 This is Twis. This Week in Science episode number 576 recorded on Wednesday, July 20, 2016. Just call it a Twis Hole. Hey everyone, I am Dr. Kiki and tonight on This Week in Science we are going to fill your heads with ketamine, new areas and smart ducks. But first... Disclaimer, disclaimer, disclaimer. A cat is a cat and a fact is a fact. A cure is a cure and a lie is a lie. But how can you tell a cat from a cure and a lie from a fact? Truth can be a tricky thing and many will tell you it is often relative. But the truth is most definitely completely the truth when it comes to science. And it is our job, each and every one of us, to find it. Because when variables are isolated, tested and tried, control groups are monitored and results are replicated. Truth can be defined. We are here tonight to discuss new truths discovered through tried and true methods and unequivocally a part of This Week in Science coming up next. The kind of mind that can't get enough. I want to learn everything. Stories that happen every day. The one place to go to find the knowledge I seek. I want to know what's happening. What's happening. What's happening. This Week in Science. What's happening. This Week in Science. Good science everyone and welcome once again to another episode of This Week in Science. Tonight we are lacking a Justin, but we are joined by our interview guest tonight, Dr. Enrique Abreu. And he's going to talk with us about the science of using ketamine for therapy for depression. This is stuff we've talked about previously on the show. And it's about time we actually got an expert in here to tell us how it all works. So Enrique will be getting you to join us on that in just a moment. I brought stories about brains, the hotness of climate change. It's getting hot in here. That's right. It is. And then other stories about, you know, zero knowledge. Zero knowledge. We'll just get to that later. Blair, what did you bring for the animal corner and other things? Oh, I brought, let's see. I have some bird brains. I have some turtle shells and some bonobos. Bonobos always make it fun. That's for sure. So without any further ado, let's just jump right into this program. I am so excited to get Enrique on the show here tonight. Dr. Abreu is a board certified anesthesiologist. And he received his medical degree from the New York College of Osteopathic Medicine in Long Island, New York. After a one-year surgical internship, he attended a three-year anesthesia residency program at Tufts Bay State Medical Center in Springfield, Massachusetts. And he's been board certified by the American Board of Anesthesiology since 2007. He holds active medical licenses in Oregon, Washington, and Hawaii and has participated in numerous overseas medical aid missions. In addition to being the medical director at the Portland Ketamine Clinic, Dr. Abreu's practice includes providing an anesthesia for numerous outpatient clinics in the greater Portland area. His services include pediatric intravenous anesthesia, sedation for adults and children. He partners with referring doctors to treat depression and chronic pain syndromes. And when he's not doctoring, you can find him kiteboarding and taking amazing photographs. You're so gracious. Thank you for having me, Dr. Abreu. I really appreciate it. And nice to meet you by the internet, at least, Blair. Yeah, of course. I'm excited to have you. Thank you, guys. Yeah, it's fantastic to get you on the show. To get started, the thing that I really, I guess the first question, not everybody knows what ketamine is. So can you tell us exactly what ketamine is and then how did you, as an anesthesiologist, come to start administering it to treat depression? Sure. Yeah, great. Yeah. So the first use of ketamine was in the 1960s. It was developed by Park Davis, a medical pharmaceutical company, to basically sedate patients. And we needed something else that wasn't just sodium thiopental, which we all know is truss serum. That's a barbiturate and it can cause nausea and it's still leaving, waking people up. It's not the greatest drug. It's no longer made. So they were coming up with something that was short acting that was intravenously administered, that was safer, that you could give in basically an enhance of a trained RN or an anesthesiologist, but that patient would not need a breathing tube during a surgery. However, they would be very sedated. They could breathe on their own, but they would not have pain, but they would be semi or unconscious, depending on the dosing for the procedure. So the first thing they developed that came out of the barn was PCP, which we know is phencycline. And as we know, it became, it made patients very aggressive. And so they went back to the drawing board and reformulated that and then they came up with ketamine. They figured out that it was way safer that people weren't aggressive after treatment with ketamine and they had a very safe anesthetic and it actually stimulated respiratory drive instead of other medications which we gave for anesthesia, which actually depressed respiratory drive, such as morphine, fentanyl, benzodiazepines like Valium and things like that. So they developed a safe anesthetic that could be given intravenously and when it went away, it went away quickly and then what would happen is the medication would be gone from the system and the patient could be discharged much quicker than if they had a general anesthetic with anesthesia gas. And so they were very successful with this and we've used ketamine now for 40 plus years in the anesthetic setting and it is the most used anesthetic in the world currently. It's used in many different countries. I've used it on many, many, many medical missions that you would say, well, you're in an operating theater where you may not have all of the things you want, the attributes in the recovery room. That's why it's a great drug to use in that setting. And so as an anesthesia resident and in training we used it a lot in developmentally-delayed adults and children and I used it a lot in my dental sedation practice here. So that was where it came from and so I was doing my dental anesthesia business for a number of years after I left the hospital work and then somebody called me one day from a dental office and he said, hey, I'm so-and-so and I got your card at this dental office and I want you to give me ketamine for my depression. At this point it was like 2012 and I had no idea what this guy was talking about. I thought that this guy's drug-seeking, people can abuse ketamine, they use it in the social setting, excuse me, recreationally. And I thought this is what he was after and I said, well, I'm not looking to lose my medical essence and this is not something that we're going to give you. And so I basically hung up on the poor guy and I just went about my day. So later that week I was visiting with a friend who was an ER doc and I spoke to him about this guy and he said, well, you know, that guy has a point. There's some data that's really good on that and you should look into it. And so this is like late 2012 and after doing some research I realized that the guy was right. There was a whole bunch of research that started in 2005 and what happened was ketamine was given to a bunch of patients initially in 2005 who had a pain syndrome called chronic regional pain syndrome, also called RSD. They recognized that the patients did well and they had good relief of their pain. However, they also noticed that they did not have any depression but only a few of them were depressed. Now nobody knew if, in fact, the patients were better from their depression because they had relief from their pain or was this another etiology? And so then the landmark study came out. A gentleman named Dr. Zarate did the groundbreaking study at National Institutes of Mental Health in Bethlehem, Maryland. And they just instituted it amongst a bunch of patients that just had plain run-of-the-mill depression and they were going to go from there. And so here you can see what they found in the study that was published in 2006 and then it was replicated. And so what you see here is the response rate is really like three quarters almost of the patients that got it in a day were significantly improved from their repressive symptoms and on the right you can see things that we normally give patients such as the ally is lithium which is one of the oldest drugs we've used in mental health for depression. The other ones, the laxifin and SSRI or other serotonin receptor inhibitors and we uptake inhibitors. And then the nortriptaline is elavil which is also a very old drug that we've used for depression but it doesn't work very well and it makes people very sedated. And so then this is the first concept came out and then people said, well that's a n equals one even though you had hundreds of 200 people however many you had in the group we don't know if that really holds water. And so then it was replicated by a number of different people and at different centers throughout the U.S. and they did a study at Mayo they did this other study DS Granados did it in 2010 and he showed that people had a rapid decrease in their suicidal ideations with a single dose of ketamine. And the thing with the Zerati article was that they also had a very quick response to the ketamine however it didn't last it lasted three to five days we didn't have enough duration in it but it was so powerful that 70 some percent of patients did well that this was worth continuing to look into and so the Zerati and the NIH and some other people have said this is the greatest breakthrough in mental health in 50 years basically and so they continued to do studies and what we figured out what they figured out was that with continued dosing you could make this last for a period of three to six weeks so many patients and so that was three to six weeks not a single dose so what happened was you would have to give it to patients like one, two, three, four, five times in a row like a few days consecutively and they would improve and they would stay well for a longer period of time so this was awesome because then you could say okay I can really keep these people well with minimal medications and minimal side effects and after this one we'll call it a loading dose of like five or six infusions close together we could keep them well for a period of three to six weeks and so I'm going to talk about that other slide in just a second but I'm going to do something else first so what is it? Ketamine is an NMDA receptor blocker and