All right, just a few things here before I get started with questions. It's been a minute since I've talked. Just an update of some of our injuries. Guys that we're anticipating back made good progress over the by. Jalen Dalton, Arnold Abercady, we feel good about Elijah. Hopefully, you know, see how the rest of the week goes for Elijah. We took Matt Hennessy off, so he started his clock. We'll see how that goes. So that's the good news with the health. The only one that we're still, you know, we'll have to see as the week goes is Chuma, Adoga, so we'll evaluate that the rest of the week. A lot of those guys coming off the by in a pretty good spot. So coming out the right time here for us, especially up front. In regards to, you know, roster moves, we didn't make a switch at quarterback. So Desmond Ritter will be the starter. It's a performance-based decision. Obviously, where our circumstances are. I talked last time about trying to get over the hump, some of these close games and where we try to push the offense. We feel like it's the best decision where he's at or the team's at as we prepare to go down to New Orleans. So, Simon Logan Woodside for depth of the quarterback. That move was made as Marcus goes and he's got an old chronic knee he wants to get evaluated. They have nothing to do with this decision. But he'll go, so he's not here right now. And we'll see how the rest of the week goes, but I anticipate him going to IR. With that, I'll open up questions. Well, you have to put the bat around on the decision. Move some of the rationale after you all get to go with the big move at quarterback. Yeah, well, a lot of things he led. So, and that's part of our job. It's what I get paid to do as you're evaluating, right? So really in the last month or so, you know, we've been in some of these close games where we're at in the season, where I thought we were trending. We've met a lot of progress offensively. Obviously, some things we've evolved and tried to push to in the passing game. And, you know, we're close, but, you know, we need to get over that hump. We feel also the growth from Desmond that we've seen. He's been one play away all season, but feel very comfortable where he's at right now to be able to handle the game plan to operate at full capacity. Other than, again, we would have adapted if he had to play early in the season. To feel really, really good where he's at right now. So both those things factored into it. And again, I wouldn't have made this decision. Didn't think it was in the best answers for this team. Not only short term, but probably a long term as well. So that's led to a lot of that. It's about other things there, D-Led. Sorry, on Marcus, you said it's Marcus who you're anticipating going on an IOR, and he's not going to be able to do that. I would anticipate that, yeah. And that had nothing to do with the move here, Josh. But there's, you know, a lot of athletes. Some chronic, nothing that's been an issue this season. But that's their prerogative. And so, you know, as this happens, you know, that's why we signed Logan on Saturday to make sure we have depth there. And we'll, you know, once that decision is made, then I'll update you. But he's not here right now. So, in case, you know, just give me a full transparency. But he would, if you had not made the switch, this would not have come out. He wouldn't have done it. Josh, I'm not a medical expert. Just telling you it had nothing to do with the decision. And we'll just see how the week plays out. Not the first time you've had that conversation with Marcus. How did it go? How did he take it? Yeah, well, I'm in a different role.  Obviously, it was that coordinator. So, a lot different this time around. Completely different set of circumstances. So, those are never easy for any position. Certainly, some of those high profiles, a quarterback that gets his most attention. You know, obviously, aware of that as well. But you try to be truthful.  And that's what we did and had it in person Thursday morning. In terms of making this decision, at what point did you start to think that this would possibly be the way that you go? Well, I mean, you're constantly evaluating where you're at, where your roster's we've done this at other spots. You know, we all know what big part of this league what drives a lot of ratings and outcomes is the quarterback spot. So, I mean, you're always looking at it, like I said, in the last month or so. Been in plenty of close games. Again, those are things that we need to see evolve in the passing game as we've evolved this season, like the progress we've made in the running game. Again, something that we think can benefit us. And certainly, not only in the short term, but hopefully the long term. So that's what you're evaluating. You know, our objective is to win. You know, as a rookie, he's never taken an NFL sound in our other season game. Do you have to alter maybe how much of the playbook would be available to you? I think if we had to do that early in the season, we would have. I mean, that's what you do as a coach. And you're always going to lean into the strength. You know, you're playing certainly at the quarterback spot. You know, I'm not rigid to that. But there's certainly now where he's at and the growth and improvement that we feel he's made. Not a lot right now, Michael. Otherwise, that factored into as well. If I thought that we had to restrict him, that wouldn't be the best move. That wouldn't be fair to this team. So that certainly factored into it. What all point did you start to maybe get comfortable with him being able to do it? Well, he's been one play away all year. And that's what you do. You adapt. No different. Kyle goes out and you've got to have a backup plan in your game, how you want to finish the game, how you contingency plans, how you alter that.  But then as you have more time to repair, you alter it that way as well. So you're constantly evaluating, like I said, he's been in one play away all year. He's interesting, won't he go play away the one actually going around the job immediately? Sure, I mean, you've got more time right now. I mean, where the circumstances change. Ironic, where the buy came this year late, where we're at. So a lot of that certainly accounted for why we made the decision and where I think now is the best time. So in one play away and then where he's evolved, I think he's taken a step in the last month. He told me, I guess, in October that he was still struggling to maybe getting a little nuances of getting the plays in and play book stuff. Was that part of it too, that you should need to see that with more confidence? Yeah, that's kind of what I'm not to be, sound like I'm being a smart alec here, but that's what I'm saying. Yes, so he's telling you the truth. Certainly that's what you want to see as rookies. Some guys hit walls and a lot of the goes on behind the scenes and what you have to prepare to be a quarterback and to be a backup quarterback. That's a huge job. So there's a lot that factored into it, and we've seen a lot of improvement from them, which gives you a lot more confidence. It doesn't guarantee anything on Sunday. We've got to prepare well all week. We're excited about going down to New Orleans and playing the Saints. And it's a good opportunity for us as a team. Do you have any when you were kind of going into the bi-week in layman's terms, what was Desmond's homework for the week? I imagine you talk about having that extra time. What did that look like for him? There's some things that he and I talked about and that we wanted to work on. And so that's kind of what we did in his private conversations. But he was around a week, as was I. And we're excited to see what it looks like the rest of the week. And on Sunday, it'll be a big challenge for us. Talk about playing in New Orleans. That's a pretty big deal for a lot of guys. Let alone a rookie quarterback is first NFL star. How do you kind of as the play caller, as a coach, make sure the moment doesn't get too big for Desmond? Yeah, I mean, if I thought the moment was too big for him, I wouldn't put him out there. I think that's the one that gives me a lot of confidence. Again, it doesn't guarantee anything. I mean, it's his first start. I don't know. You can make a subjective argument. One of the perfect time is if you make a move. That's kind of life. If you like to debate, those are fun debates to have. But the reality is our circumstance has changed where I feel we need to push this offense. And there's certainly a risk every time you make that. If you take a step back, but we think we've got a lot of confidence in Desmond, we're out. And again, a part of it too is where the offensive line's at. A very different situation where we're early in the year. Consistently, we've got to continue to do that, which also makes the transition easier, too. When your line's playing better, you're able to run the football. So that's also factored into it. What part of the game has taken the most out of the last month? I haven't been only physically felt good or we would have signed another guy to kind of give us a security blanket if we didn't worry about some of the physicals. But mentally, I mean, that's such a long season. I mean, like I said, you get through a season, I feel like it's like four lifetimes. So here we are in like the fourth quarter of the season. But really mentally, Zach, I do. And that's what we expect and we anticipate translating hopefully more success down in New Orleans. You told us that in the Pittsburgh game, that every position, not just the quarterback is going to be the L, we're going to the bike. What else stood out from that evaluation? Yeah, a lot of stuff. You know, we continue to make sure we got the best guys out there in the secondary and same with the inside linebacker. And obviously, we've got a lot of different guys play up front on defense. We continue to try to find the right lineup in terms of this game plan as we go through the week. We finalize that. That's also a huge factor. Who's up? Who's down? Part of the plan. Certainly we've got a lot of different wide outspots who can help the most in part of this plan as well. So those, we've been kind of running by committee anyways. So obviously the quarterbacks, the biggest change there offensively. And I'm sure you took a jumpstart on New Orleans. Did any drastically change from now, from what we saw earlier in the year? They're pretty consistent. The defense has been pretty good for a while. They've got a lot of good veterans there. You know, offensively, as they've gone through, like every team's gone through injuries. They were in a close one Monday night. They had to buy like we did. We know it's a challenge.  