Well, thank you, Mike, for that introduction. And thank you, Joe, for this invitation. It certainly is our pleasure to be part of this great group here, and I hope to share with you in the next 30 minutes our journey throughout patient safety, patient safety, and quality. There is great power in the experiences that we have in health care, the experiences that those of us that work on the front lines of health care and the systems of care have, but more importantly, the experiences of the human beings that we take care of. There are everyday miracles in health care and, unfortunately, everyday tragedies. We at the American Society of Anesthesiologists, or the ASA, are on a quest, a quest to build a better health care ecosystem, to work at the pinnacle of quality and safety and unlock the power of purpose. Our purpose is to improve health and relieve pain and suffering, to be there for another human being in their most vulnerable moments. We are so excited to work with the Patient Safety Movement Foundation, and we are fully aligned with our shared vision of building a better health care system. Today, I want to relate to you real human experiences as we look at the puzzle of health care. Human experiences from the perspective of a physician, a family member of a patient, of organized medicine, or a specialty society, and most importantly, the human experiences that patients have. One of the great things about being an anesthesiologist is that we have the opportunity to form these deep relationships with other human beings with our patients in just a few moments. They must trust what was a total stranger with their lives. In one word, I would just say, wow. What an awesome responsibility we as anesthesiologists enjoy. Let me relate an experience I had several years ago that illustrates the foundation of our profession, trust. My patient was an elderly ex-FBI agent from New York, who was literally suffocating from a lung mass. He could only speak just a couple of words before he would gasp for what seemed like his last breath. So we had our necessary conversations, the things that I need to do to make sure that he is safe and receives a good anesthetic, the things that he needs to know about his anesthetic. But we spent some extra time talking about his life, his work, Mickey Mantle, and most importantly to him, his family. In the room were two doting daughters, a son-in-law and a tearful wife. The sorrow and fear in the room was palpable. They all knew what was going to happen in the next few days. But they were a family, and they were going to walk through this experience together. Although our time was short, our bond was rich and deep. As we concluded our conversation, in one of those moments that seemed to last forever, we locked eyes. He grasped at my hand, and with what seemed to be his dying breath, he said, I'm in your hands. I'm in your hands. What a powerful moment. What a sacred trust we as physicians, as healthcare providers, and those of us that work in the healthcare system enjoy. Patients trust us with their lives. Families trust us with their loved ones. In a vulnerable moment, we walk across with them, across the quality chasm. They must know that they are safe. Put a little bit differently, patient safety is the bedrock upon which quality occurs. Here you can see the quality pillars of access, timely care, effective care, efficient care, equitable care, and most importantly, patient-centered care. In my 30 plus years in anesthesiology, I've seen many patient safety initiatives. Here are four or five that I wanted just to highlight. When I first started in anesthesiology in the 80s, there was a lot of focus on medical errors and a lot of good was done. But medical or medication errors still occur far too frequently and still need a lot of work. The next wave that came along that I noticed was teamwork and communication. Again, focusing on teamwork, focusing on communication added a new dimension to patient safety, something very, very positive. Noteworthy in a report a couple of years ago was diagnostic error and how diagnostic error contributes to patient safety errors. Preventable harm. And finally, what's on the horizon is artificial intelligence, or what I like to say, augmented intelligence. Artificial intelligence is not going to replace a human being, but it's going to augment the decisions that we make. This is a powerful tool that is likely to improve quality and safety. But there are some risks and we need to make sure that as we implement augmented intelligence that it is done with the least amount of negative impact on patient safety. We at the ASA wanted to think bigger than just errors to reevaluate our vision and all the positives that we had done over the past few decades. I very much like this definition of patient safety from a recent publication from the National Academy of Sciences, Engineering and Medicine, avoiding harm to patients from the care that is intended to help them. Safety has now transformed what used to be, and I shudder a little bit of using this term, but used to be callously viewed as the cost of doing business into something that is more visceral, something that is the cost to human beings, something that has impact on human beings. This is some curves modified from the work of Don Abidian and you can see that the graft is over time, state of health, and the trajectory of disease. The curves vary a little bit, but it makes an illustrative point in that the middle curve, the blue curve, is untreated disease. Healthcare systems, physicians, nurses, all of us that work on the front lines, when we do an intervention, we want to make sure that it is done with quality. Where miracles occur up on the red dot dashed line and that we avoid that green line where on safe care can eliminate and actually reverse and make people want to avoid the healthcare systems. Safety is inextricably linked with quality and the experience that the patient must have lives on that red line. For that to occur, we must develop systems, not silos, but systems of safety built on an organizational culture of safety and systems that are learning systems, always seeking to improve. From a specialty society's perspective, basically the ASA, we wanted to take a hard look. We did this a few years ago, but we want to take a hard look of how healthcare measured up. Not just anesthesiology, we weren't thinking of just the silo, but the overall healthcare system that we live in. What the gap might be, what the gap is between what is and what should be. So how is healthcare doing in America? A lot of different opinions out there. This is an op-ed piece written in the LA Times on December 27, 2018 by Robert Pearl. He's the previous CEO of the Permanent Mental Group. I don't intend for you to read this, but he makes the point that according to recent data from the CDC, the life expectancy fell for the third straight year in the United States and that we had the ability to save 500,000 lives by doing simple things that we already know, simple things with the technology we already have that address the top five or five of the top 10 causes of death as seen in the right hand side of this slide. Heart disease, cancer, stroke, diabetes, and flu. He goes on to note that medical errors are not even on this list, and if they were, they would be the third leading cause of death as we've heard today in the United States. So let's focus in on patient safety. Here are some important landmarks. 