In today's video, I received a box full of vintage Yu-Gi-Oh packs. What's up guys? We're back with another epic opening video where I am opening this box that we just received. This contains a lot of old school packs. So the guy that sold me this hit me up and he's like, hey, my dad used to have a store back in the 80s and it ran all the way till the early 2000s. It had some Yu-Gi-Oh stuff involved. I saw you do Yu-Gi-Oh. I don't care about Yu-Gi-Oh. I'm talking to him so he doesn't care about Yu-Gi-Oh. So I was wondering if you wanted to purchase any. Give me a list.  I'm not going to spoil it yet. And I was like, heck yeah. Let's do it. He was like, okay, cool. I'm not that interested in Yu-Gi-Oh. So I'll just send it off to you and you can buy it. So he was like, heck yeah. I'm down. So that's what's happened. That's how we've gotten to this point. And I've not seen any of this product yet, but a lot of it's stuff that I've never bought before. So get excited. Before we get into it, we have a giveaway. I'll be giving away this Harpy Queen Lost Art Sealed. All you have to do is like the video, be subscribed to our notifications. Let me know your favorite item in the collection. And what do you want to see opened? All right. Let's get this box open. See what's inside. Why does this look like it's a factory seal? I guess it's not though, because I don't think we, I don't think you have anything. We'll find out. I don't think anything we bought was like factory seal in the box like this, but who knows? We'll see what this is. Okay. Here we go. Oh, okay. Yeah. Here we're talking right off the bat. As you can see, there is some sealed items right here. Let me just show you what they are. So first of all, we have a legacy of darkness unlimited booster box. This is a factory seal. So this is like old school 2003. Yeah. Not first ed, but very, very cool items. Some of these sealed items, like these boxes will be available on ruxent34.com. So go check it out down below. If you guys have not checked out my website before, I have a lot of items on their PSA graded cards, sealed booster boxes, empty booster boxes for your collection, lots and lots of stuff. So go check it out if you want some vintage Yukio product. And yeah, this legacy of darkness will probably be on it. This looks really nice. It has a little sticker on there. So used to be $72. Wow. It's not $72 this time. All right. Legacy of darkness. Very cool. Let's see what the next thing is. We have another legacy of darkness box. We have two unlimited LOD. That's pretty amazing. That one also used to be 72 bucks. It looks like it would come off if you wanted it to, but it's also kind of cool to be on there. The vintage, uh, vintage sticker. And because this is a 24 pack box, it'll have Yada inside if you do open it. So two legacy of darkness booster boxes, not packs. Booster boxes sealed right there. Okay. And there's one more booster box sealed. So this one is actually really awesome. I don't know if I've ever owned one of these. It is another unlimited box, but invasion of chaos. So 2004 invasion of chaos sealed boxes. It's not 25th anniversary guys. You know, 25th anniversary just came out. This is an original 2004 invasion of chaos box. There's a little crease there, but honestly in pretty good shape. Looks pretty new. That is pretty awesome. First, that would have been really crazy, but unlimited is still really, really awesome. All right. Next, there's another box inside of a box. So let's unbubble wrap it. Man, this is some good packaging. I'm not going to lie. All right. So big shout out to Steve, by the way. He's the guy who sold me these. So Steve, you did a great job packaging these. Let's get the stuff out. Okay. I think I know what this is. All right. These are also bubble wrapped as well, but I think these are open boxes of Duelist packs. I think it's a Zane, if I can, can't really tell. Let's see. No, exclusive pack, not Zane exclusive pack. So they used to come in these like stand up boxes, kind of like the Japanese OCG product. So a bunch of exclusive pack, which all have the same cards inside. So like, you know, not super crazy to open because they always have these things and stuff like that, but still really cool and vintage. I don't even know why they made this set. It's very weird, but yeah, they're old school stuff. Here's the Duelist pack. That's why I thought it was Zane. This is Jaden Yuki. So we have not a sealed box. These are actually really rare sealed boxes, but open packs are not, you know, you can't really pull much out of them. So the packs themselves are not that expensive. All right. There we go. Got it open. That did not want to come off. Okay. All right. We have some first ad Jaden Yuki. So I know a lot of people like Jaden, you know, because he's classic. He's Duelist pack, you know, some of these, I mean, they're not in a sealed box, but these might go up for sale because, you know, there's not a lot of huge pulls. So it's more of like a collector's thing. If you want to collect some Jaden Yuki, I know some people really like those GX packs. I don't really open them too much because it's like the best card is like one ultra and it's like, you know, they're not, there's not a big chase, you know. Okay. Another box. We have not gone to the part of the packs that I've never opened before yet, which there's, there's a guess. There's a little hint there. I've never opened the pack before. That should give away something because you guys might figure it out.  If I've never opened it before, that gives you a big hint into what it is. Now put your guesses in the comments, see if you can get it right before you see what it is. So I think this could be it. Let's see. Maybe it's not. I don't know. Okay. Yeah. I think this could be it. So first one. Okay. I did get Zane. I thought I got Zane. So this is not what I was talking about, but there is some Zane packs. No Chaz. Never mind. Okay. Maybe I didn't buy Zane. Okay. Where did I see Zane recently? Okay. Chaz. The Chaz. I think Chaz and Jaden came out around the same time. That's probably why these are together, but this is not one of them. So I guess he had this store until when like Chaz and Jaden probably came out late 2000s, some like 2008 or some 2009. No GX. GX lasted till 2008 till 2009. So maybe they did come out a little bit before that. The Chaz first ed, 30 packs for box six, 3rd for pack. Looks like we have, you know, about half of them, a little bit more than that. Very cool. Open box. Very awesome. That's all that was in this one though. There are more packs. So we're getting to the ones I haven't opened. Not these. We have Rise of Destiny first ed. We've opened plenty of those, but very cool packs. Rise of Destiny. Maybe we'll get an Ulti out of there. Let's just skip the ones I haven't opened. Let's go to Invasion of Chaos Unlimited. We have a few packs of those. One, two, three, four, five, six, seven, eight. So those are original prints. So maybe we can get the CED, BLS, something like that. Unlimited. That'd be pretty amazing. Here are the ones that I've never opened. Or at least some of these. Big hint. What's the big hint? I've opened every TCG pack before. I've never opened some of these OCG. So Booster Chronicle. Don't know if I've ever opened Booster Chronicle. We have several of these packs. So we're talking Japanese OCG old school packs right there. Booster Chronicle. That's not it. We have Pharaoh Servant. This, I'm like pretty sure I've never opened Pharaoh Servant. We did open Thousand Eyes Bible. You'll check that video out if you haven't seen it. We talked about how, you know, the TCG sets are like combinations of two Japanese sets a lot of the time. Pharaoh Servant and Thousand Eyes Bible made Pharaoh Servant. I believe I'm right about that. So three, six, eight, so eight of those. So they have like half the Pharaoh Servant set in there. And speaking of Thousand Eyes Bible, I have opened these because I've opened a Booster Box. But remember how hard it was to pull foils out of there. So if I do open these, I probably am expecting nothing because we open a box. It's got like three total foils. So it's very hard to pull stuff. But if you do get that Ulti Thousand Eyes, it'd be pretty amazing. Okay, I'm going to save those for last. We have a Labyrinth of