You guys saw, that's all watched football yesterday. And we all know that it's not to give a cliche here, but it's the truth. But certainly when you're an individual opponent, you know each other so well. Those are always big games, regardless of circumstances or record. So it's, like I said, we anticipate a great atmosphere down in New Orleans. Haven't been down there a ton, obviously last year, but we know it's lively down there. I'm sure it'll be loud. People will wake up early, I'm sure, and get their day started, like they do down in New Orleans. When you make the switches, is there any concern with the job, even though you're struggling, you're still obviously at the playoff mix, only a game out from Tampa? Is there any long-term thinking beyond this year that given Desmond four games, sort of get you a head start and see if he's the guy a lot of terms? You know, there's a lot of things that factor, your circumstance changed, right? When we wore a month ago as well. And I know the reality you're talking about, but we got to be concerned about what's more important. And I think that's lost. Like you're certainly aware, but nothing matters unless we can go down and get a win down in New Orleans. And then the rest will take care of itself. So our focus got to be in the present or present situation about going down on a road divisional game down in New Orleans, because all of this other stuff doesn't matter. We can't go down there and get a win this weekend. So in terms of long-term, you're certainly hoping that it pays off, but short-term, we'll make this move, wouldn't be fair to those guys that are in that situation and fighting all year. So a lot of things factored into it, but got confidence in Desmond. And then again, there's risk anytime you make a move, but you got to be willing to take that if you want to break through and get out of this up and down inconsistency. And like I said, we've been a lot of close games, we've made a lot of progress, but our objective is to get over at home. And if it benefits us a long-term, that's a really good thing for us. Forgive me if I missed this. Do you know when Marcus will return? I don't know, Josh. I'm just giving the information that I've got. And I was putting context of why we made the move with Logan. And then also putting context that making a move with Des had nothing to do with that. Right. But is there some value in having Marcus or the guy who's been in this system back in the building to help Des? And would you encourage him from that aspect?  But again, guys got to make decisions based on what's the best interest from, you know, that's happening. Part of the professional sports, you see it happen all over the place. And you got to have plans and contingency plans. So the contingency plan was to get Logan in here, somebody I'm very familiar with. It's been, you know, obviously in Tennessee. And if Logan's job on Sunday is to be the backup, that's what happens. I'll have a clearer picture when we talk again on Wednesday to be able to give you the, hey, this is definitely what's happened, what's not, but at least having Logan in here gives you another option. You obviously got Felipe as well, but feel more comfortable. You got to have contingency plans. But you expect Mark's back this season? I can't answer that right now. Once I, obviously if somebody goes on IR, I wouldn't anticipate them back, but until that decision has been made and finalized, now we're just talking to hypotheticals. I'm not trying to be evasive. I'm just telling the information as I have it. In terms of other guys, like Zach mentioned, that you're gonna be, are you replacing any other starters anywhere across? So the rest of the week goes. So again, a lot of it will be, how we think the game plan is, some things that we need wanna see better from certain players, and we'll give them an opportunity to show us, and as we finalize the plan, and we'll let New Orleans figure that out on Sunday.  Hide a quarterback when you guys are out there not, and we got to prepare to get Desmond ready to start. In terms of corner, did you mention cornering inside linebackers specifically? Are those the... I listened to you line, I missed an outside linebacker, pretty much the entire defense. I believe I did. I don't know if I got that specific, but I set up front. They've rotated a lot of guys. I'll check the transcripts, but... Hey, you mentioned Elijah at left guard. I mean, if and when Elijah is good to go, does he move back there? I'd anticipate that if we feel he's healthy enough, yes. Understanding that your days are pretty full. Every week, is there anything extra you can or will do with Des for prep this week? You know, it's based, every quarterback, Joshua worked with different other process. Obviously he's young, and that's been a big part of his development behind the scenes, is finding that routine, and that's real, as long as this season is, the balance, the way he prepares. So a lot of it will be, yeah, Josh will be some more things we do, but I gotta also make sure, with Des too, that he's got his week in order, and I will be new to him, right? You guys are gonna have to talk to him this week, and all that stuff factors in. Those are different time commitments, and that's a responsibility of being a starter in the National Football League. So he's gotta figure that out, and we'll certainly do everything we can to help him. Where are some of the areas where the passing game could improve under? Well, you know, obviously earlier here at D-Led, there were certain games, we didn't pick the ball up that much, but we certainly have, and recently, as you continue to evolve, because you gotta improve, like I said, I've been pleased with the progress we've had in the run game, it's been pretty consistent. It doesn't mean anything. For Sunday, we gotta go down and play well, prepare against a good front, but again, some of those are private conversations, but we need more production, things that we've tried to do, and it's not putting all the blame on him, but there's certain things we wanna see, and we feel Desmond's got a chance to provide that at Spark D-Led. After the Steelers game, everybody seemed to still have Marcus's back in the locker room, guys that we heard from. What does Desmond have to do to kind of win those guys over to you? What characteristics does he have that you believe he can do that? Sure, I mean, look, I've got a thankful for everything Marcus has done for us, right, this year, other than really the Cincinnati game, and we've just been a grind, and again, we are, and the fact that we are five and eight, right, regardless of what's around us, doesn't matter, and we need to get over that hump, and that's what I said before, you know, we gotta find ways to get back on the winning track. You know, really the challenge for Desmond is you gotta go earn the respect, you know, just because the name of Starter doesn't also mean he can come in here like he's the new sheriff in town, and he's a rookie, and he's gotta, you know, prove that he can be successful and believe he will. So, but he's gotta do it his own way, and it's gonna organically happen. I think to go in there and just be himself, and everybody's got their own way, doesn't need to be anybody but himself, but I think once he finds success, he can lean into it a little bit more. That's all we're gonna ask him. Good, thank you.


If you had to help an agent out there that's struggling there, they're not where they want to be yet And maybe maybe they're new but they're like man, I'm I may quit. I'm thinking about it. Like I'm not making any money What advice would you give them? We get a lot of YouTube comments You'd have to find out and identify number one you got to be honest with yourself Because if you're not being successful, it's either something you're missing personally or something you're missing in the support system It's not you because I firmly believe I could take anybody and I mean anybody for the most part unless you're a mean person Or you have no integrity extremely lazy or extremely lazy But most people I could take that want to succeed and I could teach you how to do this You might not it might not happen in two years, right? I would say the average person reaches success by year three or four where they're truly Comfortable at that point and they don't really feel like they need a whole bunch of support necessarily I think it's about a three or four year learning curve I believe for people that work with me or someone like me or have a system like that You can shorten that learning curve to 18 months or less Six months with the right person If you have the right mentality you have the right ingredients you have the right leadership to guy What you need is a track the reason I was able to do what I did was I got a Head start on everybody because I spent a long time running an FMO agency as the sales director As a recruiter it I went through every job went through status person. I ran quotes. I was a life guy I was the under 65 guy for a while and then I spent a long time as the major support for a lot of agents on Medicare Medicare advantage I had to put together programs on how to teach somebody how to sell the stuff And I'd never saw that before I never been in the field and so You have to have training you have to have support and number one if you're relying on other people for That's your first mistake. So I Took responsibility to train myself when it was a Friday. I remember like it was yesterday My best friend was the Medicare guy at our agency. I was the under 65 and life guy That friend of mine upset a person in the office and got himself fired So at 3 p.m. On a Friday my boss came in and said you're the new Medicare expert You know everything there is to know about Medicare by Monday. Whoo. And so I went home And I studied Medicare Like it was my job because that was my new job. I had to have all the answers to every question someone could ask me And so was I able to do it? I mean I would give myself a B on knowledge after that weekend I went from I have no nothing to her.  