then too, Dad? Maybe not, Jimmy. Maybe by the time you own the farm we'll have found some way to prevent them. Oh, I wouldn't care if they're worse. I'd say just the way you and Mom did. Sure you would. And when you grow up you'll understand the reason you'll say, we're the sticking kind, Jimmy, like your grandpa and my grandpa. What we struggle to get, we fight to keep. That's our heritage. You can't understand that word yet. But someday you will, Jimmy. Someday you will. That belief passed on from father to son has become one of America's real riches. We salute their courage, both the fathers who have handed down the will to rebuild to their sons and their descendants who today are carrying on this outstanding attribute, heroes in the cavalcade of America. And here's another short story of rebuilding. The story of an amazing conquest in the realm of agriculture. Growing things needs nitrogen and plants take it out of the soil faster than nature can replace it. This was a challenge to the skill of man to improve on nature's method of rebuilding the soil. Turn back the year to 1898, to a day in September in Bristol, England, the British Association for the Advancement of Science is holding its annual meeting. The Crook, one of the foremost scientists of all time, rises to issue a solemn warning charging chemists with a vital duty to mankind. Are we to go hungry and to know the trial of scarcity? That is a poignant question. Let us remember that plants create nothing. There's nothing in bread that is not absorbed from the soil in the air. And unless nitrogen is returned to the soil, its fertility must ultimately be exhausted. The fixation of atmospheric nitrogen, therefore, is one of the greatest discoveries awaiting the ingenuity of chemists. It is deeply important in its practical bearing of the future welfare and happiness of the civilized races of mankind. Sir William gave this warning to the world because he feared the natural deposit of nitrates in South America would be exhausted unless some other source was found. Fortunately, chemists accepted his challenge, rolled up their sleeves and went to work. By 1902, they actually had succeeded in capturing the nitrogen from the air, experimentally, to be sure. But the job of rebuilding the soil was on its way. American chemists were pioneers in the first stages of this work. In 1926, in our own country, the DuPont Company started the production of fixed nitrogen on a really commercial scale. And today, DuPont is producing quantities of this vital compound for the needs of America's agricultural land. And the amazing thing is that this vital substance is made with the aid of coal from the most abundant of all raw materials, air and water. Thus, chemistry safeguards the very life of mankind by ensuring a continued supply of fertilizer essential to food crop. And today, as yesterday, research chemists are working out problems which are equally important for tomorrow. For it is the aim of DuPont to provide better things for better living through chemistry. On tonight's program, you have heard Frank Craveron, favorite star of stage and screen. Next week, this time, DuPont again presents the Cavalcade of America. This is the Columbia Broadcasting System. For your ABC, New York.


Our guest speaker today is Dr. Steve Felden. He's going to be giving a talk this afternoon about the idiopathic intracranial hypertension treatment trial and give us an update on the treatment of that disease, which of course is one of the most common diseases we see in our neuroclinic. But before that, we had a live patient upstairs with thyroid eye disease that's going to be presented by our fellow, Dr. Anastasia Newfeld. And then we have an in absentia patient with neurofibromatosis type 2 who's really had a rough time. Tara, are you going to be presenting that patient? Okay, awesome. So let's start off by having Anastasia present the thyroid eye patient that was upstairs, then Dr. Felden will comment, and then I'll have Tara come up, present the NF2 patient, and Dr. Felden will comment, and then we'll kick off the rest of the day. Thank you, Dr. Katz. For those of you who were last night at the Dr. Mandike's dinner, we got to see the vast expertise that Dr. Felden has on thyroid eye disease. So this is a really nice way to put that expertise into practical terms for you today. And I just wanted to thank the live patient we had today who is present in the room, and we just really appreciate you being able to come and spend this time with us and share your story. So my job really is to kind of give you the context of the history so that the discussion is productive for all of us. So we have a 62-year-old woman who originally presented in July of 2014 with some systemic symptoms of thyroid eye disease, specifically some shortness of breath and a bit of tremor. And of course, thyroid workup was initiated and she was found to have a TSH that was significantly low and an elevated T4. She was then referred to endocrinology, who then decided to proceed with radioactive iodine therapy and after the therapy she was placed on, Synthroid. Now we move on and fast forward a few, almost a year and a half, and we then see the patient in ophthalmology. And initially she presented some intermittent dyplopia and some eye injection. The eye was firmed to retropulsion on examination. She did not have proptosis at that time and definitely no optic neuropathy. At that time we treated the dry eye symptoms and the irritated eye symptoms with a humidifier, some head elevation and lubrication, and she was prescribed Volteran systemically and Catorlac drops. Endocrinology saw her again in March of 2016 and noted that she had Pritibial Myxidema and they were wondering whether this was kind of erythemundendosum versus Pritibial Myxidema, but they treated our patient with prednisone and tapered that off. This is the visit in April where we started to be concerned about the thyroid eye disease and its manifestations. The visual acuity had dropped from normal to 2070 on the right and 2025 on the left. And as you can see the pressures in primary gaze and up gaze are very typical for those that are seen in thyroid eye disease patients with elevation in up gaze. And we first initially, for the first time actually saw an RAPD on the right. There's just some data here to suggest that there are indeed features of thyroid eye disease and, concerningly, color vision on the right had dropped significantly to zero to tennisy horror plates. Critical flicker fusion frequency was also asymmetric, again indicating the right optic neuropathy and there was some mild pallor of the optic nerve on the right. This is the motility here and you can see that there is an esotropia and right hypertropia that's seen in primary gaze and, again, very typically up gaze restriction in both eyes. So I think this is probably the most important part of the talk and this is the visual fields representing the significant optic neuropathy that's developed. So the first field is from February of 2016, just a kind of initial presentation to us, which is really reassuring, but as you can see, the fields begin to progress. And in May of 2016, especially on the left, you see the visual acuity drop to 20 over 250 and you're starting to notice that there is some visual field deficit noted on the left as well. This is an MRI that exemplifies the features. Those are both axion coronal T1 post-Gatellinium fat suppression sequences and these are meant to show you the significant enlargement of the extracula muscles with compression on the optic nerve and the same is seen on the other side as well. So just to go back to the fields there, how did we address this and how did we treat this? In April, after the first note of the right compressive optic neuropathy, we treated the patient with