it's not to be confused with MDMA which we hear a lot about people using this is N-methyl deaspartate receptor that acts glutamate acts on so the latest theory about this is that stress has created a cascade of glutamate and the NMDA receptor channel is open and it gets bombarded with glutamate here you can see some basic schematic of what that would look like and what happens is ketamine comes in and blocks that channel and stops some of the damage that's being caused by the excess glutamate which is secreted by stress PTSD stressful episodes whether that's stress from family, job, or life in general and so the current theory is that these neuronal axons are being damaged by the glutamate and stress and PTSD and what's happening is you can think of it like tree branches so the tree branches have these limbs you have this neurotransmitter soup in here and you've had these neuronal axons endings that become blunted like you've trimmed the tree branches and so you can't re-uptake these neurotransmitters properly no epinephrine so what's happening here in this slide that Dr. Dumas has did a study that they knew that it was NMDA receptor blocker however there was something else that was making these people stay well for that many weeks and what he did is they did some rat neuronal tissue before and after and he's just scanning electron micrographs and show the blunting of the neuronal axons on the top slide and then the lower one is treatment post-ketamine and you see these basically this budding or this regrowth and this is we did not know until 2011 when this was finally published and this was kind of like the missing linking part of it so Dr. Dumas here you can see really well in the lower slide how you've got this new budding people call it neuroplasticity or also new growth like new synaptic growth like the tree branches are growing like little tiny new buds in the springtime starting to shoot off of that neuron and that's what the missing link was because the mechanism for NMDA receptor blockade okay that occurs but the drug is gone in like the half life of 36 to 48 hours but this is hanging on and as long as you give them a loading dose they're continuing to have that effect for that period of time not so great thing is it goes away you have to retreat them but you don't have to give them six treatments again you just have to give them a single booster and then they get back to baseline and then they're no longer have apathy and they no longer have a lousy mood and that kind of thing the anhedonia goes away so anhedonia is definition of when you lose the ability to enjoy things that you used to enjoy whether that's rock climbing or walking through dog or knitting or fishing but many depressed folks will tell you they don't even leave the bed they don't shower for nine days in a row and they're definitely not doing anything they used to enjoy what I find fascinating is there's also been research that suggests that SSRIs after a period of time also stimulate this kind of regrowth and so the patients that you're talking about are these are people with kind of chronic depression major chronic depression that where the SSRIs aren't working where things are not stimulating they're not getting to that point of actually stimulating the regrowth but somehow through this NMDA receptor effect they're allowing this regrowth to get started Yeah, you can think about it in a way of like the other drugs that are out there they're not going to stimulate the regrowth what they'll do is they'll put more neurotransmitters in the soup but if you don't have anything to pull it with if you don't have any tree branches for it to get attached to you can put all the soup in there you want and the more ions it's just not going to get in and so some people don't have that much damage and their depression isn't as bad and they respond to some of the things you're talking about which is SSRIs, Elville, Lithium, many other things typical antipsychotics we treat mostly patients that are really what's called MBD, major depressive disorder major depressive disorder recurrent PTSD and then bipolar 1 and 2 Yeah So this is not the kind of treatment that a psychiatrist is going to give out a prescription for just any People have talked about giving galketamine in a spray form which is a nasal spray that can be administered however it doesn't have the great efficacy so people will notice that they get very altered from it but the effect of being antidepressant may last a day or two and then they have to get really altered again to get that effect again so it's not really great the gold standard is intravenous infusions and so then we get to another issue where you've got this drug that's out but it's an anesthetic agent and anesthesiologists in the hospital setting are very used to giving it on a regular basis however psychiatrists are never going to put an IV in your arm and put you on a pump in their office and watch you on a monitor they're like there's no way they got trained to that as way outside their league and as soon as anesthesiologists go we don't take care of mental health patients normally So you've got this issue where now you have to partner you have to find partners to be able to say okay if you have patients you can send them to me and I can help them Yes and then that's something that we've struggled with for quite a while and I thought initially that there would be a lot of referrals that way however that's not happened and people really find me off the internet however we don't take self-referrals meaning you just can't call the clinic and say hey I want to come in what happens is the patients fill out an intake form and then I have to get released for them for us to be able to talk to their psych provider whether that's a counselor a therapist, a social worker, a psychologist, a psychiatrist so then I have a long conversation with that person and they're the ones that have diagnosed the patient with depression and then if I feel like okay this is the right candidate we move forward and so that's kind of the way it comes about they are self-referrals but the patients have to have an ongoing therapeutic relationship with a mental health care provider so Ketamine in the general public people know it as a horse tranquilizer people know it as a who have heard about it through the media know about it as a club drug or a drug of abuse and so are these hurdles that you are finding hard to get past in terms of talking to psychiatrists about it and getting them to start prescribing and to send patients your way is still a struggle now that there's 20 clinics in the US it's getting more media and more press in a positive way however what folks don't understand is that every drug that I use in anesthesia pretty much is also used in anesthesia for animals so it's kind of like there's more freeing for dogs and cats and pigs and everything else and it's just the same as there's fentanyl and everything else and so Ketamine is a very safe drug and it's administered as an anesthetic for animals, kids, adults for decades now but it did get a bad name that it's only used as an animal tranquilizer which is not the case it's used a lot more in humans and then there's also the route of the recreational use slash abuse of the drug and that is something that people are using recreationally in a powdered form they're insufflating it or snorting it and just so people understand basically find street Ketamine and put it in your nose and think you're going to get an antidepressant effect so that's it's not going to happen when you're talking about dosages and what you're getting if somebody does get street Ketamine like you said earlier maybe they'll get the dysphoric effect and then maybe feel a little bit better for a day but then they have to continue using it and Ketamine can be addictive versus what is the dosage that you're going to use Ketamine is not really addictive because it doesn't cause a craving so it's as addictive as marijuana is basically but the thing is that the nasal spray has a very short lasting beneficial effect and so we've basically stopped giving it to patients because it doesn't work is that because of processing through the liver and then how much actually ends up getting higher available and so we've noticed that it's just you don't get enough and if you were to get enough you'd be unconscious great so nobody's monitoring you and now you're in danger because you're not being monitored and you've got street Ketamine on board going back to the street Ketamine if you get street Ketamine obviously you can maybe buy it in any big city but what you're getting likely may or may not be Ketamine so then you've got another dangerous route there where people say well I bought this from so and so it's not small, well guess what you've got baby diarrhea medicine or you've got vitamin B12 or you've got something similar like fentanyl and then they overdose on this and so that's what's scary about street drugs of course you don't know what you're getting so in order to do it properly they come to my office they get an IV and they put on a pump and then that pump administers a very small dose so let's say I'm going to put you to sleep for anesthesia the person my size would get like 180 to 200 milligrams and they would get it pretty quickly and they'd go to sleep in the setting of antidepressant effect I would only get maybe 52 milligrams or somewhere in the 50s based on my weight and then you would get that amount over 40 minutes so really you're getting the small little bits every so many seconds and minutes and so nobody's asleep in my office nobody's unconscious they're constantly talking, they're awake with the program they become a little dissociated there's some vivid lucid dreaming going on not really hallucinations you're not going to see anything that's not there but maybe you'll see the ceiling tile looks a little bit like a polar bear instead of a ceiling tile shapes will change and things can get interesting but nobody's going to be unconscious so that's why dosing in the street recreational sense is you couldn't do it properly to get the antidepressant effects it's just very dangerous you wouldn't be able to do it someone in the chat room was asking whether or not the APA has approved the use of ketamine this use of ketamine is a treatment yet the APA came to ketamine meeting and they asked us for some recommendations this was a year ago, November and now they're they're basically going through the process of saying this is a drug that can be used