They're gonna. Oh, I forgot about that medication. I forgot about this I forgot about that and you've got to have a plan in place to how do I fix it? How do I overcome it? How do you overcome someone who cancels their policy? That's a question. I asked a lot of people then what people don't know what to do Well, it's gone now. I don't ever let it go that easy. Yeah You fight Not necessarily fight. I don't think fights right word. I I Re-educate because nine out of ten times when someone changes their plan after I've helped them it's because Somebody has uneducated them or told them something different or they saw a commercial or something something happened It's I'm gonna my first and yeah do a compliant Lee. That's a nugget. So I'll send a letter Just basically I don't know what happened being honest again You just got to communicate with the client hope they reach out back. I would say half the clients I lose I went up getting back to the next AEP with that tactic So, yeah, you want to have a plan you want to have support Yeah, you try most people just let let them leave you try to do your best to keep it I didn't always so for a long long time since I'm so hyper competitive if I lost a client I'd be like pissed off To the point where I would like think about sending them like a like a photocopy of me flipping them off I've thought about crazy stuff I've gone down weird roads and different things. Yeah, but in reality Once you come to terms with it's not you that's right. Sometimes it's misassociated You get misassociated as you are the insurance company. I Used to get mad at that but after a little bit of self-analyzation. I realized it's my fault. It's not their fault I didn't do a good enough job of explaining to them exactly my affiliation and creating the barrier that I am not the insurance company I work with the insurance company to work for you And so once I've gotten that digested now moving forward. I have a lot less I don't really have a lot of rapid disarmments. I don't have a lot of leakage. I don't lose clients to other people Very often. I can't say I never do Most most of the clients I lose unfortunately is to death Which to me is the only acceptable. Yeah, that's that one's out of your control. I think mm-hmm I hope so What how important is that the pipeline the marketing piece always? If you take if you take one day off One thing for me with my pipeline works if I take one day off or two days off like yesterday and today It's gonna take me three weeks to catch back up To get everything back to where it was Half of the pipeline is organization and so if you take your eye off the ball It's just like a batting if anyone who's played softball or baseball if you closed your eyes during the pitch For even a millisecond You lost the ball. You're gonna strike out every time you have to get lucky to hit at that point Yes, and so that's the same analogy. I can give you to the business pipeline is Your level of business is determined by your pipeline your pipeline is determined is determined by the work You did six months ago eight months ago two years ago I I just got a call before we came in here from a client From a friend who went to a meeting I did three years ago So they got my car from someone else from a meeting I did three years ago And so that's the kind of trickle down you can get If you're doing the pipeline thing at all times and so for me at this point I Theoretically I think I wouldn't hit my goals, but I could easily survive off of referrals only I could only work referrals If I wanted to most agents, that's their goal The problem with that goal is with any referral source. It's always finite There's always an end to that thing somehow some way the person is gonna retire The at the financial advisor you're getting referrals from the docker's office is gonna hire a new person Something's gonna happen and you're gonna lose that referral source. And so for me, I'm always still working leads I'm always still generating leads Why because if if if something hits the fan and I have to now rely on leads again Yeah, I don't want to be bust and rust off. I don't want to be reformulating how to work the leads I want to be dialed in ready to where I could just start back over and re rebuild it right back up So yeah, work in the leads work in the system Working you I think those are the three things working. How many points do you run a week? 30 to 50 Non a AP time During a AP more than that More than that. That's 30 to 50 appointments a week What would you say the key to doing that is if someone wants to ramp up to that level and maybe they don't maybe that's Secrets on death. Maybe they don't even work out hard. You know, you've got to have a way to do that So I have referrals. I have leads. I have leads from carriers leave out other the opportunities the opportunities from up lines this is There's a lot of different stuff that you can do I say it's up to you I did I choose how hard I work you choose how hard you work you choose how hard you work You choose how are you work? That's right? And so it it's really up to you there opportunities there whatever state you're in there's thousands of months that turn 65 I don't care which one it is. Sometimes it might even be hundreds a day. Yeah in your area What do you think about the person that complains about their area being the reason that they're not successful? I I've driven a thousand miles in a day for appointments I heard that recently someone's like I can't do seminars in my area. So I just can't do them Well, you can't you can move You could get in your car and drive two hours to the next town you could That's an excuse to do virtual ones you can do whatever you want. Yeah, you make two two choice You either make action and you make excuses. I love that you pick So I would I would say There's opportunity it might not be in your backyard, but I don't live next to the I live in Colorado And I don't live I live 90 miles away from Denver I'm living in the middle of nowhere in a town of 12,000 people 12,000 people so trust me when I say it's not my area that I'm working Yeah, it's not there's like 40 a month that turned 65 in my county even if I got them all That's not enough for me. It's 40 a month times 12 is That's less than 500 that's my AEP goal last year And so that's not enough. Hey if you enjoyed this I got another one. You're gonna love it's right there Click on it see in there.  I'm telling you like he just From like a relationship standpoint personality standpoint, you're one the easiest person


I Had no idea that they were gonna do that That's a hot mug guys. Hey guys This is my review for the season finale of season 3 of supernatural Episode 16 no rest for the wicked. This is a good season finale Admittedly in my last review of said it was great and there are a lot of moments that are great There's just one part that does kind of demitigate it a little bit But otherwise though, this is still a phenomenal episode. So let's get into it This is the climax of the season This is the climax of Dean's arc before going to hell. We went through the stages of denial We went through the stages of maybes We went through the stages of regret and sorrow and now we're at the point where we can't have any more Delays there's no time left It is now or never the brothers try to come up with a plan in terms of how to take down Lilith who holds Dean's contract Which might help him survive the hellhounds all the while they are still arguing back and forth about what they are going to do What is their plan to use Ruby to use Sam's powers? What is the level they're willing to go to to try and save Dean's life all the while Dean is going back and forth between all Seven emotions and everything. He's at that point where he's counting every second Before a foregone conclusion in his mind, and I love the fear. I love Jensen's acting in this episode his voice even sounds different He is a higher inflection because he's really really Perpetuating that fear that Dean has and Sam is showing that desperation that he has Bobby's in this episode kind of And he's a good assistant to the episode. However, there the part that does kind of For me is just the back-and-forth dialogue between Sam Dean and Ruby I feel like at this point we've had this conversation six times which essentially we have and they're just kind of Reiterating the same things that we already know. It's almost like it's a recap for a recap Just drags the episode a little bit because we're really wanting them to get there We know time is desperate. So this conversation just feels like it's just draining time Not just in terms of our attention or the episode length your hyper anxiety is going through the roof right now And they're having the same conversation again, which again Perpetuating the fear, but I feel that maybe maybe Kripke could have Just touched up the dialogue a little bit. You can tell that this is a Kripke written episode It's just funny to see it's very obvious to see when his themes his writing style when it's his pen That's writing what the characters say because it's very reminiscent of the first season It's not a bad thing But there are some times where I kind of wish maybe he would had assistants or at least someone would run through it Just to kind of update a little bit with how the characters have evolved But then they get on the road They come across a cop who then Dean is able to exploit the power that he has a temporal power of being able to see demons For what they really are even when they're in humans and they go to Lillis house, which has Had a very interesting little girl over I love this aspect of this girl being a complete omen of terror and The family just being absolutely terrified of this little girl where she ripped apart her dog And she's covered in blood and she's all like hi daddy. Hi mommy I thought that was really well done. I love it how grandpa just I think that the girl did an exceptional job She creeped the absolute crap out of you and she also leads that very Moment where samuel was kills her almost kills a child, which is kind of Again at the point of I kind of wonder why sam's holding the knife and not dean because dean's the one who's able to You know say who's who but I did love the game of cat and mouse the Real show of the brother's skill of how to take down the demons before they get into the house And then once they get in once the bell tolls, that's when shit got real I remember sitting at home watching this episode as it aired with my dad and we both Were sitting there going how is he gonna get out of this the whole time as we were watching this whole season We're thinking they're not actually gonna kill them They're not gonna do that He's gonna get out of this somehow and then it turns out that ruby's actually lilith and then she opens up the door And dean gets ripped apart This was the best display of squibs and cg gore and just practical effects of the show has done in a long time It's one of the best if not the best rip that they ever did in the show.    That part has never left my mind.  And then it was confirmed when it came back I love how this season ends because it did Infinity war but for infinity war did we were left with a season break going What is dean gonna do how is sam gonna bring him back? And then the very first thing we saw in season four is dean climbing out of a hole So it kind of lessened the weight of it But that has nothing to say in comparison to what the show has done now to the whole premise of death And the absolute not threat that it is now. I love this season finale It's one of my favorite season finales in the entire show's history It's not as great as swan song in my opinion And I think devil's trap is still just a bit more concise in terms of how this episode is structured Because like I said the beginning of the episode just takes a little bit of time to get the tracks rolling But once it does it it does it well But it just feels like there's a little bit of fat that could have been trimmed off at the beginning A little bit more of a we working with a dialogue just to kind of update it and Make it seem a little bit less Carborty more fluid. I would say otherwise though. I love how this season ends I love all the questions that is left for you until season four eventually came around How is dean gonna get out of hell? What is sam gonna do? What happened to ruby? I was always kind of wondering if bobby got away too, but in the end I'm gonna give Season three episode 16 A six out of seven Just just shy of a seven just shy of a seven, but it's still a fantastic season now Now I get to read off what you guys have said about this episode So let's see what you had to say Holy jeez there's a lot of them from you guys First one no risk for the wicked is a masterpiece the visual effects and practical effects still hold up