Okay, we're back. We're live. I'm Jay Fidel. This is ThinkDeck. And more specifically, this is Coronaville. What's next? And we have Winston, Winston Welch, and Stephanie Dalton. And we have Cynthia Sinclair, our regular, regular team here. And we are talking about 100,000 deaths in this country. Actually, Cynthia said it was 100,047, as of a few minutes ago. So yeah, it's a benchmark. I mean, what's the difference? 99,000, 100,000. Winston, you know, my problem is we have made death normal. This is part of the new normal. You should be outraged with even one death. But 100,000 deaths, and everybody sort of gets in the swing of it. How do you feel? There's so many things to distract us right now during this whole pandemic. And the way the state, how our nation has been run the last four years, that it's hard to focus on anything. Even the number of staggering is that because of all the chaos and confusion surrounding it. But I think the New York Times did a great service to our nation by listing a few of those on the front page in a way that said these are real people with real families. And some of these could probably have been prevented. But whether they could or couldn't, this is the reality of what's going on right here. So I appreciated that by the New York Times. And we do need to bring attention to it. There's a lot of work that we have to do. Well, this is an example of Trump distracting. I mean, I found it absolutely amazing that in the middle of this, he's resuming nuclear testing, the talk about a distraction and all the stuff about North Carolina, and the convention which we know the Republicans are going to nominate him. What's the issue? He's got to pay all this time and money for a convention. And that's distraction. I think we are living in a world of distraction. And I also think that he is destroying the country while we're being distracted this way. So what happened to Anthony Fauci? We haven't seen him so much. And the science community and the, by the way, the Inspector General community has all been sidelined. It's all about Trump. And Trump is not telling us the truth about coronavirus. Cynthia, how do you feel about it? Oh, it just infuriates me. He muzzled the CDC right off the bat.  There's a quote from Fauci in an interview that was this weekend. And he says that, you know, the second wave is not inevitable, which is kind of a big deal. But it has to be with social distancing, follow guidelines, wear masks. That's the only way we're going to stop a second wave. So, you know, you can't just, this is what he said exactly, that to go out without following the guidelines, that is inviting a situation that could get out of control. Don't start leapfrogging over some of the recommendations and the guidelines, because that is really tempting fate and asking for trouble. Well, I think what we have is we, you know, the whole thing has been politicized. Trump has managed, I mean, he really is very skilled at this. He's managed to politicize the coronavirus and he's managed to politicize the reopening. And so we have a national concert on Sunday. Thousands of people showed up all elbow to elbow. No masks. You know, no social distancing for sure. And I say to myself, wait a minute, you know, is this a statement of support for Trump? Because in fact, what happened in Michigan with the people in the state capital, that was politicized. And some of these governors are reopening maybe way too quickly. And that's politicized.  And if you don't reopen, you must be a Democrat and we dump on Democrats. That's what he'd done out of this. It's quite extraordinary. And wait for the July 4th military parade. Remember, he was going to have tanks in the streets of Washington a couple of years ago. He's going to do that too. And again, all distractions. You're going to be in Washington, Stephanie. You're going to be there on July 4th. I hope you report back to us on the military parade. And tell me about the social distancing among the troops who march, you know. Well, he did do tanks last year. But they, the military had great grave concerns. And so did the city because the tanks are heavy. And it's a problem on all of the roads. So they brought in tanks with special covers for the tracks and they had to set up. And there were only about two or three of them.  And I don't doubt Jay that you're right. And he'll try it again. And with more, more display. But I wanted to submit, given your question about where's Fauci. Has anybody noticed that there's no Rudy Giuliani anymore? So I suggest that this is a real good people into the gig. Okay, the trip he's on, the way he manages it. So you're there while he's using you. And Giuliani stepped right up to that with great, great enthusiasm all over the media. And now that sucker is gone. Oh, and I mean, same thing happened to the former president, a governor of New Jersey, the big guy with anyway. So, but I so there's a pattern here. So he's it's his usual way to just grab what he needs, whatever it is, whatever will do his, his stick, and then let go and encourage it. And then they're gone. I think you want to see the same thing in Pompeo, by the way. Pompeo was running into trouble about, you know, using government resources for his personal thing. And incidentally, it was an article recently about Pompeo and what he has achieved as Secretary of State. And the answer is nothing. He's only ripped things up. But let's get back to want to talk about international things. You have upswing in cases in Korea, I think in Britain, in Brazil, big deal in Brazil. So we can never forget that the world is connected to us. And even if you close down the borders and the flights and what have you, we still have a pandemic and people are dying in huge numbers, although the US and right up at the top. Isn't that wonderful? So, you know, what did you say about Fauci that he said it's not inevitable that we will have a second wave? I think he was really saying that we could stop it if we do the right thing. But if we don't do the right thing, you know, we will have a second wave. And those guys at the beach of Memorial Day, everybody like ignoring it, it's really interesting from a psychological point of view, they're all out there as if nothing ever happened. And that kind of behavior will will give us a second wave. Don't you think Winston? It's hard to tell what's going to happen here, Jay. I mean, honestly, we don't we don't know where this virus is going, what's going to happen. Brazil did pass America deaths. I think yesterday on a daily basis, it may go down or change here. But, you know, when you're mentioning about Donald Trump and this being politicized, it's hard not to be. But they have a playbook. This is a weak spot. They need to wait until the economy comes back. They're talking about a massive comeback in quarter three if they open up everything. And I think what we're looking at is that the United States has become a testing ground for essentially this idea we're going to infect people at a certain rate and we'll get immunity or we won't and some people will be sacrificed and that's for the good of the land or whatever. It's happening right now across the country. It's not happening here in Hawaii. We have had three or four days consecutively of no new cases, at least on Oahu. And so we will, well, it's going to continue to be a testing ground around around the world around this country. It is concerning to see what's happening, but we need to keep our eyes and ears open for what is true, what information we can use in new places and apply it as best as we can given the lack of leadership and that it's basically a free for all. Well, you saw the thing yesterday about how Twitter put a blue note at the end of one of his tweets saying this was not true and that people ought to check it out. And then you saw the thing this morning where he said Twitter is out of line. Twitter needs to be regulated or put out of business. And all of a sudden, the whole specter of the First Amendment comes up and he's on a tear about the media who criticize him. I worry that more traditional media will be affected by the same anger that he expressed. But I think what was interesting, and I'd like to try with you guys to connect the dots on this, is a number of organizations, press organizations and think-tank organizations have tried to do scenario building on Trump. What is this all about for him? He's not really his own man. He's working for some agenda. And everything he does is to advance the agenda, including his Herculean efforts to stay president for another four years. I mean, if you made a list of all the things he and his friends have done, including but not limited to knocking off the post office, so they can't be male voting. Incredible. Incredible. There's no benefit to doing that except for Trump. So you have all these scenarios coming out about what he's going to do to become president, to stay president, to stay in office no matter what happens. If he loses, he wins. If he wins, he wins, that sort of thing. And it's all to advance an agenda. And I suggest to you guys, I don't want to come up with theories here, but I suggest to you guys that the whole thing with Coronavirus, he's turning it around for his own benefit. He's politicizing it. He's dividing the federal government in the states. He's dividing the states. He's dividing the people. He's creating new divisiveness where there really shouldn't be. We're in a crisis. And yet the man has somehow created a divisiveness among us. The country is in, you know, in terms of working on this problem is in shambles. And if we do, as we are in some places, have a second wave, it'll be much worse. And there's got to be a purpose for it. It's not just he's stumble bumming through this. He's got a reason. He's going to use it. He's going to use it to stay in office or advance his agenda.  