Hi everyone happy Friday and happy new release day 2020 tops tribute baseball is finally here six box pick your team One is also finally here. Maybe we'll find that guy or maybe some of those guys right there That'd be pretty cool all card ship in this a lot of great stuff in here So thanks everyone for getting into the action really appreciate it Jasper's case breaks comm has more tribute on the site big. Thanks all these folks who got their team straight up Six box pick your team one Friday the 10th. Thank you. Thank you. Thank you Appreciate it All right now you notice some R&B some random number block teams So there you go So works just like our random number block breaks, but only for those teams and only for pick your team one in this particular case Here I upload that number block video come on Joe Killing me here. There you go. You got it. It's on the record now. It's uploading on the record There it is big. Thanks to everybody once again a lot of crazy times here strange days But I appreciate you hanging with me We'll make it. I Know we will all right. Let's slide that over there slide that back there. There's box number one. We're doing all six Let's go right there All right Okay Good luck. What do we see and I know Jason did a couple random team breaks. So thanks to him for coming in early for that Do we see anything anything cool, what does everyone think? This is my first live look at it What are everyone's initial impressions? No small sample size at the moment just a couple cases, but I think these are base cards on the bottom. Yes Double base card. I think so Tyler likes the sharp design. We got a Robert Otto Luis Luis Robert Phillip likes it loves the design Yeah, at first glance, I do like it. It's got that sort of what What sort of design you would you say this sort of an art deco look? like a Like a Gatsby kind of look is this the Gatsby of As a Gatsby sort of design the Gatsby of all baseball products. All right, so let's see what we have here We got Reese Hoskins Pretty good stuff Ramon Loreano And our first hit is a dual relic. It's Ichiro and Yusai Kukuchi 18 out of 150 So these don't go in 130s, huh? No, it's a little it's a little too tight for one Nice so that both of those are mariners that goes to Chris Walker and the Ems There's the babe 47 out of 50 Whoa, that's pretty cool. What is this a one-of-one kind of loose Old card here. Wow Tribute to the T206 series that is awesome What does it say on the bottom right there factory number 25? Two cent distribution VA Virginia. I'm assuming that is awesome. And that's old Old L. Tannehill remember old L. Tannehill Ryan's great-grandfather Now I'm assuming that's it says Chicago, America. So is that Chicago American League? That checklist is out, right? Stand by checklist added on cardboard connection com I'm I'm thinking it's got to be white socks. I just want to I just want to double-check and I also want to see who else is on this Checklist, I don't think this is all I don't see it on the checklist That's pretty awesome. Yeah, it will it will go to the white socks Michael K with that one Who are the other players? Maybe these are just special little inserts here. That's awesome. So Michael K With the old white sog Lee Tannehill and it's it's a little loose there. I don't like that, but When did it? When did when did he play? He played 1903 until 1912 for the Chicago white socks There you go, not on the Beckett checklist either says Derek. That's crazy. So some surprises in here ladies and gentlemen Michael K with the white socks all aboard the big hit express That is awesome tag that here. So there's no confusion. Also, I know it's a family show, but Piedmont is the cigarette of quality Yeah, we're definitely have to snap a picture of that. That's for sure. That'll definitely be picture time. All right There's a Nick's and Zell stamp of approval 63 out of 150. Now if you're not familiar with these hologram stickers here This is an extra layer of authentication if you go to mlb.com slash Authentication I think you can punch in those letters and numbers which in this case is JC 632 527 and you can see exactly what game that Jersey was from Which is pretty cool that goes to the Reds Reds is a number block team So 63 out of 150 Reds 3 Jose Jose Zepeda Kershaw right there And our first auto is gonna be Reese Hoskins 50 out of 99 That's nice Ryan Redman was saying earlier He liked what Jason said about this all the guys in here have great autos great penmanship Reese Hoskins definitely one of those guys Phillies that goes to Derek Hamilton, and then we've got Thurman Munson game use triple bat Relic 42 out of 50 that goes to the Yankees. That'll be for B.J. Jordan All right, I think we got a couple extra hits in here Maybe no extra base car Jacob de Grom chipper Jones, and we've got cool wit Maryfield. Oh, I like that look 43 out of 99 for the Royals Jonathan G With the Royals Nice iconic perspectives autographs. Oh nice Ryan. Does he have any cards? All right, and back here. We've got Austin Meadows 25 out of 99 That's for the Tampa Bay Rays that'll be for Patrick Davis All right, nice start boys and girls really nice start. I'm gonna set that set that card aside for picture time here Next one so far so good box to pick your team one. Good luck everybody Good start so far That old tobacco card is pretty incredible A lot of people ask if I collect anything these days. I really don't I have the You guys give me the the luxury and the blessing of seeing cards every day, which is nice So it kind of scratches that itch But If I were to start seriously collecting at some point I will I definitely want to start collecting some of these old Tobacco cards. I think would be really neat. All right next one My dressed up fancy today. He's got a hat a jasmine shirt and and This zip up cardigan It's not that fancy There's question here a 95 out of 150. That's a fancy autograph That goes to the brew crew Caleb with the Brewers. I don't know new new release day nice nice sweater for new release day Colton what's going on? Yeah, we are we are we are staying safe so far so good and There's Jordan Yamamoto 24 out of 99 Marlin's autograph that's a number block team Miami for is for Kevin s Kevin With that one. There's Victor Robles. What's going on here? Just a little extra glue or something like that Victor Robles Nine out of 150. I know another hat day The hair and makeup girl isn't here today also with my hair growing And this being a sort of tighter fitted cap I'm not gonna have too many opportunities to wear this My hair grows out to tease Rizzo and Randy Johnson, it's it is a zip up Mike Tower. There's Randy Johnson snakes edition Diamondbacks 53 out of 150 Nick L with the diamondbacks Sean Corbett summertime when the weather gets warmer, you'll see you'll see a lot more non hat days Freddie Freeman to 99 So stay tuned for