Auto light and it's 96,000 dealers present Tonight auto light brings you over the bounding main a suspense play starring mr. Dan Daly What are you gonna put a light in this garage?  I watched you don't think I didn't come on. Let's go in. I've got to be downtown early But what as you can make enough to buy a house at Catalina like the warrens get a new car There's a little thing called money, but you wouldn't know you've got to find the right job Are we gonna go over that again? Yes, we're going over that again. I'm ashamed when I go out Did you see what she was wearing keep your voice down the neighbors?  You'll be sorry in the morning. I'll be sorry. All right Sorry like every other morning because you'll be here In just a moment mr. Dan Daly in the first act of over the bounding main See Wilcox, what's your favorite fall hobby fishing and for what for? Compliments on ignition engineered auto light spark plugs and I catch plenty What kind of bait do you use cars with sluggish gas hungry engines who spark plugs are not functioning properly? When auto lights park plugs go to work on these lazy limp and listless lorries Wow, they start up like a trout after a fly Speed along smooth as a sailfish and use less gas than a salmon swimming downstream must have a pretty good line Yes, sir The auto lights park plug line is the best there is because auto lights park plugs are designed by the same auto light engineers Who designed the coil distributor and all the other important parts that make up the complete ignition system? Used as original factory equipment on many of America's leading makes of cars When you replace worn-out spark plugs with ignition engineered auto light spark plugs you get Performance gas savings. I'm hooked Harlow. Thank you my fickle fishermen Friends this fall have your spark plugs checked by your friendly auto light spark plug dealer and have him Replace worn-out spark plugs with new ignition engineered Auto light resistor or standard type spark plugs, then you'll know why you're always right with auto light And now with over the bounding main and the performance of mr. Dan daily auto light hopes once again to keep you in suspense If you don't need a rest I certainly do Marty I'm so tired of this lousy apartment I could scream oh scream and let the neighbors have some fun pick of them to the warrens were darn nice to invite us I didn't say we can't go you never say anything anymore or do anything either You're sure in a swell mood tonight. I should have stayed downtown in which joint layoff. I'm tired from what you're not working Now don't start that again. You know I'm looking looking can I live on nothing? Look at these clothes. I'm ashamed to go out in the street now Tell me how much better off you were when you were married to that wise operator Lou I was at least I own shoes without holes in them Yeah, Lou Barris was just a little dream man. Just so ginger peachy you could hardly wait to leave town with me The day I divorced Lou I wanted if I was making a mistake and the day after I became Mrs. Martin Evans I knew I had you're gonna be a lot of fun on this fishing trip Don't tell me we're going after all I can stand a vacation to They call it the Pacific Ocean. It means peaceful, which is something I could use right now. I guess a lot of it was my fault I wanted the right kind of a job and it was hard to find Ever since Clare had got rid of Lou Barris or X we've been living pretty close and Claire wasn't used to it The Warrens made it worse. They were well healed and I was supposed to keep up with the Warrens. I Knew I could never do it Maybe Claire knew it too Clare had got the invitation for us to go with the Warrens the Catalina So now we were driving down 22nd Street and San Pedro to the landing We're nearly six in the morning and you can see a light fog drifting in the harbor Don't forget to lock it sure look out for the fishing rods. Will you you better give me the keys? Yes, okay, I won't lose them. I know you all that junk in your pockets. You'll lose them. Don't worry I will why don't you let me hang on to him? We'll be in a nice mess. All right. All right. Here they are Thank you dear. I Guess we're the first ones here. I don't see Bob's car. I forgot to tell you We're meeting him for years on the island. Yeah, he's been there all week You didn't say anything about it. I thought each sake what difference does it make if you're worrying about chartering a boat to get us there You can stop. It's all raised Bob's paying for it. They know you're broke. Sure. You blab that to everyone I was a great guy when I had it. Well, you lost it. So let's not talk. Shall we that's okay with me? That must be the boat down there Pelican that the name I think so Yeah, that's it Watch your step. Why the devil you wear shoes like that on a fishing trip because they're all I have Hello Anyone aboard? You can sure tell this is a fishing boat. You the captain on this tub. Oh, no, I'm awesome You know, I made Nassio deck and I helped to run the engine. I thought you looked a little young Where is he? He went ashore for a minute. Well, I'm ready any time he is here sonny take my stuff below See you senora right away smart looking kid. Oh gosh, is it only six? I'm sleepy. You'll wake up when we get going Smell that air you know honey, I think we're gonna have fun. There must be a bunk somewhere. I'm going below. Oh, come on Stay with me. No Okay, but you'll be sorry I'm gonna start trawling as soon as we clear the harbor Hey, senor Evans, there's the captain coming down the dock now. Oh, yeah now we get started, huh? I read with the albacore running. Well, it may be senor I have only been working on the pelican for two days. We have some big white feather jigs you control with that as well See-see come on I'm mr. Evans. The wife is below taking a nap. Hello. All right. Let's cast off Think this fog will lift right Any idea how far offshore we might hit albacore There's no telling how long do you figure for us to reach Catalina? Depends on the fog. Oh Well, I guess I'll go get my outfit rigged up. Yeah, why don't you do that? I'm sure that feathers are the best lure for them. I have caught many albacore with it, senor If they're hungry, they will take a decision has been good. Well Hey, hey stop the boat. Hey strike, senor. Let him take it now. Give him line. Yeah, he's got it Come fight on your slow now awesome.  What's the matter with him? I would lose my line. I can't hold him Praise yourself against the rail. Oh, I can't understand it rail breaking that way What the devil was Moran trying to do we could have been killed you tell him to stop he speeds up Well, maybe he didn't hear me. I want a few words with that joker.  I'm sorry I thought he wanted me to put about thought you'd lost your tackle. I don't they'll lost my skin Ignacio hadn't been so quick on his feet. Sorry the way he said it Just like he dropped ashes on the rock or maybe brushed you casually on the street. Sorry That was dandy I've wrecked your car. I made love to your wife strangled your mother, but it's okay, mister I'm sorry and that was all I got He just turned back to the wheel and then something stuck in my memory Kept thinking I'd seen the guy before never talked to him. I met him somehow. I knew him. I Looked him over Six foot one black hair the usual amount of face Couldn't pin him down. I Figured it was just one of those mental tricks or maybe he looked like my uncle Phil and let it go. I Started after when all of a sudden Claire came out on deck.  You're sick. No, I Yes, I think I'm sick. There is a bit of a swell stay on deck. You feel better. No, I'm gonna lie down again Okay, gee you look pretty bad Come on. I'll help you down. I'm all right.  You'll feel better. Let me alone. Will you? Hey, what's the matter with the engine? Should I know what take it easy nothing serious? It'll be on our way in a few minutes. Yeah Looks like the fire getting thicker.  It's on the blank swell This tub's in great shape. That'll do. Where's the kid Ignacio? He's below hunting down the trouble nice kid, you know if it wasn't for him. Yeah, I Want to give him something when we get off. You'll do that I saw a couple of boils out there a minute ago Albuquerque get your line in the water relax It was a fine way to relax Drifting in the Catalina channel with no motor no fog horn and you couldn't see more than 20 feet out I threw my line in and tried to forget it and the way the Albuquerque was stuck and I almost did After a couple of hours, maybe three I'd had enough so I folded up with my back with a bait tank and dozed off When I woke up we were still drifting and the fog was even thick and I realized I was getting dark I Started to look for Moran. I thought something was wrong something besides the motor and when I heard their voices I know it You don't have any choice It'll be dark in an hour. I can't stall him with this bum motor gag much longer. Please.  He's with a lot more dead than alive 20 grand Just can't do it. Now. Listen, baby. There's a lot of dough invested in the guy and it's gonna go through on schedule We're going to trade one bullet for 20,000 bucks There isn't any way of backing out Auto light is bringing you mr. Dan daily in over the bounding main lights production and radio's outstanding theater of thrills Suspends a half. Did I tell you about the whale? Well, what way the whale of a job being done by ignition engineered auto light spark plugs Delighted drivers declare that for fast starts smoother engine performance and gas savings these ignition engineered auto light spark plugs can't be beat I'm going Jonah. I'm listening and like Jonah Auto light ignition engineers know their business from inside to out from head to tail Auto light engineers design spark plugs just as they design the complete ignition system used as original factory equipment on many of America's leading makes of cars That's why auto light spark plugs are engineered to work together perfectly with the coil Distributor and the rest of the ignition system. You're spouting like Moby Dick will talk Well, I'm always glad to spout about those great ignition engineered auto light spark plugs have they're unexcelled for Quick starts Performance gas savings Harlow the happy harpoon Thousands of motorists agree that auto light spark plugs are the best bet for better driving Replace worn out spark plugs with ignition engineered auto light resistor or standard type spark plugs and remember You're always right with auto light and now auto light brings back to our Hollywood soundstage Mr. Dan