Nightmare OCG pack. So L-O-N. I mean, that is so cool because like Labyrinth of Nightmare, we got in TCG, but this is like half of the set in there in Labyrinth of Nightmare. Then Magic Ruler in the OCG and then Metal Raiders. We have open Metal Raiders. We have a whole box of that. Go check that one out. Pulled a little, few more foils in that one, but Magic Ruler, Metal Raiders, Labyrinth of Nightmare, Pharaoh Servant, all the TCG sets in the OCG version. It's pretty awesome. And then finally, you might have been thinking, maybe he got them. I did. Spell of Mask. These were by far the most expensive of the Japanese ones because if you don't know, these contain potentially the Ultimate Rare Blue Eyes, White Dragon, which I have the PSA 10. You guys have seen it on the PSA videos. We'll try to pop it up on the screen. But yeah, this is a really awesome, awesome card that you could potentially get out of here. So these were really expensive, by the way. So hopefully we're probably going to be opening those in a video. All right, that's on it. We have one more box. I try to remember what else was in here, but there was something. All right, one more box that I got to open up and see what is inside. But so far, I mean, some amazing, amazing items that are going to be super fun to open on the channel. Some will be open. Some will be for sale on ruxen34.com. So go check it out. Those Japanese packs are probably going to get open on the channel. Oh, we got. Oh, no. Oh, I forgot about this. I forgot about this. This is one of the biggest things we got. Okay. First of all, we have first ed invasion of chaos, $3.75 per pack. So can you imagine that first invasion? By the way, this is not completely full. There are five packs inside. So five packs. He actually said he weighed these. So I don't know like with what he weighed, but he said one of them was heavy. I don't know. It's hard to really tell if you don't have a box, but I guess it was heavier than the others. I think that was the only one he weighed was invasion of chaos because it was first ed. So there should be one heavy pack in there and some light packs. So because these are already weighed, I might weigh out that heavy pack myself. And then if you are interested in a light pack, I'll have four of those. So we'll see if it checks out with what he said, but very, very cool. At least one invasion of chaos pack will be open. Hopefully it's heavy and has CED in it. It's out of a 24 pack box. So it could be the right, or it has to be the right secret. Nevermind.  What? What? Invade. This is only 24 pack. Wait, let's check the, check the code. Okay. That's the code. I don't know this one off the top of my head. So we'll see if that's a CED box or not. I don't know why I was saying invasion of chaos on a 36 pack box because they stopped right before invasion of chaos. The 10th set, the ninth set DCR did have a 36. So I stopped right there. Okay. We have, what is this? LOD with a few packs inside. So these are unlimited again. So they had a lot of LOD, which you know, LOD was printed a lot more than some of those other ones. So this was only 50 cents less for LOD. So I'm definitely picking up those if I was around back then for sure. All right. We have two more. One is pharaonic guardian unlimited, which there are several packs inside. I'm not going to go. Oh, there they are. Just yeah, probably like 12 packs or something like that. I don't remember the number, but 350. So that's okay. Interesting. They're about 25 cents difference. And finally one. I don't know. I don't know how I forgot about this magician's force. So this is opened obviously, but there are 24 packs inside. This is a full unlimited magician's force box. Basically. I don't know if they were mixed from other boxes or anything like that as possible, but this seems like it was opened up and none of the packs forever sold. So because this does have a 36 pack box, if these are all from this box, get a good chance at the DMG out of one of these packs. So I'm super excited about this. We will definitely be opening all of these on the channel at some point. So MFC coming up in the future, very exciting. And we're not just going to leave this video without opening a couple packs. So let me grab a few. All right. And because I know you guys love the GX stuff, we'll open a couple of dualist pack. We'll open a couple of these original invasion chaos, and then we'll open a first ed rise of destiny. That's where we're going to open up for this video. There's a lot of cool stuff in this video that will be open in the future. And if you are interested in some of it, some of it will be on ruxon34.com. So go check out my website. All right now. There's a lot of good stuff available. Let's see if we can get out of chess Princeton. What's going on? Chess. The chess. We have Z metal tank. Jamashrio. Okay. No foil yet. VW tiger catapults. So no foil in that one. That's okay. Why dragon head? We got a Z metal tank of V tiger jet and a Y dragon head. The V, Y and Z. All we need is X and then the W, I guess. But and then we got the VW or the VW tiger catapult. Not bad. All right. We got some stuff there. Let's see if Jaden can top us with an ultra rare. Here we go. Jaden, Yuki, the econ enemy controller. Let's see. Is it the first card? Nope. Bubble man. All right. Very cool. Fusing sage fusion saga and the thunder giant. So we both got fusions on the third card. They're both rare. So dark catapulter. I mean, thunder giant's pretty awesome. Back in the day, if you got this, you're pretty popular. You're like elemental heroes. They're awesome. They suck, but they're awesome. You probably didn't know back then. You probably thought they were good. Okay. Let's try IOC unlimited. I really want CED, BLS or Demok. Any of those in original, if they're centered, we're going to grade them. Even though they're unlimited, we would still send them in. See what we can get. All right. As long as they're centered, because if they're not centered, unlimited, not worth it. One, two, three, four. Let's see. Amphibious bug Roth, MK three. That's amazing. Ryu Koki. Also a great card. Gale is hard. DD borderline. Soltigre, 2100 defense. The soul of a tiger that is said to devour human souls. He is a famous soul that you wouldn't want to run into a dark alley. One into in a dark alley. That's a little bit tongue twister right there. One into in a dark alley. We have a manju at the 10,000 ants. Another problem is I can't see. It's too small. I'm getting old. Can't see what I, what I'm reading. Grin maju day eyes. That makes it a little bit hard. And we have Lekunga. All right. Lekunga. All right. Lekunga. Yeah. I see you. Not great. Rise of destiny. First edition. Let's see if we could pull something amazing. One, two, three, four. Ultimate rare, please. We have Harpy lady. Not one, not two. Number three. Mogi Mogi King, the king of the Mogi Mogi's. Furik is on. Eagle eye. Raging flame sprite. Zingsen Hu. Mirage Dragoon. Rock from the valley of haze. And we have serial spells. So we are starting it off nice and slow. We've got an invasion of chaos. Unlimited. Here we go. Here we go. IOC. One, two, three, four. Last pack magic. We have cannonball, spear, shellfish. Let me know in the comments. Will we pull something right here? DD borderline.  Democ. CD would be the best in original print. Special class. We have Ojama yellow. Griffin's feather duster. Inferno. Don't forget to check out ruxon34.com and make sure you subscribe to the channel if you've enjoyed the video so far. Roganian DNA transplant. And here we go. Final card drop jammer. All right. It's a foil. These days, getting loose packs, pulling any foil. I mean, I cannot complain. So that is a beautiful looking card. I'm not going to lie. A little bit of scuffing on the back, but not too bad. Beautiful trap jammer.  I'm going to use traps.  So that was the plan back in the day. Worked out pretty good on the playground. All right. That was fun. You guys will see a lot of these in future videos. So look forward to it. Shout out to ToFoShow, Puffins, Zudum, Ernesto, Dan, America, Deutcher, KK Beats, another side show, Ian Moos, your junior branding, Robert F. Thomas, Elaine Changelang, and Al Delso, Galicia Jr. Thank you guys for supporting the channel. And I'll see you guys in the next one. Peace.