1999, and I'll spend a little bit of time talking about this in the next slide. The Institute of Medicine reported that perhaps as many as 98,000 people die in hospitals each year as a result of medical errors. That report was a watershed moment. The report dramatically elevated the profile of patient safety and the funding that went into developing safety science. The report made several errors that I'm sure most are aware of. First, errors are way too common. Errors are costly and most importantly, errors can be prevented. In the years since the report publication, it has been increasingly clear that safety issues are pervasive throughout healthcare and that patients are frequently injured as a result of the care they receive. And let's look at some of these landmarks. 2013, and some of these have some methodological limitations, but here you can see 2013. James estimated preventable deaths, 210,000 to 440,000. Makari in 2016, 251,000. The LeapFrog Group made an estimate of 206,000 in 2016. And I very much like your goal of zero by 2020. Some would say that zero is aspirational. Zero is where we want to be. Zero is our mission. And how much better to have fallen just a little bit short of an aspirational goal than to set an achievable, mediocre goal that we all may have achieved but with a 50% of commitment. This public health crisis deserves a 110% commitment. And if we fall just a little bit short, thus, so be it, we will have saved more lives. The November issue of health affairs was devoted to patient safety.  And what they describe in short was the period since error to human was published could be considered a bronze age. We moved into the bronze age where new policies, new tools, new strategies were developed. And we now sit on the cusp of an inflection point that could move us from the bronze age into the golden era. And that's where we need to go. This is a modification of Cotter's eight step change model. And the primary modification is to put a sense of urgency right at the core. That sense of urgency needs to be there for change to occur. Once that sense of urgency is eliminated or we become callous to that sense of urgency, change stops. Change does not happen without a 110% commitment to a struggle, a struggle in our case to develop systems of safety. That struggle involves all of us being strong advocates to maximize that quality curve I showed earlier. With step one, step one never goes away. We never leave step one, but it's to convey that sense of urgency in a manner that resonates with those who matter most. It's about closing the gap, about being at the table when decisions are made and having a compelling agenda. An agenda that is not an agenda in and of itself but is linked to decisive action that changes the what is, to what should be, what must be. So let's move on and talk a little bit about a personal experience about how it is like to be a family member. And my story here pales to what we've heard today. And thank you for sharing those stories. Those stories are what drives change.  Three years ago, my father had coronary artery bypass surgery at the age of 85, which is no small feat and a decision that our family struggled with. Here to for or before his surgery, he was active, climbing on the roof as an 84, 85-year-old, fixing leaks in his roof, very strong, not having surgery. He had developed a severe, suddenly basically severe coronary artery disease would have been a death sentence to us or to him. But as a family member, I also knew what the implications were of having coronary artery bypass surgery on the brain. And it was kind of like damned if you do, damned if you didn't. He had his surgery and the surgery itself went smooth. But postoperatively, he developed what I would term hypoattentive, postoperative delirium, essentially a state of acute brain failure. That finally resolved that what lingered, the residual deficit for him was cognitive deficits that have affected his memory. I was with him a week or two ago, we still had great conversation, but he's not the same that he was. It has affected him and affected his quality of life and affected our family. Preventable harm not only affects a single patient, but their family and the nucleus of the relationships that they have. So let's talk about the vulnerable brain. We are in the midst of a great tsunami in the United States, the elderly being most vulnerable to postoperative delirium. Delirium can be termed as an acute decline in cognitive function and attention and represents acute brain failure. A high-risk group are the elderly and it can occur in up to 60% of selected patient populations. There is significant morbidity and mortality associated with postoperative delirium, including myocardial infarctions, pneumonia, respiratory failure, progressive cognitive decline or accelerated cognitive decline, and it can even enmask and maybe even accelerate the onset of Alzheimer's disease. It's been estimated and reported several years ago to cost the US healthcare system $150 billion. Dollars may be well spent, but certainly if we can attack this patient safety target could be repurposed to other patient safety issues or other healthcare issues. And 40% of the cases are deemed preventable. This made this a very, very attractive patient safety target to us at the ASA. So we undertook the perioperative brain health initiative several years ago. It was our moonshot. We knew that in order to be successful it could not be a one-year blip during my presidency. It had to be sustained over time and it needed to be collaborative. Several years ago we held our first collaborative meeting and there were over 35 stakeholders in the room. Our mission with the perioperative brain health initiative is to optimize the cognitive recovery and perioperative experience for adults 65 and older to make available a three-year comprehensive plan that institutions, organizations could use to become centers of excellence, to create a campaign through which all providers have greater awareness of the importance of preoperative screening for delirium, identifying those of us, those patients that are at high risk, and appropriate protective measures to mitigate that risk and then when that risk, when that episode of delirium occurs to provide best practices for treatment. And among the stakeholders I cannot tell you how important the collaborations are, particularly collaborations with patient groups. We collaborated very closely with the AARP and I thank the head of our perioperative brain health initiative, Lee Fleischer, who you hear from in the next panel for his collaborative relationships in making this work. They have a global council on brain health, the AARP which its mission is to maintain and improve brain health. And here you can see Lee, a letter to Lee, inviting him to the international drive to illuminate delirium. Essentially another group of stakeholders trying to eliminate this disease and it's in association with the Alzheimer's Association. We at the ASA very much like the patient safety movement foundation and their actual patient safety solutions. We connect strongly with all of those solutions. Here are a few that just jumped off the page when I read them. A culture of safety, medication safety, obstetric safety, handoff communication, airway safety and most strongly it connects with the big project we're working on now, postoperative delirium. We must develop learning healthcare systems that align science and culture and embed best practices into a system of safety. And finally, let's talk about the patient. This graph here is reflective of what's possible in healthcare showing you the evolution of the treatment of acute coronary syndrome or myocardial infarction over my lifetime. 