Hello friends welcome to today's video where we're going to show you all the details for how to get infinite items in Brilliant Diamond and Shining Pearl. Earlier in the week we already went over the new 1.1.2 cloning glitch that allowed you to get the menu glitch up and do all of that fun stuff that was patched out in 1.1.1 and now we're going a little bit step further in today's guide and show you how you can get infinite items in Brilliant Diamond and Shining Pearl using a similar process that we've already covered so without further ado let's hop into game be easier to go over all the details and show you exactly how to do it. So the items that this is relevant to are going to be anything in your bag you're going to need a minimum of one item to do this this method with but you can have multiples of items that will definitely speed the whole process up especially if you are leveling your Pokemon up you're going to need probably about 99 rare candies that's the maximum you would need you may want a hundred just to have one extra in case this goes wrong but I'm sure it won't but just in any case about 99 rare candies will make this process as fast as possible especially for leveling up. Other items that you're going to want to probably use are things like PP Ups things like ability patches that you can get from the battle zone and vitamins as well if you have about 26 vitamins then you can use that 26 infinite number of times to just max out EVs on Pokemon and EV train things super quickly the same can be said for the EV reducing berries if you can just get 26 of those EV reducing berries in each single one then you're going to be able to reduce the EVs of your Pokemon really easily and not lose any berries or have to plant anymore anything like that so this method can be applied to a multiple number of items and is super super easy to set up so how to do it is what we want to be doing is standing outside a Pokemon Center you want your poker catch app open and you want to be hovering your icon over fly and then hitting A and L on your controller and then just kind of spam this over and over until the map appears like this then once it does you're still going to be able to control your character while the maps up so you want to just head inside the Pokemon Center once you're in the Pokemon Center you want to go up two spaces and then you want to go across seven spaces or just hit across until you go down the escalator and then once you're down the escalator you'll see the black screen appear that you're going down the escalator you can also listen out for as well and you want to just hit right again which will take you back up the escalator then once you're here you want to hit left five times one two three four five and then down one two three and that should take you outside the Pokemon Center sometimes two sometimes three depends but once you outside the Pokemon Center you want to change over to the right analog stick and then go to a city that you can fly to or a location that you can fly to this next bit is the tricky bit because you want to be hitting A which will bring up the location to say do you want to fly to this location but the same time you want to be hitting X just after that so it's like a timing thing and I know a lot of you from the previous video had a lot of issues getting this working but like I say once you've got your time down for this makes it so much easier so you want to be hitting A and then X and it should bring up the option where you've got your menu over the top of the map but you've still got the yes no option for the location you want to fly to and you just want to hit yes and that should take you to the location that well it will take you to the location that you are hovered over but that is the menu glitch set up right now and this is what we need so the next step is to go into your bag like you already see I've got a Pokemon I've got your Rachi here in my party level five one thing to know when you fly to a location when you're going through your bag use your right analog stick if you use your d-pad like I've just done you're gonna walk into the Pokemon Center so it's better to just use this analog stick because it won't allow your character to move as well because your character is still going to move underneath here what you want to be doing is coming to your item that you want to use an infinite amount on it can be your vitamins it can be your EV reducing berries or rare candies or ability patch or whatever so what you want to do is here for this instance we're going to do rare candies we want to click on our rare candies we want to use this item yes we want to go down to Jirachi and we're gonna give it 95 to take it to level 100 so this is important but you need to keep note of these steps because you don't want to go too far with these steps because you will lose your items okay so you want to just give the items to Jirachi or whichever Pokemon it is click a you'll see the XP here and it's this next screen you press a again bring up these stats okay these are the final stats of it at level 100 now here is the key do not press a past this point what you want to do instead is press X bring up another menu and if you can see in my bag as well we've still got 156 rare candies it hasn't registered they've been used but Jirachi is actually sitting on level 100 and then this screen once you've brought the menu up you want to hit all and it'll save the game want to just save yep you can see there Jirachi is level 100 we've still got 156 rare candies in a bag and at this point because you've saved you want to just hit your home menu quit out and then come back into the game okay so once you're back in the game obviously we're in the Pokemon Center because we moved into that spot but you want to come back into the game and you can see a Jirachi is level 100 which is great and if we go into a bag we should be able to go over to our rare candies and yet we still have 156 of them so hasn't registered that we've used those items but Jirachi sitting on level 100 so technically we've just had a free 95 rare candies and you can use this over and over and over again until your heart's content with these items just bear in mind every time you do this it is one process so to do another Pokemon with the rare candies for instance you have to set that whole glitch up again and then do that whole process again save like we did come back into the game and then repeat the process for the next Pokemon so friends I hope you find this guide useful I hope you find this technique useful again just if you are wondering and you want a bit more in depth with how the setup for this glitch works head over I'll link the video that we originally did to clone the version 1.1.2 video where it goes a bit more in depth with how to set the glitch up so you can check that video out and you can kind of refer to both of them remember it's about getting your timing right when you're on the map with clicking on the location and then clicking the X just after that so the both the menu overlay pops up with the yes no option from the fly to the location pops up as well and then you can engage with the yes fly to the location and that is it all set up and you're ready to go with duping items and getting an infinite amount of them in the game so I hope this has been useful hope it's helpful for you all have fun with this and I will see you all for another video very soon so until then take care and bye bye


Today, you can get your DNA sequence, the letters of your entire genetic code, spelled out for like $1,000, a bargain compared to the $100 million, or so it cost 20 years ago. And for around $100, you can get partial DNA sequencing. It's only a click away, direct to consumer genetic testing, like 23andMe4 ancestry, health, love, you name it. Unfortunately, many tests currently offered have not been appropriately validated, and consequently the consumer may be paying for something that's ultimately useless or just flat out wrong. There's an increasing demand from the public for directing consumer genetic tests, but when put to the test, researchers found an alarmingly high false positive rate, meaning the analysis said you had some high-risk gene, but it simply wasn't true. And this happened 40% of the time, like they said you had the Angelina Jolie-Brocka breast cancer genes, but it wasn't true. And in addition to the 40% false positive rate, some variants they did identify correctly were misclassified as being high-risk, when in actuality they weren't high-risk at all. You can see how it's in these companies' best interest to give you scary outlier results so you'll think the money was worth it and pay for additional testing. But both false positive results and misclassification of variants can result in significant implications for an individual, including unnecessary stress and even unnecessary medical procedures. I mean, what if you got a preventive double mastectomy, because you falsely thought you were at high risk when you didn't even have the BRCA mutations? Yes, these genome-wide association studies have now successfully identified thousands of common genetic variants that influence the risk of complex diseases, as I've talked about in my video on personalized nutrition, but nevertheless, the discovered gene variants do not markedly expand our predictive ability compared with what can be achieved by using only information from long-known traditional risk factors. Take type 2 diabetes, for example. We've identified about 50 genes that are linked to increase diabetes risk, but even if you put them all together, obese persons with the lowest genetic risk for diabetes were nearly five times more likely to develop disease than normal-weight persons with the highest genetic risk. In other words, this would send out the wrong message to someone who was obese, giving them a false sense of security. Knowledge about type 2 diabetes genetic susceptibility, based on what we know so far, has no implications for decisions about who should be targeted for intensive lifestyle interventions. Everyone with excessive body fat, regardless of genetics, needs to slim down to reduce the risk of diabetes. What about this famous study that purported to show that personally tailored dietary interventions could improve blood sugar responses, to the extent that some commentators said it raised questions about the usefulness of universal dietary recommendations, period. But if you actually read this study, it turns out the results do not demonstrate high interpersonal variation in relative blood sugar responses, do not show that their model is superior to current methods of detecting high blood sugars, and do not show that personalized nutrition advice is superior to standard dietary advice to manage high blood sugar responses after meals. But hey, what about personalized genetic risk counseling, just to at least motivate diabetes prevention? And a somewhat forlorn bid to regain credibility, knowledge of individual genetic risk profiles has been touted as effective in motivating people to commit more strenuously to relevant disease prevention efforts. Here again, however, available evidence does not support the claims. And indeed, it did not seem to help those at risk for diabetes. Randomized people