Hi guys, how are you doing? This is Rich from Rich TV Live. We are 20 days 15 hours 42 minutes and 20 seconds away from history and You can see all the winners that are in the green right now Puff Ventures leading the way PUF up 42% and everything is strong by strong by strong by strong by strong by strong by so ALEF as well just Consistently going up every day up over 400% since I did my video in April strong by strong by strong by strong by up another 13% today. So your boy, Rich has got all the winners. We got our Thumb on the Pulse every day and I wanted to bring you this big news. Okay, so the horizons ETF completes rebalances of its marijuana focused ETF horizons ETF management Canada has completed the quarterly rebalance of the Constituent holdings of the horizons marijuana life sciences ETF otherwise known as HMMJ on the TS TSX and the horizons emerging growers ETF HMGR otherwise known as NEO on the NEO exchange. So HMMJ on the TSX H LMSF in America and HMJ are so if we took it HMMJ and we look at all the new stocks that have been added Bam ALEF one of the hottest stocks in the universe has just been added Chuma holdings another one that I love and I've owned in the past and made money on CHO Oh has just been added Eve one that I bought yesterday EVE has just been added GTech GTEC has just been added huge one that has been on fire HUGE has just been added James E. Wagner cultivation JWCA. I don't own it yet, but I want it has just been added now Mastay Technologies, which has been in the news a lot lately and has just been added in Diva I did a video on them a couple days ago and DVA has just been added and Tilray TLRY has just been added now. Let's look at HMJ are They have just added ALEF as well. So ALF has been added to two To ETFs, that's right Look at ASNT maybe a new one to add to your watch list true has also added to this one CSI maybe another one for you to add to your watch list once again James E. Wagner JWCA Chiron life sciences. I brought you their IPO first khrn Maple Leaf Green World MGW has been doing well lately. They've been added north 48 North cannabis one that I really like NRTH has been added and Planet 13 holdings PLTH has been added Seneva been going down lately on some low revenues SNN has been added Sproutly SPR hasn't done great since its IPO has been added and Sun SUN has been added, but look who they've removed. They've removed Ken CANN Crespo CPH and the hydroponics company THC So if you own those three, I'd be careful. Okay, two of them are Australian stocks Don't know what that means, but this is the new rebalancing of the ETFs the horizon ETF and the HMJ are ETFs, let's just read a little bit about this Right here horizon ETF management Horizons ETF management Canada Inc is an innovative financial services company and offers one of the largest suites of exchange traded funds in Canada The horizon ETF product family includes a broadly diversified range of solutions for investors of all experience levels To meet their investment objectives in a variety of market conditions horizon ETFs has more than 11 billion of assets under management and 83 ETFs listed on major Canadian stock exchanges. Wow Horizons ETF management Canada Inc is a member of the Murray asset global investment group What do you think about these news? Are you watching these picks? Do you own some of these picks? Some of these picks will explode ALEF is the first to explode on this list other than Tilray obviously Tilray's been enormous But ALEF has been on fire. What do you think about the rebalancing? If you like this video smash the like button comment down below Let me know what you think do you own any of these stocks? Are you watching any of these stocks? Are any of these stocks on your watch list? Are they on your radar? What do you think? Remember rich TV live is strictly for education entertainment purposes. We are not licensed advisors always do your due diligence Always do your research before you invest in anything that we talk about here on rich TV live Now if you want to find out all the tools we use just hover over stocks go to www.richTVlive.com hover over stocks all the tools are right there you need news Bam all the news is right there. You want sports? Bam all the sports are right there You want to know about rich TV live hit on a boat? You want to contact us? You want to follow our group chat join our group chat join our discord join us on YouTube follow us on Instagram Listen to our podcast follow us on Facebook. We are everywhere and we are growing fast It's true and we are 20 days 15 hours 36 minutes and 57 seconds away from history This is your boy rich. If you're not winning. You're not watching. What do you think about this news? The rebalancing of The ETFs marijuana focused ETFs horizon exchange traded funds. I'm out. Peace


This is the VOA Special English Economics Report. The United States, the European Union and Japan have called for talks with China under the dispute settlement system of the World Trade Organization. They want to discuss China's export limits on rare earth metals and two other minerals. WTO rules give talks 60 days to work. If they do not settle the dispute, a WTO panel can then be requested to help reach a settlement. Rare earth metals are used in the manufacture of almost every high technology device. From mobile phones and computers to batteries for electric cars. And demand is only growing. China says it follows WTO rules in exporting the minerals. In 2010, China mined about 130,000 metric tons of rare earth metals. That was about 97% of world production. But information from China's government and the United States Geological Survey shows that China has reduced its export limits sharply in the past two years. Critics say this unfairly helps Chinese companies in the production of high technology products. And they say it is a violation of World Trade Organization rules. President Obama explained why the United States was involved in the case. He said American manufacturers use rare earth materials to make high tech products like advanced batteries. We want our companies building those products right here in America, he said. To do that, they need access to materials that China supplies. In the President's words, if China would simply let the market work on its own, we'd have no objections. But he said Chinese policies go against the very rules that China agreed to follow. China says it has restricted rare earth exports to meet needs at home. And it says its policy helps limit the environmental damage caused by over mining. China now faces a slowing economy. In February, the nation had its biggest trade deficit in 10 years. Experts expect China's central bank to increase the money supply to aid economic growth. At the same time, inflation remains a threat. On March 14th, Premier Wen Jiabao discussed the need for reform. China, in his words, must continue to strike a balance between maintaining steady and robust economic development, making economic structural adjustments, and managing inflationary expectations. For VOA Special English, I'm Alex Villareal. Get more business news and learn English at voaspecialenglish.com.