safely and we acknowledge that it's being used safely in this setting and so I was part of the advisory board telling them what is the dose what would it be, what would it look like and so just trying to suggest something but their members don't want to administer it because they don't have the training to administer it so the patients would have to be referred out to somebody else there are a few psychiatrists in the country there are a few psychiatrists however they're also boarded in internal medicine or they're having anesthesiologists or a nurse come into their office and administer it under their dose and guidelines and so there are some folks that are thinking outside the box and doing that but as you can see it's this kind of like no man's land where anesthesiologists don't take care of mental health patients and psychiatrists don't deal with ketamine and so who's going to do this right now I would imagine is related to being covered by insurance because this is all has to be paid upfront by patients at this point is that right so what do you need to get insurance to start recognizing this treatment as something that should be covered yeah good question Blair so so there's something called off-label drug use which what's going on with ketamine right now we're using it for a purpose that it was never intended for however we know that it works really well and we know that the NIH has done many many trials and studies and so many other people are determined to be safe for this however the drug is a generic drug now so when it came to market a drug company has to basically send a petition to the FDA to say hey I want to use this drug for XYZ they spent a lot of money on that petition and on those studies and on those patient groups to get the drug to be approved for what's called a secondary indication right but Rogaine was originally for blood pressure then we realized it was growing guys hair back so somebody reapplied and they said okay I'm going to put this drug under patent and I'm going to continue to use it for something else and make a lot of money on it however ketamine is generic and nobody will take it back to the FDA because that would cost way too much money so nobody is going to basically have ketamine approved for this for secondary indication so what the drug companies are doing so then in that case the insurance companies will not cover it does not have an indication officially so what they're doing is a couple of companies that are developing ketamine 2.0 I call it they're trying to come up with a drug that they can patent and have exclusive rights to for seven years so that they can have a billion dollar drug and give it to patients however there's an issue there and the main thing is going to be ketamine is a home run right it's safe it can be administered in a setting where people can go home in 25 minutes and it helps 75% of the patients there's no side effects and there's no downfall to it because they recover and people aren't getting issues like kidney failure from lithium so to come up with another drug that fits all that criteria and helps 75% of patients for three to six months it's going to be hard it's not going to be easy it's on the forefront and there's drugs that are in process right now but we're probably five eight years away from anything coming to market I know that there has been some research looking into looking at exactly how ketamine is having its effect and whether or not you can get rid of the dissociative effects that go along with it can you still have the same molecular changes at the level of the NMDA receptor or at the level of the neuron without actually having the dysphoria yeah and that's something that those of us who do this clinically every day we don't think that's possible and why that is is because the patients experience a complete dissociative disconnect when they're having this procedure done so even like immediately after basically the patient says I feel like you know weight's been lifted I can you know everything's going to be okay it's kind of like the message I get from patients when they're done and so that kind of effect comes from the brain and the body being disconnected for a bit of time and then just being able to just be and not have what's called the negative ruminating thoughts that many many depressed patients suffer with on a regular basis and they take all sorts of different things like Adderall and benzodiazepines to try to quench that ongoing thought process that they have to entertain all the time and then that is basically short circuited by ketamine so by the next day the patients have a little bit of a side effect which is what I call a ketamine hangover and they may be a little sleepy they may be a little fatigued for about half the day and then they can get on with their normal day but that's really the only side effect and so for somebody who's going to consider this what kind of logistics do they need to be aware of just to we've already talked about getting the talking to the psychiatrist, getting the diagnosis getting the prescription and then finding out about your clinic but what other logistics do they need to be aware of? Sure, yeah, let me just clarify a little bit of that. So the first thing they'll do is go to our website get completely informed about the facts I have a clinic that we run here in Portland and then we have a clinic in Seattle also where we have a bunch of Canadian patients that visit us and their physician or their psychiatrist to approve this or to write any kind of prescription really they just need to have a conversation with them and say hey I'm looking into this therapy this guy's going to call you will you talk to him and then that patient would sign a release and give me permission to talk to their provider and so that's really all that has to happen and then as we get going forward there's a couple things that kind of short-circuit ketamine one is you can't be on any benzodiazepines which are things like adavam, valium, xanax chanazepam all that family of drugs will short-circuit ketamine beneficial effects and so what happens to happen is you have to be weaned off of those products and then be off of them for 14 days before we can start treatment the other one is something called lamectal which stops patients from dissociating and that's a mood-based drug that it's a mood-stabilizing drug that's used many times in depression so being clear of those two drugs those two families of drugs is very important before we start on treatment with ketamine and so when that happens we have a conversation with the patient and we schedule it for significantly right there for one second Kiki we do six infusions over a period of two weeks so we do like a Monday Wednesday Friday type schedule you have to be in the clinic for about an hour each infusion is 40 minutes and the recovery time is about 25 minutes however we used to treat patients every day and found out that it's just too hard on your body you end up having a day after day of ketamine hangover and you just won't finish the series you'll just be too pooped out and so skipping the days in between really helps patients deal with that part of it patients will need a ride to and from because you will not be able to drive until the next morning and then you should probably not eat three to four hours before because some people can get a bit nauseous however we do give them a anti-nausea medication so that doesn't happen I talked about the fatigue and then the transportation they need a ride home and then they're really just scheduled back they just go on maintenance whenever they need to be they send an email to the office three or four weeks and say ok my symptoms are starting to return where do we go from here and when can I get scheduled for a booster now people ask me another question they say well does this have cumulative effects does it stay for longer periods of time and that's not really the case here's one of our treatment rooms in Portland you can see it looks very much like a living room it's not very much looks like a clinic we have a monitor there and some IV supplies but it's a pretty simple basic setup so so we were talking about cumulative effects cumulative effects so people come to me and they're like ok I'm finally going to consider this I've had electroconvulsive therapy I've lost half my memory I've been on all these other drugs Lithium made me like have kidney problems and now they're finally coming to see me and they've been depressed for 13-20 years and they're at a low point they're not showering they're not eating properly and so we get them back to a normal state of repair they're like here and then they come here and then they get to here by the time we finish the sixth infusion and then as the month goes on it starts to fade away a little bit and then they start to have symptoms returning but what happens is they never get back to weigh the heck down here where they came in right so they get to you start here and then they get to about here and they call me and then they get a booster and then they're back up here again you know so in fact they never get as low as when they came to see us that's kind of the beneficial effect that's cumulative is that they never get as low than the first week we saw them in the clinic which is probably a result of the synaptic plasticity and the growth of the axons and the synaptic growth and as you and probably as you get more booster shots it tends to maximize that and minimize the glutamate effects so it's that first kind of that first big session several days and then you're up there and it lasts for did you say three to four weeks three to six weeks everybody's a little different I'm sure you are the longer it tends to last and there's a few other things that we do to make it last longer so we have to test some labs before we start in men it's important to take just testosterone level because that can be low in women they can have peers they have anemia that can go along with their menstrual cycle that's important to keep that higher and that would check their blood counts and then the other thing is vitamin D so a low level of vitamin D will always make you anxious and depressed so that's easy to fix and most all of our patients are in pretty large doses about six to ten thousand I use a day of vitamin D and orders to go outside right and I was going to say that's probably kind of a feedback loop because if you feel crappy and don't go outside you're not getting any vitamin D even if you were to live