to get genetic tests worth hundreds or thousands of dollars profiling their subtle differences in risk for up to 40 different diseases. In this case, it was Navigenics who described their goal as empowering people with personal genetic insights to help motivate them to improve their health. Yet it didn't work. No measurable changes in diet and lifestyle, even in the short term. Randomized people to personalize nutrition insights, like determining who might genetically benefit particularly well from eating more greens or eating to lower their cholesterol, yet there was no significant changes in diet at month 6, compared to those who didn't get that personalized info, or even a month 3. So it's no surprise there weren't any differences in weight or belly fat cholesterol, or any of the other biomikers. Put all the studies together, and what do we find? No significant benefits for telling smokers who's at particular risk for lung cancer, for instance, or who needs to eat particularly healthy, or move especially more. Bottom line is that expectations that communicating DNA-based risk estimates changes behavior is not supported by existing evidence. Yet that was the stated reason for the big presidential push for precision medicine to empower individuals to take a more active role in their own health. It's no surprise that the theme of personal empowerment is invoked. It's great for marketing, but it's not particularly empowering. In fact, if anything, at least patients are even more reliant on authority. And it's not even very personal, since the genetic contributions we know of are so small compared to how we actually live our lives. Why, then, is patient empowerment emphasized as its cardinal virtue? Because it exploits the appeal to generate political and public support for an increasingly industrialized medical-industrial scientific complex which moves literally trillions of dollars around the globe. This isn't some grand conspiracy theory, it's just the way the system works. Healthy living directly threatens many powerful corporations.  Seemingly willfully blind to this evidence, the United States continues to overwhelmingly spend its health dollars on clinical care, cleaning up our lifestyle-induced messes. So it's not surprising that we far outspend other countries while at the same time have worse outcomes. While major new taxpayer gifts were being promised to high-tech medicine, the United States had already sunk to the bottom of the list of comparable countries in terms of disease experience and life expectancy. Overrated precision medicine promises may be serving vested interests justifying the exorbitant health care expenditures in our finance-based medicine. But in many ways, the American health care system is the most advanced in the world, yet all our whiz-bang technology cannot fix what ails us. Let's start with the basics. Eat your broccoli, take the stairs, and don't worry about whether you have a 5.6% or 7.7% lifetime risk for grave disease, because either way, a sensible lifestyle is the healthiest choice.


I come with 40 minutes. Oh no, no, I don't. I'm going to have questions. I'm going to be in an interactive session. Welcome back for a new session. May I please remind you about the feedback. Don't forget to log on to the DefCon website. It's like feedback. And leave your thoughts about the presentations that you're attending. And also don't forget, in 40 minutes, our presentation to go and pick up your tickets for the party tonight. That being said, let me introduce Stanik, who is going to tell us how to be compatible in user space. Hello, I'm Stanik Ablach and I work for Red Hat as a senior software engineer for quite a few years as a team member of LVM Developers. And I've been asking Radek for, if I should give this year another presentation about LVM. And he, like I said, he would like to prefer to get a real developer talk. So I hope there are not people who expect to learn something about LVM in terms of command lines. But I assume that you all came here as developers and you want to either learn something new or maybe you will teach me something new. Please feel it as an interactive session. So if we do something wrong, let's fix us. And if we do something good, so you can learn from that. So what is my talk going to be about? I think everyone knows that the kernel, Linux kernel is compatible like forever. So the API from the kernel space is kept forever compatible and you can rely on it. The problem is that in user space it doesn't apply at all. So what do you all talk about? I will first mention what I mean by your compatibility and why we should be compatible. Then few words, not the few words, but I will talk about what does it mean to write a project in a compatible way and I will mix it in with our LVM solutions. So there will be few words about the solution there. I will even show you code from LVM to demonstrate how we will do the things. So why being compatible? I often hear from my colleagues that they complain that they have to maintain a huge set of back ported patches and they have to work on many releases at the same time. In LVM we take a different approach. We maintain one single upstream branch which on the other hand has to be compatible for all releases. So we have the same code base for Fedora, Rohite, Fedora 21, 24, 23 rails and also the device to Ubuntu and other distributions. The other reason why being compatible makes sense is that you often may want to do a git bisect and if you want to do it on a system which is maintaining compatibility it's easy. If you do it on a system which has like system, the new dev and things like that, the bisect gets somewhat more complex than you would expect because you not just solve the problems from compiling your tree but you have to also change the old your tree to apply to the new state of your machine. So it's often quite complicated. Then the other thing which at least from our perspective is like lesson learned, you often figure out after even many years that you caused some regressions either in performance or in command line parsing for example. So checking for these things is often very good reason why to be compatible. Of course, by doing your project compatible you support your users. They will be grateful for that because you make their life easier and sometimes I miss that from other projects. And of course the very important point is that address may depend on you. So if you provide a compatible API and you stick for that for many years then other users will depend on it and will trust you that you are doing your work good in a good way. So otherwise you are in the risk of this famous strip where basically the people come in and see okay, this is incompatible. I would like to rewrite and do my another project to do the stuff. So to avoid that, develop in a compatible way and you will eliminate most of these situations. So this talk is not going to be about reproducing the Uli interpreter talk which is quite old already. So it was I think released in 2002. It is available on this URL. But I will mention what we do for the compatible compatibility. So one take on that is that you want to be compatible on the compile level. So you provide some header files, functions, structures and you want to maintain the compatibility on the compile style level. This is relatively easy compared to other points. You mostly get instant warning from the compiler. You just need to check on all the distributions that you are still compatible. If you want to be a low-level library and you want to use the latest, the greatest features of your compiler, well sometimes it's not a good idea. So if you really not need them, avoid them. So if you, at least for our project like LVMS, we do not need to use the latest extension of GCC. So if you stick with this or at least you provide wrapping defines, then you should be fine. But you need to check it. Basically you have to run your builds on multiple distributions and check that you are not causing problems. That's, I will show at the end of presentation how we will do it. And now the binary compatibility, which my talk is going to be mostly about or a big portion will be about. We have two kinds. One is backward, which means that if you install a newer, your new library, it will still run the older software. So that also means that the output of the older software is consumable by your new release. So basically, whatever writes the old software is readable by your new software. In terms of LVM, for example, the LV metadata are readable and usable. The other one, the format is much harder one. That basically means that you have to think to the future. So if you have an update in the future, you should not, your new tool should not cause destruction of the older tool. So if you have like demons, which are communicating with each other and you upgrade them, and suddenly the new demon starts to throw a new type of data, it should not cause the core dump of the old one. There should be a communication versioning and the old tool should recognize that it does not understand the new language, but it should not crash like it happened for us, for example, also. So these are all lessons learned. Run time upgrade is something where I think the system is still not doing the best it could. And we try to keep the state of demon past the state of the new version and run the version in a new version and keep the same data. So this compatibility is much harder to think about, but you should not forget about it. So now I will say a few words about how we add the symbols in the library or how we change things in our library. I should mention that we talk about the LibDeviceMap library because that's the only library we provide in a compatible way. So exporting symbols means that you provide correct versioning for each new symbol. There are a few ways how to look on that and we will demonstrate it on the source code.  