1955, President Eisenhower had a moderate heart attack. He was rushed to the hospital, placed in an oxygen tent and given what was termed tender loving care, the standard of care in 1955. He conned the less than the hospital for six weeks and left the hospital at that time. Mortality at that time was over 40%. If you had acute coronary syndrome, the mortality has been steadily decreasing due to some of these interventions. First in the 1970s, a coronary artery bypass surgery came on the event and oftentimes was a solution to acute coronary syndrome. Angioplasty and stents became very common application in the 1990s. And then in the 2000s, a quality improvement initiative nationwide to reduce the door to balloon time was instituted, essentially decreasing the mortality to less than 10%. And I've never shared this in public, but in 2013, six years ago, I was in that bin, in the 2000s bin, in the QI bin. If I were living in the 1950s, I would not be talking here to you today. Just real quickly, my story, my wife and I have a regular date on Saturday morning at Hot Power Yoga. It may have been one of the risk factors for coronary artery disease, but it was about two to three miles from our home. And I had sailed through that class, was starting to drive home, and I kind of felt a little bit of chest tightness. Being in full-blown denial, I said, well, I must have asthma. I must be reacting to something in the car. So I rolled the window down, didn't improve things, had my wife take my pulse, thinking maybe I was an AFib, it was regular. So then it kind of downed on me, well, maybe I'm having a heart attack. So again, the drive home was about two or three miles, and so I said, well, I'm gonna stop into a parking lot, let you drive, and I didn't tell her this, but just thinking, you know, I might have a latent heart arrhythmia and crash the car. So we stopped in a parking lot, I went down to the back seat and laid down and told her to drive home. A great decision to let her drive, a poor decision to direct her or ask her to drive home. About 30 seconds later, I kind of realized, you know, maybe not such a good idea to drive home. Fortunately, just across the street was a hospital, hospital I'd never been to, but I told her, well, drive to the hospital, let's see what's going on. So she drive to the emergency room and I told her to drive up right at the doors, which immediately summoned a guard that said, you can't park here, no, no, go away. I told her, well, tell them your husband's in the back seat having chest pain and shortness of breath. Those words triggered a response, and within seconds, probably eight or 10 people came out. They came out first with a wheelchair, looked at me in the back seat and went back and got a gurney. They put me on the gurney, took me into the emergency room, and I was attacked by a wonderful team of technicians, nurses, and doctors. IVs went in, EKG stickers went in, crushed aspirin went in, et cetera, and I was having the real deal, an ST segment elevation. Now as an aside, one of the greatest threats to patient safety is when you have a doctor as a patient. So I was sitting there interacting with them in my, you know, column cerebral way, and I said, well, what about giving me some nitroglycerin? So they checked my blood pressure, gave me some nitroglycerin, and ST segment decreased to ST segment depression, which was indicative of a reperfusion. And that triggered another series of events where I was rushed to the cath lab. The interventional cardiologist was called in, and the interventional cardiologist essentially put, did an angioplasty and stent. On my left anterior descending artery, which was totally occluded, the so-called widow maker. So I went back, they took care of that culprit lesion. A couple days later, they come back and took care of another couple of lesions, and I was discharged the next day. Instead of spending six weeks convalescing in the hospital, I went to the gym that afternoon. Did my regular workout and was on a treadmill. And I stand today as a testament of the miracles that can occur in healthcare. I would not be here, but for the innovations that have occurred over the past few decades, and the wonderful team that took care of me, without any, at least apparently to me, adverse events. I leave you with the words of Mark Cuban. I don't oftentimes quote him, but I did find this quote very apropos for today. It doesn't matter if the glass is half empty or a half full. All that matters is that you, we are the ones pouring the water. We are the ones, and I know I'm speaking to the require here, but we are the ones that are responsible for fixing this problem, responsible with all the stakeholders in healthcare. And that includes everybody. Our work has just begun. And it's been so gratifying to be here today and hear that silence, the patient care stories are not an option. The stakeholders of healthcare, we cannot sit on the sidelines any longer with what is the third leading cause of death in the United States. It must be treated as the third leading cause of death in the United States. And we must engage or essentially continue to enable the harm. I thank you for your time and attention. And again, we enter the golden era of patient safety in a very collaborative fashion. And I invite your commentary either by telephone or by my email addresses up here as to how we can continue to work together the American Society of Anesthesiologists being 110% committed to reach a goal of zero by 2020. Thank you, the Patient Safety Movement Foundation for all the work you are doing.


Hey guys, Thundee here and yes, we have a brand new video for you. You know what it is? It's the Aya Neo Flip. It's a brand new portable gaming device and yes, it does have a flip open display. Now if you join us for the first time, hit that subscribe button notification icon so you can watch more videos like this and for our regular viewers, you guys voted for videos on Saturday and here it is. So we're giving you videos every Saturday at least guaranteed on the channel. And as you know, I love to game a lot on the channel and I've covered a lot of Aya Neo devices. The flip is the latest in the line and I have to say I do like the idea of having a device where you can actually close it up and carry around and you don't need a case, which is pretty cool. So it's really robust and rugged, feels solid and you know that you're not going to damage the display inside. That being said though, like it has this almost large Nintendo DS look to it. And you've got of course your standard buttons. You've got your left and right triggers, left and right bumpers. You also have customizable RC and LC button and then there are two USB Type-C ports in the back and a Q-Link port. You also have micro SD card slots and then you have this massive vent for pushing out hot air with the fan underneath. The front of the device has two slits for the speakers, head from jack. Kind of standard affair for gaming devices here. The grip wise, you know, it does have a little bit of a grip so you can hold it pretty well at the bottom. Now when you open it up, this is where you get the kind of flare of what this device breaks, right? So if I just kind of show you here, you open it up, you can see that all the buttons are flush. The keyboard, the analog sticks, the D-pad, everything is flush. And it's meant to be that way so you can actually close this properly. The D-pad is flat, it feels like you have to kind of dig in, especially when using fighting games while your analog sticks are also kind of sunken on either side. You do have a full flushed out keyboard which feels a little bit easier to access in the center if you're using just your two fingers from either hand and then of course you got your standard buttons, your XYBA also which kind of have a flat surface, your volume rocker and then on the top right hand side are two buttons that kind of look off place because they have a very different color scheme. The silver one is the power button and also the fingerprint sensor which is nice so quick access to turn on your device and then that black square is a mouse dial so you can actually move the cursor around while you're typing you don't need to touch the screen. It is a touch screen anyway and that screen is lovely, 7 inches, 120 hertz display and of course there's gambit and ah monami, gambit gambit such a great X-man.  