Daly in Elliot Lewis's production of over the bounding Maine a tale well-calculated to keep you in Suspense I don't think I was scared not at first You can only take in so much and then something in your mind shuts it off Stood there in the fog in the darkness to help me the only thing I could think I was how the warrens would take it when I Didn't arrive at the isthmus sounds crazy And from somewhere a fog horn sounded off in the distance, and I came to like someone had thrown water on my face I Was laughed at myself The warrens were probably playing canast over in Brentwood or drinking beer in front of somebody's television set This fishing trip was Claire's idea and the only thing she planned on hookin was a $20,000 policy on the life of Martin Evans I moved away and toward the stern. I needed help And maybe there was somebody I could count on young decking I found him all right sprawling his face in the bow lying over the anchor kid Nassio He smelled like a distillery I shook him slapped him as hard as I dare be went right on sleep Captain Moran had taken good care of the only friend I had with the mickey's poured into him. He'd be lucky if he ever woke up Now I was good and scared It was almost completely dark Moran would be coming on deck and then I remembered the gap The pole with a razor sharp hook at the end. I'd use it to pull up the albacore on deck. I Moved to the stern Quietly feeling with my feet because I couldn't see And I tripped over something Column the deck It was the gas. I Grabbed it and got up. I couldn't see him and he couldn't see me I moved silently around the deck in a crazy game of blind man's bluff Just moving away from his voice and trying to think of a way out heavens any habit I Heard him all right This voice sounded muffled as though the fog was a black foot closing off the world like they drop over a guy's head on the gallows rope There was a coil a heavy rope on the forward deck a coil a heavy rope on the forward deck. All right Evans You can't get very far Want to go around again? You still have that gaffer. Do you drop it again all is it my fault if a new deck hand I hire gets crazy drunk and shoots up the ship He'll tell only for mutinies a rough one is the book still calls for hanging on the public dock But maybe he can plead insanity, huh? I'm sorry.   I Didn't breathe any more than I had to it was about as safe as a turkey in November If we ran should notice that missing coil a rope wouldn't take him long to figure out exactly what had made that splash in the water He couldn't see any better than I could but as soon as it got light there I'd be out in the open without a prayer And the only thing I'd gain was a few hours at the most So I huddled against the rail and hung on to the fishing gap feeling like David might have if he'd have broken his slingshot just before he met Goliath It gets cold out of the ocean and the fire can soak through summer denims on a hurry I started the ship. I had to clamp my jaw to get it tight to keep my teeth with cheddar But the coal did one thing It seemed to free some of the fear out of me and I started to think I Had it pretty well figured out All except one thing When I heard Clara Moran coming out in deck Can't miss if you don't love so that those cups are smart One little angle where our stories don't match it. I'll just keep your head. Don't worry about me This is important now once more not again once more Who heard the shot? I did and I rushed on deck to see Ignacio struggling this morning. Ignacio had a gun. Ignacio had a gun He and Marty fought He hit the side Marty went overboard and our engines dead. He just disappeared in the darkness, right? Can we start back? And I got to change some parts first make it look like the engine really was out See every little angle counts. I wish it was over and for Pete's sake remember My name is Moran and you never saw me until you got on board the pelican. There's no way they can check I don't even have a locket anymore. Good. I'm gonna fix the engine So as it gets like we'll head back to port I had forgotten all about Claire's locket when she mentioned that the last chunk of this puzzle dropped into the slush Now wonder why I hadn't thought of it before That crummy little locket heart shape with Claire's picture on one side and Lou Barris is on the other the one She wanted to keep for sentiment's sake Her first husband Lou Barris the guy remembered from the picture captain Moran. That's who he was it all figured Lou scores a triple play gets his wife back with 20 grand in a person pays off Martin Evans with a one-way trip to the bottom of the ocean And I couldn't think of any way to stop him It must have been hours later or minutes when I thought of the day She was swinging from the stern about 25 feet off Somehow in the dark I found her line was about to pull on it when I saw a crack on her deck. I didn't move If you make a sound I'll hook this gaff right through your throat Yeah returned from the dead and I haven't anything to lose Pull on the rope pull on it You and me are getting to the dinghy all right You had it all figured out didn't you but you forgot one thing Lou has to marry again to collect the dough And if you're not alive, please, I'm sorry. I am give me that rope and don't move I didn't I know it sure. I'm glad you're all right. I've been wrong about us. Don't worry I won't kill you unless I have to you're my new insurance policy now get over into the boat Sure, it's little in the oceans big and we're going just the same That's how I'm getting old and Long as I had a gap at Claire's neck Luke wouldn't do a thing His one bullet would cause them Claire 20,000 bucks and maybe his life We drifted off a bit my reach for the oars but the warning the warning the oars When I looked up I saw Moran standing in the stern of the pelican Evans, I can see it There aren't any oars out there That's right But you try to shoot me and I'll kill Claire She can't help you Want a chance from honey don't you understand I'm sorry I don't want you to die. I want to be with you. I was wrong. You bet you were wrong. You're gonna find out We're going to paddle paddle with our hands if we can lose him and the fire will be all right Just remember if he finds me it's too bad for you now paddle get over on this Look out. Look on that. She's tipping. Look out. You're lost the gas. Yeah, I Lost it now. Maybe you'll believe me. I want to help you get away from him. Sure.  I'm on your side.  I saw a darker shape It was a pelican. I knew that Louis seen us. I reached for Claire I fell a shoulder Yes, I want to hit her now I felt her neck was warm and it was a little pulse under my fingers. He's lost the gap She was telling them to shoot me and suddenly it didn't matter Pelican loomed over us and then Claire twisted away from me and I didn't care I was tired All right, come on. Get up here. I want you found on deck. Give me a hand All right, Evans get out of there get it over with I'm staying give me the gun will let me do it No You better tie the thingy on then I can't hold it. Yeah, hold the gun. Thanks Lou Give me the rope Marty, I don't want you to drift away now. I Got out of the thingy and stood on the deck looking down at what used to be Lou Barris They handed me the gun and just stared at We didn't say anything for a long time Fox lifting Yeah It's getting lighter. I guess the Sun will be breaking through soon Do you believe what I told you before? Yeah, I believe you know. I'm sorry I'll try to make it up to you sure We better get going We're going back to San Pedro. Yeah, I guess I can figure out how this thing runs Marty. What about me? Gotta tell the police. Maybe you won't be too tough. I don't know Better Marty yeah Do you still care?  You're right. I'm inspired by auto light auto light makes more than 400 products for cars trucks planes and boats in its 28 plants from coast to coast These include complete electrical systems used as original equipment on many of America's finest cars Generators coils distributors voltage regulators wire and cables starting motors and electric windshield wipers All engineered to work together perfectly as part of the auto light team all engineered to give you unexcelled auto light service Don't accept electrical parts supposed to be as good ask for and insist on auto light original factory parts at your neighborhood service station Car dealer garage or repair shop? Remember you're always right with auto light next week on suspense. Mr. Dana Andrews as star of the crowd And here is mr. Andrews to tell you about it Have you ever noticed when a person dies on a city streets? How quickly the crowd gathers? As a police lieutenant, I knew that one person in that quickly gathering crowd was responsible for the death of the man lying on the busy street Yes next week mr. Dana Andrews as star of the crowd and in the weeks to come You will hear such famous stars as Joseph Cotton Miriam Hopkins and Milton Burl all appearing in Tales well calculated to keep you in Suspense tonight suspense play was produced and directed by Elliot Lewis with music composed by Lucian Morrowake and conducted by Lut Bluskin Parts of this program were transcribed over the bounding main is an original play written for suspense by Gloria L More and Jimmy Barnett Dan Daly may soon be seen in the 20th century box production My blue heaven with Betty Grable and remember next week on suspense mr. Dana Andrews in the crowd Autolike resistor or standard type spark plugs auto light safer batteries auto light electrical parts at your neighborhood auto light dealers Switch to auto light. Good night. 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Hi, my name is Alina and I'm from Atlanta. So about three years ago, I started developing stomach and digestive issues and earlier this year it got so bad that I Remember praying and I was like God I need to do something about this because I can't live like this anymore and Then two weeks later after that prayer I went to a conference in Atlanta and Vlad was there and we prayed for healing at the end and I raised my hand for prayer, but I wasn't necessarily experiencing anything at that moment So we prayed and I left and kind of forgot about it and then about three days later I was at work Having lunch and I realized that I was not experiencing any of the symptoms or pain that I usually do and I thought back to the past three days and I realized I hadn't experienced any problems at all and so a couple more days passed And it was a Friday I remember and I had borscht for lunch and I just remember because borscht always gave me stomach problems But I really liked it and I told God God. This is gonna be the real test and so I Had I ate lunch and a few hours later. I still remember the text I sent to my sisters. I said God has really healed me the only way to describe what my stomach feels like right now is like a sleeping baby it was no issues no pain no problems and that's been several months now and God is definitely a Healer and a miracle worker