Ever tried that? Okay, good. Anyone else? So how many of you are versioning your symbols in the library? Never ever? Well, you should start with that because that's what allows you to keep the compatibility to the future. So basically what you have to do is to generate a file which has some structure, but you can have some names and you can specify the function names. You end it with a local one. So basically you have a full control over what is exported from your library. So you really should take care of that and you should not export functions you don't want the other users to use or see. It's important because otherwise users will start to use even functions they were not meant to use. They were hidden for your usage, maybe, but they were not meant as an API. So you are in danger that users will look at the source code and start to use functions that they should not really use. So keep this in mind and hide all other functions. Only export what you want to export and what you want to support. That's an important thing. So the fun begins when you realize that you made a mistake in your API. I'm here talking just about the C interface. I'm not going to talk about the C++, basically one of those things is that LVM is still in C and probably will stay that way for a long time. But even in C you can make mistakes. In C++ it's much harder but in C if you forget that the structures have sizes and you are not returning those structures as an allocated block of memory but you expose the structure in the header file and you realize that you want to extend your structure in your header, then adding new members to the structure seems like a natural way how to extend it and nothing bad can happen. Unfortunately that's not true. Of course if you recompile all your software everything will work but then you have a problem that you can still have a users which do have newer header files, compile the older software and try to use it with your new software and then suddenly some structures passed to your new library will not match in size. So this is something you have to take care about and how to do it. So you will have to provide multiple functions for the same functionality. It's good for you if you can match the functionality in one newer function and you just add wrapper functions to provide interface for all users. So basically what we do in LVM and what I will show you right away is that we create a new function which has the proper versioning. We stick with the dm and version number. So now you will have multiple symbols in your library. One will be with the base. That's basically the sign where we were not realizing we have a problem, we still use the base and from the new version we will have a new... For the new function we will have a new version. And now how it looks in the source code. First maybe I will first show you how we started to generate these version symbols. When we create a new function in a library we put the definitions here in the single file. So we now from version 97 track of the history how we add the functions. And we combine them in a final file through the rule, make file rules and how it looks in the code. So here we have a new function which takes a new structure. And this is a function which gets the latest, greatest suffix with the version 97. And we provide a wrapping at the end of the file where we have the logic and the file for the old functions where we call the function getTaskGetBase and this function has no other functionality than taking the structure with the old size remapping it to the new size and calling the new function. So there are no problems with reading out of memory places. So basically that's all we have to do in this case. So it's not an excuse that if you have to change the structure you do not really need to release a completely new version of incompatible library like we see many times that developers realize that they have made a mistake and generate a new and new versions which are incompatible and cause quite some troubles to many other users. So it's okay if you just develop some plugin for some GUI tool whatever but if the whole GNOME library works in a way that even the minor changes cause that you have to throw up all your plugins, it's not the way it's been meant to be used. So is this somewhat clear to you or should I say a few more words about that? Well I just provided at the end of presentation I provide the link to LVM to LVM sources. It's really complicated because we have also quite complex make file to process those exported names. We even detect the problem if we provide a new function and we have forgot to put the new function in the proper file so we spend quite some time on that so I can probably show you after the presentation. So now what are the other problems? We are not realizing and we realize that after we spend a while on figuring out what the bug report means because we were receiving the bug reports that users are getting strange core dumps and they are installing the libraries and it's not working and we were looking at the core dumps and it's been showing that they were just accessing the memory from functions which were just looking all fine and it was not possible to explain and then we asked what the user did and they told us well we used the latest Koji to build a new library and we first installed this new library to use with our old project so we said oh we have to somehow prevent to do that and how to do it? Well there are a few things I was not aware I came from the Debian world and in Debian you store the dependencies in a very strict way so when you build a package the dependencies on other packages in raw form while on RPM the libraries are expressed differently and you express dependency on the symbols so in RPM it's not strictly limited which library will be used just to satisfy the versioning so whoever thinks that the so-called major minor version solves your problem it will not solve the incompatibility for the package maintenance but it will not solve you problem with the loading libraries which do not have right symbols so basically the problem with the structure size oh I have wrong focus these structure changes were not captured well by the RPM so we had to think about how to do it and if you check with RPM commands what the libraries are requiring or providing you will notice that it's not just glib c6 but also there is some extra symbol and that's what we learn to use so basically this is the way how you will ensure that the users of your library will map the right functions for their binaries and we can see that even in you can see that now the device mapper package contains the tool called DM setup and DM setup has dependencies on all these symbols so whichever package provides them it will satisfy these dependencies so there is one stick dependency from building the package but it's not what you will get if you are using the tirsmap library so this is what you will use in your package to bind the library properly the other important thing to think about is what you should do when you add a new feature to your project and that relates to the fact that we have one single code base in the game so we have row six, row seven still in the single tree we do not develop multiple feature branches and fix bugs fixed in the row seven in the row six and so on so things to think about if you add a new option you should provide a configurable configurable option to disable and enable it if you are sure you do not want to like provide a new feature to the all distro you should do it in a configurable way so the package maintainers of distros may select by single configurable option line what they want to have compiled or not they should not start to play diffing and patching your binaries just to disable something which they are not or they do not want to use then the other thing is you should also provide if that makes sense if it's something that users may want to use you should provide configurable defines because defines defaults may change from distro to distro in one distro usage of something might be a default and in other distro it might be disabled for example lvm we have like demons and you want to have them supported in row 7 and you want to have them disabled in row 6 because they are not supported or not so think when you add new option think about the configurable options lvm has also very extensive runtime configuration file and we recently even scaled up massively this thing so we can generate configuration files for a given version do a diffs between versions of the runtime so these options you provide in the build time you should let them configurable also in the runtime so when you install your package and you want to disable or enable features they should be all that should be all doable in runtime so the thing that developers often forget about is documenting and testing we also sometimes fail to do it sometimes new features flow in such a big flow that some pieces are missing but usually try to catch up so don't forget whenever you add something really meaningful to documentation and also the feature which is not tested it doesn't exist because if you work in the team where multiple developers are doing developing and the features are not tested then it often happens that one coder commits something and breaks something else and when it's untested it's lost and forgotten because if you have like thousands of features you don't have time to play with all the features so testing is important part example from ldm when we added for example feature where we switched snapshots from the old style to using the team provisioning you may select the type at the configure time and you may also select it at the runtime so user is not satisfied with the new defaults he has still the chance to go back and use the old one and if we figure out that we have a mistake in the new feature we can also suggest a very simple bug fix for the user the bug fix in terms that if the user had a previous functionality working and now we break something like we caused serious regression in some performance for example we can just tell him ok we will try to work on that and meanwhile you can disable the new feature and go back to your old previous settings so now testing when you add a new API functionality and you are not quite sure if that's going to stay that way you should mark the API as unstable and you should try to resolve this rather early so the users are not seeing for years this API is unstable so it's fine to release the unstable API it's fine to change it but you should not keep it forever in the state and the versioning makes even possible to if this unstable API is not so much broken you can still keep it in a shape in terms of those version symbols so even if you change the API later you still may keep the combat with it in some way whenever you do a commit especially if you introduce a big feature do not forget about the test cases also problem in LVM not always this is true but we try and that's as I said if you have a lot of features and those are interacting with each other you may easily lose them what is not tested often appears as a bug with 3, 4, 5 years regression so that's why we occasionally have to go back in quite a big history to see when it got broken and how to fix it but I personally do not like very much is that the you really should not release the stuff that you have not tested I often see especially in Rohite that it seems like the package maintenance do not even test what they have built so please if you try to do compatible software think about your users they are not your lab rats really you should check it yourself and enough about that and and let's see what I have here from LVM now it's there are many other projects how to test your stuff we in LVM team developed our solution somehow in-house we used the billboard with each commit we basically test which is virtualizing the whole usage so we collect test cases we try to add more and more of them and we also try to use more machine types like we check on browse 6 browse 5, browse 7 even some LVM other thing is that we do use the static analysis we find the reports from tools like cavity and so on very useful also prevents you breaking the code so let me demonstrate the tests we run so how it looks like this is basically a list of machines could be extended a little bit more easily and every commit causes the whole build of the whole project so by this we catch that we are compilable on many different distributions it also we also try to use slightly different options and configure settings on those distros to check for different pieces because there are