Hello everyone. Today we will see the break. I am Sachin Rathore working as an assistant professor in Mechanical Engineering department from Walton Institute of Technology, Solemn. The learning outcome of this session is student will able to understand working of single block or shoe break. Generally the breaks is a device which is used to bring to rest a body which is in the motion or to hold the body in the state of rest or of uniform motion against a action of external force. Means if any kind of the rotating system is there, so we can stop by using the break. So break is a very important term in a mechanical engineering. The types of break, first one the hydraulic break. So hydraulic breaks we will observe in pump or hydrodynamic break and fluid agitator. So generally the hydraulic energy is used to stop the rotating system. So for that case we can call hydraulic break. Second type is electric break. So in that we will observe the examples of generators and AD current break. So electric energy we are using for stopping the rotating system. And the third one is mechanical break. So the mechanical breaks in which the mechanical energy we are using for stopping the rotating system. So generally if we can take the consideration of the any systems like how are the car break is a example of mechanical break. So in that the classification of mechanical breaks. So first one is single block or shoe break. Second one simple band break. Third one differential band break. Fourth one band and block break. And fifth one internal expanding break. So we will see all these five types one by one. So first one single block or shoe break. So this is a schematic diagram of single block or shoe break in which one lever is there which is pivoted at point O that is called as a fulcrum O. And on that lever the shoe or the block is mounted rigidly and our rotating wheel is there. That is also called as a drum. So when the drum will get rotated in clockwise or anti-clockwise direction at the times when we want to stop the rotating wheel where apply the force at one end of the lever by an amount of P in a downward direction then there is a friction wheel occurs in between block and the wheel and the wheel get stopped. So this is a working of single block or shoe break. So you can think about this what are the applications of shoe break. So generally the shoe breaks we will observe in case of or the bicycle break or we can see the train for stopping the train on that the train wheels we are using the shoe break. So this is a bicycle breaks. So such kind of the break is called as single block or shoe break. So we will see what is the working of this single block or shoe break. This is a rotating drum on which when we are applying the force of the shoe and this shoe is attached by using the lever. It is pivoted at point O it is also called as a lever end on which we are applying the force P in the downward direction. Suppose the length of the lever is L and the center of this wheel distance from fulcrum to the center of the wheel is A. This is a block which is rigidly fixed to this lever when we are applying the force P in the downward direction at one end of the lever then there is a friction awkward between this rotating wheel and this block. The angle of this blocks is 2 theta and R is radius of this wheel. This is a wheel or drum. This is a lever. So we will see how the forces are acting on this wheel. So if suppose the wheel is rotating in clockwise direction. So at that time the normal reactions from this block to the wheel is acting in a downward direction and the frictional force if it is rotated in the clockwise direction the frictional force will act like this. So this is our the normal reaction R and on the wheel and the frictional force f is equal to mu R and this is a free body diagram of wheel. So what are the friction will occurs that occurs on this block or the shoe because the material of the shoe or the block is softer than that of the wheel. So we will draw the free body diagram of block. This is our the block and here the lever is there. So on this block as on the wheel the normal reaction is acting vertically downward direction. So the normal reactions occurs on the block or the shoe it is acting in a upward direction and the frictional force is opposite of this frictional force it is acting in this direction that is the f is equal to mu Rn. So like this forces are acting on this block. So we have to calculate the value of Rn because what are the amount of the friction will occurs that will occurs on this block. So for designing purpose we should know how much amount of the friction will occurs. So for finding the value of Tb, Tb is nothing but the breaking torque. So the breaking torque is nothing but the frictional force f into radius of wheel and this frictional force f is equal to mu Rn into the R. Therefore Tb is equal to mu Rn into the radius of the wheel. So by using this equation we can easily calculate the value of breaking torque. So here the important term is Rn. So our task is to calculate the value of normal reaction Rn. So for calculating the normal reaction there are two cases. So first one your the drum will get rotated in the clock way direction or your drum will get rotated in the anti clock way direction. So respective through that our the direction of frictional force will acting in this direction or in this direction. So we will see that in the next session and the second thing is that the position of fulcrum. So in this case, the position of the fulcrum it may lie along the line of the friction. So this is the line of the friction of frictional force. So this is a frictional winding force. So if the drum will get rotates in the clock way direction the frictional force will acts in that direction and if your drum will get rotates in the anti clock the frictional force acts in this direction. So, the position of the fulcrum it may be the line along the line of the action of the frictional force at this position or the fulcrum O it is acting below the line of the action of the frictional force by an amount A or the position of the fulcrum is acting at this position that is above the distance from the line of the frictional force. So, these cases also we have to see in the next session. So, these are my references. Thank you.


Loc Mayecki is a stone age site in northwest France, distinguished by its two large stone tombs and massive granite standing stones of Mejir. The monumental structure, all built within meters of each other, were built in the 5th millennium BC and are amongst the most impressive Neolithic monuments anywhere. The huge igneous stone monolith known as the Grand Menhir was a single piece of granite 20 meters tall and over 280 tons in weight. The engineering skills employed to move and erect such a massive stone are impressive, especially as the nearest source of stone was 10 miles away. The Menhir was carefully positioned, probably using earth ramps, at the end of an alignment of 18 interlocking stones, now destroyed but indicated at the site today. The large stone tomb known as the Tablet Diss Marcheau was constructed around 4000 BC. The monument's name, Table of Marcheau, derives from the huge stone slab incorporated into the roof of the interior chamber, which measures 31 inches thick. The construction is unbelievably similar to the houses of Orkney and most notably on Easter Island, and perhaps these were in fact types of bunkers to shield the earthling of the day from the synchronic radiation, and perhaps the enormous stone slab was to act as a blinder, but what do you guys think about this anyway? Comments below and as always, thank you for watching.


Currently we're at Wask, Poland and we're primarily here to execute enhanced air policing as part of a larger NATO effort to help secure the Allied borders in this region. We have aircraft sitting alert. As soon as we receive a launch notice we get our aircraft airborne and we're looking to first secure the borders and then intercept any aircraft that possibly might be trespassing into NATO airspace.


Good morning to everybody want to welcome you to our annual global ophthalmology grand rounds. It's really a pleasure to be here today to introduce our speakers to you but I'm going to turn over our introductions for our first speaker over to Dr. Emmy Hartnett. I just want to let you know that exciting things are happening in global outreach. We're just starting to gear up back again with some of our international works we're excited about that. But there'll be a flurry of activity throughout the academic year that we're just so excited to share with you all as a year progresses and there's always room for engagement and for involvement for everybody at every single level. So this time I'd like to ask Dr. Hartnett to come up and introduce our first speaker who we've been privileged to have here for the past year. Good morning everyone. Thank you for being here. So it's a great pleasure to introduce Maria Margarita Parra who is going to speak to you today and I think many of you already know her and they have helped her with her first time seeing snow and also in skiing here in Utah. So she completed a residency in ophthalmology at the Ophthalmologic Foundation of Sandhander in Bukamuranga and then a two year medical surgical fellowship in retina and vitreous at the same institution. And in about about two years ago she contacted me to ask to do a pediatric retina observership because her country wanted her to come back and start the first pediatric retina center in Columbia. And so with the support of Dr. Olson and the now late Dr. Crandall, we created an observership for her and she's done very well. She's worked here and also at