Do you worry about having enough money to last throughout retirement? Give Reed Potter at Raymond James a call. Reed has 26 years experience helping folks enjoy their best life in their retirement years. Shaping our Appalachian region had a busy and eventful year as they worked towards their goal of advancing Kentucky's 54 Appalachian counties. That's what I think Eastern Kentucky expects of us is that we're continuing to think of new approaches to common problems that we're not just sitting back and kind of doing the things the same way over and over again that we're continuing to try to throw stuff up against the wall and see what sticks to be perfectly honest with you and ultimately just work extremely hard and so we're dead. In addition to helping many businesses launch, creating new jobs, hosting many events such as the Soar Gala and the Country Music Highway Tribute shows and obtaining many grants, Soar was also able to secure affordable connectivity for those in the region in need of internet and be considered as finalists for the U.S. Economic Development Administration Recompete Pilot Program. We're really springboarding into a great 2024. As we enter into 2024, Soar is looking forward to continuing their work and making more advancements for the region. For Mountaintop News, I'm Kelsea Fidell.


TLO what's pop we are on kick KIC cake that calm we are not live But you can leave a like comment subscribe turn a post notification bells Let's continue to grow the family from Chicago to the UK Right above me if we do go live and you happen to miss it and just want to see the highlights Some of them be here if it's worthy We also got the merch Good merch We also got the patreon we post Monday through Friday today. We posted afterlife when we're done a post after life So, you know Everything that I've mentioned is down in the description. It's in a link down there. It's called link tree. Click it. Everything will pop up This is quintessentially British means 68 Okay Get into Then why is there a piece doing the fridge? You were a cheeky surprise Surprise An accident Possibly one of the worst starts to a morning nifty means no one First of all the fact that this needed translation Well, who the fault pardon away in it 17 and school nifty nifty means no one that's tough Possibly one of the worst starts to a morning No, it's the shampoo over in the shower bent down to pick it up on the way back up my head clipped something you thinking Andy what you want about Victor razor.  I Thought that was going in a different direction, but that's that's Less of a shocking thing that I was going for but that's still tough If you can do this Without How many little little little how many you man can do that? Well, you barely can do it. That's that's I hear boogers that just dying Imagine that being allergic to plants where you Smith But I get yellow mark that's crazy Thank you so horse Willy Going to house That's it merch, you know, excuse me love. Have you got the time? You sure Yo, you know what's crazy. I just did the chicken shop date with Fredo, I did the reaction and the bottle of water that stayed on there and Like I didn't know that this was going on in the UK I didn't know that it stays on so you could recycle it with it And I got ridiculed in the comments. I didn't know this was it. They don't do this in America We don't care in America, I guess What you could win your holiday home the whole package is worth a hundred and fifty thousand pounds Oh, I'm stuck on the door. Oh Obviously That's an aisle of weight Is that what I say? I love that can't say wait why it what does that say? She for the set world record I nearly killed the cameraman Jill Hello there. Hi Allison. It's so lovely to meet you.   I'm your three children right now because we're Should I say something gonna give you a lovely treat today. I've got Obviously, we're not gonna be trickle treating. We're not gonna be having past as you know in our different different houses Obviously for obvious reasons. So what I've done is I've created an amazing party. We're full of trickle treats It's gonna be amazing trickle treat What's a trickle treat? Not trickle trickle trick or trick or treat. No way Trickle treat Trick or treat 45 years old I never knew that but you use trickle treat you went around to people's houses with trickle trickle treat That's hilarious. I think this is like the first year my daughter is actually gonna be like Knowing what's going on fully. It's gonna be cool But Halloween it's coming up. Excuse me It's a regular old night out in Soho. I've seen no women in there Sir, wait, hey, how do I get to um Luga Baru What? Luga Baru, that's what they say or laugh Baru Baru Baru Luga Baru laugh Baruff Loaf Baru What Luga Baru You mean love bra. It's called love bruh mate Bruh, how did they get that love bra out of that? They say love baruff love love baruff love baruff Love baruff and I think you're driving on the wrong side of the road Not again. Oh my god. It's closed.  No, what do you think? What shall I do? Or do you think I should do? Shall I just leave her there? Damn, somebody's behind the centre. Oh, yes. I'll go knock on. They're not letting me dog out I think they're trying to take her.  Well, where are you from because your accent's all sort of all over the place I'm a tourist, actually. Where's your accent gone? I'm a tourist. I remember this episode.  No, I'm a tourist. You're picking up different things? Yeah, that's all. That's how I come Because you've got kind of got sometimes you go Birmingham and then it's all over Australia. And people say that, but I've never been down to the UK Not at all. Where's that? Not at all. All right. All right. That was Cornish, then. Biotic. Yeah, that people say that. That's Bristol.  It's the weirdest voice I've ever heard. I mean the people actually come down to Petra. So when you meet people and talk to them, I hear how the accent they speak it up. So I assume he didn't know how to speak English before he started the job and then when he was learning he learned from the other tourists coming down It's the only way it makes sense. So you hear how they talk and then you, yeah, you copy it. You'll be sound like me tomorrow. Right, I like it. Do you know him? Is he a neighbour? Yeah. I signed my son up for singing classes after school. This was his reaction when I picked him up after. It's all about singing, Mum. Singing. No. Terrible. So you don't want to go to singing classes? No. No more singing? No. Definitely not. Hey, big man. Yeah. That's everywhere. Tell all you like, comment, subscribe, turn on your post notification bells and hit that like button. Simple.


Hey everyone, welcome to Snowbreak Containment Zone and we are here with the top 5 4 stars in our game. These 4 stars will be used most probably from day 1 up to the mid game which will help all of you guys and especially free to play players who would like to know what are the hidden gems in our 4 stars. So also just want to note that all the 5 that are in the top 5 are of various weapons and now let's proceed to all of those top 5 4 stars. So we're starting off with a new addition to the 4 star which is Chen Xing. So Chen Xing is for me what I consider her, she's mainly a healer. The healing will come from the support part which is psychic so it's like a pod system that it throws out heals or vials so that your other operatives can pick it up. Then the other 2 skills that you will also need is also heavenly law. Heavenly law is a system wherein pods are being dropped near your enemies so that they could deal damage. I think this is going to be a thunder soldier is a max of 3 plus there's going to be a mama soldier during divine protection. This is a big pod so deploys one thunder token in a designated location and it gives buffs to the small guys so increase of attack speed of surrounding thunder soldiers. So not only does Chen Xing have a very very good kit in terms of heals but she also has support damage aside from those heals if you're going to be using her. So that is it for Chen Xing. Next up is going to be Fenny. So your shotgun here Fenny, I'm sorry, Chen Xing by the way uses a rifle Fenny is going to be using a shotgun. Shotgun users will be big part of the game because they're good in hitting armored or your large figures that you need to take down they're hard they need to be taken down by a shotgun. So Fenny really specializes in that including her support skill. Support skill is actually a nox target so it throws targets away once it's near the operative that you're using for support but if you want to use her this skill is a lot of damage it's a lunge it's a dash but you'll need a bullet for this one and also this one the fit of peak this is also a huge damage in a small cone area so trigger seven explosions in a line in front not really a cone so it's a line straight line so again if you're looking for a pure damage shotgun user in four-star then Fenny is your girl plus she does have a new outfit which is very fantastic. Next up is going to be Akasha so Akasha here well Akasha is queen of being slow not really being slow but queen of dishing out slow so in her support skill let's talk about support first so throws a small dagger deals chaos damage slow with a target for five seconds take note this is only one target but if you use her as your main then this one once you throws a dagger this is more for crowd control not really crowd control but more on for multiple damage if they are a lot of clustered units in one area so this is multiple damage and the last one is also going to be kind of a crowd control as well this applies slow to the units this with your user you use this then you shift to another another character for example Fenny that when your enemies are slow then Fenny can clean them up with your shotgun if you want that to happen your fourth up is going to be life so life here is the main protagonist of the game so again very nice all around unit or character I've been using life since CBT she was my main in CBT because I didn't have the five star version of her when you use her you will have go back go first to the support so support so for life she summons it's under judgment centered at one target this one is good for paralyzing targets also for slowing them down that was for support if you use her this one will give you additional fire support so this one these are kind of drones that shoots at you at a target in front of you and the last one from the windy tree this one is a huge not a huge but it doesn't really have a limitation in terms of range in which how far it can deal that lightning that it it's like a lightning storm by the way so this has good damage very large area in which thunderstorms are shooting out so basically she's one of your top four star within the top four star okay so next up after life so life is our fourth the last one would be Marian okay the reason behind why Marian over y'all four star is that Marian is is actually specializing in lure explosion the lure explosion is the taunt here so there's a taunt she leaves something taunts then explodes then her kit is mainly for high power damages so this one is chaos damage and her ultimate basically is going to be a big damage as well so huge damage with chaos damage so again versus y'all her she Marian is going to be more of a big damage dealer compared to y'all in four star so if you want a hard-hitting sniper at four star then definitely you get Marian so again the top five would be shen shing fennie you have Akasha for slow then you have life for all around then the last one will be Marian as your top sniper for four star however we do have some honorable mentions for this game just in case you have other preferences number one for the honorable mentions is going to be y'all okay because y'all is a healer if you want more heals for your you know for your team then y'all is actually it because as a support she heals she also has a heal for herself so again if you want more heals then y'all is your girl but if you want more damage for your sniper Marian is it another honorable mention that I would like to add is actually Anya Anya here very decent she has ignite damage or thermal damage this one is a very nice it has a wide area in terms she throws the flower of youth so this one when it hits the ground this is more for units that are on the ground if they're kind of a lot then and it spreads in a wide area this is actually very good for crowd control also this one is for also for crowd control hits one then explodes dealing extra thermal damage no this is only for one target but deals additional damage and feathered serpent which is a damage dealing ultimate as well so those are five with your two honorable mentions so I'd like to hear from you guys in the comment section which of these are you still using and which of these are you planning to retain in your roster so thank you very much for staying as far take care stay safe this is the warden and I'm out of here