The drama still has me emotionally invested in the acting for everyone involved is really well done Lilith is absolutely terrifying wearing an animal blood same dress I love how sarah gamble describes dean's hell scene in my mind that isn't even necessarily hell itself It's the starting place. I like to think of dean as sitting in the chair in the waiting room to hell It's not even what he's going to experience once he gets into the first chamber That's just where they stick you before they hand you the sign-in sheet There's so much worse to come for him I remember seeing this finale live growing up and hoping the show was renewed by and by absolute miracle supernatural transition from the wb channel to the Cw channel the image of dean strung up on meat hooks calling out for help and his brother has never left me the same I actually can agree with that in terms of just like a fantastic finale I do like the joke that krally made hell a never-ending queue line later on in the show But yes, this perpetuated hell is the absolute hellscape that it actually should be And I didn't know this was the time when they switched over but it makes sense No rest for the wicked aka supernatural scariest season finale ever so shocking so violent I love the creepy kid horror going on in here Although that terrifying lilith plot about torturing the family should Should maybe be a standalone episode I feel like we could have got more from that if it wasn't a frequent season finale But overall it's great and it ends with a bang with dean's gruesome fate Too bad season four ruins this big shock right in the opening scene by bringing him back right away Yeah, like I said in my review it kind of demitigates that whole thing Maybe dean should have gone to hell for a little while in season four just to make us think that they actually was that it Actually was the end for him make us suffer a little bit more until he finally comes back to life in a mid-season episode or something Would have been better. Don't you agree the tension and the feel of losing dean could have haunted us a little more I think would have been more frightening emotional. Um, I can see both sides to that argument I understand why they brought him back right away because it does play into the whole prophecy idea And we are starting to see the end of the world happen Maybe an episode or two, but I think we get enough of the Uh, kind of the mystery of hell when he talks about it in very fleeting conversations. Also Let's be honest. They wouldn't have had the budget to do it properly They would just made it look corny kind of like how they Didn't ladder seasons like how this one starts There's no way they could have perpetuated that for episodes and episodes like that a vfx shot at the end of this episode This finale must have cost a bit for the show No rest for the wicked amazing final scenes in this episode after having cleverly gotten the demon knife from ruby And made their way to where Lilith was I thought for sure They were going to manage to save dean and then the bottom falls out when the clock strikes 12 Terrific acting from both Jensen and Jared as dean gives some final parting words of encouragement to sam Then sam's devastating tears at the end But then kripke has to twist the knife and show a final scene of dean strung up in hell screaming for sam Good practical and vfx effects really make the scene heart-wrenching and made for a truly miserable hiatus Just thinking about dean hanging there in hell That was one if not the one of the toughest hiatus is for me the show again showing no fear and taking things where the most shows Fear to go. I guess I was naive in this episode and I think you said you were expecting you expected that ending Yeah, no, I was not expecting them to kill dean. I I was pleasantly but terribly horribly surprised Dean screaming sam when he's in hell always gets me. Yep. Nope Does no rest for the wicked is usually in my top three favorite season finales of the show I love how they actually killed dean in the last episode and they didn't do some stupid cop out Even though he came back in one episode It also has a really great scene where sam and dean are singing in the car It is a little cheesy, but I still loved it because it adds more tension and weight to dean dying It is a really good saying actually my dad and I think that it is one of the best scenes of the episode And I'm surprised I didn't talk about it in the review Also dean being killed by the hellhounds is brutal and I loved it one thing that Confuses me is that this device that was used to track down lilyth, but they never use it again Not a problem with this episode, but it's a little nitpick for the whole series. Yeah You know, it's funny that I've been making jokes about how dab always has mcguffin spells and whatnot But you can see that they had these things slowly start to appear at the beginning of the show Like in its earlier stages the mcguffins aren't as obvious as they are now, but they were still there The finale is still really good I think dean being ripped apart as a bloodiest the show has ever gotten at least I think And then the cliffhanger of dean being in hell is both great and exciting leading into the next series The theories I had on how he's going to get out are how to survive being in hell for the first half of season four at the time But man was I wrong all explained in the first episode next season sadly It was probably due to budgetary reasons and the balls to actually kill dean I thought they wouldn't do it and find a way out, but nope. I was wrong with there as well Also, I did not know that the fangirl was being bothered by the female characters because they Would get close to the boys like what just thinking about that makes me lose my goddamn brain cells I guess that's extreme fandom. Yep. No, that's That's what the fan base is now No rest of the wicked is one of the best finales of the series I always thought of this finale not just as a season ender But as a end for the original setup of the series after this point sam and dean's relationship Is not the same for a very long time dean as a character is a lot heavier in emotional baggage Realistically the fight is no longer humans Versus monsters, but now we'll expand into a cosmic battle with the angels demons god and the devil The series going forward is the same in this in many respects, but also very different in key areas Yeah, that's kind of like harry potter really like after the fourth book everything changed right and Same thing happens for supernatural. I can't believe I just made a harry potter and supernatural comparison And there we go. Thank you guys once again for giving me your comments And thank you guys once again for joining me on this journey We are finished season three and we finished it before season 15 game back. That was my goal That was it. That was my primary goal There's no way I'll finish season four in time if we finish that before season 15 ends That will be a miracle in itself in the meantime. We're going to be doing what we did last time again Which is talking about the seasons. I'm going to be reviewing season three in its entirety So make sure to give your guys as your little summaries of what you thought about season three Depending on how many you do I might do a separate video for that And then I will of course be doing the best and the worst episodes of season three Really the only really one bad one in season three, but otherwise guys. Thank you once again for watching these videos with me Thank you so much. I appreciate it. Hope you guys join me for my season three review Which will be coming soon in the meantime. Hope you enjoyed this video If you did leave a like and if you're interested in more subscribe and I will see you guys next time And with any luck, we'll see you guys soon


Hi everyone, I'm Andrew Barton and today I'm really excited to share with you one of the key looks of the season. What I've already done is prepared my model's hair with the Andrew Barton Professional Styling Tools Collection and now what I want to do is share with you the step by step of exactly how you can create this gorgeous sexy look. So before we start to blow dry the hair, what we need to do is prep the hair. We're going to use a heat styling spray, we spray that liberally throughout the hair. It's lightweight, it's clean and it leaves the hair feeling very fresh and protected. Once we've applied the styling product we then comb that through to make sure that every single hair on the head has got some of that beautiful conditioning mist. And then we'll start to section the hair. And then use a section clip to securely fasten the hair in place. You can forget about all the hair on top and just concentrate on the section on the underneath. I'm going to use the round conical brush and then what we're going to do is just put the brush in on the underneath and then we'll bring the hairdryer over the top making sure the nozzle is directed down the hair and we continue that all the way to the very tips. What we've done with the Andrew Barton Professional Hair Dryer is we've created a much wider nozzle. This makes it much easier for you when you're blow drying your hair. So with the first section blow dried it's important at this time to keep that body and volume in the hair. So instead of just releasing the hair and hanging it down, instead the easiest thing for you to do is to coil the hair up into a little roll and then pop in a little section clip on the underneath and that will retain the body and volume that you've put in the hair. So I'm going to do the same thing now onto this next section and then we'll move up the head. Each section we make sure to keep the clip in there to ensure that body and volume is retained. You see you just get that lovely little kick at the ends of the hair which is bang on trend this season. It's this prep, taking care in the prep to work through section after section which will give you a longer lasting blow dry and a much, much better effect. All that's left to do is the top section.  But one key tip, whenever you blow drying smooth hair and you want to get volume and lift don't put a parting into your hair. Instead blow dry the sections back away from the forehead and that's going to give it that extra root lift and volume and volume. Finally just give the hair a little spritz of hairspray. That just helps to set the hair. Use something lightweight. And then what you're going to do is just start to take the pins out. We're then going to loosen it with the fingers first. Just give the hair a loose little shake. Gosh, it's looking gorgeous already. And then using a cushion brush we're just going to start by smoothing the hair through. Just brush it back away from the face and then gently get to the ends of the hair and brush those tips and ends through as well. Use a little bit more hairspray around the hairline and then depending on where you want to part the hair you can put a middle pattern in or you could just simply brush the hair back away from the head. So you've seen now how easy it is to create one of the key looks of the season and you've got to agree, gorgeous, glamorous, sexy hair you're going to feel your absolute best.