that Stamp of approval Victor Robles 101 out of 150 over time my hope is that You know over the years as as the the hobby continues to evolve I want to see more Hologram stamps like that just so we know exactly where these jerseys were from what game it was from Blah blah blah blah. I think I think that's what it will evolve to nationals are a number block team nationals One is gonna be Jeff peace and the next one here is another Keston here This time out of 199 190 out of 199 2 for Caleb Caleb and the brew crew No, John Tamsen. I have not seen a I've not seen a Bill Simmons NBA redrafting specials. I've not seen that I should probably check that out That sounds like fun They're listening Mike tower YouTube just suggested a video for him how to cut your own hair at home after your great clips comment They're a stay-at-home hair hashtag see YouTube listening They're calling it rewatchables or Redraftables they have a show called rewatchables Which I occasionally listen to I can't wait to sell to sell jasps to To the ringer Get that ringer money And that written that that ringer production. All right, we got a blue bird. That's boba. Shet nice 155 out of 199 Nice boba Shet rookie auto for Richard Zitterman who picked up the blue bird straight up There's old Carlton Fisk Red Sox edition for Jeffrey S 15 out of 50 And these autos are nice This is not this top litter not worthy of Carlton Fisk Come on ultra pro is that I like the design this I feel like I say this every year for trivia, but I like the design this year Jeffrey asked once again with the Red Sox. I Think you're thinking of someone else vanilla granny Johnson the big unit is a dominating left-handed strikeout artist saws the albies and We've got Anthony Rizzo Two-color triple relic 14 out of 99 for the cubbies. It'll be for Josh proofs Yeah, if we could be an official something of the ringer John Sam, I can't I can't wait to get that ringer money We're always looking to sell sell out to the ringer or ESPN wants to buy us. That's fine, too We've got a dual relic both Astros Nolan Ryan and Garrett Cole 45 out of 50 both game use memorabilia Both were Philip Klein who has the strokes and we got a Dylan cease 45 out of 99 cease and desist going to Michael K and the White Sox Oh, oh, oh, I see what you're saying vanilla grill. You're asking was was he a pitcher that could also hit that? I don't know I don't I don't remember how Randy Johnson was at the plate. I Know like Greg Maddox and Glavin. I think we're a couple of good hitters for pitchers. There's Vlad Guerrero, Jr. Good hitter 99 It's Gavin Lux to 450 nice Gary Sanchez and Reese Hoskins Stamp of approval 22 out of 150 other hologram sticker right there. So Phillies Derek Hamilton again for anyone who gets the stamp of approval cards. It's worth looking up Worth looking up to see what game that's from you can even look up the box score unlike baseball reference or something like that and Go from there. I also think that these rookie numbered cards are Not super common in tribute at least traditionally that's that's been the case So that could have some more value than you think Dodgers Tyler Brenner That's the plan John Samuelson if if I could uh If I could get that ringer money right if we sell the business to the ringer They up our production value keep us on to just run the thing as we usually do right Then we can get a little bit of that ringer money get some of that sponsorship money And then top's tribute baseball would be sponsored by like would sponsor by like Roman or What else zoom Sponsors the show we get all those zoom sponsors purple mattress Casper We get all that Indeed.com Would be a sponsor. Welcome to the indeed.com Top's tribute baseball break pick your team number one from jazzy's case breaks.com Presented by subway eat fresh Oh man, then yes, we would be breaking Well, it's a tops break. So this is we're break. We'd be breaking transcendent on a jet with celebrities That'd be great. We'd like to welcome in Joey Gallo on the jazzy jet To break open some transcendent with us There's Yasiel Puig For the red has he been signed? I guess everything's been interrupted by covid, but I don't think he's been signed yet Two color triple relic for the red legs that goes to 99 Could be a good dh somewhere That's a number block team. So that goes to red Cincinnati seven that'll be for chris meyer I could go and like A good show maybe a good show would be Open up a pack of baseball cards And talk to baseball players Francisco lindore two out of 25 People people watch people eat hot wings and I answer questions What if I had a show where people open baseball we open baseball packs with Various guests that could be a show on the ringer. Should I pitch that to the ringer? Francisco lindore two out of 25 Cleveland Indians that'll be for tim got the tribe straight up We'll workshop that idea john samuelson. There's hasus lazardo rookie auto to 150 51 out of 150 for the Jay crider picked up the a straight up I'll all sell the idea to latin then And then just be executive producer on it and then still cash in the money abc always be closing We got josh bell Javier baez And eloy hymen is nice 71 out of 199 Autograph for the white socks michael k having a nice break with the shy socks And I've not watched hot ones john sam I've maybe watched 30 seconds in my entire life I can't watch it because then I have Craving for delicious delicious hot wings and that just throws me off Rod karoo 12 out of 20 hard to focus on a show like that Rod karoo dual relic going to the halos That'll be for alexander and the angels There's alex rodriguez to 99 Vlad Guerrero's senior expos. I'll go the gnats And that's a non-number. What are we doing a non-number at cards? There's stamp of approval. Should I randomize it to one person? I'll randomize it as a lot 19i 25 cc sabathea stamp of approval bj jord. What are you talking about? We see my conferences all the time Oh, so he must Oh He's a trooper then for going to those conferences There's a rod m's edition going to chris walker two boxes to go Wait, does it say in the disguise? What did I miss it? Maybe it says in the item description Where a non-numbered cards go No, it actually says all non-numbered cards are randomized in one lot at the end So I guess I was right the first time. All right, so I can't sell the show to him then I want to find someone else My amari cooper hands here Oh, the break's not over yet. Derek brenton Derek the break is not over yet We've got many hits to go here between this box and the last one all right play to the whistle there's jim tome trout and Roberto alamar blue jays edition Richard zitterman 83 out of 150 We got herald baines Nick senzel And kyle schorber 150 140 out of 150 josh proust with the cubs I like this picture right here I like this picture. He's like, yeah, let's go edgar martinez 15 out of 99 