Welcome to Texas Heart Institute Educational Programs Cardiology in the Time of COVID-19. In response to the evolving COVID-19 pandemic, the Texas Heart Institute is providing perspective to the healthcare community taking care of cardiovascular patients with COVID-19. The title of today's program is the role of cardiac CT and FFR in cardiac patients during COVID-19 pandemic. This program is presented together between Texas Heart Institute and ISCVS or International Society of Endovascular Specialists. I'm Zvon Bue Kraser. I'm an Interventional Cardiologist at Texas Heart Institute and CHI Baylor St. Luke's Medical Center. Our special guest today is Dr. Christopher Zarens. He's a founder and senior VP for Medical Affairs at Hardflow Incorporated. Welcome Dr. Zarens to Texas Heart Institute Educational Programs. Thank you. Pleasure to be here. It's a special pleasure to have Dr. Zarens here with us for this presentation. As COVID-19 situation continues to evolve, guidance documents around elective procedures are being published daily by various entities, government bodies, professional societies, publications and so on. Numerous societies, as I have mentioned, have made recommendations and guidelines regarding treatment of patients with cardiac disease during COVID-19 epidemic. It was shown from several publications that some patients are presenting with elevated troponins and other signs of STEMI or non-STEMI or acute coronary syndromes, and they may actually have COVID-19 related myocarditis rather than coronary event as shown in this particular publication. So it's important to know that myocarditis related to COVID-19 may complicate the diagnosis of STEMI and acute coronary symptoms. Now the advisory board from American College of Cardiology related to COVID-19 clinical implications for cardiovascular patients showed that cardiovascular disease is a significant comorbidity for COVID-19 in addition to age and other comorbid conditions as shown in this particular slide. Also, ACC and Society of Cardiac and Geography in Intervention have made recommendations to avoid elective invasive procedures whenever possible during COVID pandemic. So Dr. Zarens, I would like to know what is your opinion? What is the role of cardiac CT, angio, and FFR in the variation of patients with coronary artery disease in general? Well, thank you Dr. Cratcher for inviting me to participate in this very important discussion, and I wanted to just start by thanking all of the doctors, nurses, and healthcare workers who are working so hard in this very difficult and challenging time to provide care for patients with coronary artery, coronary virus disease. So the problem of diagnosis of these patients is particularly important, especially at a time when many patients are not going to doctors, not going to hospitals, but yet are presenting with coronary disease, which as Dr. Cratcher indicated sometimes is indistinguishable from the symptoms of the COVID-19 virus itself. So in thinking about coronary CT, first of all, we have to recognize how good a test it is. It is the best diagnostic test there is to find out whether or not you have coronary artery disease. It clearly shows you the coronary arteries themselves, shows you the lumen caliber, shows you plaque, and the complications of plaques such as calcifications and plaque abnormalities. And it also tells you about long-term prognosis as shown on this slide. Importantly, patients who have no significant coronary disease on cardiac CT have an excellent long-term prognosis. Some people say 8 to 10 years warranty, and people with non-obstructive coronary disease, the cadrats level 1 and 2 as shown in green, also have a good prognosis. The patients who have problems are those with obstructive coronary artery disease, and the extent and severity of disease is directly linked to adverse events. And in the short term, which is what we're considering now in the coronavirus era, what do we do with these patients? Well, normally when a patient presents with symptomatic coronary disease and has a positive significant obstructive disease CT scan, they're sent to the cath lab. But that, of course, is a difficult decision in a time when we're trying to contain the risk, both for the patients and for healthcare workers, and to reduce invasive procedures that may not be needed in the hospitals. So how do we do this? So let's look at the one thing that we need to remember as we'll see on the next slide. It's important to remember that when we're talking about CT stenosis, there's a disparity between the anatomic stenosis that we see on the CT scan and the functional significance of that stenosis. And the functional significance of coronary lesions can be defined in the cath lab by measuring fractional flow reserve. And we know that visual interpretation of coronary angiograms do not correlate well with the estimates of stenosis. In the FAME trial, patients with 50 to 70 percent lumen stenosis, 65 percent of those patients had negative FFRs that is not functionally significant lesions. Even in patients with 70 to 90 percent stenosis, 20 percent had non-functional disease. So therefore it's important to know about the functional significance of the disease. And we can see in coronary CT the same relationships exist. On the left side of the screen, we can see that for 30 to 50 percent stenosis, one out of three patients will not have a functionally significant lesion. In the 50 to 70 percent range, one out of two patients will not have a functionally significant lesion. So this is an intermediate stenosis group that perhaps really needs special attention. Even in a group with 70 to 90 percent stenosis, one out of four patients will have normal FFRs and not have functionally significant disease. So Chris, of course CT for the relation of coronary disease has existed for a long period of time. And for a very long period of time, it was considered not to be a very sensitive tool. So really what has changed dramatically, the sensitivity specificity and usefulness of CT is the introduction of FFR. Can you tell us how did this evolve and what were the algorithms used to make this test so sensitive and so reliable? So coronary CT scans are actually very sensitive in finding disease. They have a very high negative predictive value and very high sensitivity. They're not very specific, so that a lot of patients who are found to have disease that looks significant on CT actually have non-functionally significant disease. And we have been looking at the relationship between hemodynamics and alpha sources for many, many years. For over a 25-year period at Stanford University, we were looking at coronary, at blood flow and arteries based on human CT scans. These really started with aortas and the problem of aortic aneurysms and stent grafts because in treating aneurysms and stent grafts, CT scan is the workhorse for diagnosis and planning treatments. In 2005, when coronary CT came available with 64-slice scanners, we for the first time were able to see the coronary arteries, not just aortas and carotids. We then started doing computational analysis of blood flow in the coronary arteries. And when the FAME studies came out proving that FFR guided revascularization was better than visual guided revascularization, we then focused on coronary artery flow modeling. And applying the principles of computational fluid dynamics, we could then compute fractional flow reserve. Now as you know, fractional flow reserve is measured in the cath lab by giving a dent scene with maximum coronary blood flow drug-induced, a dent scene-induced. In computational analysis, we simulate the maximum coronary blood flow by reducing peripheral resistance. That then allows us to calculate the pressure gradient across lesions under simulated maximum flow conditions, i.e., computed fractional flow reserve. The problem of all our calculations was we really didn't know if it worked. So in 2009, we actually began comparing our computed values to measured values in the cath lab with fractional flow reserve. And many, many studies now have proved the accuracy of computed analysis so that a computed fractional flow reserve is very well reflected by the measured values in the same patients in the same regions. So it's interesting that this would not have been possible without introduction of artificial intelligence and finding the right algorithm to be able to, algorithm to be able to figure out exactly how to get meaningful data out of this study. Well, that's a very good point because we incorporate deep learning into our algorithm so that the more information we have with increasing knowledge from each subsequent CT scan, we validate that against measured FFR, and we can use that information to improve subsequent models. So it's a continuous cycle of improvement so that the accuracy of our analysis is always validated against measured FFR. And Stanford is well known for development of artificial intelligence in medicine. I think was one of the first institutions that actually initiated pretty extensive program in radiology, but in also in medicine in general. Is that correct? That's correct. And Stanford also has been a leader in imaging, in magnetic resonance imaging, and CT imaging, and introducing patient specific modeling. And that as I mentioned began with modeling of aneurysms and your men went on to the coronary arteries. Well, tell us a little bit about FFR, CT and interactive model results. So CT derived fractional flow reserve really begins with standard cardiac CT scans. These are the same CT scans that are performed every day in hospitals. The CT scan is uploaded through secure web-based interface to our servers of heart flow. Using special software which integrates artificial intelligence and deep learning, trained technicians developed a digital three-dimensional model of the coronary artery trees. We then apply the principles of computational fluid dynamics to compute coronary blood flow and to calculate fractional flow reserve at all points in the coronary tree. This is then delivered to the hospitals in several