It may not be the drink, but that's a bloody good tea. Hey guys, continuing my retro review of Supernatural episodes, we are on to Bloody Mary, and I don't know if I'm a little weirded out here, but this episode is near perfect. Now, it might be just because the idea of the brothers talking to each other about what is actually going on between the two is so rare, distant, and non-existent in the show now? That might be why I'm liking this episode as much as I am right now, but let me go through it. Bloody Mary is obviously their take on the urban legend, and it has a really cool twist to the idea, because at the beginning of the show, there is these girls who are playing around when they say Bloody Mary, but in the end, the girl who said it, her father's eyes are liquefied, and there's a huge pool of blood in the room. The brothers come to the town, and as the episode progresses, other people start to die, but it's not just people who say it, it's people who are around that are saying it. It turns out it was a woman who was having an affair with a married man, and she was killed before she could actually reveal what was going on. She talked about it in a journal, and somehow through her grief and being killed the way she is, she's locked to this mirror, and she starts to take vengeance on people who have dark secrets and are possibly related to someone dying, and that is activated whenever someone, or they, or someone they know near them say Bloody Mary. Now, reason why I like this episode so much is that the brothers are talking about an issue, and that is Sam's nightmares and his guilt. That is what this episode is mainly focused on. We see that they're trying to figure out, going through all the research and everything of who Bloody Mary was. That was cool. There's even this really cool cop who they had who was there for like two minutes. I actually liked the actor, but it's mainly about Sam's guilt with Jessica. And the whole time we're kind of wondering, why is that being repeated so much in this episode? And it turns out that he uses himself, his own guilt, against Bloody Mary to call her out and to try and oust her, because this is a first prelude into Sam's powers, is that we find out when he is confronted by himself, his evil self in the mirror while he's dying, that he had dreams about Jessica dying that exact same way days before it happened. And this is something that he still can't bring himself to tell Dean, but Dean is mad that Sam is having nightmares that he's calling out her name and he says, you gotta talk about this, because this is just eating you up inside. And it's a part that just they're driving and he pulls off to the side and he just chastises his brother for not telling him what's going on. And this is something that the show has completely forgotten, completely how many aspects of season eight, nine, 10, and even not so much 11, but really the last four seasons excluding 11 that issues were caused by the brothers not telling each other, hell that was season four entirely.  It's a simple camera trick, but it's people seeing themselves in the mirror and all of a sudden their other self, Jessica, stone cold dead, blood starts dripping for their eyes and they start ousting them for what they did that was guilty. When Sam is being ousted by his evil self, that is one of the coolest parts of the episode. And one of my favorite shots ever in Supernatural is when Dean comes and just smashes that window, how they did that shot was really cool. This episode is also heavily inspired by rings obviously, or the ring, because how Bloody Mary comes out into the mirror afterwards, that was straight out of the ring. And then how they defeat her by using the mirror against her, that was sweet too. So the horror element, this was actually a scary episode in terms of how people are killed, the idea of seeing themselves tell themselves that they're guilty of their issue.  This is also a really well shot episode. The characterization of the two brothers is really cool. The mythos that it starts to build up with what Sam's got going on is really cool. And just I liked almost everything about this episode. The only thing I can say that I didn't like was the older daughter of the man who dies at the beginning of the episode, because she was crap to be honest. Her acting was not the best, neither was the younger daughter. And they are the only aspect that I don't like about this episode. But the thing is, they are so heavily outweighed by everything that is good about this episode. And it turns out that a few other people think this episode is scary too. Let's check out what people commented on in the last episode review. This one is from Shanice Stevenson, sorry if I said that wrong. Bloody Mary is one of, if not the scariest episode of Supernatural Ever. I remember the first time watching this when I was 10, and I got scared to go use the bathroom by myself at night with all the mirrors we had in the house. The many glasses they broke is definitely why they never seem to catch a break, and also bad decision making. I don't think an episode like Bloody Mary would be as scary as it was back in season one if everything was so freaking bright, and I miss how dark the show was. To be honest, I do too, like I said in the other episodes. There's also a meme going around. I tried to find it, but I couldn't find it. But the reason why that everything bad has happened to the Winchester brothers is because of all the mirrors they broke in this episode. Got another one from Tia Patrick here. I really like the concept of Bloody Mary and how she would kill victims who have secrets that are related to the death of others. Whether or not it was really their fault, it started establishing the fact that ghosts are these creatures who live completely in black and white, and who will go after anyone who even slightly fits the mode. It kind of reminds me of the British men of letters this season, and how they'll kill anyone who gets into their way as well. I guess that is true.  And one more from Kay Scruton. In Bloody Mary, when the mirror is smashed, Mary starts crawling out of it. My friends screamed and covered her face. I burst out laughing because I was just waiting for her reaction. Also when Sam and Dean broke into the store, they found the mirror. So why didn't they just take it somewhere with no reflective surfaces then do it there? You know what, that is actually kind of true. That is true. But it also did lead to that awesome climax. Anyways, in the end, I'm going to give this episode a 7 out of 7. This is the first perfect episode I can think of. Sure, like I said, there's the acting issue, but really, this is one of the best episodes of Supernatural. I'm amazed at how much I like it watching it now. Anyway guys, next episode is Skin. Now that is one of my favorite episodes ever of Supernatural. Please make a comment about what you liked about Skin, as well as Bloody Mary episode as well, but let me know what you liked about Skin, what scared you, what you thought was really cool, and I'll try and talk about it in the next review. Anyway guys, thank you so much for watching this series. I really hope you're enjoying it. We'll can keep going on until I have stuff to talk about. Anyways, see you guys next time.


Thank you for allowing me to speak today. So I'm going to talk about my PhD work, one part of my PhD work. It's done in joint work with Vincent Frommion from INRA and Philippe Robert from INRIA. So I'm going to talk about proteins. So first of all, I need to make a small introduction about the biological context, the biological question we want to answer to. Then I will explain how we put that into mathematics, into probabilities language, let's just say. Then the main result, mathematical result, and here if I have time, I will explain some other aspects with some simulations. So first, the biological context. So you all know that the unit of life you sell in the particular case of bacteria, their goal is to grow and divide as fast as possible. And to do so, they are using functional molecules called proteins, which basically do everything in the cell. They are bringing the energy, they are composing the world of a cell, they are used as enzymes, et cetera. And they are produced from information based on the small part of the DNA, which are the genes. So it's a big deal, the proteins are a big deal into the cell. It represents 50% of the dry mass. There are counts of three million molecules of 2000 types and in each type you can have a few dozen of molecules up to 10 to the power of five. And everything has to divide to double in size and divide in a relative short amount of time, let's just say 30 minutes for the faster. And if we think of that, bring the biologists to say that 85% of the resources of the protein are dedicated, the resources of the cell are dedicated to the protein production. So it's the main mechanism into the cell. So how do we do the cell produce protein? So it's the most classical way of presenting it. It's the one I've learned in high school. So it's in three steps. First, you have the gene regulation. The gene can be either in active state or inactive. If it is active, then it can produce the transcription, an mRNA, an intermediate molecule called a messenger RNA, mRNA. And the mRNA has a left time of few minutes until it's degraded and each mRNA can be translated into a protein. And the protein is a very long lifetime, much longer than the cell division. So in all the model we present, I would just simply say that at some point the protein just go away in one of the two daughter cells. It's just simply dilution. So the problem is that this way of producing protein is subject to high variability. Why? Because the interior of the bacteria is non-organized medium. Everything goes with random diffusion and each mechanism to produce a protein is due to random collision between molecules. So everything of that make it a stochastic process with a large availability in the protein production. And the problem is that, as I said, 85% of the resources of the protein are impacted by a large availability. So it's a huge problem for the bacteria. And some biologists came up with the idea that there might be some mechanism in order to reduce the availability for some proteins, at least for the most important one, and so, for example, they have seen that there's other ways of producing proteins like this one with a feedback. So it's basically the same thing as I've presented before. The only difference is that each protein here has a tendency to bind on its own gene and hence deactivate it. So each protein here has a tendency to bind on its own genes and it's staying here for a certain amount of time until it's released by just by thermologic agitation. And the important thing to know here is that the more protein you have here, the more so this particular type of protein you have, the more the gene will be inactive and the other way around. If you have few proteins, then the gene will tend to be more active. So it's really a feedback process. And we came up with the idea that it might be a way of reducing the viability. It's the conjecture. There is less variability with this feedback mechanism than there is in the, I will call it, the classical model. So our goal would be to put that into equations and through probabilities equation if I into mathematical models and to compare the two distribution and to see if there with a feedback model we have less viability, lower variance than in the classical model. So how to put that into equation? So modeling protein production is not new. It did back to the 70s. And all the model have basically the same assumption. It says that every event, and the contributing molecules, the allegation of molecules that is to say the production of mRNA and the production of proteins and the lifetime of the molecules, everything of that follow exponentially distributed variables, which rate depends on the current state of the model. Of the current state of the model, yes. So for example, here you have the classical model. So it can be active or inactive and the transition is an exponential time of rate lambda in one minus. And when it's inactive, when I is equals to zero, it can active again at a rate lambda in one plus. If it's active, so if I is equals to one, it can produce an mRNA. So in that case, the big M, which is the number for mRNA would be increased by one with a rate lambda two. And each mRNA has a lifetime of rate mu