methyl pernizolone, 1 gram IV, once a week for three weeks and she required an orbital decompression which involved the medial and lateral walls as well as some lid surgeries at that time. So the story goes on and we note that later in May we still have continued visual field progression as you can see both right and left are involved and further on, again, we see further progression of the compressive optic neuropathy bilaterally and the middle field there is done in June of 2016. So something clearly needed to be done at that point again and on July 1st the patient underwent again a repeat bilateral medial and apical orbital bony decompression as well as partial ethmoidectomy at the time. In addition to that, retrobalbal steroid injection was given in both orbits. In July of 2016, in addition to the surgery, radiation was administered to the orbits and the examination in August of 2016 showed actually improved visual acuity in both eyes. The pressures were still within the normal range. There was an RAPD noted on the left, color vision had improved and critical flicker fusion frequency had improved as well. The cover testing did show is a tropia of 35 in primary gaze which is again increased from the previous measurements. Now bilateral optic nerves had some temporal pallor. So that is kind of a quick run through the history. I have some suggestions for discussion but I thought maybe we get Dr. Felden to come up and discuss the case from his perspective, offer his suggestions and we can go to the discussion questions if needed. I'm delighted to be here and it's nice to see a lot of old friends and meet some new ones. And I hope that some of you were present last night and talked a lot about potential new therapies and some of the frustrations with our current therapies related to thyroid eye disease. One of the things that's most interesting is that the incidence of this severe disease is actually going down. And whether that's due to people no longer smoking or whether it's due to some other environmental factor or perhaps we're just better treating hyperthyroidism, we're detecting it earlier and I think that that may also be a factor. The philosophy about thyroid eye disease is our myriad but the treatments are pretty stereotyped. And I think that in patients who are not otherwise at risk giving radioactive iodine to treat the thyroid condition I think is perfectly reasonable and this tends to be sort of a local phenomenon. So when I was in Los Angeles, you know, 90% of my hyperthyroid patients were treated with radioactive iodine now that in Rochester maybe five percent are treated with radioactive iodine. So there's a lot of variation which means that nobody knows exactly what the best treatment is. But I think it's pretty well established that patients that have radioactive iodine do have a slightly increased risk of developing eye findings. I think that that's been established in class one type studies, prospective studies. And also that patients who have thyroid eye disease as mild tends to get worse when they get their radioactive iodine. So there's been I think a pretty much a consensus that patients who have risk factors should be on low dose corticosteroids for perhaps a week before and perhaps two or three weeks after the time they get radioactive iodine, 20, 30 milligrams of prednisone per day and certainly not enough to get all the long term side effects and not high enough dose to have short term side effects. And I think that that's a good practice and I certainly recommend it to my patients. So the question here is, well, were there any risk factors? So our patient today had a history, remote history of smoking in the 70s so it's really hard to say that that is a big risk factor. The biggest risk factor is probably age. And so when you see patients that are in their 20s and 30s, which is the peak for hyperthyroidism, I think that they're nonsmokers, I think you really have no risk factors. But once you start to get into the 50s, then I think that the risk of developing eye disease does go up and that there may be a little stronger case even if somebody has no eye findings at all for prophylaxis with corticosteroids, low dose corticosteroids during that time. So that's one thing. Radiotherapy versus for compressive optic neuropathy versus using decompression. So last night I mentioned that when I first started in practice in the late 1970s, we had an armamentarium that consisted of high dose corticosteroids, orbital radiation, and orbital decompression. Today we have the same exact things. So we have made, in terms of progress, a lot of new potential treatments coming on the market but none that have really displaced the mainstays of therapy. There's a lot of controversy about the role of orbital radiation and there's a very thoughtful group that basically any patient, as soon as they start to develop any kinds of inflammation or periorbital inflammation, they're going to go and get radiated. And then there's another group that radiates a patient maybe once every three years when they have terrible optic neuropathy. So there's no consensus. The prospective clinical trials related to orbital radiation for thyroid eye disease. The one study that came out of the Mayo Clinic showed no effect but on the other hand they were sort of taking all comers and it was unclear what degree of inflammation where they were. And that's the problem we have with all of our patients in terms of trying to do studies, no two thyroid patients are the same. And so their end points are all different and where they are and their disease is different and what we call severe thyroid eye disease like our patient today has is not, we say well that's active disease. Well it's not active. It's progressing in terms of symptoms and signs. But the activity is probably long past. There's probably not acute inflammatory responses going on. What we're seeing is scarring and the effects of increased tissue within the eye socket. The pressure effects that I talked about a little bit last night. As well as the fact that the orbital fibroblasts which are activated are integral disease and either turn into fat tissue or into scar tissue. And then elaborate hyaluronin which brings in a lot of fluid which raises the tissue pressure and produces the meschemia. So as far as radiation the only real contraindications that I see to using orbital radiation is a patient's diabetic or has other severe vascular disease. Those patients do very poorly with radiation and I wouldn't recommend it. But in the absence of that I think that this is a perfectly reasonable thing to do. The question as well should you use the radiation and steroids first or should you have done them after decompression? I would have done it the way that you've done it here. Decompression works to alleviate optic neuropathy somewhere around 90% of the time especially in terms of color vision and visual acuity. A little bit less so in related visual field about 70%. So that's better than what you get with radiation and steroids which have to be given together. And also if patients are already toxic from steroids you're prolonging their steroids by giving them radiation as opposed to doing decompression where oftentimes you can take them off their steroids. So in terms of what the new options are I did publish one patient who after who had a course very similar to our patient today who progressed and progressed and progressed two decompressions and finally I put her on Celebrex which I talked about a little bit yesterday because it's been shown to really inhibit the reactive response, the inflammatory and immune response in thyroid disease and actually that patient did better on Celebrex and recovered vision whereas on steroids was losing vision. So there's one other thing. We don't have post-operative