Welcome to the demo of Defend, the IBM dispersed financial fraud enhanced detection solution. We're going to show you how the Defend mobile client works, along with a peek behind the scenes to simulate what happens at the backend when transactions are suspected of being fraudulent. This screen shows our server that simulates the backend of a credit card company. The server collects all of the user's transactions, alerts the user when new credit card transactions take place, and lets administrators at the bank upload and modify data as needed. On the right side of the screen, we see the Defend mobile app for Android. First, our user Charlie logs in by entering his username, password, and credit card number. After login, the Defend client displays the transaction screen. Charlie's transactions are divided into two tabs, purchases, and ATM cash withdrawals. He can choose either tab depending on what he's interested in. Tapping a transaction gives more details, and we can now see the location of the shop or ATM relative to Charlie's location at the time of the transaction. The GPS of his mobile device shows that he's now in New York City. On the map, his location is marked by the blue icon. The store or ATM is marked by the red icon. At the bottom of the transactions screen, you can see the Create Analytics Model button. This indicates that the application is still learning our user's behavior. The button will disappear after enough data has been collected to create a model of Charlie's typical behavior, or when the credit card company decides to create that model. Let's see how the app handles a new transaction like a withdrawal before it's finished formulating a model of Charlie's behavior. We're going to use our demo server to manually add a transaction. In this example, the cash machine and the location of the user and his mobile phone are identical. The cash withdrawal we added is shown as a new transaction on Charlie's mobile app, and a notification icon appears in the tray. If we expand the new row, we can see more details. You can now see that Charlie and the ATM are at the same address, and the icons for Charlie and the ATM overlap each other on the map. Let's look at another example where the transaction takes place far from where Charlie and his mobile device are. Again, we can see the new transaction on Charlie's screen and the notification icon in the tray, but when we expand the transaction, the details show us that the ATM location and Charlie's location are different. By tapping the ATM location, we can see the distance between the ATM and Charlie. The notification icon now indicates that this is a possible fraud, and Charlie has the option of deciding whether this is the case or not. If he decides it's a fraud, the transaction is reported to the bank and canceled. Now let's see how Defend handles a new transaction like a cash withdrawal after the app has finished creating its model. Keep in mind that the system will continue learning and improving even after the model is created. We're going to use a simulation server to add a bank withdrawal for a valid, non-fraudulent ATM. As before, we can see the new row added to the ATM transactions. Expanding the row displays the details of the transaction. Since Defend checked the transaction and found no suspicion of fraud, no further action is needed. Now let's use the server to add a fraudulent ATM transaction. The Defend system detects that a fraud took place, and a notification is presented to Charlie with the details of why it's probably fraudulent. In this example, the distance between Charlie and the ATM is about one and a half kilometers. Since we know he always has his phone on him, the score for the fraud is 100%. Charlie can now decide if it's a fraud or not, and the result is reported to the bank. Defend also uses call history to check when a fraud took place. Charlie often makes purchases by phone, and the system's model has learned what's normal when it comes to his behavior. Here we can see a recent call he made to a New York area restaurant. Let's go back to the Defend server and push a transaction where the phone number of the shop is not presented together with the credit card purchase. As we can see, a new row is added with the details. Defend checks the details of the transaction, and the system does not notify Charlie since the call history showed a recent call to the shop. Now we're going to use the Defend backend to add a fraudulent transaction. Charlie always uses his mobile phone when calling in a purchase, but here the store's phone number is not in his phone's call history. As a result, the system alerts Charlie with the details of why this might be a fraudulent transaction. He then reports it as a fraud, and Defend notifies the credit card company. Thank you for watching this demo. For more information, contact us at IBM Research.


Salami, salami, baloney. Oh. No. You know who that's from? What? Salami, salami, baloney. What's that? Looney Tunes. Oh. And there's a ton of stuff you couldn't do today that they used to do back then. In fact, right as I was saying it, I was thinking to myself, I have a feeling that was deeply insulting, that quote. Probably. This is in my head since I'm a little kid, but I really do think that was probably culturally not an okay thing to do. So probably. That family just sorry. Most things that were made a long time ago. It's true.  Hey, welcome back to our studio director's unit, it's up Corbin, honeybees. You can follow us on Instagram, Twitter for more juicy content. It's so juicy. Bang! Is that what that is? What? I said a honeybees. Yeah. Hanging in your tree. That's a home for honeybees. Yeah. That's freaking awesome. Is that who I said it? I've got it for her, but yeah. Yeah, I knew that was where I am. Everybody should have one of those. I love bees. Today we're reacting to a skit. It's from Kanagill, the- Oh, cool. Time Bus. Yeah. And Kenny Sebastian. We've reacted to a couple of sketches before. Very funny. The Exorcist. Didn't they do the one, wasn't it the two of them that did the guy in the restaurant and the server? Yeah. Okay, great. The Exorcist. It's called The Exorcist. Okay. The Exorcist. Comedy sketch? Hey, a little trivia for you, in case you didn't know. That is for me, like my least favorite movie of all time. What? The Exorcist. Not because it's- it's not because it's like- there's some films that are just terribly made. For me, it's the content. I- I- You don't like that kind of stuff? Right.  Here we go. Baby photos, that's great. Can we just rehaul the whole house, just rehaul it, you know? Hello! Okay! Hi! I'm from the religious place, but for the exorcism? Of course. Which religious place? All of them are good. Okay. The next name for the girl... Our last name, relationship, first name, Sun. Oh, Father, Sun relationship. Yes. How do I go? Oh, with God's speed as they say. Very funny. If you drink an amazing lemonade, it'll possess you. Cute. Actually, I'm glad you're in such a good mood. Typically, when I come to houses to do exorcisms, people are very stressed out. What's the point of stress? Exactly. Which would just be relaxed. Yeah, just leave everything after God. Which one? All of them are great. Okay, I guess the lemonade is also an amazing Vitella sandwich. I put it in nuts and chicken crunch crunch. Oh, great. Oh, hold on one second. Sorry, Machan. This is point me in the direction of who exactly is possessed. Correct. You can't be before the exorcism. Oh, damn. Leave this body.  I'm not the demon. I'm the guy who's possessed. She's the demon. She needs a lemonade and a Vitella sandwich, right? Use also. No, no, no. One question. Yes, I can introduce myself. I'm Bathsheba. Nice to meet you. Bathsheba. What, the same relationship? Yes, I got that. Yes, okay. So, Vitella.  I'm a free spirit. You're possessing this man's body. Yeah, unfortunately, Sukrit or something isn't right. Okay, sorry. I'm really thrown off because you're so nice and charming. That's very rudeness. Demons, they're very rude. They had spin 360 degrees and they bomb it. On me, they don't flush. It's very itchy. Yeah, I'm serious. You know what? My friends are not on me. No, actually, it's my fault. You made three bad demons use you more demons. Machan, I'm helping you. Okay, one second. How long have you been possessed? How does it matter, man? I have to fill it in the form. It's happened since then. Oh, God.   She will want to know. Motherfuckers. So, it's every Saturday, okay? So, this time, it's Chinese food. So, you can get fried as in the morning. It's a very good job. Who likes wet moms? Actually, you and I don't like wet moms. What's inside the cabbage? It's very tasty. You play tambourine? Of course we play tambourine. Sorry, Sukrit. Just a couple of more questions. Are you a member of the European Union? Okay, this is the last time. I can't save a lot of time. What is your GST number? It's optional. It's optional. GST, optional. How did you get possessed? It was me and my boyfriend. It was midnight. Yeah, we were on a bike.  We were drinking the water.  We took up our shorts. We were exposing our mind. We were sexy men. Yeah, we were on a bike.  We were going on a trip. We were going on a cemetery. We were going on a grave. The Sukrit fellow really sounds.  And I've been there. I understand. I'm at a weird position because it doesn't seem like you're negatively affecting Sukrit's life anyway. If anything, you've improved it.    I'll do it, man. Give me a phone. Everybody has problems. You need to touch a phone. They will leave this body. Do you moisturize? At least not just moisturizing. It's cleansing, then toning, then moisturizing. Cleansing, toning, moisturizing. It's a holy trinity. Yeah.  My old friends, they don't notice. Who am I doing this for? For yourself. Okay? If they don't recognize it, are they even your friends? You're absolutely right. I like it when you take time. Exit them in the morning. Exit them in the evening. That's sweet, man. What? Are you distracting me? So much when I talk to you too. I have to do my job. Anyway, very focused. Sorry. Just give me your phone. You come for the party? Yeah, I come for the party. We even respectfully leave the premises. Has been exercised. You are now free. I think you made a mistake. I'm staying here. But you haven't made any mistake. That was really smart. Creative. Just like the other one. They're too extremely funny. And they're good pairing. Yeah. I guess one would be a straight man. But that's the only analogy. I can come up with the ones that are straight men. The comedy. Well, what is their name? Laurel and Hardy. Thank you. Aberdeen Costello. Jerry Lewis. Yeah. And Dean Martin. There was always one straight guy and one silly crazy guy. They're good pairing like that. Very much. They feed off each other well. They're different enough so they don't seem like the same person. And it's nice to see good sketch comedy because sadly... Dying hard. Yeah. The SNL has like out of a full 90 minutes, there may be two skits nowadays that actually it's the news section that tends to be the funniest. But the sketch comedy has not been, you know, SNL used to be guaranteed to give you screaming laughter. Yeah. Like this. Great sketch comedy. Really funny. Really good idea. I've never seen that idea before. It's looking on its head and doing it that way. It's very funny. Very funny. Love to see any more of them and any other sketch comedy we can react to. Let us know what other funny stuff that we can laugh at with our bellies down in the comment section below. Dying pass. Dying pass. Dying pass. Dying pass.