This thing looks absolutely gorgeous you set it down it just reminds me of the Nintendo DS and it does have two variants there's one with the keyboard and there's another one with a secondary display. I do have the version with the keyboard and in terms of specs it's the Ryzen 7 840U it's also got 64 gigabytes of RAM, Max as well as two terabytes of storage Max. You can get it with 16 gigabytes of RAM, 512 gigabytes of storage that that model starts at $699 and you get it through Indiegogo so there'll be a link for you if you guys are looking for this device.  To be fair it's comfortable in terms of gripping holding feels comfortable while gaming now playing games on here it's an interesting perspective and you know played some Street Fighter 6 I played some Shadow of the Tomb Raider just to give you a feel now in terms of the performance we know what these devices perform we perform similar to the A and the O slide which I'll kind of compare more with this device in the second but the playability is what I want to talk about because with that D-pad being more flat and sunken it's kind of harder doing a lot of the moves in Street Fighter. Playability I think feels less doesn't have a more pronounced D-pad at least for me now the analog sticks are fine especially playing Shadow of the Tomb Raider but it feels like this limited range just because you're kind of in a sunken well while using this so it feels a bit different has ticks I'm getting used to but you can still play a function quite well with this and I think it handles that well now in terms of temperatures didn't feel that hot it felt actually pretty just warm in the hands and most of the hot air was being pushed out by the vent at the back so I definitely like that there now one of the things about this device is that you know you've got different angles for the screen so you can actually have it flat all the way you can have it slightly up kind of like a 45 degree angle you can have it almost close to 90 and then you can close it up so you've got a couple of angles for viewing angles for this which is good while you're gaming because it gives you just you know just a perfect way to actually game on this device which not a lot of devices do have that so that's something to take note now I mentioned the A and Neo slide that's a device that came out earlier and I covered it on the channel and I really like that device I travel with it a lot this is the device here and what I like about it is just the way the slide out display and keyboard in the center kind of just show up show you that again slides out pops up right pretty cool it has an angle so it's got a slight angle better for better viewing keyboard is flush but keyboard is also a bit wider than what you have on the flip on the upside of this the d-pad here is so much better and the buttons feel more pronounced everything feels comfortable and it's also wider for me as a gamer in comparison to the flip you can see it side by side you can see it stacked up here you get the idea and I wish for me personally I wish you could turn this into this and what I mean by that is have this display instead of sliding out flip over and close right over that keyboard to me will make the most amount of sense for this devices not saying that the flip isn't good it's just that the anio flip doesn't necessarily meet all the things that I'm looking for especially while gaming I think this is a good device but I think some of the drawbacks of the design kind of limits what I would like to do with the device I would take the the slide over that just because I feel like I can game more in terms of just the functionality not the specs or not the performance but just just the physical hardware functionality but it's great to have your screen in moving different angles you know that way so that is the anio flip I think it's a solid device it might not be for me it might be for you but anio does this wonderful thing that I do like with them is that they have different devices that you can select from and going to their website you see a ton of different devices they have I love the fact that they're always making something new so I can't wait to see what next they have but I think they have a device for you which is pretty great so if you guys have any questions or any comments let me know if you want to pick any of these devices up use the link down below otherwise don't forget to like share subscribe stay tuned on channel come back next Saturday and we'll have another video for you so always enjoy entertainment


The success of the Great British Bake Off has led to thousands of copycat shows. The latest is the Chop launched this week by Sky History. Now this is normally seen as a safe, if somewhat dull format. You get people to compete to sort of do a task, be that dancing, cake baking, sewing. But this time around, Sky History sort of found themselves in a controversy that they hadn't bargained for. Let's look at the advert for the show they shared online this week. So that's actually kind of a classic advert for a TV program, like it looks kind of nice and light-hearty. Someone has this juxtaposition of he's got tattoos all over his face but he's quite softly spoken. Lee Mack's there to make the kind of semi-insulting joke, but soft enough that it sort of lands well. He's saying, I wouldn't know you as the wood guy. I'd know you as the tattoo face guy. Anyway, there was something that the producers of that show hadn't bargained for. There's going to be some research is maybe in a little bit of trouble here. I'm not sure. I hope no one gets fired for this. But it turns out that those weren't just any old tattoos. Lumsden's face is covered with symbols for white supremacy. So this first became apparent because if you'll have noticed, he had a huge 88 on his cheek. So you can see there the 88. Now, I actually didn't know this. I learned about this through this controversy, but it turns out that's one of the most common neo-Nazi symbols. So H or H is the eighth letter of the alphabet. 88 equals H H H H equals Heil Hitler.  He might deny that was the intention, but that's that's what it stands for. Yeah. So if you see under there, what does it sound at the top of his lip? Oh, is that homegrown? Yeah. So, you know, there's a lot of context here, homegrown 88. And by the way, 88 also kind of looks like the SS runes. So that's a double meaning. Yeah. Yeah. Yeah. We've got Adam Rutherford, who's sort of academic. He, academic broadcaster, wrote a great book actually, How to Argue with Racists. He sort of pointed out that it wasn't just that 88. It wasn't just the 88 Heil Hitler.  So let's take a look at that Fred. So he writes, okay, a quick Fred on white supremacy symbols.  