All right, now I thought about all this, this whole monologue, everything I've been saying and planned on it. And then Christian sent me this video by Lauren Southern, where she basically says capitalism is no good. Capitalism is a real problem. She titled the video, as you can see, a conservative critique of capitalism. Now I'm going to start in the middle because it's long at 16 minutes and you know I comment so much that it gets out of hand. Sorry if I started too early. So the first critique of capitalism she had was big corporations and they lobby and they control too much. So the typical conservative attack on big business. We talked about that. It's kind of boring. It's over and over again. They don't understand that the source of the political power of business is government. Take away the power of politicians over corporations and corporations start lobbying. So we're going to start with the second critique of capitalism, which I think is more interesting one, the more powerful one because I think ultimately they oppose big corporations because they're part of this. And that is the fact that capitalism according to Lauren Summers and I think according to many conservatives today is responsible for the destruction of community and culture. Again, I'm picking a big cloud side by accident because this is the video I got, but I think this is a conventional view. You can this is Josh Hawley. This is Ted Cruz. This is now mainstream. Certainly it's it's the people who support Donald Trump. This is now mainstream republicanism, mainstream conservatism, not the old conservatives, the new conservatives. They think this is even a conservative who I like who's anti Trump. Andrew Sullivan believes this. Capitalism is responsible for the destruction of community culture. It's responsible for the for the opioid epidemic. It's responsible for people losing jobs and being depressed. Anybody, everybody from Andrew Sullivan to Josh Hawley to Ted Cruz to the people who support Trump today believe this. And if you think the conservatives are different, the only conservatives I know who don't believe this are the never Trump conservatives, the people like at the dispatch. And even they, it depends which ones, but generally the dispatch conservatives are better. They're much more committed to free markets and they understand that if they're going to win the cultural battle, they have to win it through argument, not through the use of government to do it. So let's let me put my headphones on. Let's watch a little bit of Law and Sothers. I've got two segments I want to show you. Both are important. Okay. And I haven't listened to the whole thing. She's going to get in some cases, in most cases, you're going to get my initial responses because I haven't listened to this whole segment. And that is capitalism's destruction of community and culture. I often see many on the right lamenting the loss of old traditional architecture, community, family and art. Notice architecture. I told you before, right? This is that, that thing that Trump passed where the government has to build classical architecture. I don't lament that we've lost old architecture. Good riddance. They belong in Greece and Rome. Read the fountain head if you miss that. And yet at the same time, proposing capitalism as a solution, it's not, not even a little bit. Capitalism has no incentive to preserve our culture or communities. And in fact, I'd argue has negatively impacted families. I think where this confusion comes in is some people observe that Marxism works in opposition to capitalism and to deconstruct the nuclear family and assume therefore capitalism must be working to oppose Marxism and to support the family. But capitalism is not Marxism's counter. It came about before Marxism and is therefore indifferent to it. It's simply an alternate system. And while that system can certainly bolster some people's family lives and wealth and material goods, capitalism only moderates for the markets. Capitalism bolsters some people's well-being, some people's wealth. How did we get the world that we have today? Where did it come from? What's really fascinating about this is the original critiques of capitalism, the first critiques of capitalism even before Marx and really simultaneous to Marx throughout the mid, early to mid to late 19th century. The strongest critiques of capitalism came out of Germany. They came out of conservatives in Germany, traditionalists in Germany. He bemoaned the growth of cities, bemoaned the loss of communities, bemoaned the industrialization, the loss of farming, the move to industry, bemoaned the loss of those old style kind of conventional jobs in little shops. That was 200, 150, 200 years ago. Conservatives are still bemoaning exactly the same thing. It helps some people. Sorry, Lauren Summers, you wouldn't be alive if not for capitalism. Oh, it's unlikely you would be alive if not for capitalism. Lauren Southern is her name. Neither would most of the people on planet Earth. If you look at, if you get the wealth, all the wealth we have today is a consequence of that capitalism. This idea that capitalism helps some but not others is complete nonsense. No, it doesn't help everybody equally in a sense that not everybody creates as much wealth equally, but it's the only system in human history that has allowed individual