Well, I would like to suggest or submit that he, that well, I disagree with that he has an agenda. I think all of this is just entirely self-indulgent. Okay. He wants power. He likes all the trappings of that. And he, he, he's just going one, one thing to another thing. So I don't see where there's any goal whatsoever or any agenda other than serving himself and making sure his, his properties are making money. And so, so setting that that puts us in an even worse position, because on the other hand, it could be better. I mean, it's just like with the nuclear, that scary scenario. I mean, he doesn't really seem to be threatening to bomb China or, you know, or, or do anything like that. So I, he doesn't really have overarching structures supporting all of this, this trivial stuff that he's running around trying to do, which is not trivial to those who are involved in it. But certainly he hasn't done a day of work in the White House. I also submit that he has not done an entire day of work on substantive matters. Nothing like- Let's look at how the coronavirus has, you know, affected things. Number one is we're not out of it. Number two is there was an article recently about how 30, just according to the Census Bureau, 34% of Americans have anxiety, demonstrable anxiety or depression, because they've been, you know, cooped up. At the same time, it's not at all clear that we're having a successful reopening. It all seems to be kind of like pandemonium in this reopening. Trump said a week or two ago that the reopening would be like a, you know, like we were waiting, the country was waiting to reopen, would reopen like a coiled spring. I'm not sure that's happening. You guys have any comments about the two sides of this intersection Are people able to deal with it now? Are they ready to go back and reopen? Is the reopening a successful reopening? Or are we going to be in a kind of scrambled egg limbo for a long time before we resolve either side of the equation? I think scrambled egg limbo is a good way to put it. We have right now 14 states that have an increase over the last week of cases. Increase in case you have 14 states, most of them in the South. So they've been having increases every week. Market increases even. So that's what's happening to these states that are opening up. So Georgia is one of those states that has the marked increase because they opened up so soon and with absolutely none of the precautions or restrictions or anything put in place. That place in Wisconsin where all the people were in the pool next to each other, shoulder to shoulder, no masks anywhere in sight. In two weeks we're going to find out just exactly what they did, but it's not going to be that exact area because all those people that were in Wisconsin came there from other places. So they're going to go back to those places and possibly bring the virus with them. So I think over this next month we're going to see a huge resurgence of cases because as much as we do have safe people like here in Hawaii, I didn't see anybody when I went out yesterday. I took the dog to the vet and I didn't see one single person without a mouse. Look at pictures of other people. Is anybody here going out?  Anybody here trying to live your previous life? Raise your hand. I don't see any hands raised. So you're trying to live your previous life? It's been nice knowing you Winston. It's not a hand. I'm certainly walking around. I'm limited my exposure, you know, as we all should. But again, we have to remember Jay, we had gays here. Effectively we have, we squashed the coronavirus here.  And I love the interesting results of the Civil Beat Hawaii News Now poll that just came out this morning was taken last week where it said that even if stop, even if the economy gets worse, is it more important to stop the virus or to open up the economy? 61% said it's more important to stop the virus. 30% said it's more important to open the economy. And 9% weren't sure, but it said 71% of people support quarantining passengers, only 20% opposed, and 71% support the stay at home orders still that have been extended, I think through the end of June now. I mean a lot of stuff has opened up, but basically you're seeing Hawaii is not the United States. It's not the mainland. We have sense here. We have respect for each other. We wear our masks when we go out. And we realize if we figure the thing out and we have double triple testing because half of the test results and false negatives, we need more than one test. But what does it mean even if you tested? What if you had the coronavirus two months ago? Can you come to Hawaii now? Are you going to be safe or are you still, I don't think we've really worked it out yet. But here in Hawaii it's a good story. Well, I think we, as you say, we have the Aloha spirit where we care more about people's welfare than we do about the economy. We, you know, we, I think fundamentally Hawaii doesn't like big capital. It doesn't like big companies. It's a democratic state. Yeah, it's ranked last on business friendliness for a lot of different things, but that's not exactly the, you know, I think it's that we do realize it's an island and where are we going to go if everybody gets. Well, that's the, that cuts two ways, Winston. I mean, you got to watch out for the food chain. You know, for example, those, those processing plants in the Midwest, where they, you know, do beef and poultry, they're at risk of going out of business, whether he likes it or not. And we may not see any meat anymore. What was it? One of the big goes at young brothers is in desperate straits. They want all kinds of money, millions and millions from the state. They don't get it. They're going to stop shipping. The neighbor islands are going to suffer that. We would suffer that too. So, you know, just as we're an island in one way, that we can shut the airlines down. And of course that means shutting anything left of the economy down. The being, being isolated as islands is very threatening to us. And one day you could wake up and find out that Safeway is closed. I don't see that happening anytime soon, Jay. And also this has given us a great opportunity to reevaluate our priorities for the state and its economy post COVID. So, you know, we've got food, go to Safeway. There is plenty of food in Safeway. Now, do we have the money to spend it? Not, not as much as we'd like. That's why I said everybody needs to get a voucher for right now so that we have food security minimum and a lot of other things. Okay, well, we're going to see. We're going to see. I mean, I feel that we've done this, you and I and the group here have done it long enough to know that I'm on one side of the optimism curve and you're on the other. But let me ask you about medicines. You know, so we have the guy in Paraguay. I don't know his name. The leader in Paraguay is taking hydro, what is it? Chloroquine. Yeah. Okay, thank you. I never get it right. Okay. And thousands of people around the world are taking it because Trump is taking it and Trump is still taking it, you know, and so everybody is confused about it. Meanwhile, we do not have a therapeutic. Gil had laboratories in, I think, in Massachusetts. It's a big board company, or maybe a non-state company.  I can do that one. And that might offer some hope, but it's not in the market yet. We don't have a therapeutic. We don't have, you know, an immune drug that will solve the immunity reaction problem. And we certainly don't have the vaccine. And yet, and, you know, I appreciate your comments, but it's not clear to me that we have the testing we need because in order to really know, in order to do the proper tracking on a given population, including patient one who comes in on some plane for tourism, it only takes one, you know, that's what happened last time. It's not that we can really control this. So we don't have a way to track because we don't have the technology for that. And we don't have the repeated testing you need for that. So I'm very worried that the medical side of this hasn't kept up with it. And we're vulnerable. Any thoughts about that, Cynthia? Well, the CDC has just put out a new message saying that half of the antibody tests that are out there come and they're wrong. They're false. So half. That's a lot. So how are we supposed to tell if people have the antibodies? How are we supposed to get behind these people? And, you know, how are we supposed to trace them and, and, you know, isolate them if we don't know for sure. So we can't even really trust the tests that are being given. And all of the scientists say that our case numbers are actually much, much higher than is being revealed because the testing is faulty and not working. And we don't really have as much as we like to get the press that says, Oh, plenty of testing. We got testing. Anybody who needs a test can get a test is not really true. If you hear from the doctors and the nurses and the medical personnel that are out there in the world, they're saying they don't have the testing. But one thing is troubling is that Korea has an incredible system for testing and tracking, tracing. They have really learned a few things. And for that matter, China, you know, China learned a lot about technology and how to track and trace with, you know, what happened in Wuhan. China has an outbreak now. I don't think it's all that serious, but it's an outbreak in other area of China. Korea, with all of its, you know, all the factors that have helped it suppress the curve. It has a serious outbreak. Japan has an outbreak. I think, you know, this, this kind of bubbles up here at the Rinyan. And you don't know, you don't know where it's going to go next. And you don't know whether the, the efforts you've made are going to be successful. And I think we're, we're in this long term, if not wave, then at least a small wave ripple effect kind of thing going forward. And the question is, you know, how is this going to affect our society? We can only pretend for so long that everything is going to return to normal. And I use the term advisedly. But right now, it's, it's a very thin, I'll address this question to you Winston. It's a, it's a