Darren appears to have two on his face or appears to have these two on his face. So 88 H H equals Heil Hitler, as we've just discussed. He also has 23 16. And the 20, the 23 is for W. So the 23rd letter of the alphabet. And the 16 is for P for power. So it means white power. There's also 18, which is a H which equals Adolf Hitler. And then 14 88. So this seems to be like a really big deal. What the 14 88 is a reference to the so called 14 words coined by white supremacist terrorist, David Lane. Oh, and these have been used by very dangerous white supremacists. So this isn't just an online meme thing. So Dylan Roof, who committed the Charleston church massacre in 2015, he posted a picture of 14 88 written in sand on his website. It actually gets more obviously this is all quite dark, but there's also a ridiculous element to this. So in response to social media users pointing out the symbolism of the tattoos, and especially the 88 ones, it's obviously the biggest most prominent one sky or sky history pulled the show. They said it would remain off until they investigated the meaning of the tattoos. They then followed up with this explanation. So let's get this up. These are sky tweets. They say Darren's tattoos denote significant events in his life and have no political or ideological meaning whatsoever. Amongst the various numerical tattoos on his body, 1988 is the year of his father's death. The production team carried out extensive background checks on all the woodworkers taking part in the show that confirmed Darren has no affiliations or links to racist groups, views or comments. Sky history is intolerant of racism and all forms of hatred and any use of symbols or numbers is entirely incidental and not meant to cause harm or offense. Now, there are two problems with this. So one, 88 wasn't the only neo-Nazi symbol on his face. So it'd be quite coincidental if all of these numbers had white supremacist meanings. The 1988, maybe you could do one by mistake, but to do a few by mistake, that would be, I suppose, unlikely. Two, and this is probably the biggest problem, his dad's not dead. So this was an exclusive in today's Daily Mail. So let's get up the headline. So it's exclusive. I'm not dead yet. Father whose death in 1988 was used by Sky Histories, the chop to explain his son's Nazi-style Hull Hitler, 88 tattoos, reveals he's very much alive. And the story here is really bizarre. I suppose in the style of like mail online. So let's get a quote from the story. So Trevor, who is the dad, told Mail Online, I'm here, aren't I? I'm alive and kicking, so I'm not dead yet. Darren's father has short-term memory loss after a series motorbike crash more than 30 years ago. He lives in a shared house and has support workers popping in to help every day. The father added, I haven't seen Darren for some years. I didn't know he had tattoos over his face or that he was going to be on TV. But if they are saying I'm dead, then I'd like them to know I'm not.  I mean, the dates kind of do add up to like maybe it was, maybe he fought, he died in a motorbike accident, but actually he just lost his memory. But then still, I mean. And now in 2020 he's being accused, possibly accused of being a neo-nazi. And now because of appearing on the chop and being accused of being a neo-nazi, he's been reunited with his dad who also had short-term memory loss. The whole thing is so bizarre. But again, that wouldn't explain all the various other sort of white supremacist symbols on his face. And it does seem like the explanation here is all fallen apart. Also like, let's not be entirely credulous. You've got like a really well-built guy who works with wood, whose face is covered in tattoos, has the number 88. Like there's a 99.9% possibility the guys are neo-nazi. Like you don't need to do the other stuff. Where does this credulity come from anyway? I mean, the bigger, the thing that's funnier actually, because I've always, I've said kind of like, I, you know, if I was a researcher, I would hope I would look up the meaning of these tattoos. But I, before seeing this, didn't know that 88 was Hal Hitler. But for the producers of this show to be told, look, these are a lot of neo-nazi symbols, and they just put out straight away, you know, within a day, like a multimillion-pound company. Oh no, nothing going on here. It's all completely fine. 88 was the year his dad died. Come on! Like what kind of crisis management is that? And also it's a history channel. It is. Yeah, they should show these. Super weird. It's this. And also why are they talking to people like Woodwork in the 21st century when it's the history channel? Anyway, also, by the way, this is really indicative of how widespread this stuff is. So it's a major thing. Cultural sort of adoption of neo-nazi runes and so on is a thing.  Operation Werewolf was the Nazi strategy, basically, if the West, if the Allies won, they would have carried on, basically, through a terrorist style, low-intensity insurgency. There are normal people walking around who see themselves as part of Operation Werewolf. Be interested, but maybe we should get this guy here on a lie detector. Get him to take his shirt off, because God knows what's under there. If that's what he's willing to show people. That's true. And get him on a lie detector.


What's going on guys? It's your boy DPJ here today with another Destiny video and today I bring you top 5 freakout reactions of the week. Now headphone users be warned you may just want to turn down that volume just a little bit but if you guys enjoyed the video do drop a like I'd appreciate the support and I'll catch you guys on that next one. There it is. Come on, come on please get me an LDR please. Please game please. Yes! Yes! Oh! Oh! I got one. Oh! Oh! What's on it? Oh! Oh! Oh! I saw it, I saw it. Shortgaze, triple tap, hot swap, rifle barrel. That's pretty good. Look at that. Please shortgaze. I'm done. I'm done. Oh my god. I literally just got the best gun in the game. I'm not even kidding. I got ambush as well. Snapshot. We all we all got cruise for packages so hopefully we get some good freaking luck on these things. Wait, let's wait till Kirov gets here. So are you gonna, should be open it one at a time or all at once? One, two, three. Oh! I got a special. I got a special. Oh my god. Oh my god. Yes!  Oh my god. Oh my god.  Oh my god.  Look at my soul. Oh my god, baby. Okay. Wait, everybody's done. Come to me. Come to the cryptar. Can start bagging him. Okay. Little sumo. Guys, little sumo.  Poptark, you know. Press the button to approach and keep saying Sora's regime to him. No, it's for good luck. Okay. So what you basically do, you see the square button on your PS4? Do a shock. Keep pressing that and keep saying Sora's regime to the cryptar. Okay. So it can bring me some good luck and see if I get it. Little sumo, are you gonna help me or what? Little sumo.  Don't do it yet. Gio, when I, when little sumo. Okay. Everybody ready to bag him? Okay. Are you bagging him now? Okay. One, two, three. Oh my gosh. Oh my gosh. Oh my gosh. Oh my gosh. Oh my gosh. Oh my gosh. I got seriously. I'm going to the postmaster because I do abuse tiger abuse. Maybe I'll like no. Look at this magic. Watch this. Look at the sign. Oh, damn it. Right. Damn it. I have it on the wrong way. No, my foot is, my foot is not sweaty anymore. Let me sweat it up. Sweat something up. Exercise. I know, but like, up?  Oh my gosh. Did I get a package? Oh no. What is that? Nice socket. Wait. A few items. Wait, wait, wait, wait. I know. A few items to aid a hunter traveling or to take it. Oh, I love you, my stalker. Whoa. Oh my gosh.