to create wealth for themselves and as a consequence, increase the wealth of everybody dramatically in unimaginable quantities. So yeah, it is the alternative system to Marxism. It's also the alternative system to your mixed economy. It's an alternative system to pretty much every system out there. It is capitalism that's ended, Jennifer says ended child labor, but more than that, it ended, you know, the subjugation of women, it ended slavery. But this is the thing, one of the things that conservatives so object to capitalism, you know what else it did? You know what capitalism else did? It destroyed the family. Why did it destroy the family? Well, it didn't destroy the family, but it destroyed the male-centric family in a traditional sense because capitalism created opportunities for women to work, for women to use their minds instead of their muscles and therefore make as much money if not more than men. It provides opportunity for women to excel. It provides opportunity for Dagny to run a railroad, Dagny Taggart, and her equivalents. It takes women out of the house for the first time in human history and into the labor force as equals of men.  It scares the bejesus out of them of those unmasculine, and fearful, weak, pathetic men who are afraid to match themselves up with a strong woman who actually can work, make a living. But that's capitalism. Capitalism made that possible, and that's another reason they hate capitalism, of what it's done to women. It's liberated them and freed them. So this issue of women's role in study came up in the article that I was reading and how this really upsets many conservatives who want particularly the new conservatives, the new right, who want to see women put back where they belong. Men don't want to, don't want masculine women, maybe, but men should want strong women. Men should want productive women. Men should want women who use their minds to create wealth. Men should want talented women.  You're not a masculine man.  Anyway, it, it, it, yeah, yeah. Women have detached themselves from traditional roles, and many men hate that, and many conservatives hate that. It upsets them. It drives them nuts. And capitalism did it. You're not masculine if you don't want a strong woman.  That's not masculine.  That's weak. A masculine man is not afraid of any woman. Not for the souls and well-being of its workers. There is a reason to capitalism to go about the souls of the well-being of the workers, and she is trying to fight Marx. Capitalism talk about how people can't eat in communist societies, because capitalism is really, really good at creating surpluses of goods for physical needs. But does it serve, I don't know, your safety needs? Does it serve your safety needs? I wonder if capitalism serves your safety needs. It's interesting that the capitalism of life expectancy has expanded dramatically. It's interesting that, you know, for example, because of capitalism, our buildings can sustain hurricanes, tornadoes. Because of capitalism, we have unbelievably safe airplanes, automobiles. Of course, capitalism provides your safety needs. Now, true, not safety from other people, from the violence, for that we need government. But the more important daily kind of forms of safety, that's exactly what capitalism provides for. Not really. Your financial security can be wiped away any minute by the stock market. It's unbelievable. The lack of ability to think your financial security. Where did you get finance to begin with? Where did the money come from? If you have more financial security with your subsistence farmer, where's the financial security then when you don't know if you'll be able to sell your harvest? Really? Capitalism is the only system where you have any kind of financial security, and it's only to the extent that even welfare societies have a allow for some capitalism, some free, some private property, some free markets, that wealth is created and then you might lose it. But first you have to create the wealth. It's just like the left. They assume, they assume that wealth is just here. They assume that wealth is just created no matter what. It just comes into being. It's shocking the level of unthinking on left and right. Does it serve needs relating to love and belonging? No. Yeah, it's no accident, by the way, that the idea of romantic love is an idea coming out of the 18th and 19th century. The idea that one should choose one's wife, that love should guide one's choice, that marriage is not deal making, marriage is not about economics, and what made that possible? That not just the wealth he could choose their wives, but everybody could choose their wives free of economic implications, the wealth that capitalism made possible. Love, in many respects, romantic love in particular is made possible through the time that capitalism buys you, the wealth that capitalism buys you. And much more importantly, the focus on individualism that it is at the heart of capitalism. These are conservatives. Because having a wife or a husband and definitely kids is a drain on your productivity and resources. And anyway, in this culture, apparently it's irrational to limit yourself to just one person, might as well just use Tinder and count yourself lucky to live in a free society, you prude. That's what they really hate, right? The fact that people actually have sexual