Right, shawna. Yeah, it's got Got a lot of practice edgar martinez 15 out of 99 mariners chris walker four out of 50 javier baez cubs and Edgar martinez went to chris walker and now we're going to walker bueller 144 out of 150 stamp of approval relic for tyler brenton So tyler look look that up mlb.com slash authentication jc 795 634 You can see what date that jersey was from And you can also look at the box score and see if you made a start It's harder with pictures because you have to match them up to a star a lot of times It's just like oh it was a game that they never started With the hitters you have a better chance of seeing if they did anything that day I think a couple years ago. We had a really cool Was it out of tribute or was it out of something like strata? I forget but We hit a really cool relic There's hose al 2 of a 46 out of 50 for the astro still climb We hit a really cool relic of a padres player. I think And it was just a it was just a white relic. It was just a napkin. You know what I mean? But It had pink on it like liquid. It was a gatorade And so but it had the stamp of approval thing on it. I wish I remembered who that player was And we looked it up We looked up the relic then we looked up the box score turns out he hit a walk-off home run And that's where that jersey was from. It was a white jersey gatorade stains on it And I thought that that that was really cool so that that's the potential for Potential evolution for the hobby to get more of those stamp the hologram stickers to Authenticate the actual date of all that. All right Reds 190 out of 199 play to the whistle Derek Ratten. There it is Cincinnati zero Derek B Nice player there too. Nick sends out There's eugenio suarez for nano to t's jr And vlad guerrero senior montreal expos 10 out of 10 Nationals expo stuff goes to the gnats And national zero Derek Bratton What do I tell you? What do I tell you? Play to the whistle man That's what it's all about That's what coach always used to say play to the whistle No, I don't think the team went to I don't think that I don't think that raider that super bowl raiders team did not go to Tijuana. It was just one player and an important player I'm pretty sure it was The center the raiders center and I think Well, even if some of the team went I feel like they were all they were all back in time but in by the time to get to bed but Kind of went on a went on a bender And if you believe what tim brown says Tim brown says bill callahan When facing john grude and never changed up any of the audibles or the calls and everything so Take that for what it's worth Right. All it does take is one player And it had to be the freaking center I mean He struggled with a lot of mental mental health issues and stuff like that I don't he might not even be with us anymore, but So kind of a sad story, but not the best possible time all right we got Vlad grove we just got his dad's autograph and now we got vlad grove junior the kid 12 out of 199 That is for richard ziderman with the blue jays. He's got the bachette rookie bachette and second year vlad grove nice And we've got for anotatis jr. 52 out of 150 For chris meyer and the padres Nick senzel five out of 50 For number five over here. That'll be for diane nico herner 67 out of 99 Will go to josh pruce And the cubs he has the cubs. Yeah, josh pruce and the cubs masahiro tanaka stamp of approval 7 out of 50 pinstripe relic yankies bj jordan with the bronx bombers It kind of does look like i'm playing solitaire with these cards. We got logan alan 46 out of 150 autograph for the tribe tim with the indians Ah bear robin still with us, but just trouble with the law I feel like there's got to be like a tell all book or a 30 for 30 on the horizon For that or they should there should be there's andy pettit 2 out of 5th not to be confused with with our long-time customer erin pettit This is andy pettit and that'll be for bj jordan and the bronx bombers and the last Stack here. Good luck. Roberto Clemente cal ripkin jr And we've got dansby swanson triple relic 133 out of 150 for matt and the braves Little something for him at the very end There you have it boys and girls got to do a quick randomizer for those non numbered cards Look at that. There's a nice boba shed and the That one-of-one right there the old cigarette card tobacco card pretty awesome Some great stuff all around in this break ladies and gentlemen. So thanks for getting in really appreciate it We got some more in the store. So, uh I would encourage everyone to go and get it All right Let's oh, no, I didn't want to alphabetize those Want to grab those names. I'll do that later. Let's roll it. Let's randomize it Two and a two for the hard way hard four name on top gets the non numbered cards for those teams one two three And four So a little consolation prize for drew sanford. There you go drew Yeah, I'll do a little quick little hit recap right here Sort of a longer break There are your hits pretty nice stuff ladies and gentlemen There's more in the store jaspy's case breaks.com.  This is this was one of my favorite designs right here iconic perspectives I think there's almost sort of a stained glass look in the back Which is pretty nice nice that was picker team one. Thanks for watching everyone. I'm joe. I'll see you for the next one. Bye. Bye


Hello, everyone. My name is Brianna Costello. I'm an interventional cardiologist here at the Texas Heart Medical Group in Houston, Texas.  I'd like to thank Dr. Rogers, the president and CEO of Texas Heart Institute, as well as Baylor St. Luke's and Baylor for all collaborating with us here. This is awesome, and I'm excited to talk about one thing that I'm very passionate about, and that's heart disease in women. So here, heart diseases in women, what we know and what we need to do. Just for a fun starter, there is a picture of a heart and some anatomy version heart. Male heart, female heart. Well, this is meant to be a little comical. Male hearts generally are a little bit bigger than females, but the point is we both have a heart. They both have the same disease processes, albeit at different times. I want to dig in and talk about how women are affected by cardiovascular disease. So what we know, heart disease is the leading cause of death in American women.  