We have been discussing the quantum mechanical description of a magnetic resonance condition. Let us recapitulate what we have done so far. We have a Zeeman interaction which gives the main interaction given by this. This is the Zeeman magnetic field, this is the S Z operator and the perturbation which is the small B 1 magnetic field applied in the X Y plane that is given I, this is the way it is. So the total Hamiltonian is H 0 plus H prime. The wave function corresponding to the unproduced Hamiltonian H 0 is written as psi of alpha similarly psi of beta. Here e alpha and e beta are the energy corresponding to the state of alpha and beta. And of course alpha corresponds to the this spin angle on the quantum number of plus half and beta corresponds to the minus half component. So in the presence of this perturbation we say the total wave function can be written as linear combination of this plus this. And we found that we can get an equation of this kind. Here our aim is to find out this coefficients here that tells the equation connecting the evolution of the system from one state to the other. So if you multiply on this side by let us say this one and complex conjugate of that so that I get psi alpha this gives. Now here because of the orthogonality of this wave function psi alpha and psi beta this gives 0 and this term also will give 0. If we evaluate this integral using this form of the perturbation this goes 0. So what I have here is this one is equal to 1. Now keeping in mind that this psi alpha and psi beta have this sort of form that the space part is here and the time part involves the energy this can be written as into e to the power that is the way it looks like. Similarly for the other coefficient we can write now that these equations are very important for that I have shown here in this slide minus h by 2 pi i dc alpha by dt is equal to the functional form given here. Now this can be simplified by taking this h by 2 pi i as h cross and bring it in the denominator. So we have got these two equations which are given here which shows the change of the coefficient alpha as a function of time and given by this. So here it shows that if this term which is essentially same as that if this is 0 these are not going to change. In other words for any change to take place or any transition from let us say alpha to beta to take place or from beta to alpha to take place this must be non-zero in a sense this decides the selection rule for transition. Now we have got this two coupled differential equation this is got a mistake here and this is got a mistake here. Now this e alpha minus e beta is nothing but the energy difference between the alpha state and beta state. So this gives rise to the higher energy and this is lower energy. So this is actually equal to this was missing h cross was missing and other equation is dc. So we have got this coupled equation the c alpha is connected to c beta c beta is connected to alpha. So it is not easy to solve these equations simultaneously. So what we can do is to use a perturbative technique to get an approximate solution. For that we start with this given initial condition that let us say condition is that the beta state is lower alpha state is higher. So the spin system initially is here and then when the perturbation was applied can it make transition from here to there that is what we are going to find out. So at t equal to 0 initial condition was that c alpha was 0 and c of beta equal to 1 and then what happens when t is greater than 0. So with this initial condition now let us try to find out the value of let us say c alpha then we can get d alpha by dt. Now here we have to find out this integral now for that the integral is involves this perturbation expansion. So this integral equal to cosine omega t plus sin omega t. To evaluate this integral we can make use of the lowering operator or raising operator s plus s minus let us see how that is done s plus 1 is sx s minus i xy. So this gives sx is equal to s plus s minus y2 and similarly sy is s minus minus y. So alpha sx beta will be alpha s plus s minus y2 beta. So this gives alpha half of here this is raising operator is lowering operator. So when it raises it can raise beta to alpha and lowering operator s minus operating on beta cannot lower it further where beta is the lowest state. So this gives 0 then you can use the property of the operator. So this give to get the value this belongs exactly half sy component this is alpha sy beta alpha sy beta. So this can written as alpha s plus minus s minus y twice i beta. This will give minus 1 by 2i or is equal to i by 2. So from this I can get the expression of dc alpha by dt in terms of this values exponential minus i it is the power minus i omega t. And similarly dc by dt gives c alpha by i h cross g e beta i b1 by 2 exponential this is this is alpha minus beta by t that is the way it comes up to be ok. Now we have actually started with this equation and then found this solution. If we integrate this now with respect to time then at let us say t equal to 0 c alpha equal to 0 and t greater than 0 this is c alpha. So this gives c alpha function of time and if we integrate this that is where it comes up to be now with the limit put there the value becomes. So this gives the expression of c alpha as a function of time and how it changes and it changes in this fashion. In this system we assume that our spin system to start with was in beta and then this gives the probability that it will be appearing here. But probability is not given by this number alone it will be a square of this number. But since this is a complex number we take a modulus of that which is in this fashion c star alpha into c alpha. So this will be written in terms of the multiply this and it is complex conjugate and simplify this see if I have this here ok. This gives again d c beta by dt in this fashion similarly d c alpha by dt in this fashion and then we multiply this which is complex conjugate and the simplified the equation looks like this. Now in this equation see that sin square and this is the argument inside and the denominator also similar argument here. Now this function becomes very very large when omega is very nearly equal to this g e beta e b 0 by h cross. So what you find here is that this sort of term comes there and the function we have got something like sin square x type of x square something like that which is the function here roughly speak not quite the same. But the t is there but we ignore that for the time being its function is of this kind. So this has a behavior x if you plot it has this sort of behavior that is at x equal to 0 it has very very large amplitude that is probability that the system will go from beta to alpha is very high when this argument becomes 0. Now this is interesting because this also shows that is actually equal to h cross omega and this is nothing but the Larmor precision frequency in disguise why the disguise if you write h by 2 pi and omega is 2 pi nu then this gives h nu equal to b 0 and this is nothing but the resonance condition that we have been talking all the time this also if you write here that g e beta e 0 by h cross which is actually Larmor frequency this is the this is nothing but gamma electron gamma electron b 0 equal to omega this is the Larmor frequency there. So if you have recovered the conclusion that I have derived from the classical description of magnetic resonance exactly same conclusion arrived at but the important difference is that here we have not really brought in the concept of appreciation. Larmor precision involves knowing the direction of the angular momentum or the magnetic moment in some absolute fashion that is I must know the both x y and z component of the three components of the magnetic moment then only the precision can be sort of visualized but quantum magnetic says that that is not possible we can only get one component of the angular momentum or the magnetic moment and the total magnitude of the angular momentum that is the description that you have used here but ultimate conclusion is just the same. Now this can be generalized to spin which is more than half here the description was based on only s equal to half say about two level system but if you have let us say s is equal to 1 then m s will be minus 1 0 plus 1 three level system one can actually do exactly the similar treatment and come to the same conclusion that for delta m s will be plus minus one will be the allowed transition and similar resonance condition will be applicable there also either I can write h equal to so here m s changes by one unit in plus minus half also the spin changes one unit so everything is consistent there so with this analysis we come to the end of this quantum integral description of the resonance in magnetic transition here we have understood that classical picture and quantum picture both give the same answer we end here now.