fragile, thin membrane between us and complete confusion, complete vulnerability. There's no plan out there, not in the state or the federal level. There's no safety net. There's no comfort. It's just, it's just moving down the road and whatever it's, it's lurching down the road. How can you be sure that you can go back and lead the life you wanted to lead or the lead, the life you had before that you like? Not clear when there's no, there's no plan and there's no confidence. There, it's not possible. There is before COVID and after COVID, just like there is in everything else in life, before the baby, after the baby, before the marriage after the divorce. We just have to adjust to life as it is. And by the way, I didn't want to also point out that I'm just representing myself. You're not in your organization. I might be connected with, but you know, we are all going to have to figure out individually, collectively, as a nation, as a state, inside of our organizations, our churches, our synagogues, our mosques, our communities, how we're going to deal with this new reality. I don't see these plexiglass screens ever going away between us and the cashiers. And maybe that's not such a bad thing. Other things, when will we be able to help? There's so many things are popping up. You know, for example, yesterday an article in the paper about how the Chinese are developing neighborhood watches, kind of Chinese walker people, protect the Chinese community in New York City, because they're being harassed, because there's racism, because every Asian face is responsible for the epidemic. Trump has set that in motion. That's open bear knuckles racism in this country, and they got to protect themselves. Nobody else can protect them. The mayor said something, oh, this is all wrong, all bad. But you know, it's out there. We got all kinds of, you know, racism happening in this country, and we have no plan to deal with that. Well, that is not a story of America, Jay. And that's not going to stop anytime soon. But it gives us a good chance right now to look at it and say, hey, yeah, this is ugly. We don't like it. And in our current situation, in our post COVID situation, if there is such a thing as a post COVID situation, we can address these things. We can address them well. We can address them forcefully. And hopefully in a few months, we will have the means and ability and the power at the top to say, let's take a good hard look at what we don't like, what's happened and how we want to change it to society with or without COVID. You make my heartbeat just a little faster. So what's about you, Stephanie? Are we going to return to a time when we can stop racism in this country? Well, as this says, we're going to have hopefully new leadership. But the Asians, they have shown us why you test and why you go through all of this because you find where these breakouts are, you go in, you get those people, you isolate them. They have got that down pat. They're not going to have any problems. They're going to get this thing wiped out in their country. And they are predominantly free of it now. And they know where these breakouts are. And they have the facilities to take them. You don't get to go home. You don't get to go anywhere until you get tested and sit on a chair for three days to get the results or however long it takes, then you don't go home. So I'm thinking that we are just not taking advantage of what's already been laid out before us as a recipe for addressing this. And then it also troubles me that people are not being informed about what this virus does to you.  Instead of telling us about, you see those palm trees, those things clamp on to all of the cells in your lines. And that's why you're going to be in a terrible desperate situation with a ventilator. Why aren't they telling us more about what that course of the disease is? And I think that that would help Americans get even smarter. There are plenty of smart ones. That's true. That's true. That's been kept from us as the true numbers are. We had a guest on a show earlier today whose mother was in a senior facility in England. And she was infected and her daughter here could not get back to see her. And she wound up in a hospital dying alone, which is really horrible. I mean, let me tell you, when at first we hit the newspapers, it was very, very horrible. Now it's de rigueur. Now it's just, it happens. It's a new normal that your parents and grandparents can wind up in a senior facility in a hospital and dying. You never have a chance to say farewell. It's very troubling. And this isn't going to, this isn't going to go away. It's going to continue to happen. And we, we're building, I say, an immunity to these outrages. Okay, Cynthia, we're out of time. So you have to tell us what we can do about any of this. Wear a mask, follow the guidelines. It's very simple. The guidelines that Trump has dashed somewhere and won't release. They are out there. They did leak out and we all know what they are.  Because 100,000 people have died alone, saying goodbye to their families on an iPad. That's just, it breaks my heart. And I cry all the time, every day when I see those numbers tick up. So wear a mask, follow the guidelines, please. You know, this conversation makes me want to feel better. It makes me want to relieve, you know, this sense of pessimism that I have. And when I get that feeling, I always, I always ask Winston whether he'll just share some words of optimism with us. You know what, I think Cynthia's got it right. Basically, share the, share a loha, not germs. Wear your mask. Be kind to other people. Ask your neighbors. Can I pick you up something at Safeway Costco, whatever it is? Just be a human being. And that's it. I mean, a fundamentally bottom line. Be good to others. Be kind to others. Or as Ted and Bill say, be excellent to one another. Ted and Bill's excellent. Okay, well, we're gonna do this again next week. And I wonder if anybody wants to make a, how about you, Stephanie? A prediction of how many lives will be in the toll by next week, a week from now? Well, I'm sorry to be a downer, but I think with all of this exposure in the last week, it's probably gonna go up pretty fast. Escalate. It's gonna escalate. Thank you, Stephanie. Thank you, Cynthia. Thank you, Winston. See you back here. Stay safe. Stay careful. And follow all the rules. Wash your hands right now. Aloha.


It's good to be back in the studio. All right, everyone So it's a little dark behind me because one of my light batteries went kaput on the trip out in Chicago So I've ordered a couple extra new ones to replace that one. So anyway, that's why it's a little dark behind me Just wanted to mention that and as we get going here. Yes iteration so for all the spelling bee folks out there iteration is the key word because we've got a new iteration of the new balance beacon one of the hottest shoes of 2018 no doubt and let's dive in first of all to a few specs before giving my thoughts on how it performed on my first Impression runs so I've actually done three runs in the shoe already. I just got a little well I ended up being stuck in Chicago. So I couldn't make this video yesterday. So here we go. All right Let's dive in for that drop. Oh, yeah, six millimeter right where I like it So 29 millimeter stack height in the heel 23 in the forefoot for the weight This is where the beacon I think outshines so many other neutral road Daily training shoes. Oh my goodness. Here we go. So six point eight or six point seven six point eight ounces in my size or 195 grams that is incredible in men's size nine. We're looking at seven point three ounces or 206 grams so once again Absolutely so lightweight and I think that is why a lot of people tend to think that they could use this shoe for a Tempo day or even a 5k 10k road race and I'm not gonna argue too much against that I'll give some thoughts on how I will use the shoe moving forward But it is a very very lightweight neutral road running shoe and for that upper We're looking at an engineered mesh So it is different and I'm not gonna try and turn this too much into a comparison video to the v1 But it is a new upper That's actually frankly the only difference between the v1 and the v2 is this upper and the biggest change as you can see is This collar here and it's a high collar Okay, so it comes up your ankle just a little bit more than most road daily training shoes And it has this pronounced very pronounced heel flare right above the heel counter to help with rubbing on the Achilles tendon And it's so pronounced. I thought oh my goodness. Maybe I'm gonna feel this It's gonna feel a little too awkward on the runner I'm just not gonna like it But I didn't feel it at all in the first three runs in the v2 for the beacon and for that midsole on the v2 Smooth operator. It's exactly the same as the v1 midsole and it's actually I'll just dive into it right now It's the exact same outsole as well Why fix it if it's not broken as the old adage goes and so again I was just reminded today so many times on the run why I love the shoe why it's I don't know how to describe How smooth it is through the gate cycle through the foot strike It just it's effortless and I'll also mention real quick. It is one piece of foam So there's no that's probably why it is such a smooth operator to a certain extent There is just one foam likes a lot of shoes Mix foams different densities of foams throughout the midsole This is just one piece the entire way toe to heel and now on the outsole It's got that hard rubber in the higher Impact areas in the heel and in the forefoot there you can see it that yellow there on the outsole and no You know, I would say I took the beacon ones to about a hundred and I think it was about a hundred hundred and twenty miles And I did start to see some wear and tear actually more on the outside of my forefoot But nothing crazy I guess if you wanted to get a shoe that you're gonna take to 400 350 400 500 miles this outsole I'd be shocked if you could get really that