First fellow Seniors 5-8 says give thanks in all things. Mr. Speaker, I note that the proceedings so far have been without disturbance of any kind, although I just noticed a little back and forth and I'm hoping it's not going to start now. There's a glaring absence in the chamber right now and that may be responsible, but we will hopefully go forward with, you know, very healthy exchange. Mr. Speaker, I want to acknowledge the presence for the member for Babu No. Madam, I'm very happy to see you and you look very well, you know, but, you know, I don't rush the brush, you know, just take it easy, you know, because many of us, you know, have had our challenges and Mr. Speaker, I'm sure you can appreciate, you know, we have to give thanks, we have to give thanks for every day that we live, Mr. Speaker. Mr. Speaker, I indulge your patience in... I'm trying to focus, yes, yes. I indulge your patience, Mr. Speaker, in my brief preamble just to guide the way that I will be going forward. And Mr. Speaker, it is very likely that someone following our parliament would observe that the government in office would rather not have the opposition present during parliamentary debates. On the contrary, Mr. Speaker, a healthy democracy would relish constructive discourse without the slander and maybe that has unfortunately become a norm in your house. It's a fact, it's a fact. Mr. Speaker, the estimates of revenue and expenditure presented leaves ample space for speculation and inconsistency. And my contribution today would be mainly seeking clarification and expressing concerns identified to date. Of course, Mr. Speaker, I say to date because, you know, as we go along, you know, certain things are identified and you would like to speak about it. And so, Mr. Speaker, I make my contribution well-intended, contrary to the statements made by the from the member and he has already started the member from North, from Denry North, who somehow believes that I make nasty remarks and I'm still waiting for him to advise me on the nasty remarks that I make. I'm not sure what bug I have put in his in his in his nest, but apparently there's something that irritates him whenever I make a statement. Of course, Mr. Speaker, I will make mention to matters relating to my constituency, but we'll be more detailed when we return to the house to discuss the appropriation bill as stated by the member, the Minister of Finance. We're hoping to return on April 23rd. Mr. Speaker, as I listened to the Minister of Finance, I had reason to reflect on the performance of the past administration while I, which I served him. And Mr. Speaker, Mr. Speaker, I reflected on the onslaught of COVID-19 and the crippling effect it had on our economy. Many included members opposite attempted to don't play the occasion and the aftermath of the pandemic. But history will reflect that the government of the United Workers Party was a divine intervention to save St. Lucia from the chaos and pandemonium that the COVID brought upon us, Mr. Speaker. Mr. Speaker, the Minister of Finance, the member for the Concastries East, indicated that wages and salaries cost the government about $575 million annually and made up about 40% of total expenditure. In addition, Mr. Speaker, debt servicing and interest payments of about $370 million are roughly 20%. Mr. Speaker, during the COVID pandemic, nobody had compassion for the government in office. I remember dealing with the trade unions, Mr. Speaker, and obviously the opposition then had no compassion as well. Mr. Speaker, you are fully aware that any default in debt and what the application would be for a country. Mr. Speaker, we never missed a payment or a debt obligation. And, Mr. Speaker, we did all that and the price of fuel never went past $30.05. Today, Mr. Speaker, we hear about a surplus budget. Today, Mr. Speaker, we hear about surplus budget. I think the Prime Minister spoke about a surplus of about $100 million. The question, Mr. Speaker, is could that surplus not be used to subsidize fuel at the pump? That is how you put people first. Mr. Speaker, where is the benefit? What is the benefit, Mr. Speaker, and where is the benefit to the public of boasting of surplus? Mr. Speaker, you know the government balance sheet is very unique to what we know as a balance sheet, Mr. Speaker. And the government balance sheet is very unique. And when it comes to surplus, the government obviously can decide how they adjust that surplus. As government, and Mr. Speaker, you know, the thing about it is the people out there can interpret, can interpret that a surplus could mean either overtaxing or not using the money for the people. Mr. Speaker, in fact, when you boast of a surplus, it can also be interpreted as a rich man continuing to praise and worship the money he has in the bank, but not taking care of his children. Mr. Speaker, but Mr. Speaker, very importantly, very importantly, Mr. Speaker, that's my own writing, honourable member, that's my own writing. Mr. Speaker, there was a revelation that was made and the solution public needs to take it very, very seriously, Mr. Speaker, because it appears to me, Mr. Speaker, that the government has finally opened a lockbox because according to the Honourable Prime Minister, the lockbox that could not be found, he was able to pay DFCs not only for 2023, but for 2024. And you know, Mr. Speaker, isn't I think that's extremely amazing. That's extremely amazing, Mr. Speaker, because it appears that the lockbox is working the magic. Mr. Speaker, the then opposition had everything negative to say on our borrowing to keep the country moving. But since coming into office, this government has also borrowed millions in the name of COVID and wants to give merit to their borrowing, but consider our borrowing reckless. When civil servants, Mr. Speaker, never Mr. paid it. Mr. Speaker, I strongly believe and I'm consistent in the House that there is a time and a place for all borrowing, as long as the people we serve benefit. But Mr. Speaker, let's move on. Mr. Speaker, the Minister of Finance, no less than six times in his presentation, spoke about administrative bottlenecks preventing the efficient deliverables. I say that again, Mr. Speaker, the Minister of Finance, the Honourable Prime Minister spoke no less than six times about administrative bottlenecks preventing the efficient deliveries deliverable. Sorry. Mr. Speaker, I am not sure if what the Honourable Prime Minister was referring to was meant to speak to government bureaucracy and the delivery of efficient service to the general public, because if that is what he's speaking about, I support him 100% because based on what we are all aware of, when we have voices from various quarters, people complain and what seems like an eternity to get supposedly simple matters finalised. The very member who sits next to me now, the member from Bifort North South, sorry, has lamented the challenges, the difficulties and how onerous it has been for himself and members in his profession to get things done particularly at various registries. So I seek clarification, Honourable Prime Minister, because on one hand, while I believe that you may be speaking about bureaucracy, it could also be interpreted that the bottlenecks refer to something else. And I actually faced it in government as well, various bottlenecks, but I do believe that some of the bottlenecks that they have in government is to protect us from ourselves. Obviously, Mr. Speaker, I'm in no position to lecture the Minister of Finance because in his profession, his exposure and a number of job assignments he has, he would be very, very familiar with what we call systems and procedures. He would be very familiar with that. So Mr. Speaker, under head 14 electoral department, Mr. Speaker, just some observations that I have made. I notice an increase under the recurrent expenditure of just over $1.7 million. From my experience, I know elections cost a lot more than that, but there are lots of questions that I would like to ask as to whether is that preparation for elections? Is that a particular census that we are going to be seeing coming? Or are we finally going to address the whole issues of boundaries? So these are the questions that I would like to ask just on that particular issue. Surely the appropriate place for that would have been the Standing Finance Committee. Mr. Speaker, I am referring to what is in the estimates and revenue. It is the estimates and revenue that the Standing Finance Committee approved and it is after I called each head, I called upon members whether they had any questions. I'm not saying that the Minister of Finance will not respond to you. I'm saying to you the more appropriate place for those questions was in fact the Standing Finance Committee. I appreciate your guidance Mr. Speaker, but we would have been there all day if I had to address some of the questions. So I think... Well remember, one of the things I don't think members appreciate is that the first job is a member of parliament. Guided Mr. Speaker. Mr. Speaker, under head 41, Ministry of Agriculture. I notice a slight decline Mr. Speaker and obviously I'm concerned because as a government that promotes, you know, eat what you grow and grow what you eat, you know, Mr. Speaker, I would have expected to see a major input, particularly to subsidize farmers to diversify. Mr. Speaker, we're very familiar that it is very difficult to obtain good labor now on the farms. We are also familiar with the cost of labor. I applaud the Minister of Agriculture because I am aware that he has saw some tillers. I believe a lot more of that should be distributed throughout the communities. But Mr. Speaker, I believe a lot more should be done with regards to purchasing seedlings, seeds. The member for Souffre-François Jacques had to purchase a greenhouse from her CDP. I believe that should be on a wider scale from the Ministry of Agriculture to get these for our farmers. Irrigation, Mr. Speaker, irrigation lines, Mr. Speaker, is critical for our farmers. You know, I'm sure the Minister of Agriculture is very familiar with the Delsa water tank and he can see the miracles that it does for the farmers there. So the irrigation is critical, Mr. Speaker. I note, Mr. Speaker, that there was also some funds subscribed to enhancing the cocoa sector, cocoa sector enhancement project. And I'm hoping that, you know, we do grow certain parts of Souffre-François Jacques, very, very good cocoa, Mr. Speaker. And I'm hoping that, you know, there would be some sort of, you know, allocation made to specific farmers in the areas of Choselle, Saltibus, that could take advantage of that, Mr. Speaker. But more so, Mr. Speaker, and I want to tie both the Ministry of Agriculture and the Ministry of Commerce with regards to the whole cocoa and value added as it relates to, you know, what we produce, Mr. Speaker. For too long, we've been exporting and have to bring back, you know, some of the things that we export. We see various areas in Souffre, in Babunot. We recognize people who make the chocolate, Mr. Speaker. But there's so much more that can be done with what we grow, Mr. Speaker.  