relationships outside of marriage, that they experiment, that they explore, that they do all kinds of stuff, that pisses them off. It goes against their tradition. It goes against their moral code that they inherited through tradition. Does it serve needs related to esteem? Does anyone feel esteemed in an assembly line, or at a job where their boss treats them like they should be grateful the company has room in the budget for free coffee? Notice that again, she views esteem as something that comes from the outside. Esteem is something you grant yourself. Esteem is something you grant yourself exactly on the assembly line. Esteem, and notice the assembly line. How many people today actually work in an assembly line? Esteem is something you grant yourself based on your productive ability, based on your ability to put food on the table, based on your ability to produce and create and build. These people are needed as allies. Really? Allies towards what end? Towards what end? What are they going to get you? Bigger government, more government intervention, and now they want government intervene to rule your life, to rule the moral decisions, the cultural decisions, the personal decisions that you make and their allies? No, thank you. Does it serve needs relating to self-actualization? It's the only system where self-actualization is actually possible, except for the very elites who under the systems can self-actualize to some extent. But it's the only system that allows everybody, including the masses, to self-actualize. Now notice, this is straight out of Marx. Marx is the one who complains about the work of not being able to self-actualize. And in his Marxist utopia, in his communist utopia, all your material needs are taken care of by the state, and you can self-actualize. But it's exactly capitalism that makes it possible, even from the common person, to create so much wealth that they can indeed self-actualize, that they can have hobbies, that they can pursue their personal values. What does it mean if she's critiquing capitalism? She wants the state to intervene so that culture and community don't deteriorate in the way she's reflecting. When she complains about capitalism, destroying architecture, what is the alternative to that? What is she proposing implicitly as the solution to that? Well, we need to move away from capitalism, which is what? Towards more statism. That's the only alternative to capitalism, which means state intervention, state control, state regulation. She's not arguing for, oh, we should have more robust debate. We should argue for. When culture and community, I don't care about communities, communities deteriorate all the time in some places, and they thrive in other places. What happens when culture deteriorates is you have to fight for a better culture. But a better culture is not a culture of classical architecture. A better culture is not a culture in which women stay at home. A better culture is not a culture in which we're sexually prudes. Those are not things that reflect a better culture. Those reflect a traditionalist culture, a religious culture, but not better, better by whose standards. And the reason community and culture might deteriorate, the reason why community and culture deteriorate is because of bad ideas, not because of the state or not. The solution is not the state because it's often because of the state because of the ideas that lead to a bigger state. The battle for a better culture is an intellectual battle. It's a philosophical battle. It's an aesthetic battle. It's not a political battle other than unless that political battle is a battle for more freedom, more freedom to make choices. But that's exactly what she's arguing against. She doesn't want you to have more freedom because you are making the wrong choices. A cultural revolution would be great if it was intellectual. It would be horrific if it used the force of government to implement it. That is what Mao Tse-tung did and what I think many on the left and on the right today would like to do, use government to impose a particular culture. That's what she wants on the right and that's what the world culture wants to do on the left. Freedom is the absence of coercion. Freedom is the absence of coercion.  That includes government, that includes the neighbor, that includes conservatives, that includes communists. You try self-actualizing in a gig economy or in a world where you can lose your job the instant you self-actualize in a way that Twitter doesn't like. It's exactly what the gig economy allows people. You can afford to sit there and complain but the fact is the gig economy is exactly what allows some people to self-actualize. It provides them with the income, the flexibility so maybe they can take care of their kids and work when it's convenient for them. Maybe they can go to school and work when it's convenient for them. You can make fun of that but that's exactly what self-actualization looks like. Also, on a side note, Marxism may have told women that being wives and mothers was shameful but it was capitalism that broadcast that message so that all those women would enter the workforce and drive down the wages of their husbands and sons. Oh, that is such nonsense. Oh my god. Women don't drive down the wages. New people entering the workforce doesn't drive down wages. This is like Econ 101.  