much out of it But if you're planning on let's say the 250 to 350 range I think you're gonna be just fine in this outsole and for the fit I went true to size and I'm glad that I did how was so and that's from heel to toe However, I have to mention that I'm swimming quite a bit in the toe box I don't know what's going on It feels like you can see it on your screen there that it there's some extra material Through that toe box that simply could be reduced and now maybe if you have a forefoot that is Big and strong and muscular like and you need that extra space through the toe box Then this might fit your foot perfect But for me I am swimming a little bit and I'll also mention that on sharp corners today I felt like my forefoot was sliding just a little teeny tiny bit off of the platform Inside the shoe and so in a 5k or 10k road race with sharp corners I don't know how I would feel about racing in this shoe This would not be my first choice first of all But I just keep that in mind if you're planning to do a fast workout even on a track You know the corners aren't that sharp, but you are still turning on a track I'd think twice about taking this at high speeds on corners and for comfort very comfortable Through the ride through the gate cycle. I will just say will say little comparison I'm not sure the upper is more comfortable than the v1 at this point. I'm not feeling like oh my goodness This is so much more comfortable than this straight up knit upper in the v1 And for a positive and a negative the positive again smooth operator no doubt hands down Incredible the drawback or the negative it is that toe box. I'm swimming around I'll probably have to put some spenco inside just to help fill the inner cavity of the shoe that inner volume Because I'm just scrunching up a little too much through the toe box So anyway new balance if you're listening if you're hearing other reports from other runners Maybe it's not just me. That's feeling this over pronounced upper material through that toe box and how will I use that v2 moving forward most likely Once again for my easy days, although it has some pop and it's so lightweight. It is tempting Okay, you could use this for a tempo day. Absolutely, but I think I'm gonna stick most likely to that 730 to 9 minute range for just easy kind of bopping along days Anywhere from 3 miles on my really really easy days up to you know 6 to 8 miles But I could see how you might want to take this up to higher speeds in a race or in a tempo day Because it is once again so lightweight and if you're looking for a shoe that can do training and racing I would once I would say take a look at the beacon v2 now at a hundred and twenty dollars I'm thinking it's just a smidge too high mostly because the hoker in con is coming in at a hundred and fifteen dollars So it's really close new balance. That's a that's a good price But I would say if you were at a hundred fifteen or even a hundred and ten you would be beating the marketplace so much I think more people would lean toward picking up the beacon if that price came down just a smidge It's not bad. Trust me if it was a hundred and thirty. I'd say we're not way too much But too much hundred and twenty not too shabby for the new balance beacon v2 And once again keyword is iteration and that question of the day. I'm not gonna talk about the v2 I just want to know since this video is publishing at 5 p.m. Mountain time. How was your run? Actually like today. I literally today since we're publishing this at the end of the day How was your run today? What did you do? I hope you had a great day? Thanks for watching this second video publishing today And we got a lot of good stuff coming down the pike in the next four to five days up in the mountains Sig beauty work hard and love each other those are my thoughts


So this idea of enlightenment and this yearning to be like those spiritual masters who are detached from everything is an aberration in the trajectory of spirituality. The future of spirituality will be one which is present-ness connected as a servant, as an instrument of the Source. Namaskar. Say your name please. I spoke to you yesterday and I have been contemplating on what you said. So some questions arise out of that. When we talk about surrender, I feel that from my little experience there seems to be these two different parts to it. One is that as you said there is this push from the higher Source and there is some kind of ego rising. On the same time you need to see some discernment to choose the push from the truth. And there are other times when the ego really do not rise and there seems to be a state of involuntary actions happening, some form of oneness there. So we were also talking about witnessing yesterday. So I was thinking that on the out of phase whether there is guidance, aren't we witnessing the ego or aren't we in some form of kind of separate from it but just see rising in some way. So isn't that some form of witnessing? Can you? I don't speak of a higher Soul or a higher Source. I speak of the inner residing Soul, Source, Truth, Self. Antaratman, it's given a feel of an entity because then the system relates to it better. So let's start with what are the elements of this whole experience because everything becomes very nebulous. Suddenly seven different people are talking about seven different things and nobody really knows what the other one is talking about which is also interesting because each one has their own approach but if I am trying to put clarity into these things and simplify it then I would say that you are denup, you have a name, this body and you actually take it up rather than rejecting it. You say yes I am denup because that's what the name this body has been given and to disassociate from the body will certainly result in a temporary freeing but that freeing is always shocked by the reality that the body has to face. So instead of going into that seesaw experience we start with saying okay this is denup, denup knows that at the centre of his being is an impulse which is continually in action, the Soul impulse, the Truth impulse, he knows it. It is not the same thing as Conscience. It is not something socially engineered, it is its own thing, it is the divine cosmic impulse individualised in denup. Denup also knows that there is the loud, clamouring, demanding noise of the ego which is that which has been engineered through the socialisation process and through certain inheritances also. So you have the ego lie and you have the Truth. This is a conceptual simplification. Denup certainly is the observer of these two forces at play within his system but he is not the witness, he is the one that takes action, he is the doer. I know that this shakes a lot of what we are actually over the millennia attempting to move away from doership but when one takes responsibility for that doership one is able more clearly to distinguish between the action of the ego, the force of the ego that impels the system to actions of various kinds and the very quiet, almost imperceptible impulse of the Truth that is there to be obeyed, to be in surrender to. So yes, you are observing it because you are using your Vivekabuddhi your ability to discern between these two forces at play within your system so certainly you have to observe it but you are not a silent witness who is simply observing both. You are the doer that is taking the decision to act based on the impulse. At least for short periods of time, there will be times when the ego doesn't rise at all. So at that time it almost feels for me that there is no doer or there is no choice. Exactly, precisely. And when there is just a simple flowing with the impulse, the Truth impulse, the Truth impulse, the Truth impulse the whole system becomes an instrument of that. So when you are in that state then Dinoop is an instrument and the more you are an instrument the more the consciousness expands but it expands within the system. It's not taking you into cosmic experience. It's not taking you out somewhere or you are not identifying with the soul. You're not saying I am the soul. I'm not this body, I am the soul. No, no, because the very ability to say that I at all arises from the bodiliness from the corporeality of the system. So to say I am the soul is a contradiction in terms. The maximum one can say is I am this in surrender to that. And the more one is in that surrender state the less of I there is. But there is always an entity because that is what keeps you connected with the materiality of your system. People ask me, they say, but then all the great masters, you know, they said I am that. Yes, they said that because they were that. They were in a cosmic identification. And the ones who clearly and solidly said that out of experience and not out of projection were saying that because they were not anymore connected fully and holistically with the materiality of the body. So coming back to that identity of the noob, there is some resistance there for me. I am comfortable to say I am in surrender to that inner guru or inner truth. But for me at some point, I saw this body as an object at some level. And it feels very difficult for me to see that I am this this body and the name only or exclusively. There seems to be some resistance there for me. Yes, and there would be that resistance. Since you have a history of the practice of detaching from the body, the point is that when you say, I saw this body as an object, what is it that saw this body as an object? Is it a material exercise? Is it an emotional exercise? Is it a conceptual exercise? Is it happening in Dinoop's thinking that he saw this body as an object? I can sit here now and see this body as an object. It's not very difficult to do that. I just detach from it and there it is an object. But the question is, what is thinking me through that process? What is thinking that this is an object? Or some form of contemplation, let's say. No, no, let's take it step by step because then only you'll have clarity about, you know, it