That's how we refer to breadfoot, you know. And he took me one time to see the kind of byproducts that are made with breadfoot, you know, in Miami, Mr. Speaker. And it's amazing what we can do. But, you know, we need to start to focus a lot more on what we can do with the very things that we grow, Mr. Speaker. I also want to recognize the growth in our CMOS industry. It's going in the right direction. I want to applaud the Shuozel Fishermen Cooperative for having an alliance with the Shuozel Secondary School. And they were able to produce something like 42 kilograms of very, very good CMOS. And, you know, we're hoping that we could see that sort of exercise being done in other schools, you know, to encourage and give various options to school leavers in terms of what they can get into, Mr. Speaker. Mr. Speaker, I cannot leave the issue of agriculture and fisheries without speaking about the impact that the work that's been done on the Shuozel Fish Port rehabilitation of $5.3 million, Mr. Speaker. And I want to again thank the Japanese government and JICA for, you know, supporting us when we went up to Japan and ensuring that we were able to obtain these funds. And I'm really hoping that that issue in the Shuozel Fish Port would be one that is, we will see the back of Mr. Speaker. I have been thinking, Mr. Speaker, in terms of how maybe the Ministry of Agriculture can also assist farmers. And, Mr. Speaker, I think one of the areas that we need to look at is the high cost that our farmers pay when they do not have irrigation from a river source or spring. And they have to use Wasco. However, Wasco would charge them at a commercial rate. I think maybe the time has come for us to provide some sort of subsidy for our farmers and encourage them maybe to hire one or two people. And then based on, you know, the kind of employment they create, we can provide subsidies as it relates to helping them with their Wasco bill because that's a very big input, the cost. Particularly now, we're hearing that 2024 would be an extremely patched year. And you can well imagine, you know, the struggles of some of our farmers will be going through, you know, during that drought period. So, it's just something I think that we need to start exploring in terms of how much more assistance can be given to our farmers. Mr. Speaker, the member for Soufre Fonsezac, she's just, she spoke just before me and I got the impression that she would be speaking after me because maybe she thought maybe I would, you know, raise various issues under her ministry. But, you know, Mr. Speaker, and I've told them, I've told the member for Soufre Fonsezac that sometimes she reads me very wrong. Just like some time ago, she made an accusation of something I said, which I have said to her that I never said it, Mr. Speaker. But I noticed there was a slight increase under recurrent expenditure. And I just want to ask the question as to whether that would be as a result of, as she admitted that the ministry may have to source sugar from outside of the region and whether that increase could be as a result of that.  I think maybe the time has come and maybe with the advent of the new warehouse that we look very closely as to whether the people that we provide, some of the rice flour sugar at subsidy costs, whether we need to start identifying the vulnerable sectors that really need that. And I mean, why would various hotels want to take advantage of, you know, the subsidies that we provide? So maybe the time has come for us to really hone in on the people who particularly need these subsidies, you know, and work with that. I mean, it's some work to do, but it's something that we need to start because we cannot maintain that kind of subsidies in the long term, Mr. Speaker. And we really have to, you know, look at it from a serious standpoint, Mr. Speaker. I also, as I said earlier, Mr. Speaker, I do believe, and maybe even under the MSME facility, we need to encourage particularly the sovereign constituencies where agriculture maybe is a more way of life that if they can come up with the value added products that will be quicker to assist them in getting some of the loans to purchase the machinery and everything. You know, we have already amended the fiscal incentive act to accommodate various machinery coming in, Mr. Speaker. And so now I believe we need to encourage our people to, you know, diversify. Mr. Speaker, the member for Castries Southeast, is it Southeast? Mr. Speaker, this morning he was not his usual self. I will admit he was not his usual self this morning. Normally, you know, I listen intently to his presentation, but I believe this morning he was a little all over the place, Mr. Speaker.  So, Mr. Speaker, and I believe, Mr. Speaker, it could be as a direct result of the significant reduction in his budget, Mr. Speaker. He may not have been too happy about it. But that's just, that's just me assuming, Mr. Speaker, because I was, I actually was extremely taken aback, extremely taken aback, Mr. Speaker, and we can turn to page serious reduction. I mean, there's a portion of it that has been transferred to the Ministry of Tourism, which is the NCA. Obviously, as he rightfully said, that's the right place. So I have no qualms in that. But very surprised, Mr. Speaker, under page 448, page 448, line 1601, public assistance, Mr. Speaker. Public assistance has dropped to over $10 million. I find that extremely hard to agree, to support, Mr. Speaker, considering, you know, the government that speaks. No, no, no, no. 1601 speaks to public assistance. Yes. And it dropped, last year it was 26. No, no, no, no, no. You look at wrong figures, honorable member. You look at wrong figures. Yeah, the figures, the figures are right there, unless you, unless you've got a difference. Yeah, but that, that's what it is, you know. So I think, I mean, public assistance, and we know, all of us know, as parliamentary reps, you know, the pressure we have to bear, the, the, the, the, the member for grossly told you about the, the number of people that he has come into his office, Mr. Speaker. So when the government makes such a significant reduction, you know, it is, it is a concern. And, and I'm hoping that the, the, the prime minister can maybe speak about it. Yeah. I also want to caution the member for Castery Southeast, because, you know, he was boasting about some of the initiatives. And one of them, he said that Castery Southeast will get their own truck and their own pickup. I want to caution him about it, Mr. Speaker, because I remember, when I first came into office in 2016, Chosal, Salty Bus, constituency council had in, had an excavator and a truck, and they were both rotting away. One of the reasons was that the constituency council could not maintain it. In addition to that, I think the member comes from a constituency where they have the most trucks in St. Lucia, most trucks in St. Lucia. I line, I line, I line. So I do that. I line.  So you're taking work away from your constituents, Mr. Speaker. Mr. Speaker, despite the fact that the member for then Rinov occasionally chides me, I must say that there are areas under his portfolio that I'm very happy to see increases on. And one of the areas, Mr. Speaker, is the area of adult literacy. And I say so, Mr. Speaker, because in my former life, I remember sponsoring or recommending sponsorship to an adult literacy program in Bas, Bas Laguas. And I actually had to go to some of the night classes and make some presentations, Mr. Speaker. And I can tell you, it was an extremely rewarding exercise to see how some of the adults embraced the program. And at the end of the day, you could have, it was very visible, some of the improvements in terms of their ability to read and write and sign their name, Mr. Speaker. So I'm hoping that that literacy, adult literacy program is something that is island wide. I'm also hoping that as also the Minister of Sustainable Development, the member will try to ensure that there's some education with regards to keeping our environment pristine, Mr. Speaker. Because I believe a lot of the older people are very guilty of thinking that it is okay to do various practices that are dangerous to the environment. When I drive with my young kids, Mr. Speaker, and we see people fling things out of a vehicle, they ask the question, why are people doing that? Because they understand and it's being taught in a big way at our schools, the preservation of our environment. So they know when they see certain things that it is wrong. And so I'm hoping that in that adult literacy program, there is a component to address the whole environmental and protecting our environment. Because, Mr. Speaker, the future generation will be the ones judging us. The member also spoke about the school rehabilitation. And I think it was sometime last year when he came to the house alone. And he got significant sums. And he did indicate that two schools in Chosel would be getting some support. So it is something that I appreciate. But I also want to, and the member was extremely passionate in his delivery, particularly as he relates to other people wanting to take the role of, which is rightfully his. And he spoke, Mr. Speaker, very, very passionate about that. And I want to encourage him to continue to speak like that as a member for then we know because if it's wrong, it's always wrong. Wrong can never be right on depending on what side you are. And Mr. Speaker, I can tell you, and the Honorable Prime Minister may not be aware of it, but there are interventions happening in my community that I'm not even aware of. I'm not even aware of various interventions happening in my community. And I'm getting to know what's happening after the fact. And education too, because various rehabilitations that I'm not aware of. Yeah, recommend contractors. You want to shade. You want to shade. You shade. But that's one of the two. But there's one more thing I thought I should mention, which is I'm very curious. And I made the members spoke about that under his budget, they would be paying off a significant portion of outstanding fees to you regarding the law. Yeah, yeah. But I'm kind of curious because, and I was indicating to the member for you for itself, that as far as I can remember, law has not been on the priority list. So I was wondering how far back this thing goes, because if, and you may, it may have gone very far because, because what you're saying is the university was