many combinations so we even had some other testing machines but they are currently disabled so as you can see some machines are slower some are faster some are even showing that there are bugs which are at this moment it's the row height machine and our test so we catch the mistake which made the author of SCSI debug mode driver where he basically switched the sectors to bytes I think so it's now reporting different numbers and our test is catching that we are quite surprised that the author itself has actually not tested this thing there are many other sign-ons on this commit which seemed like it has been verified by I don't know five other people did not do the same so as you can see we catch that mistake I think it will be soon prepared so so the other noticeable thing in our output which we also have several modes of running like in terms of we have like virtual mode of DM and we have also a full setup of machines so we provide complete RPM packaging and we provide single testing and the advantage of this is that we can lock on the machine and simply check what happened there the other thing our test is doing is we also detect the time of test so we can check for speed regressions and other things like that and I think it's enough and now it's time for your questions if you have some okay well as I said if you have a project which already has an existing API you cannot throw it out and build a new product yes yes but as I said the correct way of course is to return the structure from the library so it's obvious that but if you have already an existing API which has been designed like well 15 years ago you cannot just you can throw it away and you can build a new library but again that's what we try to prevent we want to have one stable library which users may rely on use it and we solve it differently and it's usable so that's what the presentation was about of course we know of course of course it makes a hit but my point is that if you even have all the library you can still provide the compatible interface GLC and provide the support on GCC and everyone should check the deeper presentation there's a lot of things explained in big detail so that's so another question okay go on one of the experience what is the work across the system which is actually great so now when you do have this experience when it's going to be LVM library ready? yeah so the question is that if when we do libdm or libdm library when we do libdm library the question is LVM library will not exist in terms of you will be able to link the library with your code but we are now focusing on providing the like deepass API so the issue I think I do not want to bother other so I can explain why there cannot be link library because there are many memory restrictions and other restrictions that your tool cannot handle especially if it's in Python and stuff basic story is that we locked the memory to the application into the memory and we really do not want to lock 300 megabytes of memory because of Python so okay another question yeah well yeah that's what we get when we run the package whatever the tool is when you build the rpm packages you get a list of differences and you have to accept them so wave them or whatever so there are tools which are checking for for that but on the other side we are not extending our library so heavily that we would like up to any 50 symbols per release so it's relatively low of new news into the library so we can do it by hand and there are 3-5 people watching the comments so that's basically it I understand that if you would have a project which generates a huge API changes every month then it's a problem but in our case it's like few functions few functions per month so there was a bigger change recently actually when we added DM stats into the library but other than that it was it's if you I can show you just here as you can see only the version 104 has a bigger bigger set of changes all others are just one, two functions all the time so you can ask me after presentation it's ok I will show you how we are going to do it it's wrapper you won't be there, right? well, if available it would be better I don't even see how to write compatibility users


We're talking Ruby volume nine spoilers. If you're not caught up, go get caught up and then come back, please. Barbara, big things this chapter. Finally, we've been waiting for it. We see Bumblebee on screen for the first time. What was that for you to finally see that happen on screen? Oh my God. I don't think I'm still mentally prepared for it. I went into the voice booth being like, how am I supposed to do this? How am I supposed to act this scene out that I know that so many of us have been waiting for? Feels like I've been waiting forever for that. I was weeping. Like, couldn't believe weeping in that moment. I think the design for that scene, the writing of that scene was just so perfect for that moment. It was a culmination of so many things that happened between Blake and Yang and finally getting to get to that moment, I think was just so meaningful for me and Erin. I have so many feelings that I think like, a lot of the characters kind of hinted in that moment, like, finally, we've been waiting for a while. But I think it was done in such a beautiful and perfect way. It's been so hard to sit on that for so long. Cause, you know, we obviously knew this was coming for a while and then we wrote this a long time ago. 2020. 2020, absolutely wrote it. We've been like just like straightened. I think we've also known this was gonna happen like even before volume one. It's been a thing. It's like it has been a thing for a very long time but we're very happy and we're happy for them and another, you know, big community out there that loves to see it and we love to see it too. I love to see it over and over and over again. Part of the thing too was that, you know, we wanted every kind of episode to feel like it's own little story and we liked putting our team at a literal crossroads through this ponder storm, right? Cause we wanted to have like just weird stuff happen to them in the ever after and it felt like a really good time to get the two of them with each other and then they have this weird weather pattern that is like forcing them to work out their issues, right? We didn't know exactly what that was gonna look like. And then in writing it, it was kind of like, oh, how do they take the next step? And that was the thing that felt like the right thing to do. This volume has let us be a little on the nose about things in a way that we're all very clear that we're doing it, right? And we try and do it in a way that is fun and different. I think also taking it away from remnant, like in this moment, it's just them. Like there is nothing else that exists in this moment just those two. You're not leaving until you solve this. So you confront this. It kind of forces them into this moment, which I think was, it was just so beautiful. What I took away from it too, was watching it again, writing-wise is like we have the whole play on the idea of, and they live happily ever after. This is a fairy-tale story. Well, they're living happily in the ever after. This might not be the end for them. This is the beginning of their new relationship. We've seen their back and forth. So we're literally addressing their emotional conflict and now together they will leave changed, but whole. I'm gonna need to watch every reaction video. Oh, I've been dying for it. Every single screening that we've had internally, like we're giving feedback and stuff. I just get Issa and Aaron just like, furious deciding. I've seen it like a dozen times at this point. It still gets me every time. I was really greedy, because I started out directing that episode and then I had to work on something else. So Issa took over, she did a great job. That one scene though, I was like, I'm still gonna do it. I'm still directing this one. It's funny, because I really wanted to write that episode. Everybody wanted it. Actually, what I really wanted to write was the reversal of the fairy-tale stuff, but it was like also pretty good secondary reason to be able to write that scene. Well, yeah, I mean, talking about that, Ruby has always been kind of steeped in fairy-tales in general. And this one is an in-world fairy-tale. Like you're writing your own fairy-tale inside of a fairy-tale. Like how was that structure important to the season? It felt like it gave kind of a, one a clear path for the characters to follow, right? Like we were trying to do the same thing that happened in the story. And then even as our characters are learning that it isn't always like it is in the fairy-tales and the fairy-tales aren't really real in the sense of the simplistic emotional messages, they actually learn that this fairy-tale they've been following is not, like it's a lie. And so it felt like a great moment, halfway through the season, this goal that they've had the entire time, this friend they've made in the cat to suddenly feel like, wait, why didn't the cat tell us everything? And now we've run into our old friend, John, and he is- Literally old. Yeah. Old friend. Our old friend. It was a part of the fairy-tale the whole time because it's a weird crazy time business. We're just like, we're gonna be weird. Let's get weird with it, you know? Like we talked about that a lot of like, it just, it's something I think felt not as interesting as like just seeing John and it was like, how do we do something with him? And, you know, we'll explore this more as the season goes on, but I mean, he's spent a lot of time on himself. I mean, look at that hair. Yeah. Oh no, he's hot. Yeah. Thanks for watching this Deeper Dive into this week's episode of Ruby. If you want more, come back every Tuesday after the episode and we'll talk about it and have fun. And go watch the episodes on Crunchyroll every Saturday. Please go watch it, bye.


You'll experience patient care that is specific to you with exceptional follow-up care that ensures your hearing and balance needs are being met. Audiology Associates at 1428 Northlake Drive in Prestonsburg. Big Sandy Area Development District and SBP will be hosting resident meetings for long-term flood recovery in Floyd and Pike counties on July 26th and 27th. Here we are a year into this that long-term recovery, you know, a lot of people, you know, it's hard to understand why it's taking so long. But long-term recovery sometimes can take, you know, a couple of years in terms of getting out there and getting case managers involved and finding out from the USDA if there's funds available to help there with FEMA. And so there's a lot of resources out there. The meetings are open to all community members impacted by the 2022 floods. Several regional and federal flood relief agencies and resource providers will be in attendance to help address unmet needs. We want to make sure that community knows. Don't give up hope. You know, contact us. We'll be able to help you get with some of those resources. The flood relief meetings will take place at the Floyd County Community Center from 4 to 6 p.m. on July 26th and the Vergy Baptist Church from 5.30 to 7.30 p.m. on July 27th. For more information, you can contact Sarah Hambrick at<PHONE_NUMBER>. For Mountain Top News, I'm Kelsey Dean.