CTs or MRIs here so it's hard to know what the first and second orbital decompressions do and I use a different technique so which bony walls are decompressed may be slightly different but in the patients where I found that they initially got better after decompression and then got worse again what I actually found is that the posterior wall of the maxillary sinus was kinking the nerve as it was coming into the orbit and so you have the anterior, the inferior rectus say well look like it's a hammock, it falls down but it's being held up by the posterior wall and so it's kinked at that point and when I've gone in and taken out the posterior wall of the maxillary sinus and just then the optic neuropathy got better and so I think that it's very important for our patient today to really go back and study those scans and make sure that you haven't produced a secondary cause for the optic neuropathy as opposed to just having not enough overall decompression. It can be very focal and 10 minutes worth of tipping away a little bit of bone and I tend to use a transantral route which gives me access to everything but the roof and that would be the other option for this patient. This is who I've had who have failed on three wall decompression. Dr. Nassiger, a neurosurgeon, popularized the Nassiger procedure and it is a transcranial orbital decompression and those patients that I've had that have been recalcitrant like this with this kind of optic neuropathy they have done well with transcranial or decompression and that's the experience of the Mayo Clinic group as well. So I think that you don't want to wait too long if you're going to consider this route but getting the entire orbital roof removed all the way back and unroofing a portion all the way back to the canal is something that might be considered in this particular patient. Well obviously I can go on and on and on but I think that this is a very concerning and not that infrequent issue that we deal with. Our patient is still on 30 milligrams of prednisone per day and she is you know that's now you're producing a secondary disease it'd be nice to find some sort of acute intervention where you could get off the steroids or at least back on to the non-steroidal anti-inflammatories. Any questions? In terms of the order of doing the decompression or the radiation some of our people have said that the tissue in the orbit is just different after radiation treatment and when you're going to be doing a decompression it just doesn't behave the same way has that been your experience? Well I believe so I think that's sort of true in some cases the I think the problem is when you get really elevated tissue pressure you get fat necrosis and that's what you're really seeing is you're seeing the effects of chronic high tissue pressure and you're getting fat necrosis and then the it doesn't you get this sort of gritty fatty fibrous tissue stuff whether it's the radiation that enhances that or not I really don't know but you know I prefer surgery before radiation there are many people who do just the opposite the real question is how many people didn't need to come to surgery if they had had orbital radiation and the answer is actually none and the reason is that all those patients end up with orbital decompression anyway the difference is instead of having it acutely and under you know all sorts of stress it's done electively in order to start the restoration process. Any other questions? Yes. I just wanted to add that the benefit that you get from radiation really is not immediate as a matter of fact you can really kind of stir things up a bit so you have to be prepared for there to be more information with the acute radiation and then hope that over the next six months the things really quiet down from the radiation so if you're in an acute vision loss type setting I think that what Steve said is very apt that there's going to be a decompression happening. And so I absolutely the other thing is that the experience that the Europeans have had with IV pulse therapy weekly therapy is very much different from what we have here in the United States where we don't they were talking about complete resolution reversal of changes all this stuff we just don't see it and in the high dose that they were using the 8 grams there was an unacceptable incidence of death from high dose methyl prednisolone I mean it's not a lethal disease but there was a lethal treatment that was advocated now with the lower doses and I the recommendations about six grams but the patients getting worse while you're watching them that's not it personally I prefer oral steroids if they're not going to get better within two weeks on a hundred milligrams of prednisone then I can manage them and taper them they're off to the operating room and then we'll see what we get after that so there there's no one way to manage these our patient here today has been managed beautifully I think that there's still more that can be done


Let us buy something online we have done this many times, so we have done this many times we probably have done it on mobile web too or you go to a site you add something to your you know check out card then go in add your card details then proceed then buy probably you get an OTP and do some two factor authentication and finally you have your product there which is ready to ship right or probably you just wanted to buy some fruits online and you had to build some shipping address and the payment options what is the shipping address what your payment address should be what is the payment type and things like this. So, here is a study done by Beymar the second most reason where people were abandoning their check out card was because of the complicated check out process right. The first one of course was like creating an account which kind of solved now with many ways to authenticate and log in the users. Can you make a guess on how long the average check out time is measured in terms of check out steps 5 to 7 steps. I was seeing a someone flashing a 5 there that is almost close it is 5.42 I think those guys for the why guys who have done lot of check out on different websites that was a very good guess right. So, around 5.42 steps and the check out length measured in terms of form fields the number of form fields you have to fill before your check out is you know unformed. It is around 10, 20, 15 shall we average it out. 14.88 is getting someone at the back got it right. What if we had this suppose our sites makes a call to some API and then that API orchestrates all our pain points of filling a check out form which already has your shipment address it has shipment modes like can it ship pass can it do a normal shipping or can it ship on a drone or something or make it faster than you or it also has your you know account information the user information mobile number and the card different type cards that the user already has and there is no form to fill it just goes and clicks on the checkout button and there is an API which takes care of all this headache and the user just clicks pay and you get the card information and then you pass the same data to your payment gateway and you are good to go. Wouldn't it be good if we have such kind of a one button checkout experience? Welcome to web payments or we are talking about what web payments is in general and specifically about the API called as payment request API. Chapter one the structure of the payment message I will probably try to dive a bit on what the API looks like what are the structures like and then we will probably look into a demo to get more clarity. So I think most of them are aware of this beautiful JSON structure which we use in our day to day for data exchange right. So I am just giving a quick overview for people who aren't really yet there like it is