That is a shocking stat for some people. Nearly 43 women are currently living with or at risk for some sort of CV disease, and more than 8 million women are currently living with heart disease and know it. 292,188 women die annually from heart disease. That's four times more than breast cancer and more than all cancers combined, and this stat is even a little older, so this is probably upwards in the 300s. Women, we know this from study after study that women are less likely to receive treatment according to cardiovascular disease prevention guidelines as well as treatment guidelines. In the interventional world, this is another thing that I'm very interested in, and women, unfortunately, have are treated less aggressively or inadequately many times, and we need to start addressing these things. So CBD, cardiovascular disease, is a woman's disease. One in 31 deaths in women are due to breast cancer. One in three deaths are due to heart disease. One death per minute among women due to cardiovascular disease, and only about 20% of women know that heart disease is the number one killer, which is one of our passions here, even at the Texas Heart Institute, in the women's heart center, is to kind of promote women's knowledge and make them aware of this disease. So just a brief overview. What are the types of cardiovascular disease, of course? We all know coronary artery disease, there's cardiomyopathy, there's hypertension, cholesterol issues, heart failure, arrhythmias, valve disease, peripheral artery disease, and congenital heart disease. But, you know, these diseases affect both men and women, and we really, unfortunately, in the South are pretty plagued by heart disease, in particular coronary artery disease and PAD. So here, rates of death by state, you can see the dark is not as bad. So cardiovascular disease deaths here in the South were much higher than perhaps in the West and the North and the Midwest. Stroke death, of course, kind of parallels this and is much higher in the South. So let's just break it down by sex. So cause of death by sex, as you can see, cardiovascular disease for men and women is the leading cause of death. 30.9 and 30.3 of men and women, respectively, died because of heart disease. So obviously, this is something that we're all very passionate about. So mortality trends, you know, back in about 2010, you can see we kind of hit a low. So we hit a nadir in our cardiovascular disease mortality trends, which was exciting. And you can hypothesize or you could surmise that all this was back in, you know, the late 90s, early 2000s, there was smoking, rates dropped, statins were pretty widely used, we're making a lot of advances in, you know, medicine and lifestyle. But as you can see in about 2010, this starts to tick upwards. Again, certainly the obesity epidemic, diabetes epidemic, has kind of caught up with us, I think, and we're back on the uptick. Fortunately, women's mortality from heart disease is actually staying lower than men. So that's a big improvement. As you can see, women's mortality from heart disease was significantly higher than men for a long time because women were treated differently. Nonetheless, we're back on the rise, but it was good to see an improvement there in the empowering, you know, movement to get women motivated to take other heart. So what's the breakdown in cardiovascular disease deaths? Like why is it happening for women? So you can see the majority of it is coronary heart disease. So heart disease of the arteries in the heart. So, you know, heart attacks, atherosclerosis, et cetera. Followed shortly thereafter, 49% of coronary disease and 16% from stroke. So stroke is another big focus for us here, especially for men and women. So what risk factors, the whole point of this is what can we do to prevent heart disease and prevent, you know, coronary disease, heart failure, et cetera. So what we have to know is what are the risk factors for that? And of course, men and women, both, hypertension is a huge one. As you can see by about the age of 55 to 64, nearly half of patients will have hypertension. A lot of people are shocked to see that. And then of course, as you see, as the ages move on up, by the age of more than 75, females have an 80% chance. So I say, if you've made it to about 80 and you don't have high blood pressure, you are a lucky human. So again, knowing these risk factors, knowing to screen your screen patients appropriately and at the right age is super important. African-Americans, both men and women, are in particular a very important group to focus blood for blood pressure. African-Americans have higher blood pressure at earlier ages. And certainly women, this is a huge portion of the population that perhaps, you know, focusing at an earlier age in their late, mid-30s, late-30s, 40s, we really have to be on top of screening for hypertension. You can see there at the age 40 to 49 group, at least 30% of African-American women will have hypertension. And the problem with this is it often goes unnoticed, undiagnosed, untreated. As you can see among hypertensive African-Americans, 88% are aware of hypertension, 68% are medicated, and 51% have their blood pressure controlled. We're doing a very poor job of controlling blood pressure, which is quite frankly the easiest thing for us as cardiologists to modify for our patients and make a huge impact. So what about the incidence of myocardial infarcts or heart attacks classified by age, gender, and ethnicity? Unfortunately, as with hypertension, African-American men and women both have the highest risk of heart attacks or, you know, coronary events. And of course this likely parallels with the fact that blood pressure is earlier onset, less well controlled, but we certainly have to focus on this sooner than later for all patients, but in particular African-Americans with hypertension. Stroke risk, comparing men and women, of course, or the prevalence of stroke, certainly as we get older that risk goes up, but you can see women's risk of stroke in the age 40 to 59 is even a bit higher than men's. So perhaps we're missing some screening earlier on for some women. Stroke death, of course, for all males versus females in different ethnicities, you can see here, the stroke risk for African-Americans is grossly higher than for any other group. So we really have to focus, and we know that stroke is intimately related to hypertension, so I harp on that one more time, especially for women and men, of course, but we really have to be screening for blood pressure earlier. So let's just recap the risk factors so we can get into some more meat and potatoes of what we are going to do for women. So what are some non-modifiable risk factors for cardiovascular disease? Well, certainly your age, you can't turn back time. Family history, of course, you can't decide what genes you were born with, so if you're an unfortunate person that has a family history of really high cholesterol or early onset hypertension, you can't change it, but you certainly can address it as we'll talk later. One thing that I really love to talk with all of my female patients, and they kind of look at me cross-eyed when they come into the office and I ask them about their pregnancies, preeclampsia or eclampsia history. This is a huge screening question or screening discussion that I think we miss a lot because patients who've had preeclampsia or eclampsia are certainly at higher risk