saying that they will no longer accept our, our, our, our, yeah, because of that. So that could be something that goes way back. But I know that that was something that, that was removed on the priority list a while back. Sorry, 900. Okay. So I think you spoke about half a million. Yeah. Okay. Mr Speaker, my good friend is also my parliamentary rep, although I don't vote in his constituency, head 54. Mr Speaker, the government has on several occasions told whoever is listening that their plans for improving spotting facilities and capturing and assisting talented sportsmen and women. No problem in that, Mr Speaker. Because Mr Speaker, if we are honest, I think various administrations have recognized the idea approach to honing this challenge should be more precise and forward and focus. Mr Speaker, it was with this conviction that the last administration heralded the sports academy, Mr Speaker. And obviously, when you introduce something, there's always going to be room for improvement. And so, Mr Speaker, we did improve spotting facilities. There was major lighting done in various fields, Mr Speaker. And the lighting was particularly with regards to our athletes having more flexibility with their time so that, you know, when they come from work, they have the avenue so that they can, you know, conduct their various disciplines. Of course, Mr Speaker, I think it's extremely important that the playing areas, the surfaces, the academy, all of that is useless if we do not have very, very rigid programs in place to encourage our clubs and our individuals to take advantage of what is available. And Mr Speaker, it is very important that collaboration should be done with the various communities and the sports desk, Mr Speaker. But, Mr Speaker, I note, and I will speak to some of the concerns. And Mr Speaker, yes, I'm guided by your advice and maybe next time I'll go in that direction. But, Mr Speaker, I note of concern to me, Mr Speaker, page 608, grants and contributions. And, Mr Speaker, I note that an amount of $1,813,300 will be provided to the National Lottery's Association, National Lottery's Authority. Mr Speaker, you can well imagine me being a bit perplexed with that allocation to the NLA, Mr Speaker, because only Tuesday gone we came to parliament to approve a guarantee of $80 million for the NLA of which, Mr Speaker, the Minister of Finance made a point that the government will not be paying that debt. It is only a guarantee. No, you made that point. Everything I say is the truth, you know. As you said, you'll come for me. You said you'll come for me. Mr Speaker, Mr Speaker, so that really is Mr Deputy Speaker and he comes to his come to his own style, as you said. But please don't stop. But Mr Deputy Speaker, you can really imagine me being perplexed, because I'm hoping that the Honorable Prime Minister would explain that $1.8 million that has been given as a grant to the NLA considering what has just happened, Mr Speaker. Because, Mr Speaker, and I think I have the, based on what the guarantee is, NLA will be paying something like $3,571,993 by annually, about $7 million a year, and we are providing them with $181,333. So it's a concern and I'm sure you can well appreciate my concern. So I do await clarification. And Mr Speaker, since I'm on sports facilities, I turn your attention to page 659, Mr Speaker. 659, head 56, line 0528, rehabilitation of the George Audlum Stadium, and estimated project costs, total costs, $2,500,000. And the government intends to raise bonds to rehabilitate the George Audlum Stadium. Again, Mr Deputy Speaker, you can imagine my eyebrow being raised because we're aware that we did receive a loan from the Saudis for $200 million, part of which would have gone to, the member would explain to me when he rebuts. But it is a concern that $2.5 million would be allocated and would be raised by bonds when we just, you know, because what to me, Mr Speaker, the question is, you know, how much would go to St. Jude's and how much to George Audlum Stadium? Mr Speaker, I move quickly to, you know, Mr Speaker, I think I should also mention that I also identified, I also identified that one of the funding sources for our rehabilitation of sports facilities, page 666, what a number, page 666, line 54, 666, rehabilitation of sports facilities from the Republic of China and Taiwan, we're getting $1,850,000, Mr Speaker. I am wondering, you know, Mr Speaker, considering that significant amount that we were supposed to be getting from the NLA of $80 million, that, you know, that would have taken care of a significant portion of our playing fields, island-wide, as the deputy speaker, well, as a parliamentary rep for Newport South, indicated ways, Newportshire. And I was pleased to see that you'd be getting an entertainment center, the member for Newport South, and I am not sure if that is related to a sporting facility or something else, Mr Speaker. But, Mr Speaker, my concern is, in addition to the $80 million, we have another $1.8 million, and I'm really hoping that the member for Grozile would address the issue of the lights on the La Fag playing field with all of that money that is receiving, Mr Speaker, and also to address some of the challenges that the sportsmen and women face from some of our fields, Mr Speaker. So, Mr Speaker, I want to speak on community intervention. Mr Speaker, I have always boasted that the community of Grozile Saltibus by far is the most pristine community in St. Lucia. In recent times, I've heard the member for Barbolo and the member for Soufret try to take that position. But we know Mr Speaker, and I have also said that many men and women around this table have strong roots in the community of Grozile Saltibus, so I'm sure they will jealously guard that position that I'm taking, Mr Speaker. So, Mr Speaker, I note in the community there is an uptake of ABNB, and we will speak a lot more to that when we discuss policy, Mr Speaker. But I raise that because from a community tourism perspective, Mr Speaker, I would really like to see the intervention from the ministry in doing various things in the communities, quite a bit of money going into community tourism, and maybe it's not sure Zell Saltibus turned yet, Mr Speaker, but we need to what they say, Mr Speaker, strike while the iron is hot. And, Mr Speaker, I am really looking for our fair share. The member for January North, Mr Speaker, makes it a point that almost every parliamentary sitting to speak to the fact that he did not get a bag of cement to do any work in his constituency. And he has every right, Mr Speaker, as a parliamentary Speaker, to speak to that, Mr Speaker. But as I said, Mr Speaker, yes, no, but in particular, the member for January North has been very, very loud. And even now in government, he still goes back there. You know, Mr Speaker? Yeah. So, Mr Speaker, as I have said to the member for January North, what is wrong is wrong. And the six members opposite at the time, the six members who were in opposition at the time, they all agreed on one thing, that it was wrong. They all agreed that it was wrong, Mr Speaker. And if it is wrong, but you know, and I was just telling the member for Meekood North, Mr Speaker, all of us, all of us in this, as a member of cabinet, have signed what is a code of secrecy. Nobody knows what's happened in the chambers of cabinet. Nobody. Because when we come here, Mr Speaker, we are all one. And I will not believe, I will never believe, Mr Speaker, that members on the opposite side do not have the fight with the Prime Minister on various issues. But you'll never come here and talk about it. You'll never come here and talk about it, Mr Speaker. So, Mr Speaker, so, Mr Speaker, unfortunately, unfortunately, unfortunately, Mr Speaker, matters of cabinet happen to be linked. Unfortunately. But that's for another show, Mr Speaker. So, Mr Speaker, I am getting, I am getting a cacada. I am getting a cacada. And, Mr Speaker, I am making most, the most of the cacada that I'm getting. So, Mr Speaker, in collaboration with the Ministry of Infrastructure, because I always, I always try to incorporate the relevant authorities in any work that I do. And in collaboration with the Ministry of Infrastructure. Member for Schoesel, you have 15 minutes left. Well, I'll be finished with it at the time, Mr Speaker. Say that again. Remember? Even my time, the member wants to take it. Mr Speaker. And so, under the CDB, Mr Speaker, I have identified two particular areas where we have seen quite a bit of vehicles falling into what is considered to be very steep gutters, Mr Speaker. And so, in slabbing these drains, Mr Speaker, we have widened the road, okay, and the residents who have had to wake up at all hours of the night to save people from that, Mr Speaker. Thankfully, Mr Speaker, we've been able to resolve that problem. I'm also very grateful, Mr Speaker, and give thanks in all things. Give thanks in all things, Mr Speaker.  I'll give thanks, Mr Speaker, because the Prime Minister made an adjustment that a portion of that CDP could have gone to social services, Mr Speaker. And I can tell you, Mr Speaker, in my community, the issue of medical assistance is huge. It's big, Mr Speaker. It is, it is, you know, Mr Speaker and Mr Speaker. And Mr Speaker, I feel for you, you know, I feel for you. I feel for you. I feel for you. If I didn't feel for you, I would have taken, I would have tackled you a different way. Okay, Mr Speaker. Mr Speaker, and I can tell you, Mr Speaker, and I notice allocations for the beginning of the whole universal healthcare thrust, Mr Speaker. And I'm really looking forward to, you know, under the last administration, we kick-started this, Mr Speaker. And I'm really hoping that you can see it accelerated, because, you know, I think too many of our people are dying from the lack of, or the inability, Mr Speaker, to obtain, you know, relevant care at our various medical facilities and also private practice, because our medical facilities cannot provide all of the, you know, services that are needed. Mr Speaker, I will also admit that there's been some input to assisting people who live in extremely deplorable situations in the community. And people are extremely grateful for that, Mr Speaker. And I want to thank the government, you know, for that assistance, Mr Speaker. Mr Speaker, there's a lot more to be said on my community. And I can assure you, when we come to debate in the appropriation bill, a lot more will be said as it relates to interventions in my community. But to close off, Mr Speaker, if I look across the road, I notice the member for the number of little books. And I'm wondering if you could assist me, Mr Speaker, by giving me two of them, Mr Speaker. So, Mr Speaker, that being said, I thank you. I thank you for your indulgence. Thank you.