just a key value pair you can assume that you have a title you have a type and you have properties and you have something like required which is an array so basically it is a JSON object. So before we see what the API looks like we need to get few key terminologies or key jargons right nothing very complex there it is this term called pay, pay is the entity that receives the fund right and then we have pair the guy who is paying to the pay and there is the payment service provider that can be your card, institutions, electronic payment message, post office, post office here we still have post office but that is directly from the spec. So these are the key terminologies that we need to keep in our mind as we proceed. So how does the payment request look like? So payment request basically will have a type or description, payment terms, payment details and payment options. So this is how it would look again it is a JSON object. So you have a type we are saying it is a payment request and the description like payment to 50p dot in and payment terms you have a payment method that is just like legacy card payment on my site it is an endpoint just for the one of it and then the payment amount 4.35 dollars it can be INR or it can be any currency value you want to set and then you would get a response from the API what would the response look like? The response would have a type description, payment terms and payment options. So something like this where we have the type description payment and the payment method specific response details will be plugged in there and we have the payment options. Chapter 1 the payment roles what are the payment roles? So assume that this API is like a mediator. So is he sitting between your browser and your payment gateway and he is taking care of all the hard work that you would have normally done with you know same probably saving the card on your side securely or having less form fields or trying to use autofill form fields to make things easier and faster. So assume that this API is like a mediator who is sitting there between the payer and the paying and helping things to get smoother. So what basically happens is the the payer comes in and adds something to his card and then goes to checkout. So then we mediate the checkout process to this mediator API which kicks in and helps to identify the card and add it and get the card details and pass it on back to the site because he is a mediator he does not really work at the payment gateway. He gives the details back to your site and you then process validate to whatever you want on that and then pass that information on the backend to the gateway get it authenticated and get the payment here. So on the front end for the user there is there is these things are very opaque he does not really see all the all the complex stuff that is going behind it just just a click for him and the mediator takes care. So if you see here we have your payment app we have a payment app and we have the mediator we have the payee and the payment network. So the payment network can be any of it can be either those cards default cards what we have or it can be the external APS like probably like Google Pay, Alipay or like even Apple Pay. These are kind of the fundamental payment networks that are supported on the request API. There are proposals to integrate other services probably even I saw a few stalls here on Razer pay or pay you guys even they could probably integrate. Only thing is it is a bit of a complex process everything should all this payment you know gateways or the app should be PCI compliance. There is something called as PCI compliance where if you are trying to make an online transaction using a credit or a debit card you should have some compliance rules you should adhere to some rules. So that you are assuring that the card is secure and you are not doing something fruity on that card. So there is also a proposal which says we could also get in cryptocurrencies as one of the payment methods. So as of now we have credit cards as basic card payments and the Alipay and Google Pay whatever it is. So here is a flow of the pair registration of a new app which I was talking about. So there is the mediator operated by the pair right. So that makes a request to the payment app. The payment app gives a registered true or false like was the registration successful and then the payment app says a payment app registered it says like hey I was registered with this mediator then there is this enrolled payment instruction instrumentation that goes in and the payment instrumentation enrolled gives a handshake. This basically the handshake that happens when you are registering a new payment app. This is the flow where the pair buys from the merchant website or maybe a small web app or a normal app. This the whole idea is to have the you know the checkout process on a browser web mobile browser to be very smooth and effective. Here is the example where the mediator the pair clicks on the buy button on the website and then the payment request is sent to the mediator where the mediator makes a check on select payment app for transaction details and the payment request is sent to the payment app and there is again the payment response the dance that happens and the payment response goes to the website and then the payment instructions goes to the payment network that is like your visa or credit card or debit those kind of network and those validate and say hey it was successful I was able to do the request what you sent to me and then finally the purchase is successful. This is the whole dance that happened but for the user as I have been mentioned it would just be I want to pay this amount and then he would probably hit his cvb or cvc number and that is it that is it. So, at any point of time if you have some clarification here you can just stop right away and we can discuss I wanted to be a more of a conversation than just one way and then the q and a they have integrated. So, you can have it I can have a Google Pay or Alipay endpoint I will probably show it when I talk about the API in detail. So, the question was if Alipay or Google Pay already integrated with this spec just WP spec is on payment request API is a WP spec it is a standard it is not like a Google AP or anything it is open and it is integrated in a few process I will be talking about what process supports me and I will think about it. But yeah of course because they are PCI compliant and then there is a process for getting users. The Google Pay you can have. I am sorry if you are going to ask a question you need to have a microphone otherwise our live stream viewers cannot hear you. So, raise your hand if you want to ask the question would be happy to bring you a mic. Kind of I repeated the question. So, the chapter two is the payment request API. So, here summarizing everything in one picture this is from the edge document where we have our web server web page in the browser and the wallet. So, we have this method called show on the API which we will dive in right after this and that would show a dialogue box which is within the browser you need not worry about making your own dialogue box for getting all the user inputs. So, it is basically check out form less check out. Sounds a bit cranky, but that is how it is there is no forms that the user will and the user chooses a shipping address he can choose where it should be shipped and if it is saved in his browser's autofill the same list will be shown here in the dialogue as well. He can update the shopping you know shipping address he can modify ads things like that and then the payment request API goes in he makes a purchase there is a success or a failure. So, we have a control whether there was a success or a failure say how could what would be the different cases