Primary Children's and she's received an Academy of Ophthalmology award. She's also attended the Academy and Arvo presenting and she's submitted three papers already with several in publication. She is recruited to join the academic program as a faculty member for the residency programs in ophthalmology and retina and vitreous fellowship at the University of Val del Calco in Cali, Columbia. And her goals for future include teaching research and clinical care. So she will tell you about one of the conditions that she's been studying retinopathy prematurity and about it in Columbia. Thank you. Thank you, Dr. Harnett for that great introduction. So good morning everyone. Thank you so much. It's a honor for me to present today at Grand Rouse this project that was developed in my country. We are going to talk about a prevalence of retinopathy of prematurity in my country, Columbia. So thanks to the co-authors who collaborated with the development of this project. The presentation or the results of this project were presented at the last Arvo meeting in 2022 in Denver, Colorado. Preventivity is a problem that is has been increasing over time and affects children around the world, especially in developing countries and in Latin America and the Caribbean. Retinopathy of prematurity is one of the leading causes of childhood blindness in Latin America and the Caribbean. And when we compare the impact of retinopathy of prematurity in high income countries with the Latin America and the Caribbean. We observe that the number of the babies that survive and have ROP can in high income countries, they can have better outcomes of visual acuity compared to Latin America and the Caribbean. So in other words, in Latin America, the probability of getting blind from retinopathy of prematurity is higher compared to high income countries. This is my country, Columbia located in South America. And as we can observe in this graph, we can observe how over the time, what is the behavior of the number of light births over time since 2007 to 2016. So as we can observe in this graph, the number of light births have been decreasing. But if we observe the blue line, what we see is that the blue line that corresponds to the percentage of ROP over time. It's actually has presented a sustained increase during the last five years, which can correspond to temperature babies for every 1000 light births. In Columbia right now, or to this date, we just have two studies that have been published about the epidemiology of this disease in the country. They have reported the prevalence of ROP at 7.7% to 18.2%. Actually, little is known about the epidemiology of retinopathy of prematurity in Columbia. And that's why we want decided to do this study in order to know more about the epidemiology of this problem in my country. So the objective of this study was to report the mean gestational age, the birth weight, and the risk factors associated to development of ROP in three different centers for three different cities from my country. Columbia is a country that has 50.88 million of inhabitants. And we already have 182 new native intensive care units around the country. Those NICUs are located in 23 of the 32 states of Columbia, and they are mostly located in the center of the country and on the west coast, as we can observe in this picture. This was a retrospective study, and we collected data from charts, from babies that were screened from 2010 and 2020 in three different cities of the country, Bucaramanga, Medellin, and Bogota. And the reason we chose those programs is because we have more confidence about the quality of the data from those programs. What were the screening criteria that we took into account for this study? Infants screened at 32 weeks or less of gestational age. Infants with 1500 grams or less of birth weight. And those infants that didn't accomplish those criteria because they were more than 1500 or more than 32 weeks of gestational age, but the neonatologist that was in charge of those babies recommended to do the screening of ROP because they presented risk factors for development of ROP. The evaluation was performed using indirect ophthalmoscopy during the four and six weeks of life. And the diagnosis and severity of the disease was based on the classification of ROP second edition. We didn't use the ICROP3D1 that was published recently because this study was performed before the publication of that one study. What were the variables we took into account for this presentation for this project? The gestational age, birth weight, sex, the presence of ROP, the stage of ROP, the different risk factors associated including supplemental oxygen, pregnancy, bronchopulmonary dysplasia, sepsis, perinatal surgeries, intraventricular hemorrhage, and finally preclamps. This is the statistics we used student T test and she squared test to, sorry, to do the analysis of the data. And also, because we wanted to evaluate the association of risk factors to with the development of ROP, we adjusted the risk factors of the patients with by gestational age by birth weight and severity of ROP. In total, we screened 1691 infants from those 43% were male and 57% were females. The mean gestational age of those screen babies was 32.44 weeks and the mean birth weight was 1,536 grams. The prevalence of retinopathy or prematurity in this study was 17.5% because we found 310 infants with ROP from the whole sample. And they presented a mean gestational age of 28.66 weeks with a mean birth weight of 1,230 grams, sorry. So in this table, we can observe the distribution of infants that presented any kind of ROP according to different groups of birth weight. So what we observe is in this second column is that the number of screened infants, the most common group of patients according to the birth weight was in this row. And the infants that presenting ROP were more likely with birth weight with low birth weight that was less than 1000 grams. In this pie chart, what we can observe is the distribution of the different stages of severity of ROP. And we found that the stage two was the most common in this study. What were the risk factors associated to the development of ROP? When we tried to analyze that and we didn't do an analysis that took into account other variables, we found four different kind of risk factors. But after doing a logistic regression analysis adjusting by birth weight and gestational age, those risk factors got reduced. And finally, adjusting by birth weight, gestational age and severity of ROP, we found that the risk factors associated to the development of ROP in this study were supplemental oxygen and bronchopulmonary dysplasia. The percentage of infants that require treatment of ROP in this study was 13.2%. And in this table, we can observe the distribution of the birth weight according to the type of treatment. So what we found is that younger babies or babies with low birth weight require more treatment than the ones that had more birth weight. And what are the key points of this talk? The percentage of retinopathy or prematurity in this study was 17.5%. In patients with ROP, the mean gestational age was 28.66 weeks with a mean birth weight of 1,230 grams. And the main risk factors to the development of ROP in this study were supplemental oxygen and bronchopulmonary dysplasia. There are some studies in Latin America about the prevalence of retinopathy or ROP. And in this one, we observed that the prevalence of any stage of ROP was considered or was range from 6.6% until 82% according to the country. The requirement or the need to do treatment in ROP in this study in Latin America shows that can be as higher as 23.8%. In contrast to our results in which we found that it was 13%. Also, when we compare the results of this study to countries of high income countries like the United States, we observed that the prevalence of retinopathy or prematurity in this country is less. But also, we can find some similarities, for example, that the peak of frequency of ROP was in the group or in the range of birth weight between 750 grams and 999 grams, which agrees with the same result that we have in our study because we found in our study that small babies had more risk of ROP. On the other hand, the risk factors that can be associated to ROP can be different among the countries. The risk factors in the United States for development of ROP are not the same that occurred in Asia or in Latin America, for example. So in my country, we found that the use of supplemental oxygen and glaucoma meridia dysplasia in this study were the most important risk factors. But here in the United States, the presence of female sex, the gestational age list and 36 weeks and a birth weight less than 2000 grams were risk factors as well. Also, 8.31% of infants require treatment. In our study in Colombia, around 13% require treatment. And if we go back to the other study, the one that evaluated different countries in Latin America, we observed that the treatment warranted ROP was 23.8 cases. So what means is that, of course, there are difference between countries. And the important thing here is try to identify what we can do to act in all those differences to reduce the burden of the disease. What are the future directions? This was a retrospective study. So any kind of retrospective study has limitations. The evolution of ROP was not evaluated in this study. We didn't evaluate how many patients presented reactivation of ROP or progression to more severe stages of ROP like retinal detachment. Also, there are other risk factors that can be implied in the development of ROP or severity. And we, we, those risk factors could have taken into account, maybe in future studies we can do it. For