Uuuhhh... Help! Hi, I'm still sick, but I- I wanted to record, so I'm here.  Um, and so, I took a few days, but I really need to get back to recording. And Season 4 of Apex just launched, and so I was like, hey, I kind of miss playing Apex. That sounds like fun, maybe I'll play some of that. I don't have any friends to play it with, because I don't have any friends. But I just thought, hey, why not, you know, play just me? And Milkman, and Hershey Highway. You know, my best friends, we all know them, we all love them, you know them, we love them. Don't expect a high-energy gameplay, because I'm dying. I don't want to be the jump master, give it away. Hey, is this a new map? I guess there's a new map now in Apex, didn't know that. I haven't played this game in a long time. There's a lot of people going down there, dude. I don't know about this, we're also losing frames, like, a lot. Look at how laggy this is. Just grab everything and I need everything. Ethan, just grab it all. Oh dude, Mozambique, best gun in the game. Let's go, baby. I don't remember, I'm just like pressing random buttons. Triple take, I like the triple take. Sniper, what is this, sniper ammo? Dude, I don't remember how to play this game at all. Everybody's gonna get all mad at me in the co- Actually, you know what, they're probably not, because I feel like my audience isn't the kind of people that play these kind of games. Which is why this video's gonna get no views. But whatever, I'm having a fun and I'm sick. Go away. What is that? Cargo bot, what is a cargo bot? You didn't give me much. You didn't give me much. Okay, let's just keep going. Hello, anybody out there? I don't see anybody. Let's just keep rockin' and riding. Only 14 squads left, guys. Not doing too bad, not doing too shabby. I like that gun. That was a good gun back in the day. Is it still a good gun? Who knows? I'm a triple taker. And I'm a down. Get him. Let's push, let's push, gamers. Come on, gamers. Come on, gamers. I've been gotten. Help, help, gamers, help, help. Please don't let me die. I got one, maybe kill. Please don't let me die. Don't let me die, gamers. I'm watchin' you. Oh, God, this doesn't look good. Come on, Milkman. Come on, Milkman. I know you can do it. He's low on health. You got it. Milkman. Guess we'll go again. I've got no friends. All right, I'm free. Oh, wait, this guy has a fun boost, right? I'll do Octane, sure. I don't know anything about him, but I'll do it. All right, let's see if we can pull a W out of this one. Give me, let me be Jumpmaster. Huh? Let me be the Jumpmaster. I know all the hot drops. Yes, I'm the Jumpmaster. I know all the hot drops. Guys, this is the hottest drop in the game, right here. Whoa, whoa, whoa, whoa, whoa, whoa. Look at all these weapons. Oh my God, I'm kitted out. Rod it up to the tip-tip. Oh, yeah. Oh, yeah. This is what I call loot. All right, legendary stuff in here. How are my friends doing? Do they have things? Oh, that person has level two, level three stuff. I don't think anything. Give me anything. In your boof. Whoa. I like it. I like this. I like this guy, guys. I like this guy. And then we go, whoa, super fast, super fast, super fast. Oh, Josh and I held down though.  Oh, and his health regenerates. I love long, I love long. Wow. That's pretty fun, guys. Look at that big yellow zip line. All right, all right. Ooh, a sentinel. What is that? Wow, is that good? I have no idea. Yeah, we should die, guys. We should probably die. Oh, good. I didn't even think about full damage today. Ooh, damn. Ooh, damn. I want it. How do I get to that? I won't be able to get to it, will I? Oh, I want it. Can't get to it. Can't do it. Thanks for nothing. Okay. Here's the plan. I go up here. I get all the sniper things. And then I go and meet up with them. And then everything is hunky-dory. There we go. Got it. Oh, that's tight. You love to see it, you know? Okay, run, run, run, run, run, run, run, run, run, run, run, run, run, run, run, run. I'm going to meet up with them. I might be near people right now. There's so much stuff over here. I'm, like, out in the open, dude. Translitely, gamers. Translitely. Oh, God. Oh, I think I saw a robin man. I see him over there. Okay, try to not call attention to yourself. He did just get back to the game. There's somebody right by me. There's for sure somebody right by me. I heard their footsteps. I know that I've been gone for 50 years, but help!  I'm being revived. You brave, brave soul. How do I heal? God, four. Ah, yeah. Snipey boy. Uh-oh. Uh-oh, airstrike. I don't like that. Uh, uh, help. Uh, help. Oh, God. Hello? Hello? Hello? Okay, I'm going to run. I'm running for it. Run, run, run, run, run, run, run, run, run, run, run, run, run, run, run, run, run, run, run. Just run, just run. Oh, I fell down the thing. It's okay. I'm very good at this game, guys. I'm very good at this game. I'm getting, someone's calling me from Texas! Ah! Ah! Guys, I'm putting up a fight. I've died. I've died. I've died. All right, gamers. You know, I died. And that's a tragedy. Big, big tragedy. Let's do one more game, because I'm feeling my gamer blood. Hold on. Let me get some gamer fuel. Should I be drinking coffee when I'm sick? Probably not. But, you know, it's fine. Don't worry about it. Everything's fine. Everything's good. Everything's great. Everything's fine. Everything's fine. Everything's fine. All right, gamers. Last game, best game. Here we go. This is what it's all about. This is for every marble that's ever been available. Honestly, not bad. For a first drop. Give it! You thought, you thought that you would have it. I kind of like to have it, sometimes. I think I should put the scope on it. All right, we're using big gamer moves. See how, guys? Are there people over here? Were there gunshots going off? I think there were. I got a kill, guys. I got a kill. You guys see that? Put some claps and chat, please. The suit came by here and didn't open any of these. Why? There was even a tiny bit of legendary loot. What a silly. What a silly. You know, just leaving all the good loot to me. You know, top kill leader of the game. Don't mind me. One kill. I'm smelling them, guys. Smelling the enemy. And sense it all happening. It's coming soon, the big bang. OK, we get it. You've seen somebody. We'll be there in a second, Jeepers. All right, coming down the side. They got you? Don't worry. Don't worry, coming around. Whoa! It was an invisible man. I'm thirsting. I'm thirsty. Thirsty for gamer blood. Come on. Come on, gamers. Ha, ha, ha, ha. Reload, reload. Come on, gamers. We can do this. Don't worry. I'll avenge you. I've got you. I've got you. I've got you. This is not the good gun to use. Well, guys, I got one kill. I feel like that's all we could really ask for. Did we do well? No, we didn't. But we got an Apex pack. And what's inside? One blue guy. Who doesn't love a good blue guy? Look at that. This leopard. We all win today. Thank you for putting up with me. Well, I'm a little bit under the weather. Well, I'm not feeling tip-top shape. I know that videos weren't coming out and stuff like that. To my editor, Justin, I'm sorry that I didn't give you anything, but I went, I had cough. So that's that. Videos will be back on track hopefully now. But thank you guys for sticking with me. Let me know what you want to see. And I'll see you later. 10 over and out, gamers.