formats. One is a PDF format which can be printed. The second is an interactive format which can be accessed with your iPhone or iPad or on your hospital computer so that remote access and interrogation of these models are possible in physicians can now themselves see and evaluate the direct results of the analysis. The mean turnaround time is less than four hours to receive the results back in the hospital. So in this time of COVID-19, if you are not in the hospital working remotely, you can send a patient to the CT scanner and then receive the results of the analysis and communicate with the physician. This could all be then potentially remotely without in-person interaction with the patient. This is a simulation of what you may see on your iPhone. This is not an exact patient study, but it shows that you can click on the model at any point and you can derive an FFR value. The red color is a positive FFR less than .8 and the green blue and the green is a normal value. You can do pull back pressures on that and you can see significance of lesions. You can use those interactive models to plan treatments and to help guide decision-making. This example shows the anatomic functional mismatch that we sometimes see. There are two patients with 70% stenosis by CT. You can see the computational models. One of them shows a non-significant lesion with FFR CT of .86. This correlates very well with the angiogram and a measured FFR of .87. The second patient has a similar lesion on CT, but this is now a very positive lesion, color-coded red. You see the FFR value is .70. When that is compared now with the measured FFR value in the cath lab, it is .71. What looks like a pretty similar lesion on CT is very different on the functional level. Even if you look at these angiograms, it's hard to be sure just looking at the visual angiogram, which one is positive. When you measure FFR or compute FFR, the difference is very, very clear and it really can help guide patient treatment. This is very interesting because very frequently performing angiography, we misinterpret the severity of the disease. There is a tremendous variability between the operators on assessing the severity of the disease. I think this really exemplifies the importance of reliable and sensitive tests to give us the information which lesion is significant and which lesion is not significant. The other thing that's important is that in the computer at FFR, you get FFR values at all points in the corner tree. You can interrogate all the vessels from that one single model. When you measure FFR in the cath lab, you measure it at one point wherever the pressure wire happens to be in the artery. You can do pullback pressures, but it's such a more complicated, more time consuming procedure to interrogate the entire arterial tree with measured FFR. Very interesting. Tell us a little bit about diagnostic accuracy of a variety of non-invasive assessment of coronary disease. Of course, we have many different tools available. Now PET is very commonly used and it's thought to be very sensitive coronary, CTA, SPECT, and heart flow FFR. What kind of diagnostic accuracy do we have and how does heart flow FFR compare to the other modalities that we commonly use? That's a very important question. Diagnostic accuracy is really predicated on functional significance of lesions and that is as we've been talking about measured by FFR. The diagnostic accuracy of computed FFR compared directly to measured FFR was done in the NXT trial and that showed an 86% diagnostic accuracy. The other non-invasive tests such as PET, coronary CT, and SPECT have been tested against FFR in the Pacific trial run by Paul Knapin. And in that trial, in comparison to those non-invasive modalities with a sub-analysis comparing to heart flow FFR CT, we found that the highest diagnostic accuracy that is the highest area under the curve of an ROC curve was for FFR CT with an AUC of 0.94. This was significantly better than PET coronary CT or SPECT. We know that of all people going to the cath lab for diagnostic angiography, more than 50%, probably close to 60%, have normal coronary angiograms, that is non-obstructive disease. So in retrospect, you might say, well, why did they need to go to the cath lab if they don't have significant disease? So the same experience that we found in the platform trial now has been found in many other institutions in the world. That is the cancellation rate of angiography after FFR CT analysis. And overall, it's around 50% of patients. So that you can now reduce the negative catheterization rate in the cath lab by doing CT and FFR CT. So what does this mean? Well, this means that you can have more efficient use of the cath lab. So patients now are going to the cath lab not in order to get a diagnosis, but in order to get treatment. So if you identify patients ahead of time that they, in fact, have a significant lesion that needs to be treated, your average revascularization rate goes up. And that's, in fact, what happens if you look at these hospitals. And from multiple reports here, we see that without CT, FFR CT, the average rate of revascularization of all patients in the lab is about 34%. But once you start using CT, FFR CT, the revascularization rate is 69%. So that the patients in the cath lab are getting revascularized. This is particularly important in the era of COVID-19 because you don't want patients now in the high intensity cath labs. The patients themselves might contaminate the cath lab, or patients coming into the hospital might become contaminated because of all the COVID patients are in hospitals now. So that in order to improve the efficiency, safety, and effectiveness of the cath lab, pre-cath evaluation with not only an anatomic test like CT, but a functional test like FFR CT helps you sort out who doesn't, who does not need to be in the cath lab. So was this just in that one study, or is this a more generalized phenomenon in a real world experience, a registry, the advanced registry of more than 4,700 patients in 38 sites across the world, the same dynamics occurred. 63% of the patient management decisions were altered once FFR CT data was available. And importantly, and this is perhaps one of the most important observations here, is that patients who have FFR CT of greater than 0.8, that is they do not have hemodynamically significant lesions, even though they may have many, many plaques, they're not functionally significant. They do very, very well on medical treatment. Patients whose FFRs are less than 0.8, they have more disease, they need treatment, they need intervention, and overall, their cardiovascular death and MI rate is higher. But additional studies by Norgaard and Denmark show that those who now get treated with intervention do better. So this really helps decision making, helps guide treatment, and has improved outcome for patients. So what have we learned from all those studies that were carried on using CT and FFR? Well, we show that it's a really good diagnostic strategy. It's a good diagnostic strategy because you can exclude significant coronary disease, and many patients come in with symptoms thinking they have coronary disease, may have classic symptoms, but actually don't have significant disease, they have something else. The FFR CT analysis can identify which one of those patients with the disease has significant disease, ischemia producing coronary stenosis that may benefit from treatment. So you can differentiate patients who are best treated medically from patients who may benefit from a trip to the cath lab. The other important thing to learn here, especially in this COVID-19 era, is that this is a treatment strategy, a diagnostic and treatment strategy, that can be done with a single point of patient contact. That is a CT scan. You don't need second tests, you don't need hands-on interactions in high-intensity areas in the hospital, you can get a CT scan. This can be done even on an outpatient basis. And from the CT scan data, you can now get the functional information, you can sort out which patients have significant disease and which patients should be treated medically. And this can be done remotely if necessary. If the risk of bringing a patient into the office or into the hospital for consultation is too high because of the risk of COVID-19, you can communicate remotely. And if a patient does indeed have significant disease that is life-threatening, that patient then can be scheduled and brought into the high-intensity facility for treatment. So this is a benefit, reducing exposure to patients and health care personnel and provides more efficient utilization of resources. Personal protective equipment is lessened and we can use the cath lab for treatment rather than for diagnosis. All right, so let's talk a little bit about COVID-19 and the use of this test, how to streamline and triage patients who need intervention and patients who don't need intervention. And CMS also made some recommendations. Can you go through it a little bit with us, please? So the Centers for Medicare and Medicaid Services released guidance on March 17 asking health care providers to postpone adult elective surgeries and procedures including dental procedures until further notice. CMS recommended decisions about procedures to be made in consultation with a hospital surgeon, patient and other health care professionals. And the chart made up this, the agency made up this chart to guide decision-making. So you can see elective procedures are postponed, but you do not postpone high-acuity emergency procedures. These are acutely symptomatic patients. These are patients who may die if treatment is withheld. Importantly, perhaps patient with a left-main disease, patient with a critical ischemia-produced left-main disease which sudden death is not an unusual occurrence. So there are patients who on the basis of symptoms and presentations are urgent and should not be postponed. And of course, it's the physician's judgment to make the decision, does someone have such a lethal disease? There are exceptions for cancers. There are exceptions for patients with life-threatening conditions including significant coronary disease, which as you know is the number one cause of death in the world. So I think the CTA first pathway is a very important pathway because it allows definitive diagnosis of symptomatic patients who need cardiac testing. A CTA first strategy allows you to answer the first important question, does this patient have coronary disease or does this patient not have coronary disease? If