example, the extra uterine growth restriction, fluctuations in oxygen tension and maternal factors, and many other factors that have been identified in the development of ROP and severity of the disease. Finally, this study doesn't show the whole sample of Colombia. We chose the three centers that we consider the best for us, that we consider in which we could find the best availability of information. However, is the best study, I mean, so far is the best study in my country. We just have to. So this is the third one. It's multi-centric. It's the first study multi-centric. And we hope that in the future we can have more research and more studies to understand what is the behavior of retinopathy or prematurity in Colombia and what we can do to work on all those risk factors to reduce the burden of the disease. The conclusions is that the prevalence of retinopathy in Colombia in this study was lower compared to other Latin American countries in which the prevalence is up to 80%, around 20%. The average, the gestational age and low birth weight are risk factors to ROP as reported in the United States. The supplemental oxygen and bronchopulmonary dysplasia are risk factors that can be target of modification or treatment to reduce the prevalence of ROP. So what we have to do or what we might do in our country is to understand that maybe we are using the oxygen incorrectly or maybe we can work on that or study that in order to reduce the number of babies with ROP and their severity. What other future directions do we have? This is Cali, Colombia. So after finishing my program, I'm going to be working in a university hospital, Valle del Calca, at the University of Valle Cali, Colombia, which is this building that we can observe here. This is Cali and I am from Bucaramanga, which is located right here, Bogotá is the capital city and this is the place where I am going to go. My purpose in Colombia is to teach all the things that I have been learning during this time, during this training, and to provide an specialty that we don't have in Colombia so far, which is pediatric retina. So I think that there is a lot of work to do, it's challenging, but I am very excited to provide the opportunity of other people to be trained to learn and to improve maybe in the future, or to make an important impact maybe in the future in our children's side. In addition, training in this institution that provides lots of educative clinic and research opportunity was incredible. I am very grateful for having the opportunity of staying here for almost one year. And also I have to say thank you for providing the support and guidance for me to be, for me to do or receive the best education as possible. So thanks to the outreach division, global outreach division here. Also, I had the opportunity of making new friendships. Thanks again to the residents, fellows and all people that have supported me and helping me here. And for her mentorship and for commitment to my education support and kindness. I had to be very grateful with my professor Dr. Hernet for allowing me to stay here and for being so kind to teach me all this time. All those things have contributed to my academic professional and personal growth, and I am so happy to come back to my, to go back to my country, and face this challenge of starting a new pediatric retina service there. Muchas gracias. I think that's a great question. And in my eyes, I think that is not very high right now compared to previous years. I think most of the population in Colombia is located in the center of the country which we have big cities which we have good hospitals. So, actually, less of the population is living in the jungle or in other areas that are very far from the center of the country, but I would say just 5% of the population would be in that percentage. Thank you so much. Thank you for that question. So, according to the first question. So, how or what, what is the, how easy is to get access to treatment and TVGF laser for us. We do have access to those kind of treatments because we have all those equipments and things that we need. Sometimes it's a little bit difficult because of the health system. Most of the patients are a. Most of the patients have health system insurance health insurance, and they can access to the different different treatments, but sometimes those are delayed. So that is one of the first challenge because we do have the resources we do have to choose the problem is that maybe we need more organization, more administrative work to to to provide those tools to the general population. And according to the second questions about imagine our order imagine imagine results or imagine resources or other kind of tools that I saw here in the United States. And maybe we don't have in my country. We don't have imagine but for sure the United States is leadership in research is leadership in in in innovations, you know. So, right now we are doing the way that we are doing screening of our opinion my country is to is to the clinical way is to do indirect of thermoscopy that's the way that we are doing. We do have red cams we do have imagine actually we have an optos camera in Bogota, but for sure we need more organization in order to provide the possibility of taking those images to the more amount of babies. And it's challenging. Yes. And, but I think that what I have to do is go there and to do an evaluation of the thing of the needs that we have and try to do how can we make it work. And for those 182 NICUs that we have around the country, I would say that just 10 are with a residence program. So, just 10 have a residency program in ophthalmology training there. And what don't have like a direct coverage for an ophthalmologist. So what we have to do is to send an ophthalmology to send a person that is trained in ROP to screen those places, because, because it's not like that we don't have enough time to service all the time. Yeah. Thank you. All right, we're going to transition a little bit. Many of you have not met Nate Gephard. He's our current global outreach fellow. He's currently on assignment in Mwanza, Tanzania. We're going to be we've, I think pre recorded his talk, Ethan will be bringing that up to our screen here shortly. And as he's bringing that up and they will be trying to join us for at least q amp a little bit shortly. He's currently doing a FACO training with some attendings there at Pugano Medical Center. But Nate comes to us he finishes medical school in 2012 at the University of Colorado, and went on to Brooklyn for his internship and completing his ophthalmology residency at UC Davis in 2016. Since his graduation from Davis he's been an attending staff at KCI Institute for HSU. And I asked Nate a very simple question you know you've been traveling around the world for a while now. What's your favorite dish? What's your favorite food so far? Was it the momos in Nepal? Was it the Tikka Masala in India? And Nate had a great answer. He basically said that so far his favorite food has been the chicken nuggets at Mwanza Waterpark. So you can tell Nate's a little bit homesick ready to come home. He will be joining us shortly in a week or so he'll be coming back to Utah to take some call and to do some administrative things and to get ready for the second portion of his year in Tanzania. So we're going to go ahead and play his presentation. He'll be speaking on adults for business challenges. Hello and good morning everyone. My name is Nate Gebhardt. I'm the current Moran Global Ophthalmology Fellow and a visiting instructor from KCI Institute at OHSU in Portland, Oregon where I've been on faculty for the past five years. Just to give you a little background about myself, it's been a dream of mine to pursue a global ophthalmology fellowship ever since residency but the stars never really aligned until recently when my department approved a one year sabbatical and I was able to arrange this fellowship with Moran. And I'm so grateful to be a part of the Moran family. This year has been an amazing year and it's taken a lot of planning and preparation and I am indebted to so many people at Moran for helping to make this possible. Namely, Lori McCoy, Jeff Petty, Craig Chaya, Abdul Khalid Wairar, Erika Ruiz and many others. So I just want to thank you all for helping me make my dream a reality. And once again, I'm excited to be with you all this morning in spirit. I'm pre-recording this presentation from Wanzat Tanzania where my family and I are currently residing. So, let's get started. On December 30th, our family of four packed all of our bags and left our home in Hood River, Oregon and set off for Kathmandu, Nepal. We packed everything we would need for this entire year into these six bags and we were off. This is a family photo here on the left. That's my wife Annalisa and my son Silverton who is seven years old and my daughter Louisa who is four. So I'm just going to take you on a little journey to Kathmandu. This is me and the kids sleeping on the plane. This is Kathmandu through the airplane window as we were about to land. And on the right, this is the picture of Nima House in Kathmandu where many, many Moran faculty and fellows and residents have stayed over the years. So here's our first morning in Kathmandu. Me and the kids on the roof of Nima House. And the purpose of starting off this fellowship in Kathmandu, Nepal was to begin with an SICS course at Tilganga Institute of Ophthalmology. It's been a dream of mine for many years to visit Tilganga, the Shangri-La of global ophthalmology. And I was just so grateful to have that opportunity. This is my ID badge on the left which I will probably keep forever as a souvenir. And on the right, this is a picture of me