Stop on red. Looks like it's green. Let's go. Middle of nowhere, traffic light. So here we are riding our bikes. Lottie, dotty, dot. And we look to the right and we see this epic spot right here called Kirkham Hot Springs. And we want to make some ground today. We want to get somewhere else, but we're like, maybe we should go there. What do you think? I think we should go there. We should go there, even though it's going to make our day longer. This is so beautiful. This is why we're doing this. That's why we're doing it slow. It's essentially like taking a hot shower. It's perfect. Jumping in the water was awesome, but right when I hit the water, I felt this necklace go over my head. And I was immediately, oh my God, where's my necklace? This is not just any necklace. My friend Danny in West Virginia gave me this on my first cross-country tour in 2009. It stands for courage, wisdom, and strength. I've had it around my neck ever since. And I just about had a freak out here. It's been about 10 minutes searching this little area with a necklace. And I found it. Oh, I feel so good. Danny, you're still with me, buddy. Allie is adding a touch of gourmet to our beans.  Thank you, Allie.  After bathing in the hot springs, we originally thought that we would just keep on going down the road. But then we're like, you know what, this is a great place to camp. And what really sealed the deal is that our campsite has its own private hot springs tub. Camp Hot Spring Allie. It really does not get any better than this.  And it's going to be dreamy. I hope they have like roadside motels with like heart-shaped tubs. This is pretty much what we have right there. Cheers to our hot beans. Hot beans and hot springs. It feels like we're cheating. Look, it's too nice. What a way to wake up, huh? Good morning, Allie. Today is a special day. Because today, in Colorado at least, is bike to work day. What are we going to do? I think we should bike to work today, Ryan. Yeah, I think we should bike for work. This is our job. Ooh, yeah, bike for work. I hope, I hope it's off the bike to work we go. Oh, red light. This highway is just like a dream. We're both loving it. Very little traffic. Lots to look at. How are you liking the hills? They're perfect. Glad to see. But enough to make you work for it. Idaho, we are fans of you. This is my first time here, by the way. And I'm really enjoying it. Ladies and gentlemen, I give you the sawtooth mountains. I've heard about these mountains, and I've just never been here. Now that I see them, they definitely look, looks like a sawtooth. Little jagged cliff, little peaks here and there. Little bit of snow. It's fun to see snow. Only two reasons why Allie stops on the side of the road. One of them is to pee. The other is to pick flowers to put in her hair. I found yellow flowers, and I found pink flowers. That one looks nice. That one looks great. Two more flowers, where should I go? I don't know, in your ears? Oh, down here. Up the mountain. I'll push you. I'll give you a little boost.  We've been climbing and climbing and climbing and climbing for like 11 miles. And the sign back there says 7,200 feet. This is the highest we've been on the ride so far. I think it's called Banner Pass. We're heading down into Stanley now. Now we're on top, and when you're on top of anything, that means there's only one way to go, and that's downhill, and it's awesome. Some of you ask where we get our water. Sometimes we get it from gas stations, and sometimes we get it from babbling brooks. This is the best water because it's cold. Straight from the mountain. Ah, it tastes so good and cold. And my feeder numb, because I've been standing in it. We've got some Discovery Channel stuff going on here. We stopped to pump water, came back to the bikes, and there's a spider on my panier who looks like he just caught a fly for lunch. A bright green fly. Nature is neat. We have just rolled into Stanley, Idaho. We went to the ice cream shop. It was closed, so then we went to the grocery store and look what we found. Fish food. Our favorite ice cream. It was $7. But luckily, we didn't look at the price before we bought it. Fish food, so good. Yum, yum. Well, I crashed my bike going about 1.5 miles an hour. Just kind of ran into Ryan and flipped over. I did like a, it was like a full flip. Yeah, I looked back and she was upside down. It was like, how did you do that? I don't know. Don't have an answer to that question, but I did bust my hands up. Let's see your hands.   I got shot by a pellet there. My bike likes to attack my legs. All the camp grounds around here are full. They're all ridiculously beautiful, so that's understandable. But we met the camp host here, Susan, and she has just been incredibly kind and generous. She's letting us camp in her lot behind her trailer. And she also brought a whole first aid kit for me so that I can tend to my wounds. I keep on saying that this campsite is the best site, but this one really might be the best site. Look at that. That is insane. Ali, we scored once again every single day. The good world is taking care of us. This is incredible. This is definitely our coldest morning. It is freezing. And I just looked at the thermometer over here. It's 40 degrees, which makes sense. Because we're at 7,000 feet elevation. I had no idea we were so high. Good morning. If you're not going to wash your hair for weeks on end, you have to brush it really well because it distributes the oils nicely. We met a nice guy in the campsite last night that pointed us to these old ruins. He said that from 11,000 years ago, which is just after the ice age. It's an antelope. Here's legs. A little tail. I think this is probably where the smoke went up from their fire.  You don't see 11,000 year old ruins very often in the United States. No crashes. No flatties. No whammies, no whammies. Big money, big money. Here we go. We are being pleasantly surprised today by a nice downhill grade. Lots of climbing yesterday. It's paying off now. We're following the Salmon River through a beautiful canyon. Mountains on the left, river on the right. And it's Thursday. Happy Thursday everybody! Woo! Happy Thursday to my cruisers! If I had a bell and a horn, I would ring it and honk it. Here we go. Another day on Planet Earth. I'm really enjoying riding right next to this river. We're literally just a couple feet away from it. You can hear the water flowing through the rocks, the rapids. Very, very soothing. We just stopped off in this tiny town of Clayton where the sign proudly says there are seven people who live here. And it sounds like it used to be an old silver mining town. Silver smelter, actually. They've got a couple old buildings, an old mercantile. I like it. It's got a good feel to it. It's fun to put yourself back in time when these towns were thriving. And just to feel like what it must have been like. I mean, the population was huge. There were lots of prospectors out here. This was the Wild West. This is where people were making their fortunes. And there's this cool town park right here with a baseball diamond.  And I asked the guy in this store who's the poor guy that has to mow the lawn with a tiny lawnmower. He's like, we got him a riding lawnmower. He just likes to use the push mower because this town doesn't have a gym. So he does this on his own accord and comes out here and takes care of this tiny park. I say good for that dude. If he wants to mow the lawn with a tiny push mower then let him do it. If it brings you joy, do it. It's like us riding bikes across the country. A lot of people think that's crazy, right? Why don't you just drive across the country? No, we like riding bikes. I think it's hilarious. That's a very good analogy, Meteor. We've only gone about 30 miles from where we started this morning. And it looks like a completely different world. It's a lot more deserty. I'm seeing the sagebrush again. Not nearly as lush and green and full of trees. Lots of great color. One of the fun activities we do is we stop on the side of the road for historical markers. And this one is especially interesting to me because I remember when I was in elementary school learning about the Native Americans, learning about how they would run buffalo off cliffs as a way to kill many of them at a time. And I guess this area right here is a spot where that happened. Where they had the bison jump.  Kind of a brutal thing to do, I guess. But it's a lot easier than bows and arrows and hunting them for hours.