New entrants into the workforce increase other people's wages because they increase productivity, they increase options, they increase possibilities. All the evidence in the world just open your eyes to see the wages stand of living has not gone down as women have come into the workforce. It's gone up. I'm sorry. I didn't know this would be as bad as it is because I didn't listen to it in advance. I should have. It is shocking, shockingly ignorant to talk about women entering the workplace reducing wages. When the labor pool increases wages do not decline. I mean there's a gazillion amounts of evidence for this. It means there are more producers, more consumers. If you have a bigger generation like the boomer generation that that causes wages to go down or up. When you have immigrant societies like the United States say the 19th century where immigration was far greater than the number of people who were present here on a racial basis, largest immigration ever. Did wages go down or up? Way up because you bring in new ideas, new opportunities, new entrepreneurs and it's not just labor increases, it's productivity production increases, people becoming more productive. Now it's true. You produce more, prices might go down, standard of living goes up, up, up. I mean the the the the lengths to which conservatives will go to get women back into the kitchen. Unbelievable. Seriously, can we really say that it's all just government systems that have ruined our happiness? And by the way how did capitalism broadcast the women should be out of the home? You'd argue the opposite. The entire marketing campaign of capitalism was to sell you know kitchen stuff and all this stuff. Yeah but I guess it made it made it capitalism made it possible to run a house part-time because dishwashers reduced the amount of time we spent washing dishes. Dryers and washing machines reduced the amount of time women had to spend with laundry. Pre-prepared meals meant that women had to spend less time cooking. Now anybody who thinks all of that is a bad thing that we should go to an era where we have no washing machines and error with no dishwashers and error with no pre-prepared meals or restaurants or whatever. That's barbarism. And in this sense the right is just as barbaric as the left. Is this any better than than the leftists? Yeah labor-saving devices but Linda it's bad because it's labor-saving devices for women and we want limit to stay in the home so we have to increase them out of labor they have to do in the home.  And I hope that the people expressing that do not count themselves as Inran fans of us as objectivists because Inran would be horrified, horrified by these kind of views of women that are being expressed on my chat. Or perhaps could some of us admit our work life addiction to media obsession with pursuing the next shiny product the constant demands that we buy things to look a certain way feel a certain way watch this. She's talking look how much makeup she's got on her. Play that drink this eat that could it perhaps be this mass consumerism and work life imbalance that has also ripped us from our family community and loved ones and ourselves.  Indeed maybe it's because the value system the conservatives that religion has provided people is so shallow and dull and inappropriate for modern life and inappropriate for a higher standard of living. That's why cultures collapse that's why people go with shallow consumerism. Maybe if instead of focusing on attacking capitalism instead of focusing on latching on to a tradition there's no longer relevant latching on to a time where life was short brutish horrible. Instead of that conservatives would have focused on coming up with a better value system a modern value system a value system appropriate to a free people a value system appropriate to a wealthy people a value system appropriate for people who have time maybe if they've embraced iron rands value system maybe if William F. Buckley instead of kicking iron rand out of the conservative movement had embraced at least some of her ideas not on free markets but on values maybe the world would look very very different maybe instead of looking backwards instead of trying to conserve what is necessary is to look forward and to innovate innovate in ethics innovate in values innovate in human relations what I invented and what we're trying to do with Yuan's rules for life don't forget we're going to have that later this week we're going to do Yuan's rules for life and there'll be a series of shows on this hopefully you guys will listen in and enjoy and I think we're going to get a sponsor for it and it's going to be exciting it's going to be a lot of fun all right that's what we need we need new rules for life that are appropriate for a wealthy culture a wealthy society a society with actual time on its hands in many ways as well what Hannah Arendt called the Vita Activa a state where we must always be busy never present and always consuming it's just soul-destroying and even if we move on to other factors leading to cultural decay such as mass immigration with no assimilation that too has largely been pushed and supported by corporations looking for cheap labor really so mass immigration was pushed by corporations before there was such a thing as a corporation for example in the 19th century so if there