where the success or failure happened. Say there the user selects an address. So, you have total control when the user selects or changes an address. So, you will get a callback which has the address in it and then you can decide whether you have the ability to ship to that address or not and right away show there in the dialogue box itself that you cannot really ship to this address rather than the user fills everything and then goes to check out and say hey sorry we cannot ship to this address it is pretty instantaneous there because you get callbacks on each and every change like there is an address change and there is a you know the shipment type where he wants to check and if it is there if it is say some kind of a prime kind of a service as what Amazon offer for example. So, it clicks on that and you get a callback again and you can check whether for this address for this item I am trying to ship can I give the service or not and decide on the fly and show him that sorry we cannot really provide you this and the payment could not the payment burden itself would not be active. So, APIs and demos these are the ingredients that goes into the API. First of all you need a modern browser then you need the method data details and options or what do you mean by modern browser to answering the answering to the question that the gentleman asked here. These are these are the browsers that are supported now like we Firefox has a plan to ship it Edge already has Chrome and Safari is there online. So, these are the the red ones are not there, but there are they have they have not given approvals to implement this API. So, it is on its way. So, can I have it how do how do I check whether I have the payment request API support in the browser or not it is very pretty simple you can just do a window dot payment request check for that if that exists well and good you have the payment request API with you or else you could you should fall back to your legacy payment process. So, it is talking about the method data right. So, the method data would have supported methods then it would have data, data would have supported networks and supported types. So, on the supported methods we say basic card. So, the basic cards include visa and master card there is also Mx or there is also a proposal for how do I handle gift cards. Suppose I have a my basic card I am doing the payment with visa, but I have a gift card I need to apply a gift card on it how do I do it. So, there is proposal on that and there is some discussion going on with that as well. And supported again on the on the method data you can have lot multiple supported methods and the supported networks for it. The second one here is example.com slash Bob Pay. So, this is where Alipay or Google Pay URL endpoint would come in and then the data would be very specific to the merchant. So, if you have your Google Pay setup then you would have your own merchant ID specific that is what you will you will pass it here in the data and suppose that API needs some options you could pass it in the data you know field of the method data. So, details, details is where we say what are all the items that we are is there in the checkout. So, you can say like the subtotal is this the total is this I am giving a discount of this and these are the summary like hey I am shipping you some noodles from my restaurant or you want to say some message or you want to say you have applied we have applied a discount coupon for you because you have been buying with us for consecutive 3 weeks or something like that right. All these descriptive messages that you want to show in your show in your checkout process is goes to the details object. So, in this example there is an ID for that store and the display items what are all the items that needs to be shown in the invoice basically right. So, you have the subtotal, the sales tax and the total due. So, here in this example it is like 55 dollars for the subtotal and the sales tax is 5 dollars, but then at the total amount you will you see that it is 65 that is that is because we need to add the shipping the selected shipping cost of if you want to add some cost whatever you want to display what is your extra like for us it is like GST or something you need to you can mention that there and it will show up in the invoice. And we can add some shipping options to like I was been mentioning you can have shipping options to be like standard or drone or whatever different type of shipping options you have and once the user clicks on the shipping option you will get a call back again to get the index of which shipping option that was selected. So, you need to say the user suppose the user selected drone and that locality does not have drone support then you can you can go through the index quickly see what that guy selected and take the location which you already have in your request call back and say hey I am not shipping I cannot ship to you for this just because my bot is dead or something like that right. So, you can give that customized message also. So, basically you will you will update your shipping options to the details object and finally, you have the options argument where you can you can decide what to ask during the you know checkout process if whether you want to ask the pair email ID name phone and shipping details all these are options you can keep all of them in then just the card will be there and you can you can decide based on what to do say for example, on the card you know where to ship already because it is users address is there with you and you do not want to ask him on the checkout process right. So, lot of edge cases have been thought through this API and it is pretty flexible and you have total control on what you want to show on what happens when the user clicks on. So, you need not have to write any extra logic to handle the different selection all of them are very need promise based APIs. Talk is cheap show me the fraud of course. So, I want to do a demo on my mobile we tried connecting it my pixel 2 is bit cranky I do not know why it was not able to detect. So, I got an idea of turning on my webcam and pointing my phone to the webcam so that you guys can see it on the screen. I have not tried this before let me see how it goes. Here is a simple demo which I have posted on my site. So, you guys can see it at least you are able to see the red checkout button. So, very bright I will probably go to the right mode and right I think this is fine. So, I have a checkout button you could you could do a thing as well you could if you have a mobile device or probably on your desktop also you can just go to hcmon.com slash demo slash payment refund request and this will load up. When I click checkout we basically see this dialog which says payment API request demo that is the title I have given and what is the card I already have and I could I could go and view the card. So, it shows the card which is there and I can go and edit or add a new card. So, adding card is pretty neat and it says these are the cards I have supported and it will validate for you whether the card is valid or not. So, you need not worry about doing all those validations. And after you add the card you just go ahead and hit the pay button and it says processing this I am just taking I do not have a server to process your card information, but you could you could definitely give me your card information. I would just ok here here is a deal it is asking for the CVV I would show you my CVV 1 2 3 easy and I just go and confirm and here we would see the JSON structure of what the response was. So, that was a demo experiment I will I will bring up the same here on the desktop it is not just the mobile web it here has the same experience I just wanted to show how good the pop-up looks within the