We want to welcome our online audience. This program is being live webcasted and will be available at csis.org following the event as a digital video recording. Everything okay? Good. I just got the thumbs up. So thank you for your patience. And again, welcome to CSIS this morning. Today's program will begin with an announcement of a partnership between the Republic of Georgia and Gilead Sciences. Gilead Sciences is an innovative biotechnology company located in Foster City, California. The goal of this partnership is to completely eradicate hepatitis C from the population of the Republic of Georgia. Until recently, there was no cure for hepatitis C and many of the treatment options were both expensive and limited in effect. Beyond this important announcement, we will examine the nature and operation of an innovative approach to public health. What is happening? Okay, ready to go? Okay, the feedback loops are amazing in this digital era. But we will examine the nature and operation of this innovative approach to public health which combines a technological breakthrough for a cure with the collaboration of the United States and Georgian public health officials to eradicate this debilitating disease. Today, we welcome officials here in Washington and are connecting via the Blue Jeans Network, I believe it's called, to people, the team on the ground in Tbilisi. We'll begin here in Washington and I'd like to introduce the two people here on stage with me, Dr. Arquill, Gekazita, Ambassador of the Republic of Georgia to the United States and Ambassador Jimmy Kolker, Assistant Secretary for Global Affairs of the U.S. Department of Health and Human Services. Their biographical statements are in the papers on your seat and so we'll dispense with the reading of these bios but we're delighted to welcome them both to CSIS and have asked the Ambassador and the Assistant Secretary to in turn make opening remarks. Mr. Ambassador. Thank you. Dear distinguished audience, ladies and gentlemen, and dear distinguished panel members, let me welcome you all and thank the CSIS team for hosting this event here, especially Mr. Scott Miller for your efforts to host us here as we are marking the launch of an outstanding exceptional program in Georgia in that absolute elimination of hepatitis C, this very dangerous disease in our country and in the wider region. And to my knowledge, this is a very acute problem here in the United States as well. And also I would like to thank AJ Jones and Pauli Fields from Gillett Sciences for their efforts to put together this event. I took several months of purposeful work of the government of Georgia, its Ministry of Health, Healthcare, the Embassy of Georgia here, and of course our US partners, US Centers for Disease Control and Prevention and Gillett Sciences to make this day. And today, Ministry of Health of Georgia has just signed a memorandum on understanding with Gillett Sciences, a renowned leader in the industry, to start the program. The Minister Sergenko and the Gillett leadership will join us soon alive and they will tell us more about the background and details of the program so I will not go into the specifics of this important undertaking. I just wanted to underline that this program does not come from nowhere over the years of fruitful cooperation between the US and Georgian partners in many areas of public health. Serious backlog has been made both in terms of research and medical treatment. And now we can proudly boast many outstanding achievements and I would single out a few of them. Let me start with the Public Health Research Center named after Senator Luger, which is a shining example of a US-Georgian cooperation towards combating biological threats. And this state-of-the-art facility which is located in Tbilisi, in the capital of Georgia, is the largest US investment projects in the country and currently Luger Center's BSL3 Lab is a center of especially dangerous pathogen related research in Georgia, supporting scientists from not only the National Center for Disease and Control, but from the Ministry of Agriculture and also from the relevant agencies from neighboring countries. The second thing I would like to also point out is that Georgia has been playing an active role as a key leader and partner in the US Global Health Security Initiative to strengthen the health preparedness and the global response to threats and as we witnessed recently, the Ebola outbreak in Africa. So it does not need additional explanation how important it is to really be prepared for this global response for the similar events. Third, I would like to outline to mention to know the collaboration with the US Centers for Disease Control and Prevention and as the agenda of partnership with the CDC grew over time, CDC decided to establish a representation in Georgia and the CDC is now involved in many projects on the ground but in this particular case, in relation with this program that we are talking about today, CDC is a key partner and it will provide technical assistance and guidance throughout the project. Last but not least is the collaboration with the National Institute of Health, particularly with the National Institute of Infectious Diseases and Immunology and I would like to take the opportunity and personally thank Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases for his consideration and effort to help Georgia address some of the most acute problems related to healthcare including by the way, Hepatitis C and the NIH has recently launched a collaborative workshop in Georgia which resulted in funding seven research projects in the field of communicable diseases including TB, HIV, AIDS and of course Hepatitis C. So the program on elimination of Hepatitis C we are about to start in Georgia is a pilot project and if successful it also be replicated in other countries and regions. Therefore I urge you to benefit from this panel and I think it's a good opportunity to learn about the origins and prospects of this program in Georgia. Thank you very much. Thank you, Mr. Rasser. Thank you, Scott. Good morning and good afternoon in Tbilisi. Jimmy Kolker from the Department of Health and Human Services and it's pleasure to be here to recognize the important collaboration to combat Hepatitis C in Georgia. As most of you know, viral hepatitis is a major burden on the health of people and economies throughout the world. There are about almost 150 million people globally who have chronic Hepatitis C infection. A degree of severity varies from being asymptomatic to mild illness to chronic liver cirrhosis, cancer and death. So as this illnesses, hepatitis illness occurs in all regions of the world but is particularly problematic where HIV co-infection or injecting drug use add to the problem and the vulnerability of the populations who are affected. US government through the Department of Health and Human Services and agencies that the ambassador mentioned, the US Centers for Disease Control and Prevention and the US National Institutes of Health address viral hepatitis disease including Hepatitis C all over the globe. We've developed multiple initiatives on hepatitis focusing on greater awareness and identification of those infected, improved public health measures to prevent the spread of Hep C, work with the WHO and the development of new therapies to combat the disease and that's really why we're gathered here today. First to build on what the ambassador has rightly said the government of Georgia has been a close international partner of the United States on many health issues. The center named for Senator Lugar is a state of the art example but Georgia's commitment to public health is impressive. Even the field epidemiology training program which is centered in Georgia also has brought epidemiologists and comparable programs in Africa have been very important in turning around the Ebola epidemic. So the training of Ministry of Health Epidemiologists in collaboration with CDC is one of our most important partnerships. But we're especially proud of CDC's active technical presence and partnership with Georgia and this is one example of the fruits of that partnership. Together we're tackling global health security, HIV and AIDS, tuberculosis, maternal and child health and notably as you mentioned ambassador the Georgia's lead role in the global health security agenda which President Obama himself launched in February 2014 and Minister Sergei Enko was president in Washington for that launch on a very snowy day. Through the global health security agenda we're addressing the abilities of many countries around the world to prevent, detect and respond to infectious diseases whether naturally occurring, accidental or deliberate as acts of bioterrorism. We're grateful to the Ministry of Health of Georgia and the multi-sector approach that you're taking to be important partners on these endeavors. The research and development has been ongoing for both vaccinations and treatments for hepatitis C but progress had been slow. Now through the hard work of both public and private sectors especially companies such as Gilead we've realized breakthroughs and therapies and combined efforts in the public and private sectors such as this initiative in Georgia will change the lives of many people who may have given up hope because the treatments were out of reach or ineffective. This turning point will be when hepatitis C and other diseases are seen to be dramatically reduced and it takes combined efforts and expertise of multiple actors some of today's greatest and most widespread health challenges. It's a pleasure to be part of an example of scaling up with CDC, with the government of Georgia and with Gilead's commitment to an innovative program which isn't just a pilot program or a center of excellence but there's a national response which will mean that everyone who needs the help will be able to get it. So thanks to all the partners from this much needed undertaking. Thanks very much. Thank you Jimmy. Now let me have the dramatic moment or what I hope won't be a dramatic moment of today's event which is to connect and turn the program for comments over to the people in Tbilisi. We have Dr. David Ciergenko who is the Minister of Labor Health and Social Affairs for the Republic of Georgia. With him in the room are Dr. John Ward and Juliet Morgan of the US Centers for Disease Control and Prevention and Greg Alton, Executive Vice President of Gilead Sciences. Let's see if this works. Good afternoon. Please go ahead. Please. We share with you our impression and excitement. One moment please. There we go. We're trying to get the volume correct here but please proceed. We share with you with great pleasure our excitement with signature for so important documents that happened just a couple of hours ago that used to my country gave so few new chances but I believe that these chances wouldn't be unique for Georgia only but it would be shared for other countries also because this is a literary new part to how new vision to this disease because this is not only improved access to treatment of hepatitis C but also comprehensive approach that includes prevention to provide the scientific survey and even before launching we are getting immediately after launching we are getting additional benefits knowing more and to explain to people how to reduce the steam of disease because this is very important to improve access before the treatment of this and with this team approach and I'm very thankful to the U.S.C.D. and Iliad Sciences that are doing literally revolutionary job in this direction and it gives to us absolutely new possibilities and opportunities. I think that within the nearest days we will get first patients and regarding prevention component we already started this project and we are already getting in the culture of let's say complex approach and I cannot mention new episodes of new opportunity in face of Google laboratory