two. So the global rate of mRNA degradation is mu two times M. And we have exactly the same with the protein. Here, each mRNA has a tendency to produce a protein at rate lambda three. So the global rate is lambda three times M. And P would be the number of protein would be increased by one in that case. And each protein has a lifetime of mu three until it's just simply diluted. So the global rate would be mu three times P. Okay. So we have that. It's a, this model has been studied since sometimes as I said, and you can have equilibrium flow, which is the mean and the variance. Everything is the terminated. So everything is good. So we try to do the same with our feedback model. So what will change here? The only thing is here, you have to see if you have each protein that does not seem to bind on its own gene. So I would say that a protein here will bind on its own gene at a rate lambda one minus hat. I will explain what there is a hat here. So the global rate of the activation will be lambda one minus hat times the number of protein. When I put a F, it means feedback. So each time you see a F, it will be simply a feedback. So why a hat is just simply, I will compare the two models and what you have to have in mind is that the average of lambda one minus hat times PF will be in the same order of managers as this lambda one minus in order to have on the average, the same deactivation of the gene. So it's just why I put a hat. It's not the same parameter. Okay. So we tried to do the same as before. We tried to make a little more flow and there is a little problem is that when you are trying to make, to search for example, the mean, you have to compute the average, sorry, it's not a C here, it should be a F, sorry. Each time you see a C, it's a F. So you want to produce, you do know the average protein gene activity, which is the mean of I and you can find it because there's a correlation when you try to make that. So we cannot, we have no way of knowing an expression for the mean and for the more for the variance. So in order to deal with that, we introduce a scanning. We try to simplify the two models in order to have a simplified enough model in order to be able to make some comparison between the two. So it's a clean result. So we introduce a scanning, which is to say that we are going to increase the speed of some parts of the model. So here I'm just saying that the activation and deactivation of the gene will be very fast and the creation and degradation of mRNA will be very fast also compared to the protein timescale. So how do we do that? So we introduce N, which is a scaling parameter will be increased to infinity and we multiply each parameter here by N here. So as N will go to infinity, we will have activation and deactivation of the gene very fast and the creation and degradation of the mRNA very fast compared to this part, which is the creation and degradation of protein. So what will happen? So you have a state with I, M and P. I and M will be on a quick timescale compared to P. In fact, we'll have any change in P where you have a creation of a protein and instantly you are I and M will reach their nucle embryo depending on the current amount of proteins. So I'll try to put that in a little bit more mathematical words. So if you have the toe one, which is the first jump of P and X will be the current amount of proteins, what you will have is that the average, the average of the gene activity will reach instantly the equilibrium with the scaling, which is depending on the current amount of protein X. And it will be exactly the same. The average amount of mRNA will reach before any change in P, an equilibrium, which is also depending on X, the current amount of protein. And so you will have a rate of production of protein, which will directly and instantly depends on the current amount of proteins. So that would be the theorem. The process P, which is the number of proteins, converts in distribution to a birth and death process with if X is the number of proteins, the birth rate will be this one. It depends on X, the current amount of proteins, and the death rate never changes. It's always new three times the number of proteins. Here it's depending on the amount of proteins. The more proteins you have, the less the birth rate will be high and the other way around. So that it is for the feedback model. For the classical model, we can do exactly the same and it's almost the same thing. The only difference is here it's not depending on X. So if X is high or low, is very high or very low, it does not change the amount of the birth rate. How much time, okay. Okay, five minutes, I'll be a bit quick. So you have equilibrium things. The first one for the classical model is it's easy, it's just a Poisson process. It's just a Poisson random distribution, sorry. And the other one is a little bit more complicated, but we can work with it and especially we can add these results. So here it's for the classical model. Here it's for the feedback model. What is interesting here is that you have two way of producing the same protein. One is the classical model, the other one is the feedback model. If you are producing the same amount on average of proteins in these two ways, in the classical model you have a variance will be the same as the mean. And the other way with the feedback model you have a variance which is lower than the mean. So it tends to go in favor of the conjecture thing that the feedback indeed reduce the variance. So since I don't have much time, I will skip a little bit that's just trying to explain the spirit of it. We try to know, okay, you have a lower variance in case of a feedback, but there is a low, is there a lower bound, lower bound? And we could find it with the asymptotic result. I'm not explaining why, but just share. With the asymptotic result, we have the ratio between variance and mean will reach one half. So that is to say that in the feedback model, yes, you have in the scaling with the scale version of the feedback model, you have a variance lower than the mean, but it cannot reach, it can reach below half of the variance, which is not very high. If you want to look at the distribution, just like a cloche, something like that, and it will be reduced only by one other square root of two because it's the standard deviation, so it's just the square root of the variance. So it is reduced, but not that much. So we came up, yeah, this is basically what I explained here. So the reduction of the variance is limited in feedback model. But the feedback model really exists in nature, so if it's not that useful, what it is useful for the cell. So we came up with another idea very quickly. We say, okay, everything will look until now just equilibrium results. Is there something different between the two models for dynamical reasons? So here we have done some simulation. Which one is going faster to reach the equilibrium? For example, you have a cell, we have antibiotics, and the cell needs to produce the counter-antibiotics very quickly, and to produce the counter-antibiotic in a very short amount of time. Which one, which way will go faster to reach the new equilibrium? So that's the biological example. So we make a simulation, we start at a low-production process, you have to obtain a high-production average production, and you see which one is going faster. So here's the other result. Here in blue you have the feedback model, and in red you have the classical model, and indeed it's going much faster for the feedback model to reach their new equilibrium. Then the classical one is going 20% faster for this set of parameters particularly. And it's quite in an equation with biological results, where they did the real experiments, and it can be 50% faster, but we are in the same range of things. So basically is everything I have to talk, sorry, at the end I'll go a little bit quick, but maybe you will have a question about that. If you're interested, there is an article about that. For now it's only on archive, but it will be published soon. Okay. Thank you for now. Questions? So on the last part of your talk, you concluded the analysis with the simulation. Is there any analytical results? No, we tried to have a look about if there are analytical results, we could not find a way to do it easily. So we just make some simulations for that part, because equilibrium is quite relatively easy to have analytical results, but then dynamically it's a little bit harder. Any other questions? If not, thanks for knowing again. Thank you.


Hello, everyone. I'm Dr. Raj Lakshmi. I'm a final resident from MNR Medical College in Hospital, Sangarethi. My paper topic is comparison of ultrasoundography and MRI in the evaluation of rotator cuff injuries. The background and introduction, rotator cuff disease is one of the most common cause of shoulder pain. With addition of history and physical examination evaluation of the patient with shoulder pain often involves assessment of the rotator cuff with a diagnostic test such as ultrasoundography or MRI. Previously an arthrography was more commonly used but however it is a very invasive procedure. It comes with risk and discomfort and is very insensitive to partial tears, especially involving the superficial surface and the substance of the cuff. Hence the diagnosis of partial tears is important because many orthopedic surgeons will operate to relieve the impingement of the supraspinatus tendon before it progresses to full thickness there. This was possible because of MRI as it has a key role in their diagnosis. Hence it has become a gold standard for detecting both subtle and obvious internal rearrangement and as in the overall joint structures. The aims and objectives of my study was to evaluate the role of MRI in the rotator cuff injuries, the role of high-resolution ultrasoundography in the rotator cuff injuries and the correlation between the clinical and the high-resolution ultrasoundography and MRI findings. Materials and methodology, the sample size was a minimum of 40 patients. Source of data, all the patients referred to MNR Medical College Department of Radiology with the clinically suspected rotator cuff injuries were taken. An informed consent was obtained and a careful examination was done before the procedure. The inclusion criteria was all the patients with clinical suspicion of rotator cuff injuries and case of all age groups with respect to the sex. Exclusion criteria, the patient having history of claustrophobia, any metallic implants cardiac pacemaker or metallic foreign body which were the absolute contraindications of an MRI study and also patients who was unwilling. A study method, it was a cross-sectional study. The technique in equipment, it was a hospital-based imaging done with 1.5 Tesla GEMR SIGNA machine in the Department of Pediatric Diagnosis Seminar Medical College. Using a shoulder coil, the following sequences were obtained. Coronal oblique T1 weighted proton density weighted image was done, which was a fast spin sequence.  