is a very challenging thing I'm saying here. And it's challenging for many, many people who have spent years, if not decades, detaching from the materiality of the system and actually seeing it as an object. Or seeing it as something separate from themselves, quote unquote, right? So the question then is, what is that that is seeing that as an object? Is it happening in the cells of your body? Is it happening in your thinking? Perhaps. Where is that thought happening? So I was practicing the self-abidance or identifying more with my consciousness. So when there is self-abidance, as Ramanoha Shiva was speaking, there is still the experience of the body and the experience of the mind. But there seems to be some form of distance there. And so there, it seems to be clear for me at least at that moment that I was not the body, at least not exclusively I experienced it, but it was not like, yeah, I can't explain. When you went through that experience that you are not the body, what is that thing that is thinking that? It may appear to be a reductionist approach where I'm actually cutting you up into pieces, but the point is that the nebulous approach to all of these practices often, not always, but often results in steps towards the mental institution because all of this is going on in the thinking, which is why I asked that question. Where is that thought arising that thinks that this is separate from it? So it's arising in the thinking, it can't arise anywhere else. It can't arise in your toenails or in the cells of your belly. It is a thought, right? Is it a thought? For me, it's more like there's an absence of the body experience and then the presence of it later. So there is a deduction from that, that since it was absent at certain times and present at certain times cannot be me exclusively at least. That's a very precise observation and my questioning is not out of disrespect for your experience. I think it's a deep experience. And what I'm trying to do here is to put clarity into it from the point of view of what is spoken about here. So the question is, could it be that this whole experience is actually a conceptual experience where the conceptual, the ability to think isolates itself or relegates itself to an area of your experience where the materiality of your system does not have a place? So in other words, it's not holistic but purely and deeply and singularly conceptual. So there's just the perceiving identity and then at one point it is one again with the body and at one point it is separate from the body. But the body is the basis of that ability to perceive. And if the body is the basis for that ability to perceive because there is no perception in the way you understand it and express it without the body. It is an impossibility, it's a contradiction. So that experience is an experience where the thinking retracts into itself and exists as a thought because a perception is only grasped when it is expressed in the thinking. Unless it is a material perception but that is not the case here. Yeah, I agree. So it's more like a deduction and definitely it's a thought because as you said there is no experience in that state. You cannot say there is real perception in this state and then from the lack of perception there is a deduction coming out of the mind which says you cannot be the body because of that. In that moment when you experience that separation, you are still aware because otherwise you won't be able to even describe it. So when you are aware that means it is perception and it is translated in the thinking. So you are perceiving that detachment and you are saying oh I am not the body. Of course I can say that right now. I can just put myself in a state where the thinking isolates itself and I just feel that. I mean I am experiencing it right now. I am not this body. Of course I am not this body but the idea that I am that cannot be derived from this experience. That's true. And if you are not that then what are you then? Then the only thing that we have that we can tangibly connect with is this body. It is an approach. It is what is taught here, the spirituality of the future because over the past millennia the attempt has been to map the cosmos, to understand what is out there, to free the consciousness from the body. But the perception is so tied to the body that any expression of that perception can only happen through the agency of the body. And therefore to in a waking state be entirely disconnected with everything around is a machination of the thinking. So what do you do then? Because now suddenly even that doesn't hold. So what do you do? What do you do? To avoid that path to the mental institution because there are that many seekers that have landed there and especially students of Neo-Advaita. And I specifically differentiate between Neo-Advaita and classical Advaita Vedanta because the Neo-Advaitan approach has forgotten the word Samarpan. It is not even taken into consideration other than the concept of the ego surrendering to itself. So in the light of that danger, let's say that challenge, why is it so impossible to simply simplify this existence and say this body has a name, it has a mother from which it was born just to give it a slim identity and then that this body actually is bending in surrender from moment to moment and to that binary impulse that guides this system and has done it with a small child. A child, a baby is operating from the cosmic impulse within that makes it do what it has to do in order to survive. And the only difference is the socialization that has happened with you. Great spiritual masters, when they spoke, most of them spoke from an enlightened state and being in that enlightened state, they identified with self. But many, many of the enlightened beings who spoke from that state also had to reintegrate. They had to come back into this and they never could really reintegrate fully, which is also why. We have so many people who come here, enlightened beings who say, I don't want this enlightenment, how do I get back into the body? How do I stay here? So the question is, do you want enlightenment? Because if you want enlightenment, remember, you're going to have to reintegrate into the body because the body is the agency of your functioning in this world. It is a jump, it's a chasm that has to be crossed, but it may be a possibility for you to do that also. I felt, I was... I'll come to you once he's finished. In these two boats, one was the spark of this meditation, long meditation and then I have to integrate, I have to go to work, I have to do my things. And so that's where I applied the surrender principles to be active in the world and then use the... So that was my other side was to do the meditation. But there is no two sides. Yeah, I know. There is only one thing. Yeah, I understand. And if you split yourself up into the meditating caveman and the work world suited booted man, you will have a split in your life. And that is the ultimate duality that you will have to suffer through a lifetime. You're not the only one, which is why this is my Agnya. It is a divine Agnya to speak these words. It's not my own invention.  That's why I'm very happy to be here. So and what you're saying makes a lot of sense because I felt a lot divided by these kind of felt like this to differentiating processes. And my natural tendency was more to surrender. And the other one is something probably I picked up. It's just about bending down. It certainly does not easy to follow the impulse of the truth. It is not. This is a very, very challenging sadhana and practice. It is not an easy practice. It is more difficult than Agora Sadhana. It is more challenging. But it is also what for the spiritual seeker is his nectar, her nectar. The difference is you're not aiming for paradise, for enlightenment, for that which is outside your system. You are in the here and the now present and very deeply connected to the soul or the source within and ready to bend to its impulse and refuse at every moment. The loud commanding, demanding, insisting, pushing, yearning, opinionating voice of the ego. It is a moment to moment sadhana here and now, here and now. It is not a sadhana to take you out of the system to go into cosmic enlightenment experience. So it is a choice. You can also choose the other thing. But the integration is next to impossible. In fact, it isn't possible. The few spiritual masters that survived this experience have been taken care of by their disciples. They were not capable of taking care of themselves. I spoke about Ramana. He was in the temple there inside with his body covered with sores bleeding and full of pus and it was Sheshadri Swamigal who went and rescued him. So those who are not rescued, what happens to them?  They actually die. A lot of them reintegrate but they can never live a normal life again. Just a life in the body. So this idea of enlightenment and this yearning to be like those spiritual masters who are detached from everything is an aberration in the trajectory of spirituality. The future of spirituality will be one which is presentness connected as a servant, as an instrument of the source. That is where everyone will have to come to because being out there, being identified with source will create exactly what it doesn't want to. It creates the duality. As you do this practice, you'll feel more and more integrated because you're here and now, you're doing your work and while you're doing your work, while you're earning your money, while you're taking the auto, you are present and you are a spiritual being in surrender, in samarpanam to the antaratman, in samarpanam to the antarguru. That is in surrender to the truth, to the master of your being, to the inner guru. You are that from moment to moment. So what is not spiritual about this life? What is not self-realized about it? Why does one have to be separate from life and create that duality in the attempt or with the idea that that is the non-dual? It is a misrepresentation and an aberration.