mobile device. On the desktop is the same experience you have your payment option you can select the card and here are the details order summary and your friends and family discount I was talking about if we see it is in INR and I have given a discount of 500 rupees and then we just go and do a pay and it asks for CVV I hit confirm. So, we see this is what the response looks like. So, the method was a basic card the details had billing address address line 1 2 3 I was lazy to fill all the address. So, I just did that and and city was Bangalore current you get all the information you get my phone number as well and the card I will I have just masked here. So, you would basically on the response you would get the entire card number I have just masked it here for the demo and the security and you just go ahead and play here and let us see the code now. So, we will get more clarity on how it works should I just bump the fonts or is it ok. Yeah so, the magic happens with the init payment request. So, we are checking whether we have the payment request support in our browser or not if you have the support we will go and init the payment request. In init payment request we have networks like amix dinners discover all this master card visa and the types we have debit credit prepared and the method data which says supported methods is a basic card previously it was taken an array now it is like we have to just give a string which is like basic card that is what we are the basic card is what we are supporting in this use case and the data with supported networks with all the networks as mentioned above and supported types are the types like debit credit and prepaid. And the details object looks like this this is where I said buy some food from an Indian restaurant and currency is INR the value is so on. So, and the display items original amount friends and family discount. So, it is a very neat you know a structure. So, suppose they suppose they you would get you would get all this response from your service right.  So, you could just massage it and put it put it your details object. So, it is very light on the front end. And then you have the payment request with method data and details I have not passed in the options here as the name says options is still optional where in options as I mentioned you could ask for the email address or phone number and things like that. So, I have a button here on clicking you on clicking off that button we would pass in the request. So, we would get the request here and request.show would result in this dialog box. So, request.show would result in the dialog box and that that is a promise with API. So, you would get the instrumented response that I was logging there you could pick up that instrumented response and pass to your server that is what we have to do to know whether the transaction went through or not. So, I am just faking the response faking the server call here just with some just some time off. And then we will get a complete success failure whether the transaction was successful or not on complete you will decide and pass a success on success I am just in this case I am just updating the DOM show the response right. So, it is a pretty easy thing to do. So, if you cancel the payment I am logging like a boarded request cancer. So, you could also just hit an escape and that would result in a cancel as well. So, any queries on this part of the code this here can you see it now. So, that is the here. So, in this use case I have not used options I will just. So, you could add options and see how it looks like I have definitely asked you to fiddle around with the code I just got a bell on the time. Hello. So, I was not really clear on where the payment actually happened like you got the response from the payment API was the payment already done by then. That is a good question it is not done. So, as I was been speaking this payment request API is just mediated does not do any payment for you, but handles all the hassles of filling the forms and collecting the card and stuff. It is abstracting the UI or the UX for the yes actually. If it does not. Basically payment gateway. Yeah. So, it you can assume that you have a big you had a big checkout form right basically where you would validate the card and everything all those processes handled by this and you just filling your card and if it is already added it you can just select the card and then in the response you will get all the information the card what was the amount and everything and you pick that and pass to your server and then your server will pass it on to the payment gateway and payment gateway will send the response and it takes the payment was successful or did it fail. I have also created a fiddle. Hemanthai. So, with this I mean when you mentioned that the payment service provider has to be PCI DSS compliant. Is he capturing the card details on the screen itself and then it is getting sent over the wire or how is it going to work? Yeah. So, there are two options here you enter the card details and it stays on your client. It does not it does not get stored anywhere it does not get you know stored in some server or something and it passes to the websites server call. So, there is there is no man in the middle attack I can expect that is what you are thinking sorry. So, if your your site is already a PCI compliant site and the obviously the provider would be if your site is already you would not be doing that and if you see all this online site where you can purchase there will be a certificate saying that these are the complaints we have. So, if that complaint is there they will make sure that it does not kind of leak over the abstraction or can get can happen a man in the middle attack and someone can steal your details that that will not really happen. And the other thing is you can authenticate with your say Google account and then you have saved your card details on your Google personal storage. So, that that details you can fetch up and say hey this is the card I see it will just be the last four digits and it will last for you for the cvp and you can hit there and it is like the token based authentication that happens. So, you have two different ways to do that. I have created one more fiddle where if you want you can go and play around in this fiddle and try to add different options and see how it behaves. In this case compared to the previous one it is a bit more verbose where you can choose the shipping address between these are all the shipping address that is saved in my Google Chrome browser right. So, these are all the shipping address and I can also choose my payment mode I can add a card the same process to be. And then I have my contact information here and like after I choose my shipping address this is the error scenario I was talking about it says you we cannot shift to this address. In this demo I wanted to show like how you could show whether you cannot can you shift to this address or not right. So, it is not like after paying or after going to the payment process we say hey sorry or it is this it says they are instantaneously. So, you can add a different address or choose a different address and after choosing you would get a payment method this fiddle I will probably tweet or something you can do or you can just go to jfiddle slash noomans and you will find it there. And probably you can you can take the conversation further offline and I am definitely I am happy to help and if I if I cannot get right answers I know folks few folks who are who are part of the development I can get interested in as well and see where it goes. Hope you like the payment request API and the web payments and hope you guys will use it on your you know mobile browsers and on your PWAs and make it even more sexy if I can call it. Thank you.