for cardiovascular events later in life, and that meaning two to three times the risk of having a cardiovascular disease event. They are definitely at risk for a much higher risk of hypertension, so they need to know that. Of course, establishing that is hard when you have a new mom and maybe in their late 20s, early 30s, the last thing they want to hear is they're at high risk, but we really need to be talking about that a little bit more. So what are we going to modify or what can we do in the office, in the cardiology office, in the primary care office? Of course, cholesterol modification is one of our main focuses. Obesity, of course, we're counseling patients on weight loss and that's difficult for many people, but we should really be striving to exercise cardiovascular exercise weekly. Diabetes, hypertension, of course, and smoking. So what are some disparities in cardiovascular disease that we see due to perhaps these risk factors being different? So African-American women have a 48.3% established CVD in the population. They have the highest CVD mortality rate. Interestingly, Hispanic women, 32.5% have an established cardiovascular disease, but interestingly, the lowest cardiovascular disease mortality. It's unclear exactly why this is, but nonetheless, we need to focus and try to modify risk factors in both groups aggressively. In Hispanic women, very high degree of diabetes, starting at an early age, high blood pressure, of course, and cholesterol, which just kind of goes with metabolic syndrome that is seen in the Hispanic population. So African-American women in heart disease, certainly, as I can't repeat enough, hypertension is huge for them, but also obesity. 53.9% are obese and 73.1% are overweight or obese in the population. Physical inactivity is certainly reported to be high among patients reporting. High blood pressure, of course, and diet with a relatively higher salt intake, sodium intake. 40% of African-American women over the age of 20 have high blood pressure. That's huge. So, I mean, that's a huge proportion of our population, of course, again, that we need to be very screening early. All right. So, Hispanic-American women in heart disease, they're also slightly higher risk for heart disease than Caucasians, and they're less aware of risk factors. Obesity, again, physical inactivity, hypertension, untreated diabetes, or poorly controlled diabetes is huge for this population. They have nearly two times higher rate of diabetes than Caucasian women. Among Mexican-American women, 30.7% have cardiovascular disease. Again, one-third of that population, it's huge. So, what do we do in the office, or what do we need to be doing in the office to kind of counsel patients regarding their risk of having cardiovascular disease ultimately throughout their lives? So, I think it's an easy discussion to start with about blood pressure, because that's something that patients can do at home, and we can often have them help us screen themselves intermittently at home if they haven't been diagnosed with hypertension yet. They're on their way there. So, I like to say, you know, a goal of blood pressure less than 120 over 80. That is normal. And that is what we know from data from the Sprint Trial and multiple other trials is going to make you live with strokes and heart attacks.  And then, of course, no smoking history or diabetes is optimal. Non-optimal, I like to focus less on the total cholesterol and more about what their ASCBD risk is in the risk calculator that we use from the ACC. However, focusing on a trend towards less than 200 for untreated total cholesterol or maybe starting a discussion about treating it if it's higher than that is reasonable. Elevated risk, certainly, if your blood pressure is untreated and you have a diagnosis of hypertension, you are certainly at high risk. So, good old versus bad old. Many times it is a choice and this is just to, you know, really hammer down the fact that many of these things we can modify early in life, meaning in your 40s or your 50s, so that when you make it to 80 and many women with diabetes can live a healthy happy 80 instead of an inactive, you know, bedbound 80. So, it's not a disease that we're powerless over. Counseling for the patient every day don't smoke, manage your blood sugar and in saying this, someone needs to be screening patients for blood sugar. So, I screen every one of my patients for diabetes when they're a new patient in the office because guess what? Heart disease is related to diabetes and it actually changes some of the medication management that I do if you have diabetes. Know your numbers again, counseling patients on screening themselves for hypertension, cholesterol via diet versus medical therapy, family history, huge if you have a really early onset cardiovascular disease history you need to discuss this with your provider. I say 150 minutes of activity per week as the AHA recommends to decrease risk of heart attacks and strokes. So, that's 30 minutes of day, 5 days a week whatever you want to do, brisk walking, jogging Zumba. And lose weight. Losing weight is hard, it's really hard and there is certainly a large body of evidence that say most patients don't lose weight but, you know, talking about small changes in life to help modify weight or at least get some fat off is important for us every day. Smoking is no brainer, the risk of smoking the risk to your heart is just huge so the risk of smoking is 25% higher in women than men which is a shocking stat and the risk of stroke is 2-4 times that of non-smokers. So, if you have a patient, they don't want to have a stroke this is like number one check mark. So, of course as we've always been told since being young kids don't smoke. Diabetes among Americans it's been diagnosed in 18 million and this is certainly higher now because it's a little bit old data. Diabetes is undiagnosed in 7 million and pre-diabetes is present in 79 million. I almost think it's a little hard for me nowadays if I'm screening patients to find a normal A1C. Many patients are living in the pre-diabetes range and they don't know it or they haven't been counseled on it. I find it really is motivational for patients sometimes to say look you're pre-diabetic. We're not going to do anything but medication wise but we need to make some lifestyle changes. And of course, why we care so much about diabetes here, heart disease, kidney disease, peripheral vascular disease. Again, this is just harping on the fact that women certainly are suffering just as much or more than men from diabetes and we need to focus on this and start to modify, discuss and manage patients in the cardiology office and in the general office aggressively. So, knowing the numbers, again targeting to a normal blood pressure 20 over 80 or lower, we know is going to make patients live longer with less strokes