To me about like what it's like to be owned and traded and I don't mean by a man I mean by a you know professional basketball it's an old system that we had in we that we had in Hollywood and you know it's still what how sports run what is it like being at the whim of someone else well it's a really odd thing because you play basketball you play a sport any sport professional you know as an amateur and you're just playing for fun it's all fun it's all fun it was fun for you let's just clarify but keep going you know it's supposed to be fun it's supposed to be pure and you're just playing the game and then all of a sudden you know and for me the WNBA draft in 2008 which is the year I graduated was the day it was the day after the championship game so Stanford we made it to the finals we played Tennessee in the national championship game we lost the very next morning I get drafted so I didn't even have any time to even think like what's going on and realize that my whole life was gonna change so we have the championship game that night the next morning I just drive and I go to the draft and they're like you're getting drafted to Minnesota yeah you know it's you're just like it's just crazy you're and then you know you don't even have time to think and all of a sudden you sign a contract and you just you basically you know you kind of sign your soul away a little bit you know in terms of you know it's exciting this is what you've lived your whole life for but you don't really understand the business side of it and then it doesn't become it's not it's not necessarily fun anymore it's it's a business now and now you are expected to perform and you are expected to do these things and you just kind of forget like what am I doing that you lose yourself


Good afternoon. My name is Dr. Marcus Alvatore and today's lecture will be on LV Cystallic Function. This is the lecture for week 7 of the TGHAPTE prep course and it was originally presented on February 17th, 2021. Early in echo training, I felt that the assessment of LV Cystallic Function must be incredibly nuanced and challenging, as it is such a key piece of information that heavily influence my clinical management. And although the information is vital, TEE assessment of the LV is quite simple compared to some of the other skills you will acquire throughout your training. We will start this lecture by looking at regional wall motion abnormalities, a crucial component of your eyeball assessment of the LV. We'll then go on to basic LV measurements used to quantify the degree of LV dilatation and hypertrophy. We will review ejection phase indices including fractional shortening, fractional area change and ejection fraction. These indices are useful in clinical practice and feature heavily on the APTE exam. We will also review DPDT, an isovolumetric phase index that can be used to quantify LV function in the context of MR. We will review the load-independent indices of ventricular function including encystallic elastins, prelude recordable stroke work, preload adjusted max power and strain and strain rate. With the exception of strain, these indices only have relevance for research and exam purposes and will not be part of your perioperative TE studies. We will briefly touch upon strain, tissue Doppler imaging and speckle tracking although these are advanced modalities that appear rarely on the exam. Lastly, we will link to some videos reviewing 3D LV assessment which is becoming more commonplace in clinical practice given the advancements in echocardiography software on modern machines. There are two main ASC guidelines relevant for the assessment of LV systolic function. The first is the 2015 recommendations for cardiac chamber quantification by echocardiography and adults by Lang et al. It is important to note that this guideline was developed primarily for trans thoracic echo and it has been applied to the interpretation of transesophageal echo where possible although not all the recommendations may be valid. The second is the 2020 guidelines for the use of transesophageal echocardiography to assist with surgical decision making in the operating room. This is a fantastic resource that you should all be familiar with as it is the first guideline developed specifically for intraoperative TEE. It has a comprehensive section on TEE for ACB surgery which involves assessment of LV systolic function. We are also very proud to say that Dr. Annette Vegas is one of the contributing authors for this new and invaluable guideline. The assessment of LV systolic function involves two main priorities. Number one, the identification of regional wall motion abnormalities and number two, the quantification of ventricular performance as an indicator of cardiac output. Although newer methods such as strain can help to precisely quantify the degree of hypokinesis, the ability to quickly identify regional wall motion abnormalities by eye is a fundamental skill for any cardiac anesthetist. Equally as important is knowledge of the coronary perfusion territories so that the surgeons can direct their attention to the culprit lesion or vessel should new wall motion abnormalities rise. The coronary perfusion territories are clearly outlined in the 2013 ASC guideline entitled perioperative transesophageal echocardiography examination, a consensus statement of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. When assessing for regional wall motion abnormalities by eye, it is important to be able to quantify both the degree of thickening and the direction of motion relative to the other segments. A normally functioning myocardial segment will display both inward radial motion and thickening of over 30%. As the degree of dysfunction progresses, wall motion and thickening may be reduced, absent or even paradoxical. It is important to note that wall motion may also be influenced by features other than myocardial function such as external pacing and RV pressure overload. It is important to recognize these extraneous factors to prevent misinterpretation. When initially training your eye, it can be easiest to practice your assessment of both LV systolic function and regional wall motion abnormalities in the transgastric short axis view. Keep in mind, however, that this view will only reveal abnormalities at the mid ventricular level and is not sufficient to identify abnormalities at the level of the base or apex. Let's go through a few examples. Take a few seconds to visually estimate the EF of the ventricle shown here. Do you detect any wall motion abnormalities? The EF here is approximately 35% and you can appreciate marked hypokinesis of the entire inferior wall from septum to lateral aspect. A useful trick is to imagine a dot in the middle of the ventricle and see which walls approach the center and by how much. Here's a second example. Try to identify the hypokinetic segment. In this case, it is the anterior and antireceptile segments that are contracting poorly, which is the territory you would expect in patients with LAD disease. Bonus points if you also detected the pericardial effusion. Let's try one more. Try to identify the hypokinetic segment in the transgastric short axis view shown here. This one was a little harder, but it is the imperilateral segment that is hypokinetic, which could signify RCA or circle flex disease. The more you practice this skill, the more sensitive your eye will become. We'll move on from regional wall motion abnormalities to basic or linear LV measurements. These measurements are most valuable when assessing LV size and the degree of LV dilatation. Guidelines regarding linear LV measurements can be found in the 2015 ASC recommendations for chamber quantification. Remember that these guidelines were written with transterrassic echo in mind. As such, they recommend that measurements of the left ventricle are performed in the parasternal long axis view at the level of the mitral valve leaflet tips during diastole. All reference values cited in the guidelines are in relation to the parasternal long axis view. By convention, the best approximation of this measurement using TEE can be achieved using either the transgastric short axis or two-chamber view. Matthew's textbook, Clinical Manual and Review of Transesophageal Echocardiography, describes in detail how to best take these measurements. First, get a clear transgastric short axis view with good endocardial border definition and minimal foreshortening. If you can see both pepillary muscles clearly, you'll likely have a good cross-section. Pause the clip and end diastole on the frame immediately before mitral valve closure or the frame with the largest ventricular dimension. Measure the distance between the inferior and anterior endocardial borders, making sure to measure past the pepillary muscles. Although lateral measurements can also be made here, there are no relevant reference values for comparison, and the LV dimension may be impacted by RV pressure or volume overload, causing an underestimation. Using this view, you can also assess the inferior and septal wall thicknesses, fractional shortening, and fractional area change. Another technique is to measure the internal dimension using M mode through the largest ventricular diameter of either the transgastric short axis view or the transgastric two-chamber view at the level of the nitro valve leaflet tips. Remember to use your ECG to take the measurement at end diastole, not the middle of the envelope. This view also allows you to simultaneously assess wall thickness and fractional shortening. Shown here is supplemental table 3 from the 2015 ASC recommendations for chamber quantification, which lists the reference ranges for the LV internal diameter. Notice that there are different ranges for males and females, although this is rarely taken into consideration in clinical practice. Both echocardiographers use an internal diameter of 5.5 centimeters as the upper limit of normal in all patients. This table also lists reference values for LV wall thickness, which is 1 centimeter for both septal and posterior walls. We will move on from linear measurements to ejection phase indices. Ejection phase indices are indicators of both ventricular function and cardiac output. The ejection phase measurements that you are most familiar with will be the left ventricular ejection fraction, but it is important to know about other indices, not only for exam purposes, but also for when you don't have adequate views to calculate a biplane. The main ejection phase indices include fractional shortening, fractional area change, and ejection fraction. Velocity of circumferential fiber shortening is a rarely discussed method that derives from fractional shortening that is only really relevant for exam purposes. The three principle ejection phase indices are all based on a common formula, which is endiastolic value minus end systolic value over endiastolic value as a percentage. Fractional shortening is a one-dimensional index of ventricular function that is measured using M-mode through the same planes used to measure maximum LV diameter, that is the transgastric short axis view or the transgastric two-chamber view. Subtract the narrowest systolic diameter from the largest diastolic diameter, then divide by the diastolic diameter and multiply by 100 for a percentage. The lower value of normal is 25%. Fractional shortening can be quickly and easily measured in real time while performing your TEE study, which makes it a useful tool for quick estimation of LV function on the fly. However, it is only accurate when the LV moves symmetrically and there are no marked regional wall motion abnormalities present. Because you are only looking along a single plane at the mid-PAP level, you will miss this function related to hypokinesis of the apex or base. Let's work through an example. Use the data shown above to calculate the fractional shortening. As a hint, focus on these two values, the LV internal diameter in diastole and the LV internal diameter in systole. Subtract the systolic value from the diastolic value and divide by the diastolic value, which yields 0.329 or 32.9%, representing normal LV function. For the sake of completeness, we will touch on velocity of circumferential fiber shortening, a value that is rarely used in clinical practice. The velocity of circumferential fiber shortening is derived by multiplying the fractional shortening times 1 over the ejection time in seconds. As an exercise, try to think of the two ways that you can estimate or measure the ejection time. Measuring the ejection time is the same as measuring the aortic valve opening time. The two ways to measure the ejection time are shown here. The first technique is to use M mode through the aortic valve in the mitisophageal long axis view and measuring the duration of the aortic valve opening. This is the same view you might have used when assessing patients for early systolic closure or coarse fluttering of the aortic valve leaflets in patients with Holcomb. The second way is to use continuous wave doppler through the aortic valve in the deep transgastric view as if you were assessing for aortic regurgitation or gradients across the aortic valve. The duration of the ventricular outflow envelope will approximate the ejection time. Fractional value is 350 ms, although different sources state different normal reference values. Multiplying fractional shortening by 1 over the ejection time will yield the VCF. The normal value is 1.1 circumferences per second. The shorter the VCF, the worse the LV dysfunction. Let's work through an example. For a patient with a fractional shortening of 24% and an average ejection time of 350 ms, what is the VCF? The calculation shown here yields a value of 0.68 circumferences per second, representing