outside and you know you did you worked in the yard you did maintenance crew in the field every single day in this latitude you would never get enough vitamin D we're talking Pacific Northwest Seattle Portland it's much higher latitude and the amount of sunlight that you get especially as you get into fall and winter you're never going to get enough so we all can supplementation at least two to four thousand a day so those things are checked at the beginning and then we check them again like a month or two down the road to make sure they're still high and sometimes we hold off on therapy until we get vitamin D levels high enough and or testosterone specifically for men is if that's really low it's going to be really hard for them to have any kind of get up and go it's not just a sex hormone it's a drive hormone to do exercise and just to get out of bed and hold right now because we've sent them to the endocrinologist to get their testosterone levels higher and then we will treat them when those are more normal it's fascinating it really does sound like you have to become an integrative collaborator so you've gone from being just an anesthesiologist and only worrying about whether or not is somebody under enough for their pain management or for surgery whatever it is now you're having to integrate all these other aspects and with other doctors as well to really help a lot of them that part of it has changed my practice significantly and I enjoy it there's a couple of things that we talk a lot about with the patients one is the CBT the Cognitive Behavioral Therapy they still need to have treatments with their psychiatrists they find out that now they can actually get some benefit from these sessions with these psychiatrists because they have the energy to participate and show up and like do the skill set of the things that they're teaching them to do and so I get a lot of that from patients now they can actually go and they're making some headway with that relationship they were having with that person and so we make sure that that continues to happen too so that we are not just an island of ketamine and this is going to make you better and that's it like you still need to like eat right you need to have endorphin release from working out and then proper diet and sleep and so sleep can be a problem for a lot of our patients one of the things is they can put on stimulants that makes it hard to sleep or they can put on these other drugs to try to make them sleep that make them sedated throughout the next day and so we struggle with some of the sleep disorder stuff also but once we get that in check the ketamine will make it so that the remaining thoughts go away so that they're not laying in bed just like ruminating and not being able to sleep from negative energy yeah so it's really part of an entire holistic if I can make that sense exactly it's not it's totally multifactorial and my patients that do well we have a really high success rate of higher than what was in this RATE study because we're screening appropriately we're taking the patients we know we can make better and then we have patients that are they're part of the team you know I'm part of their team the psychiatrist is part of the team their family is part of the team and they're pulling for themselves and that's what makes them better is a team concept and making all these little points on the star work positively for them this has been so great I really appreciate all this information no problem just fascinating and if anybody is interested out there in learning more there are resources that come from Dr. Enrique Enbreu and others the Ketamine Advocy Network Ketamine Advocy Network.org this has been a really great resource for folks it's written by a patient there's no advertising on it none of the other clinics have any part in it it's run by a patient who lives in the Pacific Northwest who we know and it's a really nice question and answer section and it's just patients talking to each other about different doctors they visited throughout the country and there is a nice map that shows of the 20 some clinics that are out there recently there was a clinic that opened in Nevada in Las Vegas and there are a few more that are opening I teach some physicians how to do this when they come here and we have a small conference and we've also been working with the Canadian Health Service to see if they'll approve it up there and so I have a colleague who lives in Toronto and so she and I will be hopefully partnering to put a clinic in Canada if they will let us do it yeah that would be amazing yeah there's a lot of stuff on the forefront keep driving north yeah keep driving north there are still people there in the press we need another delivery method so another way of delivering the drug would also be great and so the drug companies are trying to figure out other different ways of doing that and developing a different kind of clinic also it's so inspiring and kind of exciting in a weird way I'm sure everybody knows somebody who has battled depression at some point in their life and when it comes to this ultra intense clinical depression that can often lead to thoughts of suicide to think about an alternative when these people think they've tried everything and there's no way out it's really exciting to meet it and to see this is just the beginning hopefully we'll see more clinics sprouting up all over the place and we can reach more people that way oh yeah it's going to be fascinating we've already helped a lot of people but getting the word out even being on this show it's been great because everybody knows somebody like you're saying Blair and they can tell somebody else and say hey look there's people out there that come to my clinic and they have a date on the calendar like months or a year whatever from now it's your suicide date and if they don't get better by then that's going to be it and so we're here to tell you like we need to try this before that day comes if nothing else has worked and for those interested in the Pacific Northwest region the Portland Ketamine Clinic can be found at portlandketamineclinic.com and then there's also the Seattle Ketamine Clinic which is Seattleketamineclinic.com that's correct you got it I got it I got it awesome so for any more questions direct them to the people who know these things like Dr. Enrique Embrayu thank you so much for joining us tonight on the show and sharing the information you are welcome thanks keep up the good work I love your guys show thank you so much thanks for stopping by yeah yeah thanks Dr. Piqui all the best you too have a wonderful evening see you too so for anyone out there like I said Ketamineadvisinec.org and also portlandketamineclinic.com or Seattleketamineclinic.com and if you know somebody who has not responded to other treatments for depression this could be something that they might find of interest there is scientific data there is a page on the National Institute of Mental Health Mental Health's website where the National Institute of Mental Health is very interested in learning more about how ketamine is as their headline says a new and faster in parentheses path to treating depression so fascinating stuff it was great to be able to talk with Enrique so good so good and so that will do it for us for the first half of our show because you know we still have to talk about the news this week right of course so much news there is so much news out there so stay tuned for just a few more minutes because we've got bird brains turtle shells people brains hot earth so hot so hot and I got zero knowledge coming up that's not true but it is true we'll find out what the heck that means alright so everyone stay tuned we will be right back with more this week in science you will become the most excellent specimen the power to live on and on for all days is right at your fingertips if someone plays he says that his aura will keep you alive for three easy installments of 1095 the device he uses sucks out the bad juices and here's no bad loses it simply deduces the proper percentage of vaccine brain this miracle cure there's no permanent pain alright everybody I want to say thank you so much to those of you who have been signing up to help us reach 10,000 subscribers on YouTube we are now less than 40 subscribers away 39 subscribers actually that's what we need to reach 10,000 subscribers you can help us do that if you have not yet subscribed to us on YouTube log into YouTube please just click subscribe go to youtube.com user slash this 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help us grow and be able to do more of what we love doing for you we really couldn't do this without you we thank you for your support and they were sitting in the universities like people letting them defend they were teaching and we're back you're listening to This Week in Science what news did you bring Kiki? oh I brought some I brought some kind of bad news first I'm gonna start with the bad news because then it'll just get better from there and I don't want to end on a downer note right so what news did I bring 2016 we're breaking all kinds of records yeah yeah we're breaking records right and left 2016 is the record breaking year I'm guessing a bad record yeah kind of oh no it is the first six months of 2016 according to NASA's Goddard Institute for Space Studies in New York um warmest on record since about 1880 not that bad it's also lowest extent of Arctic sea ice ever that's especially not great especially not great and we are going to be talking with NASA Goddard scientists in the month of August so we'll be able to talk with them about the sea ice extent and what NASA is doing to monitor that and what they've actually been seeing as a part of the sea ice trend and what kind of predictions they can make about that so they're studying the sea ice melt currently and they're going to be looking at the effects of rising temperatures on the Arctic ecosystems what is happening especially to the the frozen tundra which contains as we've talked before a lot of methane and could have some major effects uh down the road but anyway we look on track to continue breaking records in 2016 that 2016 will probably be the hottest year on record we'll probably have the least sea ice on record I mean even though the year is not done that's what they're predicting the thing that is potentially going to come in and put a dent in it is that we're switching from an El Nino cycle to a La Nina part of the cycle and so El Nino allowed for a lot of