tremendous service to Puerto Rico and for the U.S. Virgin Islands and we're really we were so nicely treated by the U.S. Virgin Islands and frankly over the years the great people. We set sail on the 31st party. The intent was to go down and support partner relief efforts in Texas and Louisiana. By the time we got down to about this point on Florida, Irma had manifested herself in the track and certainly what he carried for me. So we changed and altered our plan and came through to the Florida Strait and positioned ourselves along this track.


Live from Mountain View, California, it's The Cube at OpenStack Silicon Valley, brought to you by headline sponsor, Mirantis. Here are your hosts, John Furrier and Jeff Frick. Okay, welcome back, everyone. We are here live in Silicon Valley. This is OpenStack SV. This is The Cube where we go out to the events of the Silicon Noise. I'm joined by my co-host, Jeff Frick. I went Silicon Angle. Our next guest is Harshal. Pimp out. Pimp out. Pimp out. So good. You almost got it. I almost got it. Too busy tweeting. I couldn't memorize it fast enough.  A-10 Networks, welcome to The Cube. Thank you. All right, so first time on The Cube, so it's pretty straightforward. We're going to ask you all the toughest questions. We're going to make you sweat, no, I'm only kidding. All right. Share the folks out there quick. A-10, the update.  And thank you for having me, John and Jeff. A-10 Networks is a leader in application networking and we provide products and solutions for application performance, application security, and availability. So we have products in both the hardware form factor, as well as virtual appliance form factor. And what we are trying to do sitting between the application and the network, we want to provide policy enforcement, a consistent policy enforcement as workloads move between data center or within data center and across cloud domains. So that's really what we are bringing to the table. So to basically deliver what the app needs, when the app needs, based on some rules. Exactly, yes. Okay. So the networking landscape is littered with a lot of stuff that didn't make it, some did. I mean, we're talking to the folks at Cisco, Juniper, and Juniper is a little struggling now, but the network landscape is north-south east-west now and you got virtualization. So talk about what's changed. Certainly north-south, everyone understands the old school networking. And how do you guys fit into this massive shift? Dockerization just got 40 million in series seed funding. This is about distributed computing. How does the networks fit into that? That's a great question. Yeah, so if you look at the last five to seven years, you have had a tremendous shift in terms of traffic patterns, right? You had the north-south traffic pattern traditionally and we had the three-tier data center to address that. As we move towards virtualization, there's more workload mobility and then there's more east-west traffic really essentially coming out of this kind of workload mobility and applications, right? So as far as ADCs are concerned, it is the onus on an application delivery controller to provide the policy as the workload moves within the data center. So to give you an example, let's say you had a virtual machine providing a certain application or a certain component of the application, whether it's a web tier, database tier, or really the presentation tier, sitting in on one bare metal server or a virtualized server. As that workload moves to a different part of the data center, perhaps on a different server, the policies related to security, so let's say the web application firewall, policies related to availability, let's say the load balancing that occurs across the different compute nodes have to move with that workload. So as it relates to ADCs, we still have to provide all the great performance that we always did, but now in addition, we have to provide the flexibility of moving around as the application evolves, as the architecture evolves inside the data center. So on the VM world, we were talking about this as well. They're embracing OpenStack and Docker. How does that affect your business? The VMs of the world, VMwares of the world, Cisco might have a different approach. There seems to be a different approach to networking. What's your answer to that? Yes, so our response to that is the world is definitely changing and it is changing on the SDN side for sure, like you touched upon VMware, you touched upon Cisco and there are new SDN paradigms. Each one is coming from their own position. We have the cloud orchestration platform, for example, OpenStack being one of the key ones that we are focused on and as each of these SDN or cloud orchestration pieces evolve, it is really the responsibility for us to integrate with all of them and what we can do from our vantage point of view is provide a operating system on our application delivery controllers such that we can easily provide or quickly provide the policy enforcement that is necessary in any of the evolving architecture. So it's a dynamically changing world. There are emerging cloud frameworks and it's our responsibility to integrate. So if I understand you correctly, basically you're a DevOps dream from a networking standpoint because DevOps, they want to program down into a dynamic resource pool, no matter what that is. So policy is being set at the application layer. Exactly. So why is that important? What is your ASOS advanced cooperating system and due to enable that and why is policy in the cloud important? All right, so I'm glad you touched upon it. So yes, we are a DevOps dream but I just want to highlight that the value that ACOS brings, our advanced cooperating system brings, also provides rapid third-party integration. So let me first focus on the DevOps piece. Programmability is important in the do-it-yourself camp on the DIY, wherein you need APIs to connect with the networking device, whether it's L2, L3 device, or an L4, L7 device. You need APIs to connect to the device. Make sure that your application or whatever code you're writing runs on top of that or integrates with it really. In our latest release of software, we are coming up with deep integration capability. So we have really a single source of truth that allows you to get auto-generated GUIs, auto-generated CLI, auto-generated APIs. So once you have auto-generated APIs, what that means is you have 100% consistency day one. So you have the functionality on the CLI as well as the API