the patient does not have coronary disease, that patient could be very well treated medically as appropriate. If the patient has anything between 30 and 90 percent stenosis, that could be a patient that you may want to get an FFR CT evaluation to determine whether or not this is hemodynamically significant ischemia producing. So this strategy can be done without excess contact with the patient other than the initial CT itself. So this can reduce the need for diagnostic angiograms, alleviate the burden to hospitals and health care facilities, and minimize negative cath procedures. It allows you to risk stratify patients, enabling you to select patients for revasterization and only referring patients who are at the highest risk to the immediate use of the cath lab with the remainder of patients can be deferred. Of course all of these decisions are made on the basis of doctor-patient interaction, communication, and the judgment of a physician based on the symptoms of the patient. So obviously I'm sure a lot of internationalists would have or those that take care of a patient with acute coronary syndrome questions for you related to several important issues that we have to deal with on a regular basis. Number one is how many institutions are able to perform good quality CTAs and how reliable those tests are to be able to get meaningful FFR data that will be obtained from the hard flow analysis. Well that's an important question because the hard flow analysis is dependent on a good high quality CT scan and the CT scan imagers of today are fully capable of producing high quality CT images. Now coronary, I'm not a cardiac CT expert but so you need to consult with them but a couple of things that are important. One is when you image for coronary CT for heart flow analysis is important to follow the strictest society guidelines including heart rate control. This will cause great improvements in image quality ideally heart rates of 60 or less are hoped for and to give coronary vasodilators such as nitrates just before the CT scan. The reason that is important is because coronary arteries that are not dilated will give an abnormal reading in the cath lab when they measure fractional floors or they give nitroglycerin vasodilators. So the comparison of FFR to computed FFR has to be on the basis of the same anatomy that is not constricted coronaries but dilated coronaries. So following SCCT guidelines for coronary acquisition the machines no matter which kind of 64 slice or greater machine you have is capable of good quality CT images. Now there are situations sometimes the patient moves. One feature that is talked about a lot is calcification. Now calcification interferes with image reading the quality of the images because of calcium blooming. It's been shown that FFR CT analysis is possible even in calcified arteries with good quality results. So care in CT imaging, training the technician, dedicated technician, following the protocols and careful attention to the process of image acquisition should allow most every place that offers cardiac CT to perform heart flow analysis if they wish. Now this could be a potential problem in the patient in the COVID era. A lot of those patients whether they have COVID or they don't have it but they have let's say cardiac symptoms and hemodynamic instability it is very difficult to control the heart rate and bring the heart rate down and they might have tachycardia or atrial fibrillation and rapid reticular response. They might be hypotensive where nitroglycerine cannot be administered so either we cannot do this study for that particular reason or it will be suboptimal. And is that of concern? Yes it certainly is and FFR CT analysis is indicated for stable patients not patients with recent MIs. If there's been a myocardial infarction within 30 days there's no evidence to show that this is useful. So this is for patients with stable symptomatic disease suspected coronary disease with stable symptoms not for acute patients so with acute instability being admitted with acute coronary syndromes. Well I understand that I was not trying to point this towards acute coronary syndrome but point towards the patient that admitted with possible COVID infection and symptoms. Symptoms could be due to many different reasons whether they are perbrile or have respiratory issues and so on. So I'm trying to figure out how we can make this beneficial and useful and safe in this type of a scenario. Well this is where the physicians need to get together to establish protocols within the hospital and how to manage patients and to prepare them properly for CT if they wish to perform CT. And this is a very important question that really needs to be looked at and addressed at each institution. One group of patients of course is in the emergency room. Patients come in with symptoms and may have symptoms that are very suggestive of acute coronary syndrome even though they are stable. And there need to be protocols in place. This requires the CT scanner being ready with trained technicians who can do proper quality CT scan and systems in place for data acquisition. Prompt reading of the study to determine whether or not there is a 30 to 90% lesion and then a system in place where those images then are uploaded to heart flow so that the results can be returned. So what else can we expect in the future as far as heart flow technology is concerned? Of course it takes up to four hours or maybe sometimes longer to get the reading and sometimes we don't have that luxury to be able to wait that long. So do you foresee in the future where artificial intelligence might lead us even further in being able to get this data in a shorter period of time? We are certainly working on that and the analysis times and the capabilities are getting shorter all the time. They will never get to zero of course but we are working on that in order to reduce turnaround time to get the reports back as quickly as possible. Certainly patients with relatively straightforward disease can be done more quickly than patients with complex multivessel calcified deletions. So that requires a little bit more time. But overall the process is getting faster. Well Dr. Zarans thank you very much for your very valuable contribution to Texas Heart Institute educational programs in COVID-19 epidemic. We are greatly appreciative of this information that you have provided to us. Thank you very much. Thank you very much and good luck to all the healthcare workers in this difficult time.


Discoverability helps get customers to your site, but how can you measure their behaviors once they get there? Hi, I'm Sarah Clark, and I'm here to introduce you to Site Analytics. We want to know what users are doing on our site, which pages are popular, whether users follow the paths we expect, and if anything goes wrong. Analytics is all about collecting measurements of user activity on the site. Google Analytics is a service that collects, processes, and reports data about an application's use patterns and performance. Adding Google Analytics to a web application enables the collection of data like visitor traffic, user agent, the user's location, et cetera. This data is sent to Google Analytics servers where it is processed. The reports are available in the Google Analytics web interface and through a reporting API. Google Analytics is free and highly customizable. Integrating Google Analytics is simple. First, you must create a Google Analytics account. Each account has properties. These are JavaScript properties, but refer to individual applications or websites. Google Analytics then generates a tracking snippet for each property. This is a piece of JavaScript that you paste into your page. It sends data to Google Analytics back end. You can also use the Analytics library to create custom analytics, such as tracking specific user actions or tracking push notifications. I want to say a bit more about properties. An account has properties that represent individual collections of data. These properties have property IDs, also called tracking IDs, that identify them to Google Analytics. If an account represents a company, one property in that account might represent the company's website, while another property might represent the company's mobile app. If you only have one app, the simplest scenario is to create a single Google Analytics account and add a single property to that account. The analytics server will then generate a custom bit of JavaScript matching your account and property. This is the tracking snippet. This is the key part of the tracking snippet. The entire snippet needs to be pasted into every page you want to track. At a high level, when this script runs, it creates an async script tag that downloads analytics.js, the Analytics library, defines the GA function called the command queue, creates a tracker that gathers user data, and sends this data as a page view hit via HTTP request to Google Analytics. This data is analyzed and stored in your Analytics account. In addition to the data gathered by tracker creation, the page view event allows Google Analytics to infer what pages the user is visiting, how long they are visiting them, and in what order. For simpler applications, this is the only coding required. Note that you can replace analytics.js with analytics underscore debug.js for console debugging. Using this version will log detailed messages to the console for each hit sent. It also logs warnings and errors for your tracking code. The data is sent to Google Analytics back end where it is processed into reports. These reports are available through the Google Analytics dashboard. Here is the audience overview interface. Here you can see general information such as page view records, bounce rate, ratio of new and returning visitors, and other statistics. It's also possible to view analytics information in real time. This interface allows you to see hits as they occur on your site. I encourage you to take some time and explore. There's an extensive set of features in the dashboard. You should explore the standard reports and look at creating your own. Knowing how to use analytics effectively is a skill in itself. Fortunately, the Google Analytics Academy offers a free set of online courses. I encourage you to install analytics on some of your sites if you haven't already. Check out the free Analytics Academy courses as well. Then, once you're comfortable with analytics, come back, and I'll show you how to integrate analytics into a PWA. Thanks for watching, and I'll see you soon.