Welcome! The following video will demonstrate how to program a GoControl Z-Wave battery-powered thermostat into a GC2 security panel. It is recommended to first install the GoControl Z-Wave battery-powered thermostat into its final location before you begin programming. Connect the common wire between the thermostat and the current HVAC system. This will allow you to use the current HVAC system's 24V AC power to operate the thermostat. Note, you have the option of powering up the thermostat via the four AA batteries instead of using the existing HVAC system's power. This is not recommended because it will prevent you from being able to use the thermostat as a Z-Wave repeater. To begin programming the Z-Wave thermostat into the GC2 panel, ensure the panel and device are within 5 feet of each other. If needed, disconnect the panel from AC power and walk the panel over to the location of the thermostat. The panel will continue to run via the backup battery. Next, navigate to the GC2 Z-Wave toolbox. Press the Services button. Then press Z-Wave. Press the wrench icon. Enter the installer code. The default installer code for the GC2 is 1, 5, 6, 1. You are now in the Z-Wave toolbox. Z-Wave devices, such as the Z-Wave thermostat, may need to have past programming removed before they can be added to a panel, even if they are new. We do this by performing the removal process, which is also known as exclusion. To begin the removal process, select the Remove Devices button. The Remove Z-Wave Devices screen will appear. Press and hold the thermostats fan button for 5 seconds. You will see setup display on the thermostat screen. Press the up or down arrows until Z-Wave display is on screen. Choose Select by pressing the Mode button. Install will display on screen. Choose Select by pressing the Mode button. You will see the message done display on screen once the thermostat is removed. The GC2 panel will also display a notification on screen that the device was removed. Press OK. Press Back. Now you can add the thermostat. Press Add Devices. The Add Z-Wave Devices screen will appear. Press and hold the thermostats fan button for 5 seconds. You will see setup display on the thermostat screen. Press the up or down arrows until Z-Wave displays on screen. Choose Select by pressing the Mode button. Install will display on screen. Choose Select by pressing the Mode button. You will see the message Wait, Success, and Done flash on screen. The GC2 panel will display a notification on screen that the panel is querying device information. Do not exit the screen until you see the details of the thermostat display. Press Back to return to the Z-Wave toolbox. If you have any additional Z-Wave devices, add them to the panel. Then, install the panel and all Z-Wave devices into their final locations. Lastly, complete a Network Rediscovery. During Network Rediscovery, the panel will recreate its Z-Wave routing table and optimize the mesh Z-Wave network. To initiate a Network Rediscovery, navigate to the Z-Wave Toolbox. Then, press Advanced Toolbox. Press Rediscover Network. The panel will display a message that it is rediscovering the Z-Wave devices. Then, the panel will automatically redirect you back to the Advanced Z-Wave Toolbox. Note, the panel will continue to run the Network Rediscovery process in the background. Network Rediscovery will take around 1 to 2 minutes per Z-Wave device. Z-Wave services may be unavailable until Network Rediscovery is complete. Press the Home button on the panel. The Go-Control Z-Wave battery-powered thermostat has now been programmed into a GC2 panel.


What's up everyone? It's your girl Kenzie here from Layton Sports Guards and I'm ripping another personal here for Jeff W We've got another 21-22 Panini recon basketball. Best of luck here. Jeff. Thank you for hopping back in Green we have for the Mavs a Sam Perkins 137 of 249 Perkins Perf Ups teammates with durability and determination claim to fame auto Kobe white refractor and future legends Kade Cunningham Josh giddy Ricky base Blue to 99 Steph Curry and Moses Moody on the rookie recon Hollow white pink Van Blee Luca Garza rookie bronze the 299 D'Angelo Russell maneuvers Russell Westbrook Call Anthony AD Kuzma, we've got hollow Marcus smart and white magic on the rookie review That's the white that I remember Young the white for the magic Robinson Earl and be rock the rim LeBron. J We have how about some white chocolate? That is four of 25 claim to fame Jason Williams Fancy passes no passing fancy for Sacramento's Williams Cool one there Clay Thompson hollow and Horton Tucker on the pink Third we got red to 199 Greg Brown the third and Halliburton on the future legends Sub Shadow Got Josh giddy hollow rookie and maneuvers on the gold 10 of 10 Allen Iverson There you go. Jeff killing these recon boxes Nice gold AI.  Oh, yeah, I put some nice cards so far today shadows some nice basketball cards I just pulled a gold rookie auto of Gavin sheets out of tops chrome We've got bronze to 299 Tyler hero and Josh giddy on the rookie recon Alrighty Jeff that will do it for your second box there of recon. Thanks again for hopping back in and we'll get these right out to you


The adherence junction, AJ, is an actin filament anchoring junction that is essential for epithelial morphogenesis. It is composed of catherans, which bind to each other and to alpha-catenin, which acts as a tension transducer that changes its confirmation in response to tension. This tension sensitivity of alpha-catenin is important for the proper rounding morphogenesis of epithelial cells. This article was authored by Riosuke Nishimura, Kageaki Kedo, Misako Saita, and others.


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Hello and welcome to this presentation of the STM32 Nester Defected Interrupt Controller or NVIC. We will be presenting the features of this controller. The interrupt controller belongs to the Cortex-M33 CPU enabling a close coupling with the processor core. The main features are 109 interrupt sources, 16 programmable priority levels, low latency exception and interrupt handling, automatic nesting, power management control. When trust zone is enabled, the V8M NVIC handles both secure and non-secure interrupt sources. Applications can benefit from dynamic prioritization of the interrupt levels, fast response to requests thanks to low latency responses and tail chaining as well as from vector table relocation. When trust zone is enabled, the NVIC handles both secure and non-secure interrupt sources and two cystic timers are available one per security level. All interrupts including the core exceptions are managed by the NVIC. The NVIC and processor core interface are closely coupled which ensures a low interrupt latency and enables the efficient processing of late arriving interrupts. Access to the NVIC's control and status registers is performed through the private peripheral bus OPPB internal to the Cortex-M33 CPU. The NVIC provides a fast response to interrupt requests allowing an application to quickly serve incoming events. An interrupt is handled without waiting for the completion of a long instruction sequence. These instructions will be either restarted or resumed upon the interrupt return. The priority assigned to each interrupt request is programmable and can be dynamically changed. The vector table containing the address of the exception handlers can also be relocated which allows the system designer to adapt the placement of the interrupt service routines to the application's memory layout. For instance, the vector table can be relocated in RAM. Software is in charge of assigning a priority level to each interrupt as well as to all exception sources not including reset, non-maskable interrupt or NMI and hard fault. Whenever a peripheral interrupt is requested at the same time as a supervisor call instruction is executed the relative priority of these hardware and software exceptions will dictate which one will be taken first. Concerning the STM32L5, NMI is caused by an SRAM parity error, a flush double ECC error or clock failure. The priority of any of the 109 peripheral interrupt requests is programmable in a dedicated priority field located in Cortex-M33 NVIC registers. The NVIC provides several features for efficient handling of exceptions. When an interrupt is served and a new request with higher priority arrives the new exception can preempt the current one. This is called nested exception handling. The previous exception handler resumes execution after the higher priority exception is handled. A microcode present in the Cortex-M33 automatically pushes the context to the current stack and restores it upon interrupt return. When an interrupt request with lower or equal priority is raised during execution of an interrupt handler it becomes pending. Once the current interrupt handler is finished the context saving and restoring process is skipped and control is transferred directly to the new exception handler to decrease interrupt latency. So back-to-back interrupts with decreasing priorities are chained with a very short latency of a few clock cycles. When an interrupt arrives the processor first saves the program context before executing the interrupt handler. If the processor is performing this context saving operation when an interrupt of higher priority arrives the processor switches directly to handling the higher priority interrupt when it's finished saving the program context. Then tail chaining will be used prior to executing the IRQB interrupt service routine. When all of the exception handlers have been run and no other exception is pending the processor restores the previous context from the stack and returns to normal application execution. When a fault occurs while executing either the bus fault handler or the memory management fault handler or the usage fault handler the processor escalates this event to the hard fault handler. Note that bus fault, memory management fault and usage fault have to be explicitly enabled. By default any fault leads to the hard fault handler. When a fault occurs while executing the hard fault handler the processor enters a state named lockup. It asserts the lockup output to indicate that it has encountered a serious non-recoverable error. In the STM32L5 microcontroller this lockup output is internally connected to timer break inputs so that a safe state can be entered when the STM32L5 is used to control a power electronic equipment such as a motor. When trust zone is active both secure and non-secure partitions will be executed by the Cortex M33. The secure partition is in charge of assigning the secure attribute of all interrupt sources. When an interrupt source is programmed as secure all its related control and status register fields are read as zero and cannot be written by non-secure software. The secure partition can read and write register fields related to non-secure interrupts by using an offset of 0 times 20,000 to access the non-secure register instances. For example, if the secure partition configures the SPI-3 peripheral as non-secure it has to write 1 to bit 3 of the NVICIT and S3 register. By default all interrupt sources are considered to be secure. The non-secure kernel and secure kernel have separate vector tables. The vector table contains the addresses of all the exception handlers. The vector table offset register VTAR that contains the base address of the vector table is banked one per security level. General purpose registers are not banked. Therefore their contents shall be cleared on any transition from secure to non-secure to avoid that secure information present in these registers is accessible from the non-secure partition. When a non-secure interrupt occurs while a secure partition is active the contents of all general purpose registers is automatically saved into the secure stack and then the microcode writes 0 to these registers. When accessing the NVIC registers ensure that your code uses a correctly aligned register access. An aligned access is not supported for NVIC registers as well as all memory mapped registers located in the Cortex M33. An interrupt becomes pending when the source asks for service. Disabling the interrupt only prevents the processor from taking that interrupt. Make sure the related interrupt flag is cleared before enabling the interrupt vector. Before relocating the vector table using the VTAR register ensure that fault handlers, NMI and all enabled interrupts are correctly set up on the new location. The NVIC is linked with the timers Cortex M33 CPU and trust zone modules. Please refer to the related presentations. For detailed information please refer to the programming manual for the Cortex M33 Core and the reference manual for the STM32L5.