and heart attacks, cholesterol. I think now as the guidelines are kind of suggesting if you have that intermediate risk patient who as we all know many patients are wary of statins, getting a calcium score to see if there is a presence or absence of atherosclerosis in the coronary arteries is super helpful. I'm pretty aggressive obviously in the established cardiovascular disease we're going to target that LDL quite low to less than 70 but even in the patients who are otherwise asymptomatic but have identifiable plaque on a calcium score driving to at least less than 100 and perhaps if there's a large burden of cardiovascular disease adding a baby aspirin for a calcium score maybe more than 400 per the guidelines in Europe. Weight and BMI of course patients need to know you're overweight, you are obese, sometimes they don't even realize that they need to shed pounds and we have to counsel them and why it's important. Again back to the diabetes I can't emphasize this enough prediabetes is so prevalent and it certainly will lead to diabetes as patients age if they aren't aware or making changes. 32% of Americans engage in no meaningful physical activity and of course women this is higher than men and we can all hypothesize why as speaking as a woman myself I think you know especially if you're working you work all day you come home and perhaps you're the one who's doing the childcare or you're the one making dinner or whatever it is not making time for yourself as a female to get active it's important for your health and we're taking care of the rest of our family but we have to take care of ourselves. So again 150 minutes or more a week is what we know is going to be helpful. Weight loss again it's hard it's not impossible but it is hard so just you know working on lifestyle changes instead of just focusing on a diet is very important for our patients. And then I like to say eat to live instead of live to eat. So yes you can enjoy what you love to eat but remember that whatever you put inside your body it's got to be your body has to handle that so if you're going to eat the fried food all the time or you're going to eat the french fries and carbs and pasta your body is going to respond in an unfavorable way so be smart about your food, Mediterranean diet certainly is what I discussed in the office with an emphasis on limitation well not limitation but being mindful of your portions of carbohydrates and starches. Alright thank you guys I hope this was fun I again appreciate everyone you know being here with me today I hope we all learned a little bit of something and women's heart disease continues to go down. Thank you.


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So I'm going to talk about simultaneous amplification, the case of non-interactive zero knowledge. And this is joint work with Vipul and Amit. So in this work, as you can guess from the title, we just consider a very basic question. And the question is that, suppose I give you a non-interactive zero knowledge scheme, which is not fully secure, by which I mean that it doesn't have full soundness and full zero knowledge property. Then we construct an ISIC argument system, which satisfies full security. So let me define the problem formally and show you how we do it. So let's recall what non-interactive zero knowledge is. In non-interactive zero knowledge argument system, there is a trusted party, which outputs a common reference or a random string, as you will. And then any prover can take an instance and a witness for that instance, along with a random string and output approved to convince a verifier of this fact. And it has two security notions associated with it. The first security notion is the soundness notion, which is associated with the following experiment. The experiment is that the trusted party gives out a CRS randomly. And then there's a malicious prover, which is think of it as a polynomial time malicious prover, who wants to convince the verifier of an incorrect state in a statement, which is not true, with a proof that verifies corresponding to that CRS. And we say that an ISIC argument system is delta s sound if the maximum probability with which this malicious prover can convince the verifier of such a false proof is bounded by delta s. And I will refer to this delta s throughout the talk, delta s is I will refer to as the soundness error. Likewise, there is also the zero knowledge property in which there is a simulator. I will denote it with Mysterio. And what it does, it takes an instance x, and it can fake a CRS and a proof and gives it out to the verifier, and then verifier can verify this fake CRS and the proof. And the zero knowledge properties say roughly this, for any polynomial time verifier, any cheating verifier, it holds that the probability with which it can distinguish between a fake proof and the CRS generated by the simulator with the anonymous proof and the proof, this is bounded by probably delta z. And I will refer to this delta z as the zero knowledge error. Okay, so now let me try and discuss the relation between these two parameters. So if you look at standard Nizek arguments, we have this property satisfied. So take your favorite Nizek argument that you know from LWE or bilinear maps or even trapezoid permutations. It holds that delta s plus delta z is negligible because they are fully secure. On the other extreme, there's a setting which you can construct really, and that setting is when delta s plus delta z is equal to one. This is because I can give you two particular examples, let's just take delta s zero and delta z one. This you can easily construct by having the prover always output witness in the clear. So because it's outputting witness in the clear, there is no soundness loss. And you can't expect zero knowledge because the witness is revealed. And there's a complementary condition when delta s is one and delta z is zero. In this case also it's very easy to construct an Nizek argument by just having the prover output zero and having the verifier always accept zero as the valid proof. All right, so what we do in this work, we show that let's take a setting which is very slightly non-trivial. We just have delta s plus delta z a little bit less than one. Let's say it's one minus epsilon for an arbitrary small constant epsilon. And then if you're willing to assume public key encryption with some exponential security, what we can show is that such an Nizek is enough to imply a fully secure Nizek. And along the way, we also introduce a new object, which we call as secret sharing for NP instances, and I will talk about it later in the talk. So let's just, so first I will describe how the overall approach of this work. So what we do is we define two transformations and somehow use those transformations one after another to start off with a weak Nizek to a fully secure