Pacific Ocean heating and La Nina will likely lead to Pacific Ocean cooling so these uh the El Nino La Nina cyclic oscillations change where water goes change how temperature patterns fall and have a big effect on the rising temperature in the Arctic and what happens to the sea ice so La Nina may yet end up bringing down to 2016's average but that's part of the planet too it's a global average so also for those of you that had snow out on the east coast in May or something like that again it's important to remember this is a global average so it causes weird extreme weather in different places and whereas the Pacific Ocean is going to have a La Nina it doesn't indicate what's going to happen on other bodies of water no it doesn't it doesn't they all tie in together and these effects are you know far far felt and they do affect other cyclic oscillations but yeah we don't know what a system exactly but anyway like I said we'll be talking with NASA Goddard scientists in August about their long running operation ice bridge campaign and what they're going what they've been measuring in Arctic sea ice cap and the surface and melt ponds which are like you know just ponds of melting water that they start out as puddles and they turn into ponds and what is that melt water have to do with sea ice and what happens generally and so they'll find out much more from them later this summer when they actually have more results to report but so far we're breaking records and they're not good ones something that is pretty cool that we hadn't known before is that there's been this national institute of health project called the human connectome project when you think of connectome you're like oh how humans are connected one another no nothing to do with the internet this is a project looking at how all the areas of the brain are connected actually looking at neuronal pathways and brain areas and connectivity the connectome of the brain and so researchers using MRI imaging they measured cortical architecture, activity, connectivity and topography in a group of 210 healthy participants the measures included cortex so we're looking at the cortex which is the outermost area the one with all the infoldings that we talk about the part of the brain that's supposed to make humans so smart cortex thickness myelin content is the insulation around the wires the neurons whether or not they're insulated determines how fast they can carry information whether or not you're looking at a dendrite or an axon axons are myelinated while dendrites and cell bodies are not they also looked at task and resting state functional MRI they cross validated everything all the measures cross validate each other and then they confirm them again in another independent group of another 210 healthy participants so it's not like they were like oh we're just gonna we talked about the fMRI studies that we don't the questions that have arisen about the accuracy of some fMRI studies so they weren't just resting on their laurels they used multiple measures cross reference to cross validate and multiple replications across individuals as well so this is a very well supported study and what did they find well what they found they mapped 180 distinct areas in the brain's cortex this is more than twice the number that were previously known they confirmed 83 in each hemisphere that were previously known but they identified 97 new cortical areas per hemisphere that had never been discovered before and so like when you look at stuff like you know a map of the homunculus of the brain so you know this idea of how is everything mapped out on the surface of the brain I'm going to open an image in a new tab so I can put a pretty picture out for everybody to look at but if you look at the if you look at an image of the brain at the surface of the brain there are all these different areas and most of these areas had only previously been determined through microscopy through staining and microscopy and so it's like you have stuff like Broadman's area for speech these very general areas and we've always had questions when some studies have turned up and said well we expected to have this result because it supposedly was in this particular brain area but there was a different result and so now this can potentially lend some new information to old studies that were not well understood because maybe we didn't have the finer resolution finer scale resolution for identifying brain areas this can also help us in identifying brain areas for brain surgery for for treatments for determining where strokes have taken place and what areas they're really having effects on and so okay so question so every time that we've done a story on this show where we say oh this area of the brain that that is used for this thing it turns out is also used for this thing right every time we've said that is it because we were identifying these larger spaces that are actually broken up into smaller more defined spaces and so there isn't this overlap in some of these cases where we thought the same space was doing multiple things actually it's multiple smaller spaces that are more defined there are subdivisions that we didn't know about before that things are things can be better defined exactly I can't say that I'm surprised that the brain has confused us and eluded us this far that we might have to start over on a lot of our brain mapping well it's kind of you know for I mean thinking about it I mean I used to do brain studies we'd slice up a brain and we'd stain it and basically be like okay there's an outline of an area we'll say that that area is a nucleus and all the cells in it have the same function and they all work together and that works generally well but I mean it's just very broad brush strokes right and you know of course there were ablation sort of experiments where those areas were maybe destroyed using acid or something very specifically or in humans or monkeys perhaps we looked at stroke victims or victims of some kind of brain damage that lost certain functions and so you cross correlate and you go okay yeah that kind of brain area kind of generally matches okay right there it all works and I mean it's just I'm thinking about how we've done it in the past and now we've got stuff that's much finer resolution cortical architecture they're using connectivity actually they're following myelin from one area to another that is so cool well and not to mention too isn't there a little bit of variation from individual to individual with this stuff too so that makes it even more intricate and difficult to decipher and define and categorize the brain is a tricky mistress I think absolutely the brain is very tricky but it's just fascinating and wonderful now that we're getting finer grained tools it's like when we went from trying to identify species on the basis of only morphological features on fossils that had you know fossils that have been affected by wind and weather and being in the ground and erosion for you know God knows how many years to finally being able to use genetic information to be able to highlight how species are related you know it's that kind of a jump I think that's what we're looking at that's fantastic and very exciting yeah yeah what we're gonna learn more we're gonna learn so much more about the brain it's just great just keep learning I love it let's learn more news flash Kiki likes learning about brains if you just tuned in this is this week in science and I'm Dr. Kiki and it's time for Blair's Animal Corner oh I turned that down never mind let me start that over take two take two this will be edited out okay we were just talking about brains let's talk about some more brains let's talk about duckling brains so ducklings let's talk about ducklings ducklings are pretty cool besides just being just stinking adorable ducklings are super easily imprinted so what that means is that within their first day on this planet they have to identify their parents their mom and be able to follow her around wherever she goes in order for them to survive because in this world as a baby duckling if you are not with your mom things are not gonna turn out great for you in this world yeah you're gonna get so so the imprinting process means that this animal needs to figure out what their mom is and who to follow within as little as 15 minutes after hatching and in a new study published in the journal Science ducklings were presented with a pair of objects to imprint on and they were either the same as or different from each other in either shape or color so an example would be two spheres versus a cube and a rectangle or two red objects versus a red and a blue object so basically they just need to find out the difference between the same and different so after they were imprinted on these items which the video is pretty hilarious if you're listening to the podcast if you can go into the show notes and watch the video that is linked in this news release it's really funny because there's this kind of this crane it almost looks like a mobile that you would put over a child and it rotates these two objects around the duck and that's how they imprint and eventually the duck starts to follow these objects like it is their mother then the scientists show them two new objects and they are not in any way related to the original objects that they imprinted on but they're actually shown two sets of two objects and they are either the same or different so for example two pyramids and a sphere and they would have to figure out to follow those that were the same or those that were different so if they showed them something that was the same the first time around and they imprinted on two boxes then when I show two spheres and then a sphere and a pyramid they should follow the two spheres because those are the same so they just need to know the categories same and different if you tried to get me to do this when I was just old enough to crawl I don't think I could do you Kiki? I don't know if I should have done this with my child you should have darn it yeah so these ducks can figure this out this is the amount of imprinting that we haven't really seen previously and so the really big difference between this and other animal training that we've seen is that there is no reinforcer we are not training these ducks to do anything we're just showing them this set of things they imprint on those things then you show them a new set of things they react to those things there's no reward system for anything that they're doing and so spontaneously