significant LV dysfunction. The next ejection phase index we will discuss is the fractional area change. A much more common tool that can be valuable in cases where poor endocardial border definition precludes an accurate biplane. Fractional area change is an index derived with TEE by using transgastric short axis views. Good correlation has been shown between FAC and EF using nuclear techniques as the reference standard. You can calculate the FAC by tracing the maximal diastolic and minimal systolic LV areas, then plugging these values into the formula shown here, which is common to all ejection phase indices. A normal fractional area change is 36%. Although this technique is quick and easy, and avoids foreshortening of the LV apex, the measurements are dependent upon getting a perpendicular cross section through the ventricle, and it will be inaccurate in the presence of significant regional wall motion abnormalities. Next we'll move on to the ejection fraction, which is undoubtedly the ejection phase index that you are most familiar with. The Simpson's biplane method of disks is the currently recommended 2D method to assess left ventricular ejection fraction, according to the 2015 ASC recommendations for chamber quantification. The Simpson's method is based on modeling the LV as a series of stacked cylindrical disks. The volume of the disks are calculated and then summed to yield the ventricular volumes. This technique mandates clear images of the midisophageal 4-chamber and midisophageal 2-chamber views with clear endocardial border definitions, increasing the gain if necessary. Caution must be taken not to foreshorten the apex, which may cause an underestimation of LV volumes. When performing these measurements on the EPIC machines or I-33s, make sure to use the native labeling software so that the volumes are averaged to yield the biplane, as opposed to a monoplane calculation derived from a single view. A principal drawback that all these ejection phase indices share is that they assume that all flow moves forward, and they do not account for significant MR. Calculating an accurate EF in the presence of significant MR requires isovolumetric phase indices, which we'll move on to next. In the absence of significant MR, a normal ejection fraction is over 52% for men and over 54% for women. Despite these values that are listed in the guidelines, by convention a normal ejection fraction is typically defined as being over 55% regardless of patient sex. If significant MR is present, then an alternative option for assessing ventricular function is to use the DPDT, or the maximum rate of rise of LV pressure during systole, representing how fast the myocardium can contract. This is an isovolumetric phase index, meaning it is assessed while both the aortic and mitral valves are closed. This measurement requires that an MR jet be present. First, visualize a clear MR envelope using continuous wave doppler through the mitral valve in the mitisophageal 4-chamber view. Release the frame and use the calipers to trace the rise that occurs between 100 cm a second and 300 cm a second, as shown in the echo picture above. The magnitude of the rise does not matter. What matters is the duration of time measured along the x-axis required for this rise to occur. Once you have measured the time, or the DT, plug it into the following formula, 32 times 1000 divided by DT. The lower limit of normal for DPDT is 1200, although some sources say as high as 1600. The strengths of the DPDT method are that it is quick and easy to perform, it's accurate in patients with MR, and it's afterload independent. The drawbacks are that there needs to be a clear MR envelope, and it's preload dependent, meaning that it will change with loading conditions. So that summarizes our review of the clinically relevant injection phase and isovolumetric phase indices. For the purposes of the exam, we will now review the load independent indices, including end systolic elastins, preload recruitable stroke work, preload adjusted max power, and strain rate. With the exception of strain rate, it is important to note that these indices are not possible to perform during the course of a routine perioperative TEE, and their utility is reserved for research conditions only. However, they have been known to come up on the APTE exam. Let's start with end systolic elastins, which is described as the best and most load independent index of LB contractility. I'm sure you remember these pressure volume loops from residency, meant to graphically illustrate ventricular function in the presence of various pathologies or loading conditions. As a reminder, the letter A represents end diastole when pressure is low and volume is high. The letter C represents end systole when pressure is high and volume is low. End systolic elastins is calculated by plotting these pressure volume curves under variable loading conditions and then calculating the slope of the line that connects these curves. As you can see, this is not an echocardiographic parameter and there are no reference values. You will never be asked to interpret end systolic elastins values on the exam, but you may be asked to identify the load independent indices of contractility if given a list. Preload recruitable stroke work similarly uses the pressure volume curves as another load independent index of contractility. The integrated area within any one pressure volume loop equals the stroke work for that particular set of loaded conditions. The preload recruitable stroke work is calculated by plotting stroke work as a function of end diastolic volume. Again, this is not an echocardiographic parameter and is unlikely to appear on the exam. Preload adjusted max power also uses stroke work by plugging it into the formula above for the third load independent index. This is not used clinically and is of little value outside of exams and research. The fourth and final load independent index of LB contractility is strain. This is the only load independent index of clinical relevance and it is becoming more routine with modern software packages. The concept behind strain is straightforward and can be conceptualized simply as the change in length caused by the application of stress. Measuring strain in the perioperative setting is usually performed with either Doppler tissue imaging or speckle tracking, which are more advanced techniques which we will only briefly touch upon during this lecture. There are three types of strain in the heart, which correlate with the different patterns of myocardial fiber orientation. The three strain types are longitudinal, radial, and circumferential. The clinical focus is limited mostly to longitudinal strain, which has a negative value as the myocardial fiber shortened during systolic contraction. Normal strain values are between negative 16 and negative 19%. The more negative the value, the greater the degree of shortening. And thus, the greater the degree of LB contractility. Tissue Doppler imaging uses a form of pulsed wave Doppler to assess strain. TDI focuses on low frequency, high amplitude signals from the myocardial tissue, as opposed to blood flow, which is more typical of Doppler imaging. Although useful, the major limitations are that it is influenced by the translation of the heart, it's angle dependent, and there's overlap between normal and abnormal values. Speckle tracking takes advantage of an echocardiographic artifact to quantify ventricular function. Ultrasound imaging of the myocardium creates speckles due to scattering, reflection, and interference of the ultrasound beam. Individual speckles can be isolated and tracked from frame to frame. An analysis of this movement provides an angle and translation independent tool for measuring both strain and strain rate. The major limitation of speckle tracking is that it is limited by noise. Speckle tracking can be used to generate global strain maps or bullseye plots, which can be used for identifying patterns of myocardial dysfunction that may be characteristic or pathodynamic for various diseases. In these maps, dark red signifies normal myocardial strain and function, with dysfunction represented by light pink and blue. The strain patterns associated with cardiac amyloid, apical holcomb, and septal MI are shown above. So that brings us to the end of our review of left ventricular function as it relates to the APTE exam. Please feel free to contact me or send me emails if you have any questions regarding any of the material that we covered here today. I would encourage you to practice some of these advanced techniques, such as TDI and speckle tracking, next time you're in the OR. On the next slide, you will be able to find links to videos that demonstrate how to perform some of the more advanced techniques, such as 3D left ventricular ejection fraction using multi-planar reconstruction. Thank you very much for your attention and for participating in the TGH APTE prep course.


My fellow Americans, this coming Thursday we'll celebrate a holiday that belongs uniquely to our nation, Thanksgiving Day. Millions of us will travel from all parts of the country to gather in family homes, observing the holiday according to long-standing tradition, turkey with all the fixings, pumpkin pie, laughter, the warmth of family love, and yes, a moment of prayer to give thanks. Yet at the same time, many among us will be less fortunate. And just as Thanksgiving Day has always been an occasion for counting our blessings, so too it's always been a time for making life better among our fellow Americans. In churches and synagogues across the country, for example, food will be collected in the next few days for distribution to the needy or on Thanksgiving Day itself. And with this spirit of thanksgiving in mind, I thought I'd speak with you for a moment this afternoon about the goodness of the American people and our willingness to give each other a helping hand. The spirit of volunteerism is deeply ingrained in us as a nation. Maybe it has something to do with our history as a frontier land. Those early Americans who gave us Thanksgiving Day itself had to help each other in order to survive, joining together to plant crops, build houses, and raise barns. And perhaps they discovered that in helping others, their own lives were enriched. In our own day, a poll showed most Americans believe that no matter how big government gets, and no matter how many services it provides, it can never take the place of volunteers. In other words, we Americans understand that there are no substitutes for gifts of service given from the heart. In our recent history, there was a time not long ago when this spirit seemed endangered, when philanthropy and personal involvement were giving way to bureaucratic plans and federal programs. So when our administration took office, we made it one of our main aims to encourage private sector initiatives, to reinvigorate the American tradition of volunteerism. And I have to admit, our success in this area is one of the accomplishments of which I'm most proud. For in the past few years, we've witnessed an unprecedented outpouring of the volunteer spirit, a tremendous reassertion of goodwill and neighborliness. Last year alone, individuals, corporations, bequests and foundations gave nearly $80 billion to good causes, a record high. You can see these volunteer efforts all around. Consider the United Way founded a century ago next year. Today, there are more than 2,200 local United Ways in communities throughout the country. Just last year, the United Way raised more than $2.3 billion, supported more than 37,000 health and human care agencies and programs, and served millions of families. In 1958, for example, Dr. William Walsh asked President Dwight Eisenhower for the use of an old hospital ship, mothballed after World War II. Ike provided that ship, charging rent of just $1 a year, and Dr. Walsh turned the old ship into Project Hope, a seaborne hospital and medical school that traveled the world. Today, Project Hope has been modernized and medical volunteers traveled by plane recently to El Salvador to help with the after effects of the devastating earthquake. Then, there's just say no, a largely volunteer organization that's teaching children around the world to say no to drugs. This organization got started when Nancy was visiting an elementary school in California. A little girl asked what to do if someone offered her drugs, and Nancy's answer was simple, just say no. Well, not long ago, Nancy hosted a just say no rally here at the White House, more than 2,300 children attended. Although just say no requires school officials, teachers and especially parents to devote to it a great deal of time. Nancy told me that everyone she spoke to at the rally, was convinced that it's not only worth it, but a vital importance for the future. Local efforts may be less well known than major undertakings like just say no in Project Hope, but that the very heart and soul of the American Volunteer Spirit, many of you will be able to think of good works being performed in your own communities. I think of a house for the homeless here in Washington, founded by a young priest, Father Jack Fonda-Steel, and sustained by his own hard work and that of volunteers, McKenna House offers shelter, food and human concern to the homeless men right here in our nation's capital. Of course we must do more, striving always to give of ourselves to those less fortunate, but it's good to reflect that here in America, perhaps more than any other nation on earth, we have a tradition of giving, of neighbor helping neighbor, that makes life better for tens of thousands every day. And for this too, on Thanksgiving Day, let us give thanks. Until next week, thanks for listening. God bless you.