Welcome back everyone in this final video for lecture 41 I actually want to introduce the root test, which is like the little brother of the ratio test I say it that way because the three conditions we use for the root test are very similar to that we saw the ratio test And in fact the proof of the ratio test The proof of the roof test pretty much always uses the ratio test So basically the ratio test can prove everything that the root test can prove But there are some situations the root test actually makes to lead an easier limit calculation So we do actually want it as an additional test for us So this time as the name is going to suggest the root test We're going to be looking at the roots of things so particular We're going to look at the sequence where you take the nth root of the absolute value of a n the ratio test We took the limit of ratios the root test We take the limit of roots and we look at what does that limit? What is the sequence converged to what's the limit in that situation? Well, if the limit of the root sequence if that's L And that's greater than one then that actually gives us an absolutely convergent series just like the ratio test If the limit of the roots turns out to be greater than one that actually means the series was divergent In fact, we could have used the test of divergence to determine that and if the the if the sequence of roots Turns out to converge towards the number one then in that situation just like the ratio test It's inconclusive so let's jump immediately to an example One example where the root test actually does turn out to be a little bit more effective than the ratio test would be the series We would take n equals one the sum of n equals one to infinity of the Sequence 2n plus 3 over 3n plus 2 all raised to the nth power and so while the root test Why the root test is a little bit nicer because everything is raised to the nth power right here Ratios could work right here But as we have a rational expression raised to an exponent if you took ratios here gonna have fractions inside of fractions It's gonna be quite messy, but the root test is actually super clean in this situation If you take the nth root of this term the absolute value of 2n plus 3 over 3n plus 2 All raised to the nth power right here the root the the nth root is gonna cancel the nth power right here And we end up with the absolute value of 2n plus 3 Over 3n plus 2 and if we take the limit here because this is a balanced rational function We have a 2n on top a 3n on the bottom This is going to converge towards the limit two-thirds taking absolute values there now this limit value L This is the limit of the root sequence. This is less than one and so this tells us that our series is going to fact be Absolutely convergent by the root test and so the root test works out really nicely here Alternatively, if we wanted to use the ratio test we get 2n plus 3. Sorry back up a little bit We're gonna get 2n plus 1 plus 3 over 3 in plus 1 Plus 2 raised to the n plus 1 power and this will sit above 2n plus 3 over 3n plus 2 to the nth power and while you can argue that this limit will converge to something L and that L value be less than 1 you could use the ratio test to determine that this thing is Convergent you could do that But if you compare the two side-by-side you can see that the root test is a much cleaner argument here And so it's nice to have the root test as an alternative to the ratio test Especially you have nice powers that will cancel out with the in route with that that comes with the root test here


Hey, this is Brett with Summit Automotive in Fond du Lac and Beaver Dam, Wisconsin. We are at the 2019 Chicago Auto Show, and we're just checking out a bunch of different things at the Auto Show. This is something new that I've never seen, but this is a Kia Tellaride. I think it's all new for this upcoming year, and this particular one is pretty crazy. We can't get to it because they got it in this glass enclosure and everything, but I just wanted to do a quick video and walk around to this. Spears to be a branded Maxwell edition. There must be some doorsman guy or something, but this thing is pretty crazy. It's got the LED tail lamps. It's got this ladder climbing rack on it, which is kind of neat. That roof rack is like actual wood grain. The door handles have actual leather wrap on the outside. I don't know how well that would hold up. This one's got KMC wheels on a four-wheel disc, middle pterograpler tires. It's really a neat green, but it's got the leather wrap on the mirrors and everything, so I'm guessing that branded Maxwell package is not even sure. Just thought it was cool, and since I'm here, I might as well do a quick video on it. It has the LED headlamps, some off-road, what are those? They got the names all blacked out, but some off-road fog lights on there, Baja lights, whatever you want to call them, it has leather wrap hood straps on it, big snorkel. Just thought it was kind of cool. That's about all I know about the Tellaride and this particular package. Thanks for checking out the video. If you'd like to check out more, go to youtube.com. Remember to like, subscribe, and share on this video and all the videos that you see there. We're going to be at the Auto Show the rest of today and most of tomorrow doing these videos, so check them all out. Remember to like, subscribe, and share, and thanks again for checking out my videos.