were no corporations they wouldn't be mass immigration people wouldn't want to come to the freest the best the richest country where there are more opportunities than others why the conservatives blame mass immigration corporations why do they need to do that and no assimilation capitalism is the greatest assimilating machine ever known to man we saw that 19th century early 20th century america where people were assimilated into a society in numbers that are unbelievable but no everything is capitalism fault just like the leftists everything bad in the world happens because of corporations just like the leftists what's the difference anymore guys as for old architecture the utility of a building being nice relative to its price just doesn't add up if you've seen anybody uh being to hong kong or to shanghai and the beauty of modern architecture have you ever seen a frank load right home i mean because it's old it's beautiful give me a break tell me there's not a demand for beautiful buildings when people are flying halfway across the world just to take pictures with them the problem is that the demand clearly doesn't lead to enough profit no there's no demand for boring architecture there's no demand for architecture we've already seen before there's no demand for the second-handed actual joy of the citizenry in daily life is not a business by the way i ken says you're on cherry picks the weakest conservative to represent the whole group this was sent to me by somebody else so i i you know i i barely picked up at long summers was a was a was a favorite of the new right for a long long time but you're right maybe she is particularly weak and i need better opposition so here's the thing you guys pick send me who you want me to confront send me who you think i should be critiquing on the right send me who you think better represents conservatives because i think she represents them perfectly i think she does it exactly this way so go for it find somebody better than law and southern to represent the conservative point of view i'll take them on believe me i'm not afraid of conservatives i'm not afraid to defend capitalism in front of marxists or conservatives this is in large part why the left have won the culture war they didn't care that their arts degrees weren't particularly profitable they just wanted to create art and sure i'm conceding ground to progressives in some regard but i'm also not going to sit here and pretend that you can eat an art degree or that it was the arts that doubled our average lifespan that was absolutely innovation pushed by commercial interests and capitalism but the question still arises what is the point of a long lifespan if increasingly people aren't wanting to live said life really did she just say that we cannot understate how consumerism makes surviving insultingly easy but we must also acknowledge it makes living insultingly hard no it doesn't it makes living easy if you choose your values if you choose your personal values capitalism makes it possible for you to pursue those values now the last one here number three capitalism is indifferent to morality capitalism is indifferent to morality really isn't there more code embedded in the in in a very nature of capitalism isn't that particularly attitude a particular view of the world embedded in capitalism a view of the world that is individualistic that's what you resent but yes if you mean by morality altruism then capitalism and altruism clash they don't fit so we're gonna listen a couple of minutes here and then we're gonna go on because it is getting late and have capitalism is not a conservative view of the world true capitalism is not a conservative view of the world finally she says something true capitalism is about new capitalism is about different capitalism is about innovation capitalism is about change capitalism is about the future not the past capitalism is about building not destroying it's about creating new stuff not old architecture it's about modern architecture modern in the proper sense of modern everything capitalism is not about tradition it's not about the old it's not about conserving capitalism is about uber replacing taxis conservatism is about keeping taxis capitalism is about iphone 13 replacing 12 replacing my old flip phone replacing my dial phone that's capitalism yes it's not a political view at all really it's simply a tool which sways towards the highest bidder if you live in a culture that is deeply sickened the products that are both created and sold will sicken with it they won't save it they won't pull you out of your moral darkness capitalism just amplifies what we as humans desire in our hearts that's right and if you desire the wrong things and if you have the wrong values which is true of the conservatives then capitalism will only amplify that and make the culture more sick and make the culture more decayed if you stick to your religious values values that are outdated are you relevant values that are anti-life in many respects then what you get is a sick dying decaying destroyed culture what you need is to embrace a modern world what you need is to use your reason to question those old values that's what is needed what's needed is to bring reason into the equation what's needed is to reject the values that are destroying this culture and those values are the values of