Nizek. So the first transformation is a soundness amplifying transformation. And the goal of this transformation is to improve the soundness of the Nizek. So it takes a delta s, delta z Nizek with an assumed sub exponential pk, and it improves the soundness from delta s to delta s to the N, whereas N is any polynomial parameter of your choice. So it improves the soundness, however, what we show is that it doesn't kill the zero-knowledge property completely. We show that it goes from delta z to this parameter that I have written, 1 minus 1 minus delta z to the N. Don't worry about this at the moment, but this is what it does. The second transformation is the zero-knowledge amplifying transformation. Its job is to improve the zero-knowledge property, and we show that analogous to the soundness amplifying transformation, it improves the zero-knowledge from delta z to 2 times delta z to the N. So it exponentially improves the zero-knowledge. And we also show that it doesn't kill the soundness completely. So it goes from delta s to this number 1 minus 1 minus delta s to the N. So now let's see why these two transformations are enough. And so the reason is that you can use these two transformations one after another to construct something secure. So let me not bore you with the general theorem, let me just give you a concrete example. So let's say you have delta s as 0.3 and delta z is 0.6, so that soundness error plus zero-knowledge error is actually quite large, it's 0.9. So in this setting, what you can do is first apply the soundness amplification with this parameter log lambda, and what you get is something like this. Don't worry about the calculations. These parameters are correct, but you get something. And then you use this nizek and apply the zero-knowledge amplification with this parameter, and what you get is something constant and negligible. Finally, you can just also do the soundness amplification again to get something fully secure. So this is why these two transformations are enough for our purpose. All right, so let's now look at these two transformations. The first transformation is the soundness amplification, and as you already know, how do you increase soundness? You just repeat it in parallel, and this has been studied in many, many words historically. So what we do is that we have, we just have some parameter n and have the CRS, the generation be just sampling n-independent copies of the CRS using your underlying nizek. And then, if you want to prove a statement x, then what you do is using each copy of the CRS, you generate an independent copy of the proof for the same statement x. And that's it. That's your proof. So we know this time and again that this improves soundness. So this is the latest version of the soundness amplification, which directly applies to some parallel repetition, and this was due to Kennedy-Hellevian Steiner. And we also re-proven this in our paper, what they showed is that suppose you have a nizek argument system, which is say delta s sound, and the soundness holds against some adversaries of size s, then when you repeat it in parallel with the n repetitions, then what you get at the end is something like delta s to the n plus a small additive factor n epsilon, and it holds against the adversaries of slightly smaller size, which is o tilde of s epsilon. And I am hiding some factors in o tilde, but they are not important. So let me repeat again, what it does is it takes delta s sound argument, which holds against adversaries of sizes. What we get is, what ideally we would expect is delta s to the n, but we don't quite get that. So delta s to the n plus some additive factor n epsilon, which also factors in the reduction of the size for which against the class of adversaries, which the resulting system holds soundness against. And further in this work, we show that if you are willing to assume public encryption, then even the adaptive soundness is conserved. So this was soundness amplification, and this we already know how to deal with it. Let us now focus on the zero-knowledge amplification part. This is new to our work. So in zero-knowledge, the first idea that comes to mind, which I would show is wrong, is the following. Suppose you want to increase zero-knowledge property, what you would think is, let's just compose one proof with another. So let's have the CRSB, two independent sampled CRS of the underlying music. And let's prove x is in L using the inner, this x using the CRS1. And then you can use CRS2 to prove that this proof that you generated is valid, and you will output pi 2. So that's the idea. However, you would expect that this shouldn't increase zero-knowledge because suppose inner one is delta z secure, then on composition you would think that you should get something like delta z square. And what we show is that this intuition is completely flawed. In fact, there's a very simple counter-example to this fact. And this counter-example is the following. So suppose you want to build a Nizik, so a counter-example, let's just start with a secure Nizik, and then we build the counter-example as follows. So the CRS generation for this counter-example is just the CRS for the underlying secure Nizik. And then in order to prove a statement, if your statement has some specific structure, let's say it has bought appended with some string, in that case you just output the witness in the clear along with this statement. Otherwise, you just sample a bit B. If B shows up one, then you output the proof honestly generating the underlying Nizik argument honestly. Otherwise, if B is equal to 0, you just format the string with bought and output it along with the witness. So don't have to worry too much about the detail, but the point I'm trying to make is if you use such an argument, then there's no hope to increase soundness beyond one half. There's no hope to increase your knowledge beyond one half because with some half probability clearly leaks the witness. So we need to develop new technology in order to handle this issue. And what we do is we define something called as verifiable sharing for instances. And here the goal is that suppose you have an NP instance and a witness, you will secret share it into an instant witness's pair. So XW is the instance witness, and you will get shares X1, W1 through X and WN such that there are two security properties that are satisfied. The first security property is that if X1 through XN are like an adversarial sharing of X, and they happen to be in the language, then X should also be in the language. So this holds with respect to adversarial sharing of X, W. And the second property is that if X1 and XN were honestly generated shares, and I happen to just leak out N minus one witnesses, then those witnesses should not leak any information about the membership of X. We can actually construct it in a not very