Sujaital oblique T2 weighted without fat suppression, axial T2 weighted gradient echo sequence, axial PDW without fat suppression and the field of view was 14 to 16 centimeters with slice thickness of 2 to 3 mm and a matrix of 512 into 512. Technique in equipment, for the ultrasonography, we use GE Logic QF6 machine, which was equipped with a linear probe with frequency of 6 to 12 megahertz. The patient position, it varies from institutions to institutions, however, I used a revolving stool and the patient was seated comfortably and the height of the patient's stool was adjusted to be ergonomically comfortable with the scan performance. So, according to the results, my first table shows the age distribution of the studies and we realize that about 52.5% the highest percentage where of the age group less than 40 years. Next, Table 2, it shows us the range of moments in subjects with rhetoric of injuries about 65% of the patients had a decreased range of moments. The average distribution of subjects of the 40 patients studied 26 patients were male and 14 were female. The mean age, the main age among the female was 42 plus or minus 1.98 and the mean age among the meals was 46 plus or minus 2.2 in our study of rhetoric of injuries. That's about 65% of patients with meals. Table 4 it is a patient with history of trauma. In our study about 15% of the patients had history of trauma. That is about six subjects. Next we will see the association between dominant side and the affected side in our study majority were right handed subjects about 82.5% and 17.5% were left handed subjects. The other seven left handers had rhetoric of injuries on the left side and about 80% of the right hander had injuries on the right side. The association was statistically significant. Next we see the ultrasound findings in tendon injuries. In ultrasound it is observed that 15 patients had tendon tear of the supraspinatus muscle, 12 patients had infraspinatus muscle, three patients had sub-scapularis tear and two patients had biceps tendon tear. And there was no tear in teres minor. Two patients had tendinosis of supraspinatus muscle and three patients had tendinosis of the infraspinatus muscle and one patient had tendinosis of the sub-scapularis. This is the same data expressed in percentages and graphical representation. Next we have MRI findings in tendon injuries. It was observed that 23 patients had tendon lesions of supraspinatus muscle, five patients had infraspinatus tear, three patients had sub-scapularis tear, and there was no tear in teres minor, and two patients had biceps tendon tear. Two patients had tendinosis of the supraspinatus muscle and one patient had tendinosis of the sub-scapularis muscle. This table 10 is the same MRI findings expressed in percentages and graphical representation. Next statistical measures of the ultrasonography findings in comparison with the MRI findings in tendon injuries. Ultrason findings in comparison to MRI findings show the sensitivity of the ultrasound was low in detecting the tendon injuries at all sites. High sensitivity was observed for sub-scapularis and biceps tendon injuries. Specificity was 100% at all the sites except infraspinatus which was 69%. Diagnostic accuracy was low in supraspinatus and infraspinatus tear and highest for sub-scapularis and biceps tendon injuries. The agreement between the ultrasound and MRI findings was measured by Kappa and the highest agreement was observed for sub-scapularis teres. Next we the statistical measures of ultrasound findings in comparison in detecting the peri-bicepital tendon fluid. MRI showed 12 patients positive for peritendinous fluid out of the patients whereas ultrasound showed out of 40 and ultrasound detected 9 out of those 40. And the three were non-detected and did not detect three cases. There was a significant association between ultrasound and MRI findings. MRI was better in detecting the peri-bicepital tendon fluid than ultrasonography. Next we see the association between ultrasound findings and MRI findings in detecting the peri-bicepital tendon fluid, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy where the p-value was less than 0.01 according to G-square test. There was 75% sensitivity, 100% specificity, 100% positive predictive value, 90% NPV and the diagnostic accuracy was 0.925. Next we see the association between ultrasound findings and MRI findings in detecting the sub-acromion and sub-deltoid bursal fluid. MRI showed 10 positive for bursal fluid out of 40 whereas ultrasound detected all the cases of sub-acromion and sub-deltoid bursal fluid. There was significant association between ultrasonography and MRI findings that is USG was equivalent to MRI in detecting it. Now we have a diagnostic accuracy of 1% and 100% sensitivity, specificity, positive predictive value and a negative predictive value. Next we see the association between ultrasound findings and MRI findings in detecting the joint effusion. MRI showed 23 positive for joint effusion out of 40 whereas ultrasound, USG detected 18 and did not detect joint effusion in about five cases. There was significant association between USG and MRI findings, however MRI was better. Now we see a 78% sensitivity, 100% specificity, 100% positive predictive value, 77% negative predictive value and a diagnostic accuracy of 0.875. Next we see the acromion type, majority of the type of acromion was 67.5% had type 2 acromion, 50% had type 3, 10% had type 1 and 7.5 had type 4. We also see a graphical representation of the same. Table 18 are MRI findings of a labral tear. In our study about only 12.5% had associated labral tears, that is about five subjects. Now we see a variation between the MRI diagnosis with the ultrasound diagnosis. In our study it was observed that ultrasound had 66.67% sensitivity, 100% specificity, 100% positive predictive value, 42.86% negative predictive value and a 73.33% diagnostic accuracy in diagnosing the rotatory cuff injuries. Now we see a variation between the USG and MRI was 0.44, that is fair agreement. Table 20 we have the statistical measures of the final diagnosis in comparison of ultrasonography in comparison to MRI, 100% specificity and product positive predictive value 75% sensitivity, 50% negative predictive diagnostic accuracy of 0.8. The standard reference for diagnosis was taken as MRI in our study. When USG findings were compared with MRI it was observed the diagnostic accuracy of ultrasonography was significant in comparison to MRI. The sensitivity, specificity, PVV and NPV as I already mentioned and the diagnostic accuracy was 80%. Here we have images of T2 coronal fat suppressed images where you see a full thickness tear of the supraspinate distendant at this insertion with retraction of fibers and you see a hypoechoic area in the ultrasound image which shows the site of supraspinate distendant insertion. Here we have a GRE-Axial MRI image shows an evolution here of the subcapillary standard with the dislocation of the bicep stand on and ultrasound shows full thickness tear of the subcapillary stand on. Next we have T1 coronal oblique MRI and ultrasound images of the tendinosis of the supraspinates muscle here. You can see the altered echogenicity here and the hyperintensity here. Next you see the ultrasound where a hypoechoic area on the articular surface of the supraspinate distendant near its insertion and also a hyperintensity at the articular aspect of the supraspinate distendant near its insertion. My study conclusion in our study most commonly involved tendon was supraspinates followed by subscapularis and then infraspinates with terrace minor and biceps tendon least commonly affected. And among the rotator cuff tears partial tears were about 57.5% and they were more common than a full thickness tear. Among the partial tear most common was where the articular surface tears were about 75% followed by basal tears in 10% and intrasubstant tears in 10%. The age of the patient with rotator cuff disorders range between 23 to 62 years with a mean of 45 plus or minus 2.06 years with males affected more than females. Dominant arm about 97% affected more than the non-dominant arm with all of the cases showing history of trauma with rotator cuff injuries, depicting the fact that increasing age, male gender, dominant arm and history of trauma were predisposing factors for rotator cuff tears. Patients with decreased range of movement had rotator cuff tears in about 65% of all the cases, depending the fact that decreased range of motion is a manifestation of the death. In our study, 57.5% of the patients with joint effusion and 45% of the patients with bursal fluid show tears in the cuff, tendon depicting the fact the presence of joint effusion or bursal fluid is a marker of rotator cuff tears. In our study, most common acromion type was type 2 followed by type 3 combined with 70% of these patients showing rotator cuff tears. Thus in this study, the rotator cuff tears were more common in type 2 and type 3 acromion. The rotator cuff tears were more sensitive than ultrasound protecting the peri bisapital tendon fluid, joint effusion, sub deltoid sub acromial sub curcoid bursal fluid impingement. Labral tears, acromion type and adjacent bone genus were detected only by MRI. In this study, ultrasound had a sensitivity of 75% specificity of 100% positive predictive value of 100% negative predictive value of 50% and diagnostic accuracy of 80% and a copper degree of agreement of 0.37. These results are just that the positive sonographic reading is more reliable than a negative one, and is still less reliable and detecting rotator cuff tears than MRI, which has the highest diagnostic accuracy. That is all the references for my study.


We are on kick KIC K calm We are live by the time you see this we probably won't be so just leave a like comment Subscribe turn on your post notification bells. Let's continue to grow the family from Chicago to the UK And the Germany because you know Germany's my second biggest, you know, you did lately So, you know, we got a We've got a you know, see what's got to check it out, man. If you missed the live This is where you can catch up at we do got the patreon And we also got discord. Don't forget. We got merch as well All of the links to this will be down below and I forgot to turn off the chat I should restart it, but I'm gonna just let it rock out. You know saying that was my bad.  It's crazy Come on here. I'm trying to have a peaceful entertaining Monday morning and First thing second thing first thing I see was something probably the worst thing I ever reacted to and this is the second thing Germans talking about how fat Americans are and They're not wrong So, let me just I've lived in Germany on and off since 2016 and living here has given me a very valuable outside perspective of my home country the USA and a huge takeaway for me has been that Germany is sort of the land of Moderation and the middle while the United States is the land of extremes extremely rich extremely poor extremely beautiful extremely ugly Put Ohio Oh, that's funny. I'll be on Ohio. Ohio is terrible looking.  Why they doing them like this? Beasts among the highest in the world What contrast is to Germany a western nation with a lot of societal similarities to the United States And you'd think a country that's obsessed with bread and beer would also have this problem on the same scale But Germany actually has a much lower prevalence of obesity with the rate being around 19% even when just walking around in these two countries you can notice this difference So for the past few weeks, I've taken a deep dive into why this is it's been fascinating at times No cap. I feel like Miami is a separate part of the world. I mean a separate part of America I do not if you're fat and you live in Miami.  You need to go see like Like somebody maybe you got an overactive thyroid gland or something because I don't think it's possible to be big and live here How it's hot? The moment you walk you lose three pounds you walk two steps three pounds sweat it off instantly I don't know and shocking at times. That is why So settle in and let's talk about why Americans get fat and Germans do not Americans are not winning their battle against obesity They can juggle these I was actually pretty good. You see that Okay, chill out right little subjects. Let me tell you guys a little bit about my health So many of you guys know I've been an athlete almost my entire life So my health and wellness are super important to me. I really like to take care of myself and my body I always find that I feel my best both mentally and physically When I really take care of what I put into my body that is where the sponsor of today's video comes in I understand that you got to pay these bills, but they ain't got nothing to do with me.  Physically each video So there's a few main categories that I think we need to discuss The first is lifestyle Love to walk of course there's walking and there's walking the Zontag spa see a gang of Sunday stroll has long been an established feature In the lives of many German families, but Germans are pretty famous for loving the outdoors now This is not to say that I'm that's true I had a I used to date an old pair here. First of all, I miss her and if you ever wanted to come back I'm here for you She was like she was like in shape before she moved here And then like she got out of shape but not out of shape because she was tall She's like six feet tall so out of shape to her country standard She to her and to herself and then when she went back She got back in shape like she got small again like instantly But yeah Americans don't also she like to walk a lot love outdoor activities I would actually even argue that certain American states like Colorado and the arts of my state Oregon are just If not more active than Germany, but we're talking about the countries on average as a whole Germans are much more active in the outdoors that Americans and from my perspective Germans seem to participate in physical activities that are sort of Mild in nature, and they don't really seem to Separate their life from their exercise I feel like it's all one which probably makes it way easier and doesn't feel like a daunting task People in the United States either are obsessed with fitness and working out almost in an unhealthy way or Don't work out or exercise at all. So for example with activities like walking or a mild hike or a little bike ride I ain't never heard of a mild hike.  