they have this ability to imprint and make a decision based on that imprint and they can make these categorizing decisions which is phenomenal right so not having it be reward based not having it be something that has to constantly be a trainer based you don't need a clicker yeah yeah and then it's just something that happens the imprinting just happens it is a neural pathway within the brain that's there at birth that just happens yeah so the main professor on the study professor Kaselnick said it may mean that Kaselnick, thank you it may mean that relational concepts are adaptively useful or even necessary to a wider variety of animal most animals will, like the ducklings need identification mechanisms that are robust to natural variation a challenge we face now is to identify the process by which these animals brains achieve it so see it goes right back down to the brains what is allowing them to do this but I do think there is a pretty big difference between me as a one year old and this duckling as a one day old in that they are precocial young and we're altricial so they are young that can get up walk around within a day and we cannot we are little gooey flops of dependency for a while I wonder you know there are other animals that are fairly altricial so precocious so you have animals that are born like deer or other four legged mammals that just they come out and then they are walking in a couple of minutes and then they get their milk from their mother and ta-da off they go so I wonder if a lot of these animals have similar mechanisms for imprinting or if this is simply something that is very unique to birds yeah and I think that's what would be really fascinating is talking about relational concepts is this something that yeah is a bird thing or is animals that need to keep up with mom thing or is it an all animals thing there are all these different kind of layers of where this organizational ability to discern these things might live in the brain and I think that do that does kind of take you back to wanting to look at the brain and figure out where this all comes from but little ducklings much smarter than we may have thought yeah and then skilled without very skilled without any prodding yeah and then another animal that has a little more to it than we had previously thought comes from a recent discovery by an 8 year old in South Africa I love this and this is one of the earliest fossils of something that looks like a turtle turtles are kind of this weird evolutionary mystery when I was in college and I'm sure this is true for you Kiki they were a dotted line in the cladogram of life so people did not know where they fit when these shells showed up just there were animals without shells and then pop animals with shells where did they come from to turtle to turtle where did the turtle come from where the shell come from we don't know then my senior year in college they found some fossils of animals with flat rib like plastron like structures that's the bottom part of the shell but no carapace that's the top part of the shell so they found these fossils that kind of looked like a missing link bottom shell no top shell so definitely they knew that the ribs flattened out and connected and made the bottom part of the shell first this was a huge discovery I think it was maybe March of my senior year of college I love that you can like pin that down oh yeah because all of a sudden all of a sudden it was right after midterms and my professor says so there's going to be some changes on your final that's awesome and that was so exciting to me like this is science right and this new fossil that was found and is expected to be about 260 million years old shows that that original fossil that they found that had the bottom part of the shell made them think this animal is definitely aquatic and that that was a form of protection from predators that would be attacking from below makes perfect sense because turtles today use their shell for protection this new fossil found in South Africa from 260 million years ago makes it look like it has nothing to do with protection it's all about digging so large hands and spatula shaped claws and the shape of the body and the location where it was found all these things point to this shell being used to burrow into the ground to escape harsh arid environments from South Africa in that time so this the the 8 year old found this fossil that was the third in a series of fossils that had been found in that area and it was kind of the last one that put the final finishing touches on this theory to really make them feel like this was the right idea and so it's it's really it's interesting because in so many ways that kind of evolutionary jump that I was talking about the very beginning is hard to imagine because going from an animal with ribs which one of the lead researchers says ribs are really boring they're pretty much the same in all of the animals whales, snakes, dinosaurs, humans that's because they're really good at what they do ribs are really important to locomotion and to breathing and that's why they're not very different so the fact that you take this thing that helps with locomotion and breathing and make it detrimental to both of those functions so flattening and joining your ribs makes it harder to move around and harder to breathe why would an animal do that right because then you're going to limit if you're limiting oxygenation you're going to be limiting function you're going to be limiting in your limiting motion you're also limiting your ability to get away from predators exactly so it all signs point to kind of a lack of reason for this to be the winning evolutionary strategy but once you look at it in this context of it being a stable base from which it could use the large hands and specialist shape claws to dig underground it suddenly starts to make sense so this is completely rewritten the hypothetical turtle history so okay hypothetical turtle history hashtag hypothetical turtle history we have it started as burrowing for environmental protection and also probably a certain amount of protection from predators and then move to actual just protection yeah it looks that way however there still are so many turtle and tortoise species that dig that's always been something that I haven't quite understood the desert tortoise the California state reptile is a burrower they spend most of their life underground and it always seemed kind of odd to me that this animal that could just kind of stick its arms and legs in and pretend it's a rock decides to go into a burrow instead this certainly makes more sense now if that was its original plan to get out of the elements and then all of a sudden oh guess what I'm also protected plus right because if there's if mutations move in that direction to lead toward the hardening of the carapace creation of a carapace and the hardening of it and the minimization of the ribs and everything if it is going to move in that direction then there's nothing negative about it so it started it had to have started out positively for the burrowing exactly yeah and I think that does make more sense because it kind of is this middle ground you don't suddenly encase your entire body in this bony and then keratin shell that protects you and then start digging exactly there's kind of this all these middle processes where you're not actually providing yourself full protection while you're over generations and generations and generations getting a shell that that was always the part that didn't make a whole lot of sense to me either is when you have these broad ribs that are just barely poking out of your skin that's not actually protecting you very much yet so this is the perfect reason for that to start happening is because it is still providing a solid base for you to push against to dig even when it's not giving you any protection yet yeah so turtles completely rewriting history that dotted line is getting more and more solid I'm hoping that eventually one day there will be a very clear solid line in the vertebrate clado gram of where turtles go and on that day on that day Blair will celebrate I will it's a solid line they understand things you know those of you that have heard me say I love cladistics and been like I'm not really here it is yeah she loves cladistics I love cladistics and if you don't know what that word means go look it up go look it up let's see okay time for some zero knowledge everybody this is this week in science okay zero knowledge doesn't mean no knowledge we are dropping knowledge all the time on this week in science what I do want to talk about though is very interesting descriptive paper of a theoretical device that was written and published in the proceedings of the national academy of sciences related to the testing of nuclear warheads currently the testing of nuclear weapons nuclear warheads is difficult because scanning we don't really have any method to scan a warhead and determine whether or not it's been dismantled as another country might say it has been without finding out how it was built in the first place and those design secrets are secrets you know it's like the secret sauce or coca-cola the secret recipe it is every country even though we're all doing kind of the same thing every country has their secret nuclear warhead design that they don't want anybody else finding out and so those secrets are all they're very closely held close to the chest and so previous methods that kept the secrets safe were all kind of vulnerable there was cheating that was possible and so as we're trying to get through the US and Russian stockpiles and other countries as well and actually determine if we're following the strategic arms reduction treaty right we need to send inspectors out to actually look at these stockpiles and how are they going to test these instruments of war without giving up some secrets so inspectors aren't being let in well anyway this paper discusses and describes a new method that uses high energy x-ray beams to scan through the warhead so send an x-ray send an x-ray through the body suddenly you can see the hard stuff inside and see what it looks like no if bones are broken in this case no whether a warhead is dismantled or even whether it's a fake some of the x-ray photons are going to be absorbed by the nuclear materials inside the warhead and then there's a pattern that emerges and so you can figure out the geometry but the emerging beam then in this theoretical device would be directed onto what's called an encryption