Adapted for hockey from Saturday championship game in the PI division and brainered. They go back to back state titles and 11 four win over Robbins Dale. Then it was a hero's welcome back for the team as they were escorted to the high school Saturday night. Police cars, fire trucks, ambulances all led the way as the warriors celebrated their back to back state titles. Two in a row is is really cool. It had been 17 years since the team had won a state championship and so to get, you know, two undefeated seasons back to back has really been a fun fun time. It's really unique. Not a lot of people get to experience it. I'm just thankful I got to I got to experience it with a really good group of kids for teammates and a really good coaching staff. Did each other and said you know this is this is your time to those senior captains and they stepped up and you know really really gave us a good performance with seven goals in that third period. If you enjoyed this segment of Lakeland news, please consider making a tax deductible contribution to Lakeland PBS.


All right guys, so today I have a case for you and I think you guys will really like it and we're gonna use this case to go ahead and teach a topic so while I'm preparing for residency I thought it would be a good idea to Use my education to go ahead and kind of attempt to teach Let me know if you guys enjoy this kind of format because I continue to make more on a weekly basis So here's the case. We have a 75 year old male that comes to us To the internal medicine service and he comes in originally complaining of fever He complains of a cough And he says he can't really breathe that well So he actually comes to one of our colleagues and they do some work up and they realize that you know He actually just has a basic pneumonia So they're treating him for pneumonia They treat him with some antibiotics and then you happen to be the lucky intern or resident or med student on call When a few days later the nurse calls you in the middle of the night or the middle of the day and says he has some really bad abdominal pain So this is where we are and apologies for any spelling issues In advance, but we have abdominal pain in this patient. So the question is what do we do? You know? We have a patient with abdominal pain What kind of things should you be thinking about as you're walking to go evaluate them? And so let's quickly just give you some insight into his abdominal pain So you likely will not want to know excuse me. You likely want to know where it's happening So it's right in the middle epigastric of his belly You want enough he has any other symptoms. He says yes, I have nausea vomiting You want to know if the pain really goes anywhere? He says not really you also want to know things about you know fevers and We're gonna say change the color here for a second. We're gonna say he doesn't have any fevers And he's not bleeding, you know in his stool. His bowel movements are okay so really all we have is that he has middle pain and Some nausea vomiting. So what should be some of the next things you would be considering in this patient? So, you know other things you may be asking him and just kind of how bad is the pain? There's just her and he says oh, it's 10 out of 10 So it's a big deal, you know, it's the middle of the night So you need to know do you is this serious or is this not so let's you know Let's talk a little bit more about other information. We want to know right where you are the Kind of covering intern resident medical student and this is a new patient to us so we want to know some details and so We're gonna want to know their past medical history And so when you ask the nurse you look at the chart you realize he has hypertension You realize he has kind of all the common things he has diabetes You realize that he has coronary R disease Just lifestyle kind of issues That he has and you want to know kind of is he on taking on any medications? It says yes I take a blood pressure medication take two actually I'm not gonna worry too much about which ones they are. He takes the statin drug so it helps lower his cholesterol for his CAD Sorry about that and then He Will say that's all the medication he takes and then you know, you want to know other things like let's ask about his Social history. What are his lifestyle choices? So he is a smoker long-time smoker But he doesn't drink so no alcohol use I'm just gonna say I'm just gonna say OH Negative, okay, so this is what we have right? We have a 75 year old with abdominal pain pretty bad He has a lot of lifestyle issue with choices takes the medications for and he seems to be Recovering from what he initially came with but he has looks like what seems to be a new problem So you as a doctor, what do you want to do next? And hopefully you are asking to want to learn more about the patient Their vitals are physical exams. So let's talk about their physical exams.  So let me give you their vitals first. So his blood pressure is about 120 over 70 his heart rate is up He's about in the hundreds and the rest of his vitals are fine you look at his lungs You look at his heart. They're doing okay. But when you look at his abdomen, right? That's what you're really focused about It's just tender everywhere So he has tenderness everywhere But no rigidity this is really the main finding right here and then the other thing that you notice on his vitals is that his pulses So his pulses especially And towards his legs are just diminished. They're just not as strong as the ones in his arms So based off of what I just gave you, you know, looking at all of this What would be kind of what we call your differential diagnosis? so What would be things that you'd be considering about so again, just to paint the picture you have an older man Who has abdominal pain who in the middle some nausea vomiting is pretty severe His physical exam shows that's pretty bad. He has some weird thing going on with his pulses What should be we thinking about so when I think about abdominal pain? First of all, I look at location location really can help you determine a lot of different things So because this is in the middle of the stomach There are certain things that we are more likely to think about than others And if you go down at the bottom of this page, you'll see kind of a nice diagram to show you what type of things You should be thinking about depending on where somebody's pain is so because in the middle We're thinking about things like pancreatitis Sorry about spelling and during the care What other things would be in the middle? So for example, if someone had like a peptic ulcer disease Somebody could have let's see. What else would you expect to have? He could have a ruptured ulcer and then the main question that I love to Kind of hit on and this is what you want to think about as a doctor is what could kill your patient, you know As grim as that is you want to know what's the most important thing You need to be considering every patient with abdominal pain chest pain because you want to make sure you don't miss it So what could kill our patient with middle abdominal pain? Who's older who smokes has history of hypertension and you may be screaming at me while watching this video? But it's a triple A. So this is an aortic aneurysm. Okay an abdominal aortic aneurysm So this is kind of what we're going to be talking about because this is what this case teaches So just to go ahead and be simple. I'm going to go ahead and just kind of erase what we kind of worked on And then we're going to go ahead and teach about a triple A So an aortic aneurysm or a triple A. So let's kind of quickly talk about what that means So your aorta for anyone foreign is basically like your big trung that supplies blood To your body, so it obviously blood comes from the heart And you're gonna have blood that goes down to the lower extremities and then some that go up And so this right here is going to be your aorta. It is kind of like your highway So you're gonna have an aorta that's in your thorax your chest and obviously you're gonna have one of your abdomen So now when you go into your abdomen You have a risk as for many different reasons of developing an aneurysm Which is essentially what I like to consider like a bubble or a pouching. So your wall We're gonna zoom in right here. We're gonna zoom in and this is kind of what we're gonna see when we're zooming in So your wall And here's they order all is made of several different layers. Okay three different layers in fact and Again, you have blood going through it Over time what happens is that the wall gets weaker for many different reasons that we'll talk about But it gets weaker specifically here around the lower abdomen. So that is why you can have a triple A So a couple of reasons that you can have this are things like age, you know, just our heart and our Vessels working against each other for so many years can cause this to weaken. You can have things like smoking, you know smoking just