it gave to us new basement new new resources for laboratory control because we do qualified laboratory control even having resources in face of appropriate medication appropriate medical staff we the ex-competition of laboratory and without state of quality of testing of disease we would be are on a spot with not only hepatitis but other diseases also and I'm very happy in my vision that I would share with you this is some kind of important part of also global health security agenda because we are all recognizing that health is not managed with a force of isolated country even the strongest country the most developed country but this requires literally global approach I really will be very happy as minister of health in the country that we are launching this program and finally let me present my thanksfulness to our partners and thank you very much for this great attention thank you very much thank you Dr. Ward or Juliette, do you care to make comments? It's areas in the room there in Washington as well as my HHS colleague Jimmy Copa it's my privilege to represent the the Atlanta portion of the U.S. Centers for Disease Control and joined here by Dr. Juliette Morgan who is the lead of the office here in Tbilisi we feel very privileged to be asked to participate in this novel and a pioneering effort in the world to set a national goal for the elimination of H.C.B. transmission and disease this is a first and I think it's very very courageous for Georgia to embark upon this effort but also one that they see is very necessary given a large burden in the country and we would like to begin to lend some of our technical assistance and work with our colleagues here in Georgia to to make sure that they're successful as was mentioned by the health minister a few weeks will be setting off on the international survey to provide some current estimates of how many people are living with this infection something about their modes of transmission and about the different types of viruses of hepatitis C circulating in the country that are important to know for treatment we also will be looking at laboratory quality using the Luger lab that was built as a U.S. Georgian partnerships some years ago Keston is very important for this disease known as the silent killer most people can live unknowing the few symptoms of this but their virus is slowly and progressively happening with the need to liver damage and liver cancer so the testing has to be of high quality to get the diagnosis you need and unfortunately in Georgia as is true most countries around the world as a result of this silent nature most people are unaware of their infection so testing is very important and then lastly we're looking at the helping them develop their policy for elimination the first order of business to identify those persons already ill with this disease and get them into care then we can start out on reaching the goal of eliminating death from this virus and then move into a second phase we're going to to expand testing increase the number of people being treated and then magnify the management efforts in the Department of Transmission and healthcare settings through behavior such as injection drug use and sexual trans along the way we're going to be developing information systems to see what's working and what's not working so that we can improve the program here but also because this program is the first of its kind the lessons learned here in Georgia will be helpful for other countries recognizing this is a public health problem for their people and seeking to eliminate it and Georgia will be paving the way and shining the light as the virus do in this regard so Georgia will be going to become a leader in hepatitis C prevention and I think this partnership exemplifies that there's no one part of a health system or an international agency or a company can do this alone you have to pull together so we're very appreciative of CDC be working with ministry of health and also strong partners by Gilead Science who come here and are helping provide a life-saving therapist which is a critical part of the elimination plan so this is a very ambitious goal but I feel like if we work together we pull together and we can be successful thank you I'm turning over to Gilead to see if she has any other questions the launch of the program was led by the highest levels of government the prime minister we had the patriarch present as well many ministers from different ministries and I think it's a demonstration of the commitment that Georgia has put forward to make this happen and without that clearly this wouldn't be possible it's extremely exciting from a public health perspective to be able to participate something like this very exciting and I think also the fact that we have a partnership stepped up to as John said provide the critical elements just everything seemed to come together to be able to do this we have very high expectations and I think I think we'll be successful thank you Dr. Ward Dr. Morgan Greg would you like to make some comments please first I want to thank CSIS for hosting the event in Washington D.C. I'm sorry I can't be there but I had a sign of OU today so I just want to thank the embassy of Georgia in Washington D.C. as well as here that George is here for the hospitality that we've had and the support that we've had and put this program together this is a very exciting moment for Gilead you know we've we're very excited about the breakthrough therapy that I think has been discussed before and the potential that it offers to do something we've never been able to do in hepatitis C before which is not just cure the cure of the disease but cure it in large numbers of patients and really roll it out in a way that we could not have done with the prior therapies so we're very excited about the opportunity to show how that can be done and there's a lot of components that go into this let me just I think we want to try try to say how did we get to where we are today you know I think this started you know certainly in Georgia with a recognition of the science and seeing the science that was developing and seeing about the science that could really benefit patients here in Georgia which then resulted in conversations which initially started not around this particular project in this in the grand scheme that it is today but really you know talking with the minister of health about how they get access of Sevaldi and then Harvoni at an affordable cost for Georgia so that they could use it within their program and what we learned and the and in these conversations the questions were getting to understand what is the what are the patients in Georgia what is the prevalence what kind of capabilities are there in Georgia to do the treatment we've learned very quickly that there was incredibly strong commitment of the governor of Georgia to do something and and really be something big around hepatitis C for the people of Georgia and not just treat patients who are infected as the minister said also work on prevention to stop new infections in the country in Georgia that was very strong came through quite clearly the other thing we learned you know related to that commitment is that the significant investment have already been made in Georgia in the United States we were able to see some of that today in some of the hospitals laboratories but some really a comprehensive investment in infrastructure and diagnostic to treat patients that was there as well a couple other things we learned is that Georgia actually there's there's multiple modes of transmission of hepatitis C so you're not just dealing with a country that you know is all IU or is all hospital setting there's multiple modes of transmission as well as multiple genotypes of other diseases those of you who are familiar with it has six different genotypes and there are three predominant genotypes in in Georgia which are very interesting to us as well the other thing that's very unique about Georgia is the oh well there's a very high prevalence in Georgia it's one of the highest in the world but also a relatively small manageable population so hearing all this from the minister of health we kind of took this back again and said this is a real opportunity to see what could be done by the government that has the has the investment and not just the drug but all the other components that go into it and if we're able to really scale up treatment could we see the ability to eliminate hepatitis C in an in an entire practice in a subpopulation so and so that's really how it started and then the conversation turned to that with the minister of health and then the other key component there was CDC having the US CDC on the ground obviously part of this as well gave us a lot of comfort but also a lot of resources to do the type of work we need to do to demonstrate what what can be done not just here in Georgia but elsewhere let's keep in mind we're talking about an eradication program but this is actually a hypothesis but now that we can do this we don't know if this is important or we think it will work we know it will treat lots of people we hear lots of disease but the real the proof of being in you know several years from now we can see that that would have estimated 6.7% is coming down that is really and then I know that there's a number of other delegates in the room at CSIS from other countries and that would be very important to us to make the case globally of the value in better treatment of hepatitis C the value of the line of treatment the value in being able to cure and prevent disease for long-term benefits not going to people and for the government so for Gilead this is a signing opportunity about the patient she's she's working to develop on this little lot of similar programs all the way thank you and it's an exciting very comprehensive program that you've heard described what I'd like to do is now move to your questions here what it would ask you to do two things first once you're recognized wait for the microphone because all the experts are in Tbilisi and they won't be able to hear you unless you have the microphone and second let us know your name and organization or affiliation before you ask your question so Senator Daschle I'm Tom Daschle I work with the Daschle group and with Gilead but let me just first thank you Scott and CSIS for hosting this important event and let me congratulate the people of Georgia the leadership of Gilead and of HHS in arriving at this momentous moment for all of us it is clear that hepatitis C is one of the most devastating diseases and is certainly a death sentence for so many people not only here in the United States but around the world and I think what you've accomplished in this new level of cooperation is a recognition that we are actually going to save lives and improve the quality of life for literally millions of people I think we will also demonstrate the importance of public-private partnership and a recognition that if this works it could serve as a model for other countries as well it seems to me whether we're successful will be determined in part by our resilience certainly by our innovation by the level of collaboration and certainly by our engagement at all levels and so my question would be what are your expectations in the timeframe that you've laid out how quickly do you believe we began to see some results and how might we begin to anticipate the progress that you've just described this morning thank you Greg you may be the best person to answer that you describe this as a hypothesis that we can eradicate the disease how does this play out over time in Georgia to that question the estimation of the total all of the required treatment and we will have particular exact date a new year to August and based on these latest results we are planning with preliminary calculations that it could take more than three years and approximately five but final the figures