foil and the encryption foil can be any set of materials that the warhead's owner knows but the inspector does not and so then the x-rays the x-ray photons pass through and hit it in such a way to emit gamma rays and the gamma rays can then be picked up by a gamma ray detector that the inspector has so the inspector will then be able to kind of get a signature of the composition of the warhead and it's general layout but without actually giving up specific designs and so there have been many other tests and methods proposed over the years and this is one that may not be open to deception that if it were done or implemented in the right we way maybe everybody would be happy with it inspectors the countries that have nuclear warheads that they are holding onto even though we're supposed to be reducing the number of warheads in our world but we'll see so they just need to they basically need to test this method they need to get warheads they need to design it and test it and see if a country with nuclear warheads will let them test the warheads to see if it actually works to do some confirmation validation of the technique but part of the problem I think all of it even if they do test it and get it to work is whether or not countries will allow inspectors to use the technique and trust it in the first place so there's politics and diplomacy that may be in the way what we really need is some sort of instrument that can be mounted on a satellite and then you can just scan the whole planet and then you can just have a map of where every single nuclear weapon is on the entire planet and know exactly which ones are active and which ones are inactive exactly there we go there you go science take it do it there's my idea can we just make this easy come on let's just make this easy please yeah so I think it would be a really great zero-knowledge device that did a zero-knowledge overhead verification no this is a great step in the right direction yeah what yeah let's see if it gets let's see if it goes anywhere from here what are your last stories Blair oh so I have an exciting kind of sequel to the bonobo story that I had either last week or the week before I had talked about how bonobo societies are very calm and it might have something to do with the fact that they are female lead well a recent study out of a Japanese university looked at it was the it was Kyoto University they looked at bonobos at Wamba Democratic Republic of the Congo and they found that dominant females protected younger females from male bullies no matter what their relationship to those younger females was so whether they were related whether they were friendly whether they had lived there for very long the females the dominant females pretty much always teamed up with other females to protect those younger females that were lower on the totem from those males these dominant females help keep the peace in their bonobo societies so that also definitely has a influence on the reason that bonobo societies are much less violent than chimpanzee societies what's interesting is that actually in bonobos which I guess I didn't realize it's usually the females that disperse after they reach sexual maturity and so in like chimpanzees and others it's the males right exactly and so usually all the females are related in all those other types of animal societies but in the bonobo groups it's always the females that are unrelated so it's it's kind of a one-two where the females because they don't know anybody when they're younger and they join a new group they don't they're kind of on on shaky ground they're low down on the totem but the older females that are procreating have a clear benefit besides just keeping the peace to keeping new younger females around and safe because they're the perfect females to pair with their sons. Awesome. I don't know if we should necessarily take that particular bit of insight from this study as humans but I'm thinking that you know in terms of populations of individuals where historically there have not been female mentors maybe if female mentors could band together to bring in younger females and actually mentor them and not view them as competition that maybe then females could do better in certain institutions like technology, science and others that have not been female even not even not female dominated but not even had close to equal numbers of women represented through the years. What a great takeaway I completely agree it's one of those good reminders to build each other up as women as opposed to compete or try to break each other down when there are new people in your circles whether they be social or working or any of those things work together take a lesson from the bonobos take a lesson from the bonobos always in so many ways and then my very last story which really just comes down to a couple of sentences here is that birds are more aggressive in suburban landscapes than in country landscapes so when it comes down to city bird versus country bird the city bird is more angry you could say you know I had to do it and it could be because there are more resources in less space and it is something that's worth looking at and Kiki Sanford neurophysiologist says this finding supports past research showing that urban birds are more aggressive in defending their territories we need to understand widespread behavioral differences between various species of urban and rural bird populations to get an idea of how urbanization will affect their survival and diversity in the future so it's definitely something that we could look at in many different bird species but it proves something that I think we've looked at in many different species before as well birds and other types of animals that when you put humans in the equation especially urban landscapes where you have higher concentrations of people higher concentrations of resources it changes dynamics in those species yeah it absolutely it absolutely does I think I thought it was fascinating when I found out about this study the work is done by a previous lab colleague of mine from when I was at UC Davis Kendra Sewell her lab and her her was it postdoc postdoc Scott Davies who did the work on this I thought it was just fascinating that we've known that there are differences in the behaviors of urban and rural birds where urban and rural birds have different calls they sound different but that they're actually more aggressive in cities is fascinating and it's not because they've got higher testosterone levels or they don't have higher cortisol levels either it's not they're not more stressed out they're not more you know just they don't have that male aggressive hormone going on either it actually does seem to be there's more food around and so it's fascinating that it's like you would think in the country where there's less food that birds would be more territorial of places where food is but that's not the case in the city more aggressively defending this abundance which is fascinating yeah and of course I can't help but anthropomorphize this a little bit and think about the stereotypes of city life versus country life for humans and it kind of fits this exact stereotype think about someone walking down the street in Manhattan and then think about someone and super country Louisiana on a front porch just hanging out yeah well it's like you go to you go to Manhattan and walk down the sidewalk and if you are walking slowly you'll get bumped into people will rudely walk past you elbows hitting you people are going places in the city they're not like they're not out for a stroll they're going places whereas like in other more rural areas maybe you are going for a stroll maybe you're just actually sitting on your front porch on your porch swing absolutely yeah so I couldn't help but anthropomorphize it a little bit but it would be interesting I don't think it would be a huge leap to see if the same factors affect humans and these individual animals because there certainly are more resources but less space in cities for humans as well yeah more resources and less space yeah fascinating something to think about I gotta keep what I got gotta defend it what do you got I have I'm gonna call it I'm gonna call it the end of the show I am I think we've done it all right yeah I think we've I think I'm calling this the end and we certainly did a lot of science we did a lot of science we did a lot of science saying great interview with Enrique and Brayu today on ketamine therapy for depression unfortunately we missed Justin I hope he feels better he was not doing well today he hasn't been doing well for a number of days so I hope that he is feeling better because we missed him I hope you guys out there missed him as much as I did I missed our little trio Justin we miss you get better come back yeah get better come back but in the meantime I do want to say thank you to our Patreon sponsors thank you to Paul Disney Chris Clark Richard Onimus John Ratnaswamy Byron Lee EO Jared Lysette Ulysses Adkins Dave Friedel Kevin Parachan Keith Corsell Jake Jones Mark Masaros Corey Advardus-Rimkis Brian Hedrick Cassie Lester Patrick Cohn Sarah Chavis Layla Bob Calder Marshall Clark Charlene Henry Don Cumberidge Galeria Garcia Randy Mazzucca and Dyer Tony Steele Steve DeBell Haroon Sarang Melissa Mosley Jesse Moreno Jason Schneiderman Rudy Garcia Gerald 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Dave Wilkinson Steve Mishinsky Rodney Lewis Braxton Howard Phil Nadeau Rick Ramis Selged Sam Matt Sutter Emma Grenier Philip Shane James Dobson Kurt Larson Stephen Insom Michael George Russell Jensen Mountain Sloth Jim Drupal Terrapane John Maloney Jason Olds James Noah Wiles Paul West Alec Doty Illuma Lama Joe Wheeler Ducal Campbell Craig Porter Adam Mishkan Aaron Luthan Marjorie Paul Stanton David Simmerly Tyler Harrison Ben Rothig Colombo Ahmed Ryan Swinsburg and Brian Condren. Thank you for all of your support on Patreon. And if you are interested in supporting us, you can find information at patreon.com slash this weekend science. Thank you also to our brand new Patreon supporters. Thank you for becoming supporters. Remember that you can also help us out simply by telling your friends about TWIS or by subscribing to us on YouTube. On next week's show, we will be back once again broadcasting live online at 8 p.m. Pacific time on twist.org slash live. You can watch and join our chat room. We're going to have an interview with the bad astronomer himself, Phil Plate, because you know what day it is today. Today is the anniversary