and my Mongolian ophthalmologist friend Baissa who just happened to be finishing his own SICS course as I arrived. So Tilganga is an amazing place. Many Moran faculty have visited Tilganga over the years and many Tilganga faculty have visited Moran. There's been an ongoing partnership and affiliation which has been ongoing and so many of you might recognize some of these faces. These are some of my mentors who helped me with my SICS training. This is Dr. Ben Limbu on the left and Dr. Sagar Ruit on the right who is Sandu Ruit's son. After spending about a week at Tilganga, we went on an outreach trip to Sinduli. Sinduli is a province to the south and east of Kathmandu. It's about an eight or nine hour bus ride. So our family and I joined the Tilganga outreach team, loaded up the bus and we drove over windy mountain passes, forwarded creeks and streams as you can see here in the left hand photo. And we finally made it to Sinduli, specifically a small municipality called Lampantar. And this is where we conducted our outreach. As you can see, the Tilganga team brought all of the surgical equipment and instruments that they would need for the surgical camp. It's a very basic setup with microscope table instrumentation. In the center you can see the small community hospital where we set up the surgical camp. And then on the right, this is us going into the hospital on that first day. So in Sinduli, my two mentors, Dr. Rogita and Dr. Sanjita, were able to mentor me in SICS techniques and also were able to complete over 120 SICS cases themselves. Not only were they teaching me, but they were also doing pretty high volume cataract surgery during those three days. In the pictures here you can see Dr. Rogita and Dr. Sanjita on post op day one checking patient's vision. And in the center we have a picture of the operating theater. And on the right hand side that's me and my family at the end of the camp where we're posing with some gifts that some government officials had given to all of the participants. Here's another picture of me with Dr. Rogita and Dr. Sanjita who were wonderful, wonderful mentors. And just a couple other photos of Sinduli. It's a beautiful, beautiful place, lush green fields, mountains, lots of goats. You can see me posing here with my son in a goat pen. And here's another family photo from that Sinduli trip. After we got back to Kathmandu, Annalisa, my wife, continued homeschooling the kids. You can see her homeschooling here on the roof of Neema House. And here's just a typical picture of the fair at the Tilganga canteen. We really loved our time in Kathmandu. It was very fruitful and productive time for me professionally, but also personally. I experienced a lot of growth and we as a family also got to experience a lot of culture. You can see my daughter and son here at the Swayambuna Temple or the Monkey Temple in Kathmandu. And after one month in Kathmandu, we journeyed to Hattauda, which is about a four to five hour jeep ride to the south of Kathmandu. So we loaded everything up into this jeep, drove over some more mountain passes, and then arrived in Hattauda. You can see this is Hattauda Community Eye Hospital in the center photograph. That's my son on his bike posing in front of the hospital. And on the right hand side, you can see a picture of all of the Autorikshas that zoom up and down the streets. And that's how we would get around town most of the time. So Hattauda Community Eye Hospital is an affiliated hospital of Tilganga. And so they basically operate with a similar philosophy and model. They are committed to outreach and committed to reaching patients in underserved areas. And they do a really good job of reaching those communities. As opposed to Tilganga, Hattauda Community Eye Hospital typically conducts its outreaches without doing the surgery in those locations, but rather they bring the patients by bus back to the Community Eye Hospital for surgery. In this slide, I think I'm posing here with the operating theater staff. And that's Dr. Sunil, who was my principal mentor that month on my right. As I was mentioning, Hattauda Community Eye Hospital does a lot of outreach, just like Tilganga does. This was one of our outreach trips. I'm posing here with Cecile, who is one of the outreach coordinators. And so we screened 100 plus patients and those who were eligible and good candidates for cataract surgery, we transported back to Hattauda where we performed their cataract surgeries. And this was, again, a great opportunity for me to learn from my mentors in the center photo. You can see me being mentored by Dr. Sunil in SICS techniques. And these are the atomic technicians preparing post-op medications and eye patches and taking care of the patients on post-op day one. Okay, so that concludes our journey through Nepal, both in Kathmandu and Hattauda. The next stop was Tanzania. So after spending a month in Hattauda, we took a Jeep back to Kathmandu where I left my wife and two kids at Nima House. And I flew to Tanzania to meet up with Jeff Petty, as pictured here in the center, and the rest of the Morayan global outreach team. On the left-hand side is a photo of Bugando Medical Center, the primary place where we collaborate with our Tanzanian ophthalmology partners. And on the right-hand side is a picture of the FAKO machine that we typically use on these outreach trips, the Ortley cataracts, which I found to be an amazing FAKO machine, which packs a lot of punch for such a small compact and portable machine. So here we are, the Morayan global outreach team with some of our Bugando partners. By the time I arrived in Moansa, Tanzania, where Bugando Medical Center is located, the Morayan team had already been there for a week. Dr. Hoffman had been doing pediatric ophthalmology training week with Dr. Everista, the pediatric ophthalmologist at Bugando. So I joined the rest of the Morayan team for the second week, where we primarily focused on cataract surgery. And as shown here, the Morayan team worked in collaboration with our Tanzanian ophthalmologist partners to conduct this program and to screen patients for cataract surgery and to perform their cataract surgeries this week. A couple more photos of our partners at Bugando. And this is Dr. Christopher Mwanansao. He's the head of the ophthalmology department at Bugando Medical Center in Moansa. And he's such a wonderful person and physician. He really is the person who facilitates these Morayan outreach trips to Bugando. And he's been an amazing partner for Morayan. And I now count him as a dear friend. And after the Morayan team left, I stayed behind for a few days looking for housing for my family and looking at different schools that my kids could attend for when we would return. And Dr. Christopher and his family had me over for dinner, so we are here posing outside of his house the afternoon they had me over for dinner. All of the department staff are such wonderful people and Morayan is so lucky to have such a wonderful group of people at Bugando as collaborators and partners. I felt very privileged and very honored to have had the opportunity to work with all of them. So after our Morayan outreach trip in Tanzania, I flew back to Kathmandu where my wife and kids were waiting and we bid farewell to our Nepali friends. This is Nima and Pemba, the owners and operators of Nima House, who many of you may recognize. That's my daughter posing with them. This is Krishna in the center photograph presenting me with my SICS certificate from Tilganga and then me and the kids touring some temples on the right. And then the last week of March, it was time to pack our bags again and we were off to India. So here are a few photos of my wife and kids at the airport. And here's my son Silverton learning his Indian geography. He's pointing to Madurai in the southern Indian state of Tamil Nadu where we would spend the next month at Aravind Eye Hospital, who I'm sure all of you are very familiar with. So this was where we would spend the month of April. Aravind, as I'm sure you all know, has for many decades been an epicenter of global ophthalmology and they've done pioneering and groundbreaking work in global ophthalmology outreach and in reaching underserved and marginalized communities and providing them access to high quality and affordable cataract surgery and other ophthalmic care. It's also been a dream of mine for many years to visit Aravind and I was so grateful to our Moran partners and our Aravind partners for helping to facilitate this and make it happen. On the left-hand side, I'm standing with my SICS mentor at Aravind, Dr. Avatesh and Dr. Jena, who is the current Global Ophthalmology Fellow at the Seva Foundation in San Francisco. We just happened to coincide the same month for our SICS courses and that's my daughter there as well. So Aravind is famous for its outreach as I'm sure most of you know. We had the opportunity to go on several outreach trips, visit several vision centers and to visit one of Aravind's secondary hospitals that they're building. Aravind these days is a vast network of multiple hospitals, secondary hospitals, vision centers and a very well-oiled machine of outreach programs that basically covers all of Tamil Nadu and other parts of South India. So this is one of the outreach trips where all these patients are seated on the left-hand photo, screening patients in the center photo and then that's just me standing in front of the Aravind Eye Hospital original building in Madurai. So we did have time for a few family field trips. I've never worked so hard in my life as I did at Aravind. In India they just work so hard. It's a six-day work week from dawn to dusk and so often I felt like I was neglecting my family duties