we will know at August after knowing the exact date thank you please I will just chime in just a little bit I think one of the things that also that makes this program very unique and exciting is that we will have data and some populations that are going to be really have them have very limited data as people who inject drugs we will have data not population also a big commitment to a prison population in Georgia I think we'll have results back very quickly to see not only the cure rates which we believe based on the clinical data we will receive very high cure rates for these populations and what's going to be very important to see is what's the reinfection like what's the prevention aspect of this and I think we will get that data some preliminary data short very quickly on this that'll be extremely helpful what we're doing globally in the U.S. and Europe and everywhere just a follow-up question for Dr. Ward or Dr. Morgan you mentioned the difficulty of actually identifying patients people who carry the hep C disease but don't know they're ill how will that how do you expect that to progress as this test goes on first order of business that we're already hard to hard about is looking at the laboratory quality so that the testing that is done is a it is a high quality and so you're getting accurate diagnosis and then we want to begin to bring more laboratories in the country into that quality assurance program we also need to follow that up with what we call policy development who needs to be tested Greg mentioned two important populations prisoners persons who inject drugs it's well known they have a very high prevalence of infection it's a very common infection many people don't have those characteristics and so we'll probably have to move to more broad based testing in the United States we've adopted a year of birth recommendation because of a high prevalence among the so-called baby boom population here it may be some other type of recommendation but we'll have to be a fairly broad to capture the large number of people who are living in this infection and don't know it Julia and as has been mentioned we launched the National Survey next week and this will take a few months to conduct but at the end of that we will have a national estimate of the burden of disease and the transmission of the disease so we'll understand the risk factors and then this will lead us to the implement to the to the prevention implementations in the in the areas that have been identified where the transmission is taking place so not only in the IV drug users and the prison population where we know transmission takes place but in the other people that don't know that they've been exposed through different different risk factors and haven't been clearly identified yet so I mean the launch is taking place while we are also launching National Survey which will really give us the evidence and really point where we need to invest our prevention efforts so okay let me you know the other critical element here is what's called health systems strengthening the treatment for hepatitis C used to be actively done by specialists because of these complex had a lot of side effects one of the big advantages that these new curative treatments is that they are safe they have very few side effects and they require much shorter durations of treatment so you can begin to move treatment out of the specialist I'm gonna into a more of a primary care setting of some other setting that is a lot more widely available than a hepatologist or a gastroenterologist or infectious disease person so I think over the phase two try to train primary care providers to become providers of hepatitis C treatment which should be very possible with these new curative treatments that have been produced thank you thank you yes here in the hall thank you Kelly Miman with McClarty Associates I have a question for the the minister I'm just curious and it's kind of a good follow-up to yours I think Scott on testing what modes are you considering given that there are different ways that that hep C is transmitted in Georgia what modes of education are you considering in Georgia public education both from a hey have you been tested perspective but also from a prevention perspective what do you think will be most effective in the Georgian population thank you it includes literally comprehensive action plan that includes not only treatment not only prevention and infection control but enhancement and improvement of patient society education because we already started implementation kind of labs who went experienced and already treated patients that are well-known faces in our experience of all these so we are trying to bring it through this kind of if I may say artists that they this is some stigmatized in our country and by sharing experience from other countries who went patient societies are much well developed and in in Georgia we are thinking that we very intensive information campaign that we already started a couple of months ago with establishment of these patient societies or let's say patient clubs and with announcement maybe not announcement but with showing already treated patients that have just no chance before implementation of this program we will give us question here and then one in the back Hi, Paul Wolfwoods from the American Enterprise Institute just around the corner first of all I want to associate myself very strongly with Senator Daschle's comments and I would underscore that I think the pioneering nature of this program is particularly important because it's being done by a European country and it's true that many people in Europe don't know very much about Georgia but I think the fact that Georgia has pioneered quite a few innovations over the last decade or more I think this is another opportunity to do the same thing and it takes I think some political courage because as the minister said this is a disease that carries a good deal of stigma and admitting that your population is infected is an essential first step to doing anything about it and as you said this is a disease that people can have it without realizing they have it and so therefore it would be easier to just skate along and pretend it doesn't exist but my impression from data on Southern Europe at least in Southern Europe this disease has a prevalence that extends far beyond intravenous drug users and is partly the result of insufficient awareness of the risk in medical practice so I also have a political question related to this which is it's true that people don't know that they're infected but presumably they will know that they've been cured and it seems to me that is a very positive impact that can be had here and so I'm curious if it's possible to make any estimate of how many people in Georgia not how many have the disease not what is the prevalence of the disease but how many people have relatives or close friends who are candidates for this program because I suspect the number is actually quite large in the political impact the positive political impact could be quite large here and sort of related to that same question I'm curious to know whether anyone in Tbilisi or here in Washington has insights into what is the prevalence of hepatitis C not in Georgia but in some of the surrounding countries some of which is we are more extremely important these days thank you Mr. Minister do you have a comment on that regarding data for the neighborhood countries we have different different data let's say for Georgia we have the last data from 2002 and for our neighborhood to neighborhood countries with different states but I think much more important as you mentioned the recognition that yes we have health care problem in our country and we are not trying to somehow paint and keep it somewhere to rise our countries ranking up to some ratings but to recognize and describe the ways to deal with and to manage with so I think political will will is leading one that this is absolutely mandatory but of course not sufficient factor for successfulness of the project and the people are representing our partners I think with in support we will be we will be unique at least data makers for other countries also and just and it go to Lee I think just to address you mentioned the impact more generally beyond just the absolute number by time here in Tbilisi in almost two years I'm always impressed with the amount of people that I meet that they're either their brother their cousin there somebody in their immediate family is impacted by this almost on a daily basis I think the the population is is very excited about this opportunity as I think the impact is very big if you're part of the question regarding problems in other parts of Europe as we've already mentioned several times we're going to be doing a very high quality survey to really get precise estimates many countries lack that type of information so we don't really know and have a have a good idea and to the other part of your question you're saying it's sort of easy to skate on by I think that's what you know people are doing through ignorance of the problems burden of this disease I mean we with the data that are available we we believe that in countries such as Ukraine have a have a substantial problem perhaps a country like Romania Portugal Spain Italy and some areas like that but I think all of those areas could benefit from some additional after doing watching data so that they would have information that perhaps just make one comment because I visited Ukraine when I was working at UNICEF four years ago to look at the HIV hepatitis C co-infection among adolescents which was a huge problem by far the leading cause of death of HIV positive people in Ukraine but also in all of Europe the hepatitis C is the you don't die of age your immune system doesn't work so you die of something else and hepatitis C was the biggest threat but some of the things we've heard this morning are really important because in many societies especially those in the former Soviet Union any kind of drug use was criminalized it wasn't seen as a public health problem you're identifying this as a public health problem where people need interventions not to be put in jail also talking about patient organizations and the role of civil society the word is going to spread when people get cured and if those organizations aren't able to be part of the coalition that's bringing this program and it's great here that they are also that's a real limit on its effectiveness so there are a number of aspects of this program that I think really have lessons far wider than just Georgia great point great point thank you question in the back my name is Manos Harrison and I'm from Last Mile 4D the question is probably most to everybody and I want to echo Senator Daschle's comments as well are you using as you do this survey will you be using a national registry of disease prevalence are you actually setting up a national registry for that how would this data be some place that other health issues then can be either compiled or driven out of this for other matters that matters health matters that are in Georgia thank you to see how they progress and the outcome so we envision many opportunities building on these platforms we have time for one more question if it exists not seeing one let me bring us to a close by first congratulating the government of the Republic of Georgia the U.S. officials involved and the people from Gilead in this amazing partnership that is going to make an important difference in people's lives but also thank you so much for for giving us some insight into this test market that you're running and we look forward to following the progress of this initiative and seeing it not only succeed in Georgia but replicated beyond this thank you to those in the room who have joined us here at CSIS this morning and have a great day


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