What is that? I'm too in the city to be mild hike First of all, I couldn't even walk down the block in Chicago Let's be real Ever since I moved to Miami every chance I get to walk I walk But like cuz I I didn't have that. That was a luxury. I didn't have in Chicago But now that I'm in Miami, you know, I take it, you know Get my little steps in you know Sam I'm relaxed. No pipe on me. I'm just walking freely out here salute This seems to be very common with Germans and stats back it up 80% of German households own a bike Well only 48% of American households do now touch a little bit more on this stuff later But I think it's important just to recognize sort of the different attitudes of these activities between the two different countries So since living in Germany every time I go back to the States. I feel a little bit Sick for about a week and I always kind of joked that it's like oh my body Got used to not consuming all those American chemicals while in Germany now I'm back and my body is Dealing with those chemicals again, and I was always like kind of a joke but after Researching every now. It's not on standby.  It can't just be you know, say anywhere thing It seems like there's probably quite a bit of truth to that diet food Chemicals it's the early 20th century times are hard in the u.s. We're facing the dust bowl And eventually the great depression So during this time farmers face severe economic hardship And so the government implemented interventions to stabilize agricultural markets and support struggling farmers Including the subsidization Of corn now. This was actually supposed to just be a temporary measure, but over time We realized all of the industrial applications of corn aside from it Just being a very below average food that I never get on my chipotle It has a wide range of applications such as biofuel production animal feed and food processing Eventually lobbying groups came into play as well, which leads this to still be happening today So the situation in the u.s. Today is that corn is subsidized by the governments And it is cheap and abundant and this has led to the development and widespread use of high fructose corn syrup Yep, yep Yeah That's how I taste like uk drinks And all the uk food that i've been trying and it's like a clear difference Like it's not even it's unmeasure The uk stuff tastes way healthier than the american stuff Like literally like I had a fruit boost I know what a fruit boost is of course. I had a fruit boost from the uk And I thought it was like a diet drink. I was what's this? It ain't taste no hot fructose high corn syrup or nothing I was like, okay I'm not used to this But I imagine this is why y'all skinnier This is an artificial sweetener made of corn. That's cheaper than sugar And satisfies that american sweet tooth palette But if you saw the video where my cousin ty tried that sort of I forgot what it was called But this pastry from the german bakery, which is one of the most sugar-filled pastries You can get at a german bakery and he described it as like a diet donut and ty Actually picked out something that I've never eaten before a quark tache Okay, it tastes like a diet donut Ty says it tastes like a diet donut That just kind of shows the difference right there our american honestly, it's the same for the uk for me I feel I feel like every time I eat something. I'm eating this diet Palates are hooked on sweets, which is satisfied by this incredibly unhealthy high fructose corn syrup Which helps plump us up. So today the most subsidized crop in the usa is still corn, which is Juice water strawberry puree sugar lemon juice. Okay All right, but No high fructose corn contentment No high fructose corn syrup It's not the case in germany germany primarily subsidizes wheat Hey, it's will from bucker law. Do you know big So they'll set up will I don't know what you what you You Barley and dairy and this is possibly why whenever germans come over to the united states They always complain about the quality of american dairy products That was one of the things my girlfriend excited when she came back to germany to get good dairy again So we're drowning in the high fructose corn syrup in the usa and it's in an alarming amount of food And this is corn syrup in the usa It's in a big mac It's an ibuprofen or molten It's in an alarming amount of food and this is helping to make us fat It's also crazy when you look at a food products the exact same product the american version versus a european version And how much more sugar conversion versus Yeah This no this literally be high z for the uk as well Literally be like four ingredients and something i'd be like, how is that even possible european version and Look at this vegetable oil, sunflower Rippus seeds vegetable oil canola oil corn oil soybean oil hydrogen Why how much more sugar is in the american version and how many more chemicals are in damn Yo, my daughter eats macaroni and cheese almost every day and she loves it Oh, man. I gotta give me something else. I gotta do something different I don't even like how that looks American food is governed by the fda the food and drug administration While the eu is governed by the european food safety authority, but check this out The fda allows additives to be used in american foods until they are proven harmful Europe on the other hand will only allow certain additives in food after they have been proven to be unharmful So they don't care about our health fda is a reactive government while the european agencies are precautionary That is white Now i'm not necessarily saying that all of these chemicals and additives are making us fat and obese like high fructose corn syrup, but It is i'm gonna take the easy round out and say it is Probably not healthy and probably not helping us Another obvious major point with food is fast food culture and portion sizes The united states is a culture that values convenience and there's nothing more convenient than fast food all the major So white castle is really only a illinois thing, huh I didn't know that Your fast food companies come from the united states and it's ingrained in our culture Additionally portion sizes in the usa are comically big I didn't even realize this until I lived in germany and then came back to the states only to see how crazy they really were You know another thing is I Live in an old european town that was built for the foot not for the car And I very conveniently walked down to the grocery store to pick up these groceries something i do almost Every other day. So it's just sort of built into the lifestyle here Walked down to the grocery store. That probably gives me 2003 thousand steps every time I do it and I do this multiple times a week Something I don't do in the united states in the united states when I go to the grocery store. I'm driving there and I'm buying less healthy foods with a lot more Yummy, but bad for you chemicals And this subject of walking brings us to our next topic cities and Infrastructure, but we all know that the united states is a huge country and incredibly spaced out and more often than not You do need a car to land in the united states It's just too big and things are too far apart american cities were largely made for the car while european German cities were made more for the pedestrian and the foot. So this is the typical excuse. I like that You probably find love more often as well In germany than america since you got drive everywhere and everybody's in their own world when they're driving But when you walk and you can run into people. Oh, excuse me How are you today beautiful day outside? Isn't it? What's your number? Let's have kids. Will you marry me? You get me it goes a little something like that in america. It's like Eh, watch out. I got stuff to do The age you can drive in the u.s. Is like with a permit. I think 15 14 15 16 17 then at 18 I think you can get a license or 17 you can get a license used for why americans drive more than europeans And walk and bike way less It's because our country was built for the car and we can't do anything to help it That's just how our country set up and how it is But what if we eliminated some of these variables and found a little bit of consistency for an example I came across this really interesting set of data that took a look at stuttgart and washington dc These cities have similar economies labor markets and core populations of around 600 000 people Funny enough, these are also two cities that I have spent quite a bit of time in I went to college for four years in washington dc And I do a lot of work now in stuttgart with the stuttgart surge football team So I know both of these cities pretty well dc is also known as one of the very few american cities with good public transportation dc You know what they call dc chocolate city beautiful black women out there Shout out dc, man. I've been there one time. Had a good time I can attest to this. I actually use this in college and it's also one of the most walkable cities In the united states. So let's take a look at some of this data and how people Transport themselves throughout these respective cities 76 percent of people in washington dc own a car while only 58 percent of people in stuttgart do the percentage of all trips made by car 83 percent of americans in dc just 58 percent of germans living in stuttgart This is also interesting the percentage of trips made by walking 11 percent for people in dc Me and my daughter walk everywhere 4 percent for people in stuttgart and for cycling 1 percent of trips made by americans in dc were made by bicycle Whereas 10 percent of all trips were made by bicycle for germans living in stuttgart 10 times as much So even when walking and biking is an option like in washington dc We americans choose not to I think it's ingrained in us a little bit I would argue that's sort of low and this is what my mom wants me to get a car so bad You know what i'm saying and i'm like i don't really need a car You know that's for what i'll be trying to tell like i don't need a car Like all the only time i need a car is to take my daughter from My house to your house and that doesn't seem like it's worth it for me When you have a car and you can do that You know what i'm saying I'm cool walking Intensity mild exercise like biking and especially walking are the best ways to lose weight and lose body fats You can do a lot of it casually and it's not like jogging or running That's a bit more intense and it will possibly work up a big appetite for you So you come home and you splurge on a bunch of food after working out This is why walking is probably the best for losing body fats But we just don't do it americans refuse We hate I noticed that though Walking is walking is walking is pretty cool for me I feel like doing it walking in in florida. I've been losing a lot of little you know Little pockets of fat and things of that nature It get me Walking and a lot of it can be blamed on our cities and how our country is structured But looking at this example of dc and stuttgart and scene the differences in these statistics really opened my eyes To show that it's not just that we also have different attitudes when it comes to this stuff If people in germany do not seem to get as fat and obese as people in the united states It's a fascinating subject. I'd be interested to hear if you guys have any opinions on this if you have It's very interesting. I ain't even gonna lie It's like half of it. We kind of know though But at the same time it's still pretty interesting to hear it out loud like Like damn we fight a sale in america. That's crazy Tlo leave a like comment subscribe turn on post notification bells. I'm gone


Well, I'll tell you, it's pretty scary, but you also realize that there's nothing you can do at that point. It's going to do whatever it's going to do, and you've built as much as you can, you've done as well as you can, and it's whatever you have done, now you're going to find out what it does. So it's scary, but it's also a relief when it goes and works.