doesn't Work well with the vessels and so you're likely going to damage these walls And so it's going to lead it to be weaker and that's gonna lead the blood to kind of push the vessel outwards So you can have some outpouching going on and other things. Sorry. This is all getting really dirty and messy high blood pressure and other things as well include things like infections. So syphilis Salmonella other infections and we're not going to touch on every single thing But just know that anything that can really cause a weakness in your vessels can also Be a cause for an aneurysm. So should we care like this is a big deal or not So yes, you should care because this is the 13th leading cause of death in the US. I Really have to work on my placement here apologies and That's roughly about 9,000 deaths There's a last stat that I saw on this So it is a big deal and it's also a big deal because pretty silent So our patient, you know came fine We had no issues with abdomen and suddenly all of a sudden we have something going on with a risk of an aneurysm and The aneurysm is not the the problem The problem is you could rupture this wall and your highway that supplies blood Towards your lower extremities your upper extremities can essentially blow open and that's going to lead blood to leak out and avoid having blood going into the other parts of the body so You want to avoid what we call a ruptured AAA Okay, so we talked about risk factors You know, we talked about what we're trying to avoid obviously. It's very serious So how do we kind of identify if our patient this old man supposed to have it? So I'm gonna go ahead and just take a second and let you think about what ways if this patient was yours What would you want to do? And if you said you would want to ultrasound this patient then you are right So ultrasound is super effective I'm not going to throw too many numbers out But sensitivity is a big thing that you'll learn about a medicine if you haven't already and it's basically the idea that if your patient does have The thing you're looking for, you know, how likely is the test going to be positive? Okay, so for An ultrasound it's about like 96 to 98 percent. So It's it's a very good test to identify if it's positive you are likely going to have a AAA and so, you know if our patient had it perfect, but again, remember this happens to a lot of people With these risk factors and so because a triple a can lead to imminent death pretty quickly We actually evaluate people anywhere from like 65 to 75 At least once by just doing an ultrasound if there were a smoker Because we know smoking is such a big risk factor for a triple a so we now we know kind of what to do in terms of identifying it so You know, let's talk about management and that's kind of what we'll end it at So what do you think is going to be our plan for management? What would you do if you were this patient's doctor? So some of you guys may be saying, you know, take them to the operating room and doing surgery Others may have other plans like some just medicine and honestly, they're both right And it really depends on a special number and that number for a triple a is five point five centimeters. So essentially Your aneurysm this thing right here this big baby right there If it's bigger than five point five centimeters You go to surgery because your risk of a rupture on a yearly basis is 11% okay, so that's obviously big enough and then if you're you're smaller than that then we do what we call conservative management so that includes controlling your blood pressure stopping you from smoking and You know causing more issues And just lifestyle choices weight loss Giving them a statin to lower the cholesterol, but that's basically what we do and we keep evaluating it Okay, so that is a big overview on what a triple a is how to evaluate somebody with abdominal pain and the worst-case scenario Which is a rupture triple a that we want to make sure we avoid and our patients are at least are ready to take care of So hopefully you guys enjoyed this video. Hope you guys enjoy this tutorial apologies for all of the kind of mishaps and Marks and spellings and issues But if this was helpful, let me know because I am more than willing to keep doing this on a weekly basis If you guys find it to be advantageous So check out the resources below this video for kind of more Explanations pictures and whatnot and obviously please give me feedback, but thank you guys so much for watching And I'll see you guys in the next one.


there's been a lot of complications during the course of this year what's like now just to have things finally simple win two games at home and you're in the playoffs thanks big dog now feels good it feels good to be in this position hard fought and just want to take it one day at a time and get prepared for Indiana coming Sunday and you know have some good results there get better that day and then get ready for Tuesday so it feels good like you said with all the complications stuff like that that's the past now we just control we can control get ready to hoop for either what you guys were 17 what in your estimation led to that lead kind of dwindling and then them taking the control and leading and just the NBA and their pros and well coached and talented you know it's first quarter it was early so they got back into it making shots we put them on a free throw line so game around you know they made their run we made as early they hit us in the mouth and we like how we respond it so it's just been the nature of our season just get knocked down and and seeing how we were sparring I thought tonight was a good example of how we can respond Andre was saying this morning he felt like these last two games were must wins you guys have obviously played in some of the biggest must win games in recent history but are you viewing Sunday as a must win given that it locks in the seventh so you didn't give you two shots in this plan every every game that we we play we feel like it's a must win when give our best effort but obviously with this plan tournament this playoff idea playing idea you know spend a little bit more pressure but that's part of being an NBA and you know preparing daily for these type of moments so we just want to come in with the same mentality that hey let's let's put our best foot forward let's put our best effort out there and like K said just be able to respond to other teams runs now hold our head not allow it to carry over into any other possessions and live with the results that way so we feel good about it and obviously it's been a little up and down but Kevin when you're when you're doubled you're obviously confident in your teammates you're willing to get off the ball what's the sort of the key to executing out of that double for for everybody else is it a spacing thing is it just the the how quickly the ball moves yeah I think it starts with me just being patient I think a lot of times I see an extra guy I want to get rid of the ball quick and but sometimes I gotta wait on my teammates to set up and make themselves available so we've gotten so much better at that this year and we've seen all different types of schemes and how they how teams guard me and I think my teammates are understanding on where to be if they actually do come in double so Bruce has been you know being that guy that flash in the pain and make plays on the back side Dre has been doing a good job Kessler you know so I just got to be better at being more patient playing stronger and just making those passes make sure those passes on time and on target Kevin you mentioned Bruce he complained to us for not asking him about his near triple double so maybe this evens the score but to assist shy four blocks also just what would you make of his whole performance yeah I didn't think he deserved a triple double tonight so you know because he talked about it at the we didn't know and he's like oh I need two more serious I'm like you're not getting it tonight you shouldn't have said nothing but you know we all love how Bruce has been playing lately for block I mean we expect at this point I expect him to come out here and play well now and I think once you build those expectations up for yourself as a player and that's when you start to develop even more and more and you build that trust in your teammates so I'm sure he'll have more opportunities to do that just ask about Kessler Edwards and what you guys have seen from him since San Diego and him taking advantage of the opportunity that was given to him puts in the work he listens professional every single day and he comes in he asks questions and he's very attentive to the details that we're asking out of him so for that he deserves to be rewarded and we put in that much work and you have that consistency and we see it all the time you know guys get really blessed in a position to be able to be with us for the long haul or be with the team for a long haul so we're excited to have him and he deserves it