You're watching News Made Easy. I am Anandya Chakravarty. So it's officially official now. This has been the worst year ever for India's economy, ever since India's independence. The last time our national income, which is the total income generated by all sectors, everyone in the economy contracted or reduced, was in 1979, 42 years ago during the oil shock. When petrol prices went up across the world and there was a global recession. This time it's because of COVID. There has been a global recession. Almost every economy has been hit by it. India pretty badly. The only exception has been China, which grew marginally by about 2 odd percent in 2020. Now for India, if we look at the GDP numbers that have just come out on Monday, there are some green shoots, which is some positive numbers have come out for the first three months of this year. Now remember GDP is calculated on the basis of fiscal years, which is 1st of April to 31st March of the next year. So it is always two years that are taken together, right? You know about that. So the GDP that we're looking at is the GDP for 2020-21, which is the 1st of April 2020 to 31st March 2021. And the first three months of this year, which is 2021, becomes the last three months of the fiscal year, right? Because January to March is the last quarter of the fiscal year. So Q4, the fourth quarter of the fiscal year, is showing some signs of recovery. Now it's marginal, just a shade over 1%, 1-1.5%. But that's better than what most economists expected. They expected India's GDP to grow in the last quarter of the fiscal year by about 1%. It's beaten that. Where the numbers are even better is actually when we look at the gross value added. What is that? That is the value added in the overall economy. We take aside, if we put aside taxes and subsidies by the government. So if we look at gross value added, then India has grown by more than 3.5%, about 3.7%, which is significantly better if we compare what economists expected, who expected a growth of about 2.5%. Now, what is more heartening you could say is the fact that manufacturing sector, which is factory output, things that are produced in factories, that has grown by almost 7%. And remember that this is a period when India believed that it has beaten COVID. So things were picking up. Demand was picking up from the end of 2020. We know that there was a decent festival season that took place. So that recovery continued in the first three months of this year. And as we can see compared to last year, there's a 7%. 6.97% growth in value added by manufacturing of the factory sector. If we go to utilities, which is electricity that is supplied to you, water that you consumed, gas, that grew by more than 9%. So again, very good growth in utilities, the value added by utilities. Come to construction, it's even better, more than 14%. That's a very decent recovery for the construction sector. And remember, that would be some amount of pent-up demand because a lot of construction would have stopped during the lockdown, which was in the process of being done. And that picked up in the first three months of this year. So these are three very positive growth. Again, services, professional services that we avail of, which is banking, financial sector, other professional services, real estate, lawyers, things like that. That has also grown decently by about 5.5%. So overall, a decent growth, if one looks at the value added. The place where there seems to have been continued slowdown, obviously, because that's going to take time to recover, which is tourism, hotels, restaurants and things like that. That has taken time to recover. That is still in the negative zone. And mining, again, has been in the negative zone. That's not really grown. Now, think about it. What we have is decent growth in the factory sector, decent consumption of utilities, and very good growth in construction. And again, decent growth in services. Shouldn't that also show up in domestic consumption, as in what you and we are consuming? Now, in the numbers that the government puts out, there's something called private final consumption expenditure, which is called PFC. Now, that stands in for household consumption. It's a proxy for household consumption, everything that you and I are consuming. What has happened there? What we see is that private final consumption expenditure has grown by just a little bit above 2%, 2.5%. That is pretty bad. Considering that manufacturing has grown, construction has grown, utilities have grown, services have grown, who was consuming all of that? Where has it gone? It suggests that households or people like you and me haven't been consuming it, because that hasn't really grown. What has stood in for that is essentially government final consumption expenditure. Government sector consumed and allowed these factories to kind of grow. It allowed utilities to grow. And perhaps some of that construction is also showing up in the building of assets. So, we are seeing government final consumption expenditure or what the government spends has gone up by 28%. There's an interesting thing here that if you look at the way government final consumption expenditure is calculated, durables consumed by the Defense Department, which is the Army, Navy, etc., is actually put under government final consumption expenditure, even though it's a durable. It is something that is going to be used later. It's not considered to be a capital or equipment or machinery that will be used later. Let's look at capital formation. That has grown dramatically. That, again, is a significant growth. Capital formation, which is factories, new construction, machines bought, equipment bought, that has gone up by double digits. What is a cause for concern is that inventories have also gone up by 12%. Inventory stock has gone up by 12%. So, we see capital formation, which is essentially things that are used to produce later. It's a form of investment that has gone by 11%. Stocks and inventories have gone up by 12%. So, what are we seeing? Consumption demand in the economy has actually not picked up. It is the government which is standing in to consume. Its consumption has gone up by 28%. Construction has revived. So, some kind of capital formation has taken place. And it's possible that companies have produced, assuming that demand will come back. And it's showing up in inventories. Inventories that have built up and maybe inventories that have been pushed out to the dealership channels. Cars which might have ended up with dealerships. Gadgets which have ended up in dealerships but not been sold. So, consumption has not revived. Now, this is a problem. We know that the second wave actually peaked from April-May. So, at least two months out of the three in the first quarter of this fiscal, which is 21-22, is going to see bad consumption growth, bad production. And yet an inventory which has been pushed out, yet investments for future consumption. So, this is a worry. Now, what that means is that when the economy begins to revive, demand begins to revive, there already be production out there. So, manufacturing might not keep pace. There will be a lag between consumption by households and what manufacturers are producing or what services are being given out. So, if real estate and banking is a significant growth that we've seen in the first quarter of this year, by the time the second quarter comes, maybe the loans have already been given up. Maybe the houses have already been bought and sold and we might not find any demand for that later on. So, what happens then? Manufacturing will drop. Factories will start reducing their production. Manufacturing growth will drop. Services might taper off and that effectively means even consumption of electricity which a large part of which is actually industrial consumption might actually drop. So, these are problems because that means that we'll actually see growth in consumption but a drop in things like manufacturing and investment. And therefore, that suggests that these green shoots that we're seeing might just be an illusion and we might end up with another collapse, another recession in this year as well. Maybe the GDP numbers will show growth because remember there was a collapse last year, right? In the middle of last year, there was a collapse in GDP. So, you might see the next quarter showing a high GDP growth but if 100 drops to 50, even a 25% growth on that 50 is what? Just 12 and a half percent. You just go back to 62 and a half. So, that will look like great growth but it will still not be back to normal. So, effectively we will take a very long time to return to where we were in the pre-COVID period. That's the reality of the Indian economy and the only way to come out of it is to boost consumption demand and that only the government can do. The government has been sitting on it. It should have been done yesterday but it's still not very late to do it today and tomorrow.