on the same day. So all the DIY cam, all the DevOps cam, can use that to write their own code on top of it. But we also have auto-generated GUI. So you can, if you were a third-party integration, you can cut down six months on your development time to integrate your homegrown application on top of our ACOS platform. So that's how we view and the DIY and the third-party integration works. Talk about the customers. What's in OpenStack specifically? What is the customer perspective? So it's interesting. I was at OpenStack Atlanta earlier this year and I was impressed with the turnout over there, both in terms of customers as well as vendors. I think this year has been a pivotal point in terms of the necessary mind-share or the tipping point, if you may, in gaining the critical mass as customers take this from a real deployment perspective point of view. So for example, we have Deutsche Telecom who has used OpenStack along with the A10 networks of virtual appliances for the CGN solution. We have several conversations with customers now more so than before, now more so in 2014 than before, where they're actually asking for use cases, trying to figure out how OpenStack fits into their vision. So NetNet, I think customers are looking at it seriously from a deployment perspective and it's both the large customers, the large service providers, large enterprises, also the medium-sized enterprises for who the total cost of ownership is really feasible with OpenStack. And how mature is that Deutsche Telecom project? So Deutsche Telecom, it's a pilot project on Terrestry which is the next generation all optical, all IPv6 network. We have it on our website, I encourage you to review it but it's really interesting how they've deployed the IP, they've deployed the virtual appliances by A10 networks to provide IPv4 as a service. And really that allows them to consume IPv4 as a service on a neat base in the OpenStack environment. So talk about the attraction you guys have when I was talking with Jason Madelof, your VP of marketing, he was saying you guys are killing it with customers. Is that true? Yes, certainly sir.  We're killing the problems with the customers. Killing it in a positive way. Killing it as in doing well. Talk about a quick before we break here, I want to hear a customer success story that really highlights your value proposition. Sure, so if you look at our customer base, we are approximately around 3,300 customers and these are across 27 countries. And we have customers in almost every major domain. So we have customers on the service provider side, we have large enterprises and customers really in the web 2.0 giants as well. The one thing that resonates frequently with our customers is the price performance. So if you look at our customer base, they're taking our appliances and using it from a performance perspective and throwing difficult traffic in the direction of the box so that their business needs are met from an availability perspective, from a security perspective, from a performance perspective. That's speaking generally. I refer to the Deutsche Telecom case, it's an all optical IPv6 next generation network and that's really how we view our customers are going to take this forward as they deploy next generation networks, as they deploy next generation data centers. Certainly the game is changing significantly next generation networks, really a software driven, software led infrastructure, whole new ballgames, exciting. Of course we've been documenting it from day one with our Wikibon analysts and obviously Cloud Mobile and social here at Silicon Angle and theCUBE. Arshal, thank you for coming on theCUBE, really appreciate it, sharing your insight. 810 Networks here at the OpenStack SV. So to our crowd chat.net slash OpenStack SV if you want to join the conversation, we'll be right back after this short break.


So I've been in the mood for chili hot dogs. So I figure why not take the camera out make Chili for my hot dogs, and then I'm gonna be making just turkey chili The two are different in my opinion chili for your hot dogs. Don't include beans. Don't include anything extra It's more of a chili sauce. Whereas chili Tend to be a little bit more chunkier. Okay, so here are the ingredients We have salt onion powder Garlic powder powder red pepper flakes chili powder black pepper onion pepper brown sugar Chili package here. We have some cumin Then we have some tomato sauce dice Tomatoes and I have them in green pepper celery and onion. Let me tell you something This is what I have in my pantry and this is what I took out. Okay, we have some ketchup back there some black beans Red beans tomato paste as far as veggie skulls. We have garlic one onion one bell pepper Now the ingredients are going to change and the spices are going to differ depending on the chili sauce versus the chili itself Like I said that the beans are not going to my chili sauce If you want to have beans in your chili sauce by all means go at it And then I have a package of turkey that I'm going to be using For both of the chilies. So here's another difference excuse the dent The vegetables for my chili sauce are finer and I'm cooking it in a cast-iron skillet for the chili itself I'm cooking it in more of a soft pop or stew pot And my veggies are chunkier. Okay My brown turkey has gone in with most of it going into the chili itself the chili sauce Not so much turkey. This is probably what about half a cup Over here. So yeah, I'm going to start seasoning this up Go ahead and add my season Just realized I had some jalapeno in there. So I chopped up two slices. Just go ahead and throw that in there, too Now I'm going to go back in and add some more seasonings because I just seasoned the meat I didn't season the actual chili. So what baby the chili sauce This would be done about 15 20 minutes matter of fact I went ahead and turned the eye off the chili Minimum one hour you want all of those ingredients to simmer together come together if you have time even longer I'm going to let her go for two hours great thing about both of these dishes. They freeze very well I'm going to freeze the majority of this actually made turkey dogs yesterday. So I'm going to pour my turkey chili sauce I'm so sorry for the background my turkey chili sauce on top of my turkey dogs later on and then I'll just freeze the rest of this And here is my finished turkey chili now I'm going to allow this to cool down and I'm freezing this But you could put whatever toppings you like on top and that is