All right, so my name's John Spangler. I'm here to talk about value stream mapping and analysis at under four bits a second, hopefully. The slides are available through my blog unifyingIT.net and probably through the conference here as well. I've been a technologist now for 22 years, starting off in manufacturing. That's my interest in background in Lean Six Sigma. I'm currently an ITSM process architect at DeVita. If you're interested, you can follow me via my Twitter account or my blog that I mentioned earlier. At DevOps conferences, we hear a lot about value streams, but what exactly is it and how can we use it to improve our delivery pipeline? So value stream mapping is a lean technique for optimizing your value stream, your end-to-end process flow. Here's a picture of a complete value stream map. We'll go through each component through this presentation. Let's start with vocabulary. End-to-end means from the customer's viewpoint, so we optimize the entire flow. In Agile delivery, it could be product backlog to deployed or it could be order to cash, for example. Next are process activities which are like high-level flowchart items. Cues are the items waiting for work to be done in them are regarded as non-value add time. Work in progress, I'll catch up my slides here or just let my slides catch up with me. So work in progress are items in the queue waiting for things to be worked on. While processing time is the value add time or something that the customer would actually pay us for doing. And then lead time is the total process time plus the non-value add time, like waiting in queues. So too often we focus on what we are doing and how to improve that, but the biggest opportunity is really what aren't we working on? What valuable things are sitting in a queue waiting to be worked upon? So reducing queues is by far our biggest opportunity to increase our velocity. So where do we traditionally see these improvements? For large enterprises, it's reducing whips and queues. For Agile development teams, it's establishing lean flow with operations. For DevOps groups, it's decreasing your cycle time. So where do we traditionally see these improvement? Oh, I'm sorry. So it's about focusing on the biggest process bottleneck. Theory of constraints tells us that just one area constraints our overall flow here just like the funnels here on this diagram. DevOps focus on continuous integration and deployment and that word continuous really means lean flow through your delivery pipeline. Let's look at our map and our process activities here. They're typically three to eight items in a value map. These activities are often determined by your current data sources and that's okay, we can always improve our data collection later if needed. Queues are represented by the yellow triangles with the number in the center, the number of items that are in that queue. Value stream mapping is a point in time tool. So either pick a date for your data or grab an average or median over a period of time. So for the same time period, add your non-value add and your value add data. Often value add time is not initially captured by your organization. So if this is the case, consult a team, perform the activity for an estimate. The 100 items in 90 days on the left hand side show good agile practice. This is exactly where we want our large queues because we maximize agility. If we clog up the pipeline with WIP we just end up slowing everything down and it makes it hard to expedite items. The monthly deployment window on the far right is the bottleneck here with the large WIP and queue as such improving any activity before that is just going to stack up work at that bottleneck. If we want to improve our delivery speed we really need to have to address that deployment bottleneck first. The efficiency metrics here show value add versus non-value add time. The 16% indicates we have a big gap with our customer demand rate. The 63% shows that we have a lot of opportunities to improve our work in process flow. So to recap it's always the customer's view of end to end. You should identify and improve flow at the bottleneck, never flood or starve the bottleneck and tolerate any flow and efficiencies outside the bottleneck. Smaller batches are generally better if they don't starve the bottleneck. And for DevOps teams don't forget to look at your retirement cycle times because that's going to affect your next iteration. Finally, use a tool called a cumulative flow diagram to monitor your flow over time. So five minutes really isn't enough time to learn value stream management but this is a good overview. I highly recommend the book Value Stream Mapping by Karen Martin and then there's also another book called Learning to See. It's written more in the manufacturing context but it's a little bit easier to digest. So no matter if you're looking to increase your deploys per quarter, month or day, your check list is here to improve your velocity. Like a race car it doesn't matter how much horsepower you have when your foot's on the brake. It's got to be on that throttle to actually deliver value. So finally remember that Value Stream Mapping is just a tool, it's not the solution. These resources I have listed here might be helpful with addressing some of those challenges that you're facing. You can find me at JWS Pro Services on Twitter, unifyingit.net for my blog. Also now said DeVita is hiring and lastly Deming Rules.


What's up everybody, Jayce here for jasperyskatesrace.com We just sold out 23-24 prison basketball hobby six box half case break PYT number five All cart ship here guys There you go Boom Thank you guys for getting in and good luck guys. So again, this will be the first half of the case Second half some PYT six which is down to six left now guys Every team in there available seventy dollars or less guys. So love to try to run this back I had empty case As always left to right one two three for the left four five six for the right Four one two three four five six.  That'd be awesome pretty close guys. Here we go. That's some big hits here guys Here we go case on walls for my thunder And have a little second-year Chet Holger for my thunder Chris Butler for the Hornets going to Jordan and we got a Hosea Alvarado 149 Pelicans are down and Jordan Paul Ronald's IE man. Awesome.  There's a little scoot Henderson And nice Brandon Miller silver He's probably sell extremely well to the silvers Brandon Miller's been ballin James Najee Joe Harris for the Pistons Deandre Hunter for the Hawks. All right, did we get cheated and only get one autograph in this box? I think we did All right, Stephen. I'll make sure to tell them that you checked and don't see anything I don't know. Maybe once a spam or maybe it's a different email I don't know sometimes customers have multiple emails But I'll ask I'll make sure to ask them that you double-checked But see if you can expect one. Maybe I'll tell them to resend it or something Thanks for checking the buddy. All right, hopefully we got an extra auto here somewhere It just is young Don't hit me going I'm one spot away I think that's what he meant by like we're just gonna make more tomorrow.   No, she probably be like what? All right, we go guys next box Chat Sorry John Timberlake case on George And Colby Jones for the Sacramento Kings that's going to Joe and we got a Marquis Noel Autograph there for the Toronto Raptors quickly Andre Jackson Junior and Jared Vanderbilt is 60 next minute and we got Anthony Davis To race Walker for the Pipe Pacers out of 149 KD and sirs of Ari rise for the spurs little teaser Brown and Miller under Wiggins and we got a Chris Murray autograph for the Portland Trailblazers. What a Jordan red wave Brown and Miller All right, let me look at some more senior pick up. Let me write back. Let's go to box three Here we go guys out of 49 Seth Curry short prints Like in prison like an image where you should why they have those here too sometimes Grady D Polsar Austin Rivers There's Victor women. Yeah, we got to 125 Patrick Ewing For the Knicks. Oh That prison mania. No, I haven't I feel like the prison mania is like It's like the way colorblast is for prison football where it's like You know, like once every X amount of cases I have not seen one yet I've done like three cases already. I think that's when you're talking about I did it Benedict Mather in there Luca Donchich and then Jalen Clark for the Timberwolves Timberwolves going to Jason. I feel like we're due for a big color. Oh, you did Steven. Awesome. Okay Well, I'm a little scoot Anderson though Polsar That's very nice there blaze is going to Jordan you can Hockeyes manual quickly Aiman Thompson and PJ Washington Jr To 299 Tyrese Halliburton 299 I Think this was another box where just hold an auto bro What's going on here? Better give us something massive in here You know, yeah, the liquor games on her now. I forgot noble bronze today though, right? Who has pots today? David does actually Amy Thompson. We got Alan Iverson. It's a 75. Oh That's hyper book to 149 for the Suns Ben Shepard for the Pacers Pacers autograph One new Nila. I'm sorry. Kelly Arbor is number there The 299 Colby White he's having actually having a really good season this year Oldsman Jordan and a mojo Moises moody not pods David, but a little mojo coming your way Duncan Robinson Desmond Bain Rupert and Marcus smart with the Grizzlies To 175 Grizzlies went around and second autograph here's Patty Mills for the Nets What a Joe Like he's no well for the Raptors and a Marcus sass or silver for the Pistons All right, two more boxes guys Gotta heat up gotta heat up cares Laverte to 149 They're lightly silver the brawn Ben Shepard and then a Grant Williams to 299 Terry Rose here and then Colin Castle Castle 10 sorry For the Lakers Lakers going on dress Jared Jackson Junior to 299 Another Patrick Ewing to 7175 Noah Clonley For the Nets going to Joe each inch. I've got to get something in his last box I would not like that second half has to be cooking something nice I feel like we're lacking it on the color Early on with that Thompson auto was nice, but Got to get something here guys Jalen Green to 149 and Belial Holy Bay For Washington Linda Tristan Jordan Walsh little Lulu Harrison Barnes to 199 for the Kings Luca Donchich 32 out of 99 It's one of the Mavs and Jordan got that from that filler Jalen Williams little J. Dub for my thunder Thunder's Chris Bother Oh spend the ink youth camp to 175 Come on man All right, we got to do the second half guys Second half has to be way better than this half got some great colors for some players some teams, but I just feel like definitely could have been a lot better that school was nice. So Brandon Miller was cool But definitely looking for a lot better guys Yeah, so we were this one only had one autograph as well guys So unfortunately, we're missing a few autographs in this half case here, but Again, I did have a case yesterday where the autographs are missing in one box for another box So the other half of the case is over there guys But like I said, I feel like the second half has to be much better than this We haven't seen a gold yet either. I feel like I've been averaging at least one gold per case But yeah, definitely not not too good here. Sorry Sean. Yeah, I'm hoping for a lot more Wendy's in that second half because I've been averaging like at least four to five a case So yeah, like I said, I definitely need to see that second half guys Unfortunately, but like I said, thank you guys is number five number six is in single digits Let's get that done guys so you can see what's happening in that second half guys. Thank you


Inserting 700 meters from the objective, the helicopter company of the 31st Muse Battalion Landing Team conducts a no-signal raid on an enemy held town. Broken into teams with heavy machine gun and sniper assets, the squads infiltrate the town and assault the enemy positions. Parts of the unit's pre-deployment package, this raid falls into a succession of training events for BLT-21. No friendly casualties, the Marines take control of the town, isolate and provide explosive devices and capture a high-value individual. Corporal Jonathan Wright, Combat Town, Okinawa, Japan.