difficult manner. There is this thing called MPC in the head, which was proposed by Ishae Kusilovits Kostropsky and Zahae. And then we can instantiate it for semi-honest MPC protocols with perfect correctness. This in a very not so indirect manner gives you this notion. And you can use public key encryption to implement commitments for this. So I would refer you to the paper for construction. So now once you have the sharing, the zero knowledge amplification question is very simple. What you do is just have independent copies of CRSs as a part of the CRS, have this public key at the setup for generating commitments. And then to generate a proof, you just secret share your XN witness to generate shares. And then for each XI, you will use the CRSI to generate the proof. And that's it. That's the output of the zero knowledge amplification, the compiled version of the argument. So now let's now look at this transformation. In zero knowledge amplification case, we have, we can prove the following thing about the soundness. We prove that the soundness is not completely killed. And we show that suppose we have a delta S sound argument system, which happens to be against the adversity of size S, then when you use this transformation, then what you can get is something like 1 minus 1 minus delta S to the n plus order of epsilon sound against adversity of slightly smaller size, that is S times of epsilon. Again the same phenomena happens here. We started with delta S and we would expect 1 minus 1 minus delta S to the n, but we don't quite get that. We get an additive term, which also factors in the reduction of the size of the adversity. So this is the main theorem for zero knowledge amplification. And what we show is if we started with delta Z zero knowledge, assuming public key encryption, which is some exponential secure, what we get is 2 times delta Z to the n plus order n epsilon zero knowledge property against circuits of slightly smaller size. And the two term here comes just because we first argue witness indistinguishability and then we argue the zero knowledge. So there is a factor of two laws there, alright. So let's now look at the how do you argue soundness theorems in both the cases. And the idea was present even before our work. This is this notion of verifiable, weakly verifiable puzzles. And I won't talk about it in detail. You can look at the hour paper or also the Kennedy Hallevi-Steiner paper. Let's now look at how do you argue zero knowledge theorems. So for arguing zero knowledge theorem, we actually need to rely on this machinery called hardcore sets. And we rely on this very beautiful theorem by modern Tessaro who proved an indistinguishability version of this hardcore set theorem and it's on the next slide. So it looks scary, but actually it's what it says is quite simple. What it says is that suppose I have two functions E and F, which are gamma indistinguishable by gamma I mean this probability is gamma to any adversary of size S. Whenever X and Y are sampled randomly, suppose I have E of X and F of Y are gamma indistinguishable then what you can do is find sets S0 and S1 which have high enough density like 1 minus gamma such that when you sample randomness from S0 and S1 then E and F become epsilon indistinguishable for adversaries of slightly smaller size which is S times epsilon square. Let me repeat myself. What this theorem says is that if you have two functions E and F which are gamma indistinguishable against some class of adversaries of size S where X and Y were randomly chosen. Then there exist two sets S0 and S1 of density 1 minus gamma 1 at least such that when you sample from them E and F now suddenly become epsilon indistinguishable where this indistinguishability holds against adversary of slightly smaller size. So now by choosing this epsilon appropriately you can set you can choose this advantage appropriately. So this is a very powerful theorem and it is used in almost all amplification results. So here is our zero-knowledge amplification strategy unfortunately I would not have full time to talk about like the complete details but here is the first idea. So the basic idea is consider a mental experiment where you are sampling a uniform string. So as I told you the for NISX since it is delta Z zero-knowledge it has a hard core set or a good set of density 1 minus delta. So a uniform string will lie in the hard core set with probability 1 minus delta Z and it will lie in the complement otherwise. And so we can actually use this property to construct a hybrid like this. So what you do is you sample a string you sample a string like this such that 1 is set with probability 1 minus delta Z and 0 is sampled with probability just delta Z. So now when you get a 1 you generate CRS1 and the proof 1 from the hard core set otherwise if you get a 0 you generate it from the complement of the hard core set. And remember when you are in the hard core set you can switch this part to a simulated proof and your goal would be to somehow simulate at least one of the indices. So that now you can get rid of one of the witnesses for one of the excise and then it will become a hybrid will become independent of the witness and that will allow you to argue security. However, this is a simplified approach this as is cannot work and the reason behind is the following. The reason is that if you look at these sets hard core sets they are extremely inefficient to sample from and they are very complex descriptions and so if you sample from them you can actually completely break the security of the secret sharing scheme. So it seems like we are in some trouble but fortunately what we have at our disposal is that the sets have very high density and so if it is like 1 minus delta Z dense where delta Z is like 1 over poly then it has high density and then it does not leak too much information about the secret sharing scheme. So we can formalize this argument using an idea which was also there in my work with Prabhanjan and Amit on IO and we use those ideas here to formalize a way to efficiently sample from hard core sets and I will refer you to the paper for details. And with this finally let me conclude with some open questions. So first is it possible to get rid of public encryption to get an unconditional result? The second question is can we construct this amplification with better parameters? So right now we have this our compiler is not very efficient. Also there is another annoying thing that is we can only handle when delta S plus delta Z is 1 minus some constant. Can we go all the way to 1 minus 1 by security parameter? And finally another interesting direction is can we study simultaneous amplification for other cryptographic primitives? With this I would like to conclude and please ask me questions. Thank you Aiyush. Do we have any questions? If not let's thank Aiyush again.