altruism the values of collectivism the values of tradition the values where you're stuck in the past instead of discovering new values better values values that are pro-life pro-human pro-freedom pro-achievement pro-building but that's what the traditionalist that's what the conservatives don't want and now the the latest evolution in this is that they want to use the state to impose the value system because they've they've lost they've lost the cultural wars they've lost the culture and they know they've lost the culture and their conclusion is that freedom doesn't work for them thank you know that's very very much appreciated freedom doesn't work for them because of the freedom or the perception of freedom the perception of capitalism they've lost the cultural war and therefore what they need is to use force in order to win it what they need is to abandon freedom and to embrace statism and embrace the world of government in defining and defending cultural values the only way to defend a traditionalist value system they believe is by use of force it's with the use of the state and here's how we get to where the left and the right are the same they both want to use the state to force their values and all of us they both reject freedom they both reject capitalism we have to accept the fact that to the extent that we advocate for freedom advocate for individualism advocate for reason we are the tiniest of minorities we're a small group of fighters and when we allow ourselves with the people who would like to destroy us we do ourselves no favors when we allow ourselves with the statists we grant them sanction they do not deserve and we weaken our position and we weaken our ability to fight so we all of us need to stick to our guns stop compromising stop selling out to these conservative wimps and fight fight for freedom fight for individualism fight for egoism fight for human reason what we need today what i call the new intellectual would be any man or woman who is willing to think meaning any man or woman who knows that man's life must be guided by reason by the intellect not by feelings wishes wins or mystic revelations any man or woman who values his life and who does not want to give in to today's cult of despair cynicism and impotence and does not intend to give up the world to the dark ages and to the row of the collectivist roads all right before we go on reminder please like the show we've got 163 live listeners right now 30 likes that should be at least 100 i figure at least 100 of you actually like the show maybe they're like 60 of the matthews out there who hate it but but at least the people who like it you know i want to see i want to see a thumbs up there you go start liking it i want to see that go to 100 all it takes is a click of a click of a thing whether you're looking at this and and you know the likes matter it's not an issue of my ego it's an issue of the algorithm the more you like something the more the algorithm likes it so you know and if you don't like the show give it a thumbs down let's see your actual views being reflected in the likes but if you like it don't just sit there help get the show promoted of 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Good morning, and thank you for the opportunity to present my work this morning. My presentation is on the imaging genomic analysis of TCGA and TCIA diffuse lower-grade gliomas by molecular subtype. And this work is a collaborative effort with the Cancer Imaging Archive TCGA glioma phenotype research group. So since we're a diverse group of cancer researchers and we each have our own tumor specialties, I thought I'd start with a few fast facts on brain tumors. So there are over 120 types of brain tumors, but today we'll focus on a subset known as glioma. This year it is expected that over 66,000 cases of primary brain tumors will be diagnosed, and about 30% of those will be glioma, so that's just over 19,000 cases. Glioma makes up about 80% of all malignant tumors, and as it indicates here there's only four FDA treatments approved. And treatment effect varies, as we've seen with all of our cancers, and here we can see survival will actually range between less than two years, for some cases over 15. So glioma is a cancer of the glial cells, so not your neurons that's transmitting the signals in the brain, but those cells that support the brain. So if you have a cancer of the astrocyte, this is astrocytoma. If you have a cancer of the oligodendrocyte, this is oligodendroglioma, and there's actually a mixed form currently being recognized as oligoastrocytoma. Now in the lower grade glioma groups we focused on who grades two and three, which are infiltrative and moderately diffused or proliferative disease, but these may progress into glioblastoma, which is who grade four disease. And those have a high mitotic rate in our prone to necrosis. So in the past five or so years we've learned that there are specific subsets of glioma with genomic alterations, namely about 80% of grade two and grade three gliomas harbor a mutation in either the IDH1 or IDH2, that is isocitris dehydrogenase genes, and this leads to alteration in methylation and genome instability. In contrast, only about 10% of glioblastomas happen to harbor this IDH mutation. Furthermore, in about 30% of gliomas, we have observed mostly in oligodendrogliomas a