Welcome to my channel. In today's video, I'm going to share with you some really important tips. If you use these tips while you're studying for UDCnet exam, I'm pretty sure that you'll be able to learn faster and you'll be having more fun when you're learning. So let's start. The first important tip that I would like to give you is that you all must know your personality type before you sit down to study. Guys, as you all must be aware that we all are designed very differently. Like even two siblings coming from the same mother have completely different set of ideology, have different style of working. Similarly, every student is designed in a different way. Their brain functions in a different way. We succeed in our life. We succeed in any exam when we do things which are according to our nature, which is according to our personality. For example, there are people who can study best when it is morning. There are people like me who can study best when it is night. So you must be aware that what is your peak hours? Peak hours are a set of period in every day, in every person's life when their mind functions at its best. For example, I have certain friends who study in the morning. They get up at 4 o'clock and then till 8-9 o'clock they study the most important and the most difficult topic and they are able to retain it very fastly. Whereas there are people like me, if I want to study a very difficult topic or I want to work upon something which I am not interested in, my brain functions best when it is night. Like I sit down at 10 and then probably till 3 or 4 in the morning I will be working and that is the time when I am energised, when ideas come to me, when I am in a state of flow. If you guys are aware, I would like to tell you that this flow is very important. There are times in our day when there is this rush of energy coming from our brain and we feel like studying. We feel like touching the most difficult and the most annoying topics and that is what your peak hours is. How to identify your peak hours?  After 7 days just go back to that diary and see what is that particular time when you are working in the most efficient manner or when ideas come to you or when you don't feel lazy, when you feel energised. That is the peak hours. Every person has a peak hour of 3-4 hours every day. So it's common to all human beings. So don't even think that you know I never get a peak hour. We all have a peak hour. But the problem is that the successful people use their peak hour in making their career in working upon ideas whereas people who are not so successful use the peak hour watching matches, gossiping with friends, chatting on social media. So all these stuff should be done when you are not in the peak hours zone because those 4 hour period every day is the golden period of your day. That is the period which if invested in the proper pocket will take you to certain heights. So it's a request from my side to all the net aspirants that please start identifying your peak hours and then gradually make sure that every day you study the most difficult topics during your peak hour. The second important topic that I would like to touch in this video is the forgetting curve. I've already mentioned about this forgetting curve in my previous videos as well. If you have not watched the video 5 mistakes students make when they are preparing for UDC net English then do go and watch that video on my YouTube channel because that video will help you with certain ideas will prevent you from making certain mistakes which are commonly made by different students. Also there is a video in which I've talked about the study routine. The title of the video is study timetable for UDC net aspirants. You must go and watch that video as well because it will help you prepare a proper study timetable for your upcoming UDC net exam. So I was talking about forgetting curve. Now what is important to understand that this forgetting curve is very scientific. It is designed by a very prominent psychologist whose name was Herman Ebingor. The Herman Ebingor designed this forgetting curve wherein he said that our brain functions in a particular manner. When we read something or when we are studying something after one hour of that study session our brain forgets 25% of the information if not revised. After one day you would see that your brain will forget 40% of the information. After one week if you don't revise the topic that you have studied before a week you will see that 60% of the information has vanished somewhere. And the most annoying part is after one month if you come back to that topic and you have not revised it during the period of one month you will see that 80% information is deleted from your brain. This psychologist has to say about and this is called forgetting curve that how our brain forgets the thing. Now how to use forgetting curve and help take the help from this curve and then prepare for the exam. You must be aware of the stuff that whenever you are studying timely repetitions or revisions are very essential. So make use of this forgetting curve whenever you study please make sure that after one hour you do make a revision or whatever you have studied in the past one hour. For example follow a 50 by 10 rule. 50 by 10 rule says that 50 minutes of study then 5 minutes of break and then 5 minutes of revision of what you have studied in the 50 minute period. This is called the rule of 50-10 and this will help you to register information faster. See guys there is no point putting so much information in our brain bombarding our brain with like dozens of information dozens of writer, dozens of work and then not actually remembering anything when it comes to the exam day. So a perfect student or a student who are actually enthusiastic about performing perfectly would definitely do timed revision and that is where forgetting curve comes into the role. So what you need to do is that whenever you are studying anything make sure that you study that thing and then revise it after one hour. So next day never start a new topic unless and until you have gone through the notes that you have made previous day and every Saturday or Sunday please make sure that you devote one complete day to revise all the information that you have collected in your memory in the past seven days or past six days and this is how you will channelize your preparation because I have seen students who keep on reading books keep on making notes and doing stuff which seems to be a very very long in a very very hard working journey but when it comes to the exam day they don't remember anything and that is where stress comes in because before two days of your exam when you open your notebook and you will see that you are not able to recall information your energy your entire hard work will go into vain your brain will start functioning in such a manner that the entire hormonal system of your brain will stop for a time being or all the hormones will somewhere down the line so it is important that whenever you are studying and whenever you are preparing for any competitive exam do make sure that you revise at a certain point of time or you revise after a certain interval so that will help you to retain maximum information on your exam day and you will feel confident when you are going to sit for that particular exam now guys let's move on to the third important tip the third important tip is that whenever you are studying try to associate the information that is there in the book or on the website with information that you already know see our brain works best with connections with links if you have ever seen a web or you have seen how the body functions you will see that everything is connected to every other thing and that is how the proper working or proper functioning of body happens similarly our brain works best when we actually connect any new information with already known information for example just think of a song that you recently heard or think of a song which is very dear to your heart and when you close your eyes and think about the song you will try it and recall all the information or all the memories that is associated with that song for example if I hear a song which was played on the farewell day in my school I will recall all the dance performances I will recall all the memories that I made on the farewell day so you can see how one particular song or one particular incident can link to so many other information and you can recall everything in a proper manner for example this is a term which is very very common in psychology and it is called schemas schemas say that if you go to a restaurant you can automatically imagine all the things which are there in a restaurant or when you sit it down in a restaurant you can automatically condition yourself to behave in a particular way when you last sat in a restaurant so similarly when you try and link completely new information with already known information your mind will be able to retain things faster and it will be much easier for your mind and probably that thing would be remembered for a longer duration of time so what you can do is that always try and relate writers and their works to certain Bollywood movies to certain characters for example when I am studying about angry young man movement I somewhere connected to the movies of Amitabh Bachchan during that period when he was portrayed as angry young man and I can completely take out the references I can see how the angry young man or the protagonist of the plays of the angry young man theater would be like so my mind doesn't need to actually learn things or you need not go into the rote learning method because you already can link it to the previously known information similarly there is a friend of mine who is very very similar to Daisy from Great Gatsby so whenever I am reading Great Gatsby somewhere I can just recall my friend I can see the traits and I can totally make a connection with Daisy and I am able to retain things faster I am pretty sure that all of you must have related things related characters to people you know in your life or you must have related certain concepts to your life when you were studying during high school or in the secondary school but somewhere down the line when we prepare for competitive exams we forget all the important techniques that we were using during our high school days so it is very important that you recall all these techniques and then make use of them so that your study time becomes a very very interesting journey the last and final advice that I would like to give all the net aspirants is that please don't neglect the role played by sleep by meditation and by diet now these things will seem very superficial because people will think ok diet and meditation say where net will be cleared it has no link with clearing net but I am telling you guys it helps a lot I have seen that in my preparation when I was preparing for net I made sure that my mother gave me food items which had greater amount of protein content because protein somewhere helps your brain to remember better and that is why you were always advised during your childhood days because almonds have protein content in the maximum capacity also at the same time protein will make your brain efficient will energize your brain so that you don't feel like sleeping when you are studying that is very important see your body should aid your study schedule and only then you can achieve the results because body and mind together will work towards your success if you are using your mind but you are not taking your body along somewhere your health will suffer and if the most role of stress comes in something or the most effect comes in something that is our body whenever you are stressed out you see that the entire hormonal system the entire emotional system of your body hampers so it is important that you take enough amount of proteins milk products then if you are a non-vegetarian you have so many other supplements of protein that you can take then there are times when you can take sprouts you can take pulses you can take nuts so all these things try to incorporate them during your day every 2 or 3 hours take something which has certain protein in it so that for the next 2 hours your brain is energized meditation will definitely work wonders because when we are studying we are trying to accommodate so much information in our brain that our brain actually gets really tired so meditation whenever after 1 hour you will meditate for at least 2 minutes or 1 minute you will see that you can again get all the power of your brain and your brain will be in a mode to perform in the best manner for meditation you can download an app which is called Headspace I have been using that app since like 5 years and I have seen wonders happening in my life all the kind of work that I am producing the results that I am doing all that is very much connected to the meditation routine that I follow so meditation will help you after every 1 hour make sure that you just meditate for 1 minute meditation is very easy if you download that app it will guide you I would not be able to guide you in this video about meditation but then definitely Headspace will do wonders in your life also make sure that you have enough sleep guys people think that we go to the exam and we hardly sleep for like 2 hours 3 hours but I am telling you guys it never works why it never works let me tell you our mind consolidates information that you have taken throughout the day when you sleep because while you are sleeping the conscious mind is not at work so now all the energy that is there in your body is working on all the residual things for example if there is any wear and tear in your body your body is working on that if your body wants to consolidate information it can only consolidate when you sleep because when you are awake your body is functioning you are working so your body has to work for you but when you are asleep your body your mind actually works on consolidating the information when you wake up you will see that you remember things quite easily the things that you have learned in the past day when you wake up next day you see that they are more properly consolidated you are able to recall them better that is because your brain has helped you with that process while you were asleep so these things will definitely aid your UGC Net preparation and you will see that somewhere when you follow all these strategies you will be able to learn better revise more efficiently and perform extremely well in the next UGC Net exam so before you leave do subscribe to my channel because I post videos on every weekend to help UGC Net aspirants also if you have not gone to my website do go and visit arpitakarva.com you will find a list of all the important writers that you must study if you are preparing for Net exam so just make sure that you have that list on your tips and you prepare accordingly if you like this video do give it a big fan thumbs up share it with other Net aspirants and do follow me on the social media platform because I am running a Go Net quiz that will help you in your exam preparation so you can follow me on all the social media platform link is given in the description box so till the time we meet next happy learning, keep loving literature and stay tuned to arpitakarva.com