and responsibilities as I was training at Aravind but we still did manage to have some family fun. This is my daughter and my wife Annalisa on the left at the Chittirai Festival which is the big festival in April in Madurai. In the center this is us I think posing in an auto rickshaw and then on the right-hand side it's my two kids in front of the famous Minakshi temple in Madurai. So the SICS course at Aravind was also just an excellent training experience. This is Dr. Madhu Shikhar presenting me my certificate at the end of the course. Aravind has SICS training down to a science. They have surgical simulators. They have goat eyes every single day in the wet lab for their trainees. They have surgical mentors and almost daily training cases. And so by the end of the four weeks at Aravind both Dr. Jen and I were feeling much more comfortable and much more confident in our SICS skill set. As you can see here on the left this is me at the Help Me See surgical simulator and a couple more random photos. That's me and Dr. Shankar at his coconut farm. He supplies coconuts for the hospital and this is on the right-hand side during the Chittirai Festival. All right so where are we now? My wife and kids and I are now back in Moonset Tanzania and I'm currently working with our Bugondo partners and Lori McCoy on enhancing the efficiency and the quality of care in the clinic and surgical theater. Lori McCoy was here for about two weeks and just recently left and did a lot of work helping to streamline their clinics and to help them prepare for moving into their new building. Now one of the other things that we have started doing is phase one of our FACO training with Dr. Wan and Sao. So Dr. Wan and Sao the head of the department does have some background in FACO. In their new building they will have a FACO machine. It's in the storage room ready to be used as soon as they move in. And so one of the primary objectives of me being here several times this year and for my extended stay later this year is to help Dr. Wan and Sao and Dr. Everista along in their FACO training. And I'm really excited about this and I'm excited about the skills exchange that will be taking place and already has taken place. I've learned so much from them surgically and clinically. They are masters of SICS and so I've been learning so much in terms of SICS. Another ophthalmic surgery and I'm happy to play a small role in helping them to become more proficient FACO surgeons. So fellowship goals and plans. So for the remainder of the seven months of my fellowship we've got quite a bit planned. I'm going to be participating in some of the Navajo Nation outreach trips I think with Dr. Chaya and Petty. We have the Global Ophthalmology Summit in Park City in August. As I said earlier from August to December I'll be going back to Mwanza with my family. And we'll be staying there for an extended stay to really work with our partners in a longitudinal FACO course and also working on different research projects and skills exchange. Also we'll be helping them facilitate the move into their new building and hopefully getting their new FACO machine and operating theater up and running. Obviously I'm excited to continue my education in global ophthalmology. I'm really interested in social determinants of health and barriers to healthcare, particularly in ophthalmology. I've already learned so much from Tilganga and Arvind and from our partners at Bugando of how healthcare systems can deliver eye care to under-resourced and under-served areas. And it's just been an amazing education and I feel so grateful to have had this opportunity to work with these partners and learn from them. Next point, I have finished two SICS courses, one at Tilganga and one at Arvind and I hope to continue to hone my SICS skills throughout this coming year working in Tanzania. And also hope to pursue some additional collaborations with some of our other partners in Mongolia and possibly American Samoa and Micronesia. And last but not least, my post fellowship goals and plans. I'll be returning to Casey in January of 2023 after I conclude my fellowship. And when I return, I plan to continue working with Mitch Brinks, who many of you probably know. He's done a lot of global ophthalmology work over the years and particularly in the South Pacific. And I hope to pursue additional collaborations and potential synergies between Casey and Moran and global ophthalmology outreach work. I would love to continue to support our Moran partners in Tanzania, Mongolia and elsewhere. It's been a pleasure being with you this morning in spirit. And if any of you have any questions, I will try to call in. And thank you very much for your time. Appreciate it. Looks like Nate just logged on. So we've just a few minutes later. Wow, that was good timing. I just barely logged in. Awesome. Perfect timing. Well, we've got just hear me. Yes. Here you date. Hear us. I'm sorry, what was that Craig? Okay, I was just wanting to making sure that you could hear us but we've got just a few minutes just finished up your presentation. I apologize. I had introduced you as talking about strobe business. I was questioning that my mind, if you're really going to be talking about strobe business, but business I heard. Maybe maybe you could just entertain if you question any questions from the audience here. Sure, happy to answer any questions. Are things going for you there so far. Great. This is my second time here in Tanzania. This year and the second time. It's been about four weeks now and we have gotten our FACO training of Dr. one and so underway. We just finished a couple of cases this evening. And so we're still in the OR. So we're going to be able to see our last patient and see if we can get discharged our last patient. Let me see if I can get some video. Maybe you can see me and Dr. one and so here. Is anyone able to see the video or no. Yeah, we can see. So there's Dr. One and so. Here's Dr. Salima. Our staff. You've had a busy earliest part of your fellowship so far. We're thrilled to have you come back for a short period of time so we can reconnect and regroup for the second half of your year. But thank you so much for presenting your tour so far and the impact that you've had in different locations. So we'll reconnect when you come back to Salt Lake. I appreciate your time. Yeah. Absolutely. Thank you. Looking forward to seeing you all in in a couple of weeks. Good. Thank you everybody for attending. Good morning. Thank you.


In our previous video, Dr. Randy Anderson walked us through the biology of weed seed survival in no-till and conventional tilled conditions. And in this video, Dr. Anderson takes this biology and shows how it actually works in real life based on one of his three-year studies. And so what we did is we went out to a field, let the weed seeds that were produced in that growing season dropped to the ground surface, and then we imposed two treatments. One was no-till, and the other was tilled, and our tillage was like cultivating. In other words, it wasn't plowing, it was just blading and putting the seeds somewhere between one and four inches in the soil. We then monitored the seedling emergence over several growing seasons afterwards to try to get a sense of the trend that's occurring with no-till versus till and the placement of seeds and soil. So in this study, what we did is we established quadrats. We went out and counted the seedlings every week, and after counting, we would pull the seedlings and then allow the new seedlings to come. We counted these quadrats for every week of the growing season for three years, and that gave us a sense of the trend that occurs when we compare no-till versus till. If you look at this graph here, I'm showing here seedlings as percentage, the reason being is we had four studies plus several reps, so we just averaged over everything. So these were four sites, and then there were reps within each site as well, we got it. And I have the growing season here, one, two and three, so like this number one, this one hundred value would be from this quadrat, every seedling that emerged for every week during the growing season, we just kept totaling it and then expressed it as a percentage. The yellow bar is the till treatments. We tilled once each year, it's basically to replace the seeds into soil, and then we had no-till, and that would be the white bar. First thing I'd like you to notice with time, the number of seedlings decline. In other words, around 100% here, here we're around 20%. So that shows you the benefit you can gain from having diversity of life cycles in your rotation. The second point I'd like you to consider is the difference between the two bars. So in the first growing season, this yellow bar which is tilled, we had a hundred seedlings, we had 88 and no-till. So for a management perspective, that's really no benefit at all, they're about the same density. In the second growing season, we got 48 seedlings in the till, we got 32 in the no-till. We're starting to see some difference here. If you look at year number three, when we had 33 seedlings in the till, we had only four. In other words, this difference is an eight-fold difference in year number three, while here we had no difference. The key point is no-till is a benefit for weed management, but it takes time. Wow, just in case you missed that, this is an eight-fold difference in only three years. Pretty amazing. Yes, and to repeat Dr. Anderson, the key point is that no-till benefits in weed management accrue over time, and in this case, it was over a three-year period. So how do we tap into this time element of no-till? Stay tuned, because that's exactly the subject of our next video. See you soon.