loss of both chromosome 1P and 19Q arms. So we see this co-deletion about 30% at the time. And nearly 100% of those that have co-deletion also harbor an IDH1 or 2 mutation. Both the IDH mutation and the 1P19Q co-deletion are associated with better prognosis. So though we have preconceived notions, as I mentioned, we tend to see that co-deletion going with oligodendrogliomas, about which types of glioma will harbor which types of genomic alteration, we found that there's actually not a strong concordance between the IDH mutation and co-deletion and those that histology and grade subtypes, as shown here in this cord diagram, where you can follow the IDH mutation with co-deletion across to the oligodendrogliomas of type 2 and 3, as expected, but also find those purple cords going into oligoastrocytoma in other groups. So in particular, we notice that IDH wild type here goes into all of the six histology and grade categories. And actually the IDH wild type follows right along with a GBM profile on a survival curve. So in fact, the analysis working group for Loa-Greig glioma went on to show that the distinct molecular profiles shown here, and you'll notice this color coding kind of following throughout, these three groups, IDH wild type, IDH mutant with co-deletion and IDH mutant without co-deletion, are following this molecular pattern as shown by the distinct groups here, DNA methylation, copy number, and then the cluster of clusters across the group specifically, but also with these molecular profiles. And of note, again here, these IDH wild types are really mimicking GBMs showing EGFR, P10, CDNK, 2A, a lot of those same genomic alterations that we would expect to see. But notably, it's not following histology or grade, so that's kind of the punchline there. But in parallel, the Cancer Imaging Archive, which is in the Informatics Division of the NCI's Cancer Imaging Program, was collecting preoperative radiological imaging sets for the glioma cases as profiled by TCGA. And this is something that they've done for over two dozen, I believe, now, different cancer types. So this includes T1-weighted MRI with and without contrast enhancement, T2-weighted MRI, fluid attenuated inversion recovery, or FLARE MRI, and the DWI-80C maps for our particular cancer. And so you'll see a lot of these screenshot images here as we go forward, and I use the xnatview.org, I'll give a little plug for you, David, that this is a great way for those of us who are not wanting to download all the images to be able to go through and view them. So unlike the study we saw yesterday by Mary Ellen Geiger, which was doing this by computer automated searches, we are actually using a set of neuro radiologists. There were nine neuro radiologists that read each sample in triplicates. So we had three people per sample, they were blinded to the diagnosis or molecular group of the tumor, and they looked for 26, I keep hitting the wrong button, 26 features of the tumor. And these are features that were defined to be related to what you would expect to see if you were looking as a radiologist attempting to diagnose this tumor in the clinic. Okay. So our question for the study today is, are there neuro imaging features that are associated with that IDH co-deletion-defined molecular subtype that we found from the LGG Working Group that we can see here in the radiology images? And one thing in particular that I was really fascinated to see is, do we see that IDH wild type really showing up as a glioblastoma? So just to get a sense, we have 70 cases here in our first round of reviewer assessed images. You can see that this pattern here of IDH wild type mutant non-codel and mutant codel is following just what we saw. It's really mixed with the different subtypes. We see that this subset also has that characteristic drop in survival for the IDH wild type. So these 70 is a good representation of the 293 that we used in the full study for LGG. So some of the things we found, first thing we found was that IDH mutant codel tumors were likely to be centered in the frontal lobe. In fact, 75% of those tumors were found in the frontal lobe compared to other locations. Similarly, the IDH mutant non-codel tumors were split between the frontal lobe 41% and the temporal lobe 41%. So 80% were found in this region. In contrast, we saw that the IDH wild type could be found in any region of the brain and they did not have any specific localization. And this is something that we did note in the LGG marker paper, but it was nice to have that confirmation that we were finding on the same page. So other IDH mutated associated features. IDH mutant codel tumors were more likely to have a T1 flare signal across the midline. We'll see a little bit more on what the T1 flare signal is looking like. They have presence of hemorrhage and they have presence of cysts, more prevalent than other tumor types. The IDH mutant non-codel tumors were the least likely to have the presence of satellites. So less likely to have little bits in other regions of the brain. So these IDH wild type tumors, we found that they tended to be more infiltrative. So here's that T1 versus flare. And in fact, what we were looking at in this case is the T1 region and the flare region and were they of similar dimension or did the T1 flare, the T2 flare region have a more expansive molecular footprint