We are the United States. We both are the nation and are the source of its existence. Government management is our citizen challenge, because granting authority to public leaders continues to fail our purposes of freedom, prosperity, and support for family. By our founding document, we are parties to a constituting agreement, that we owe contract duties to one another, even as other citizens owe their public duties to us. We are all in this together. This is a course in citizen empowerment. Even more on point, this course does not give power to the citizen who passes through it. It uncovers the power that is already there, and it reveals the source and nature of citizen sovereignty. The knowledge imparted within this area of study is designed as foundation for taking actions as citizen owners. It includes the study of our legal foundation, and governmental structure, so that citizens share a basic understanding of the nature of their empowerment, and that nature is citizen sovereignty. When we the people come to agreement among ourselves, we are the center of all national power and authority. It was by agreement among we the people of the United States, that we became a nation instead of a confederation of independent states with common interests. At the time of our nation's founding, we the people were not ready to assume management over our nation. We entrusted it to those who were elected to represent us, to see to our interests as both individuals and as a corporate nation. Even the leaders were unprepared. They believed in sovereignty of government, and changing this was seen as a cost. Our leaders did what they knew. They assumed the U.S. was to be a sovereign government ruling well over a common people. We have continued to this time as a people unprepared to assume our legal duties to one another. This course is a foundation for using our authority as a gathered sovereign people. It is managing over our nation, our government, and our economy. The tool is management, giving proper and effective executive management direction and support to those who we have hired to operate our nation on our behalf. The tool is not one of doing the management. It is providing exception management services to our leaders. It is giving them direction where needed, providing support to do the things we assigned to their responsibility, and providing adequate rewards for serving our assigned purposes. We just begin with the Constitution as our initiating agreement. It is a source for our agreed purposes, stating authority we granted to our leaders and what our leaders were to deliver to us as a product of their performance. All management starts with purpose, with something that those who are hired into labor are to accomplish as a basis for our hiring them into service. This is the management purpose we set on those who are elected or hired into public service. Our constituting agreement serves as an assignment of those purposes to our public servants. Our citizen effort should establish and maintain our management over constitutional officers for the purpose of gaining these results through their efforts. Needless to say, this purpose has not been historically filled by we the people as a public owner to establish exception management we need to assume direct authority over three areas, finances, personnel, and discipline. For this we need a forum in which we can regularly come together to receive and to evaluate management feedback on our government's fulfillment of our purposes. Voting annually for which of a few offered candidates will be given authority is obviously inadequate to meet this purpose. And as exception managers we only need to actually exercise authority when there is a need for additional assignment, for additional public resources, for review of personnel actions or matters of discipline being taken in our name. Our need is to support this government as it accomplishes what we have assigned. Our means of addressing these will be management feedback from operation of our government. We need to receive information on what is being used up in running this government and the goods and services that we receive from its operation. One obvious exception management direction would be that our public resources are only to be used on efforts that return value to us. Where there is no value delivered to us, expending public resources should be treated as criminal acts of either embezzlement or misrepresentation. We also need to have a forum for intentional review of the management feedback on success or failure of each funded government effort. Our review provides our leaders a clear vision of what we the people both receive and value from their representative actions. The concept of executive management was clearly not a part of the original vision that established this nation. The only apparent people's body for review is the grand jury of citizens with the power of presentments. This will probably have to do as a first effort, though we are in authority as we are agreed to establish other executive management bodies. We also need to address a review of personnel actions. The constituting document does not have a body of citizens performing this function. It rather sets Congress in authority to perform review of elections as a representative body. This is technically inadequate to serve the purpose of executive management. Congressional review can form the basis for information supporting our executive review of personnel actions, but the review is necessary for our executive management. There, once again, needs to be an executive review to accept or change the hiring and termination actions. A jury review should be appropriate, arranging a final approval to all personnel actions. This has recently become an issue with presidential candidates who specifically stated qualifications for office appear to be in question. Such matters should have been settled before the office was filled, but were obviously left in the hands of those who had other priorities. Having other priorities is appropriate for we the people, not for our representatives to whom such requirements were assigned for performance. The third matter is discipline, both review of discipline by representatives and discipline potentials for original application. The first is a simple review, and the people can and should be final arbiter and approval on all hires where we choose to assume this review. It would certainly include discipline of elected officers who are empowered as citizen representatives. This first type of representation would involve submission of all internal disciplinary actions to senior officers for we the people's review before any application. The second is origination of disciplinary actions. This is sitting as the representative jury originating whatever disciplinary actions we find to be appropriate. I note that our grand jury system is not now arranged to perform the whole executive management function. I would suggest that there be a gathering of we the people by whatever means are acceptable to more thoroughly document and establish the management system that serves our corporate purposes. It also seems appropriate that no government burden upon we the people be authorized without the express approval of we the people as the only party in interest. As owners of the nation, we are the ultimate source of public resources whether through taxation, fees, seizures, or other means. Ongoing burdens on we the people would also be subject to periodic review. I note that there were severe limitations placed in the original writing of the Constitution and government leadership chose to ignore these. Without our executive management review, that has been allowed as if it was authorized. No system of taxation should be considered as authorized without executive approval. Unauthorized taxation is a reversal of the purpose of serving we the people, a reversal of representation. Such efforts involve people being forced to invest in their government's efforts independent of receiving anything that they value in return. We the people want our nation to function and will support such taxation as may be needed to perform the functions of government to our purposes. Another matter is secrecy. There is no such thing as secret representation. Even the attempt at taking actions unknown to those who are represented is intentional misrepresentation. The value in protecting certain actions or information from general publication is recognized. A potential performance approach is again jury review of the actions that public officers would secure from wider public scrutiny. A finding of need by we the people as represented by the sample who are on the jury would then authorize securing the matter from the larger public. This is also for review as to dealings with other nations. If these are undertaken by public officers in the name of the people then securing them from the people is the exception. We the people are not the ones who claim some need to secure representation from ourselves. Citizen rights to representation should not be considered as absolutes as we already recognize that parents do not politically represent their minor children. It is only when our youth reach their majority that they are entitled to independent representation services. In the alternative, our leaders need to know who they represent. We need a recognition of acceptance of the United States government that we own. It is reasonable that every citizen who would be represented sign a copy of our constitutional agreement and be verified as to citizenship. Each signatory will then be recognized by government as personally entitled to a citizen's voice in our constitutional government's operation. This supports a registration where the death of a citizen is noted and removed from the list. It simplifies the constitutional requirement for a census in support of the operation of our government, setting the voting rolls so that citizens can be identified with their signatures on the Constitution. The periodic census would also include verification of citizens on the voting rolls, removing those who are no longer living and verifying transfers to and from other recording jurisdictions. This list of citizens entitled to vote would provide an initial requirement for federal jury duty and for representation through any grand jury or other gathering to exercise executive authority over government operations and personnel. Any citizens who are not on the list of constitutional signatories will be assumed to be represented as part of the larger citizenry. We, as the only party in interest, are able to establish executive management over our government. This additionally includes the purposes written into our Constitution which should be signed by each and every citizen as accepting its terms and limitations. Any such signing includes recognition of the like rights of other signing citizens. This would include authority to assign additional duties and responsibilities to public officers and to see the three functions of final review for finance, for personnel, and for matters of discipline. The management accomplishing this is not a current part of our Constitution but is most closely aligned with an expansion of the grand jury empowering it to perform the functions that are essential for executive management. Each grand jury would act as a sampling of we the people representing the larger population of those citizens who have signed our Constitution and those names on the list of the signing citizens.