than the T1 weighted region. And so for the mutant codel cases and the mutant non-codel cases, we tended to have more of them where the T1 and the flare regions were similar, showing a similar expanse here. So not showing that infiltration, whereas in the IDH wild type, and you can kind of see this guy here, but you can see it's much more expansive in the flare region. And so we're showing that infiltrative pattern. IDH wild type were also less likely to have a not well-defined non-enhancing region. So the enhancing region is that part that you scoop out when you're actually doing the resection. It's that part defined by the blood-brain barrier being broken down. But the non-enhancing region is that expansive region beyond it is showing that edema, that growth, that infiltration. And so if you were in IDH wild type, you were more likely to have this type of a fuzzy, just broad, expansive infiltration, whereas you would have a better or more circumscribed tumor if you were in an IDH mutant case. The IDH wild type tumors also tended to be smaller. So here we see an example of an IDH mutant codeleted tumor that has 57.6 centimeters squared area in its largest region. And you can see this big guy here in the frontal lobe as expected for an IDH mutant codel. And then the IDH wild type here is only this one is 21.5 centimeters squared area in its maximal range. So they tended to be smaller. And the hypothesis there is kind of twofold. So one might be that it's more aggressive, it's expanding quickly, and so we're catching it in that rapid growth phase, whereas these guys are kind of growing a little more slowly and we're not catching them. Also, it could be that being in the frontal lobe, you're less likely to get into some of those eloquent regions as quickly. And so we're not catching them by symptomatic diagnosis as early until they've grown to a larger state. So even though we've seen some things that are related to IDH wild type tumors and aggressivity, there are two key features that we see in GBM that we did not actually see more common in IDH wild type. So this is a GBM. So you can see that real bright enhancing region showing that breakdown and that hemorrhage of the blood brain barrier and that hemorrhage. We've got a necrotic region here, which is key to the who grade four disease that necrosis prone. Now in the lower grade glioma, the grades two and three, we actually saw about 66% of our tumors had an enhancing component and it was not more prevalent in the wild type than the other groups. It was more prevalent in grade three, but we did see some groups with enhancing tumor in grade two disease as well. Likewise, the necrotic component was found in about 26% of our cases. So these are lower grade gliomas. Grades two and three did show necrosis in 26% of our cases, but it was not isolated to wild type. And in fact, five of those cases are about 30% were found in the grade two disease. So we tried to go one step further to see if maybe we could come up with some classifications, some clustering algorithms, and this is one of our attempts at it. We used a bi-clustering metric because this allows for the ordinal and the nominal types of data that we have because really the only thing that we have that is continuous is the dimension. And even though we found some great clusters here, none of them are really aligning except for this one cluster which has five IDH wild type grade three tumors and shows this series of features in common. So in conclusion, there are several MR imaging features that are associated with LGG molecular classes. IDH wild type does seem to show an aggressive phenotype, but it does not seem to be that it's simply an underdiagnosed GBM. Imaging patterns are present, but we're still working on exactly what those patterns mean and how we can use them for clinical impact or whether they have other genomic associations. So this work could not be done without the support of our large group here in the TCGA glioma phenotype research group at the Cancer Imaging Archive, without the support of the Hermelin Brain Tumor Center for my time and our colleagues in the lower grade glioma analysis working group. I'm happy to take questions now. You're welcome to email me at any time or I'll be wandering around my poster number 98 later today. Thank you. Great presentation. And I applaud you for using nine different observers. But the question that comes in is what was the concordance between the nine observers and what was the Kappa value? So it actually depended on each of the 26. So concordance was higher for some than others. We ended up in some cases we would have five categories like really strong, strong, neutral and so forth where we had to collapse some of the highest or the too high and too low and have a high none and low to gain concordance. So we did go through a training phase. I unfortunately I can't give you the Kappas for all of them. We went through a training phase with each of our readers ahead of time to make sure that everybody understood this 26 features and how to score them. So in all in all it was fairly strong. In the end we did a voting and they had somebody who went through and did a check to make sure that it was best representative. So there was a fairly rigorous amount of data checking and quality behind that. But I don't have the exact Kappas for each one.