of Neil Armstrong's Walk on the Moon. We were talking about ketamine therapy for depression today. So next week, we'll be talking about with Phil Plate about wonderful things like walking on the moon, conspiracy theories about walking on the moon, and you know other fun space stuff that's going on. I've got a list of things that we're going to talk about, but Phil Plate is always a fabulous fun conversation. So I hope that you can make it for next week's show. If you can't make it though, you can find past episodes at twist.org slash YouTube or twist.org. And thank you to everyone so much for listening this week. We hope you enjoyed the show. Twist is also available as a podcast. You can find that by searching for This Week in Science in iTunes. Or if you have a mobile device that is not of the Apple variety, you can look for Twist for Droid in the Android Marketplace. Or if you do have Apple devices of any sort, This Week in Science in that Apple Marketplace. Oh yeah, and for more information or anything you've heard here today, show notes are going to be available on our website twist.org. You can also make comments there and start conversations with the hosts and other listeners about the content. Or you can contact us directly. You can do that by emailing kirsten at kirsten at thisweekinscience.com Justin is at twistminion at gmail.com or me Blair is at Blair Baz at twist.org. Just be sure to put T-W-I-S for Twist into the subject line or your email will be spam-filtered into oblivion. You can also ping us on the Twitter. On the Twitter we are at twist science, at Dr. Kiki, at Jackson Fly and at Blair's Menagerie. We love your feedback. Menagerie! We love your feedback. If there's a topic you would like us to cover or address, a suggestion for an interview, a haiku that came to you in the middle of the night, please let us know. And we will be back here next week. We hope you'll join us again for more great science news. And if you've learned anything from tonight's show, remember it's all in your head. This Week in Science This Week in Science This Week in Science This Week in Science It's the end of the world So I'm setting up a shop Got my banner unfurled It says the scientist is in I'm gonna sell my advice Show them how to stop the robots with a simple device I'll reverse the overwhelming with a wave of my hand And all it'll cost you is a couple of grand This Week Science is coming your way I say I use the scientific method for all that it's worth And I'll broadcast my opinion all over the Earth This Week in Science This Week in Science This Week in Science Science This Week in Science This Week in Science Science I've got one disclaimer and it shouldn't be news That what I say may not represent your views but I've done the calculations and I've got a plan If you listen to the science you may just better understand But we're not trying to threaten your philosophy We're just trying to save the world from jeopardy This Week in Science is coming your way So everybody listen to everything we say And if you use our methods you may just better understand that what we say may not represent your views But we're not trying to threaten your philosophy We're just trying to save the world from jeopardy This Week in Science This Week in Science This Week in Science Science This Week in Science This Week in Science This Week in Science Just do you have any rational thought And I'll try to answer any questions you got So how can I ever see the changes I seek When I can only set up shop This Week in Science is coming your way You better just listen to what we say This Week in Science This Week in Science Science This Week in Science Science This Week in Science This Week in Science. This Week in Science. Week in Science. This Week in Science. This Week in... Another episode of This Week in Science. I would like to thank everyone for joining us on this flight if you would be sure to check beneath your seats and in the seat pockets to make sure that you have not forgotten anything. We would appreciate it if you got off the plane. Kidding. Kidding. This is the after show, y'all. It's 9.45. It's 9.45. Dave Friedel just joined us. Thanks, Fada. Thanks for watching the show tonight. Thanks, everyone, for joining us in the chat room. We hope you enjoyed. Enjoyed, enjoyed, enjoyed, even though we don't have a Justin to add flavor. It's upsetting, but what can you do? Yeah. So I missed celebrating Nikola Tesla's birthday. Oh, we got two more YouTube subscribers since the start of the show. Thanks for subscribing, guys. 37. Oh, I need to refresh that page. That's why I didn't see it. 37. 37? We need 37. That's amazing. 37 YouTube subscribers and we'll hit 10,000. And then what? We get to use the YouTube studio. Yeah. Which is where in LA? In LA. There are several of them, actually. Yeah. They have several studios around the world. Main studio in LA, one in New York City. They might be building one in Seattle. I'm not sure. I'm not sure. I'm not sure. But there's that and then at 10,000 it also... Sometimes it just helps to have 10,000. Sure. To get more. And who knows? Maybe people who are subscribing will actually watch our YouTube videos. Yes. I want people to subscribe to my... To the Twists RSS feed. Oh, Tom Jackson Jr. says he watches the Twists science on YouTube on his big screen TV. It makes the hashtag science more epic, in his opinion. Love it. Oh, one story we didn't talk about that was sent to us several times. This week, Blair. Which one? The ferrets? Dingos. I didn't get sent any dingos. Yes, you did. Can we get it? Yes, you did. The dingo cannibalism. What? Yes, seven times. Oh, through the Twitter. It was twice on Twitter. Crap on a stick. Sorry. I probably shouldn't have said that. The afterglow. I didn't swear. Oh, do I get a YouTube patch? Do they send me something? I want a YouTube patch. I want a YouTube swag. Thanks for plugging the channel and the Diamond Club IRC strengths. That's great. That's what we need more of. Yes. The dingo ate my dingo. That's right. The dingo ate my dingo. I got like 10 more Twitter followers since the start of the show too. I'm so close to 2000. Yes. So we're both the show and Blair. Inching. Inching to goals. I still need 89 people to get to 2000. Is this for your Blair's menagerie? Yes. I've stopped marketing shouty Blair. I'm not diversifying my votes unnecessarily. But shouty Blair was so fun. I still use shouty Blair every once in a while. You need to because it's awesome. It's good. Okay. Let's see here. Oh yeah. Dingo cannibalism. Maybe I'll do this next week. Yeah. Dingo cannibalism. That was an interesting one. I thought that was very interesting. Yeah. I might use this next week. Yeah. Yeah. That's one. The gem doctor followed Blair in all three of her accounts. Oh yeah. I have my one latent account that I just got so that no one else could be at Blair bastard. Yeah. That's good to have. I only have like 13 followers or something on that one because I've never tweeted from that you have. You do have to kind of use it. Use it or lose it. Right. Yeah. No, but that's why I'm not using it because I want everyone to go to Blair's menagerie, but I don't want anyone else to take at Blair bastard rich. You see. No, you don't. You're going to have it your own. Look at him yawning. So somebody needs more vodka. See. I'm trying to see if I have any more interesting zoo pictures. Well, I have this picture of a penguin that I drew. Look at the penguin. It's a cute penguin. You do that. It's fluffy. Yeah. I would try that again. Hold on. That was cute. I didn't get to see it enough. It's my dad's birthday card. Aw. Happy birthday, daddy. Oh, that's really cute. Yeah. Yeah. Nicely done. What was it? Fata says is Shoudy Blair like the loud family? Yes. Yes. She's very shoudy. Yes. But I think the difference is that the loud family just has trouble controlling the volume of their voice. Shoudy Blair is angry. So I think that's a pretty distinct difference. Here's a Cooney Cooney pig. Hold on. His fat face. Oh, he's a pretty cute little piggy nose. He's hairy. Dave, you're rude. What's a hairy pig? I'm only going to follow. National Zookeeper Week. It is. I was featured. You were. I saw something about that. Where are you? There you are. Okay. I got to share this with everybody. Oh, yeah. Share it. Okay. Look at how young you are. No, that's yesterday. I took that picture. There she is. American Association of Zookeepers San Francisco chapter. Yeah. It's exciting and awesome member who keeps the zoo. And Blair says, I love going to work every day knowing that together we can make the future brighter for all of the wild places and wild things. You're so optimistic. I know. It's sickening. And then, yeah, they asked me all these funny questions. Like they made me pick a scientific name. See it on there. Oh, okay. There it is. Yes. There we go. There we go. Member Blair B. Educus besdaricus. Yeah. My niche. Niche, niche education. Natural habitat lands end. Is that like the catalog? No. It's the, it's the space right next to the cliff house in San Francisco. Yeah. Yeah. Okay. I like that. Keeper span, 10 years, enrichment, reading, science, news, press releases. That would be twist. I love it. Yeah. Yes. I'm holding a ferret. Ferret. I am a keeper. You're a keeper, Blair. I'm a keeper. That's a funny hashtag. Yeah. That's what Marshall's grandmother told me. She's a keeper. Yeah. Or told Marshall when he first brought me home to visit the family. Aw. She's a keeper. That's very cute. Strengths gross. Hashtag food. It's called a ferret. It's just a ferret. It's a member of the family mustelidae. Close relative to Martins. Dinty Moore, stew. We're getting USS rovers giving us crock pot recipes in the chat room. That's awesome. Eat sushi every day. It gets so full that you're going to throw up while you're doing twists. Yeah. Doi. Oh, good gosh. Good gracious. Good gracious. You know, I'm glad we don't have dingos in America. So who was it? The earlier posted. Okay. People post. Oh, your rhythmics. Nice fata. The sisters are doing it for themselves. The sisters are hard doing it for themselves. That's good. That's good. I will listen to that later. And then somebody else posted a link to, like a brain website. Here it is. The gem doctor. Okay. You got this link from Bleakworthy and it's yourbrainhealth.com.au. So first thing, the first thing I'm going to say is that this whole website is an advertisement. So take it all with a grain of salt. She's probably a great, fine neuroscientist. She's moved into science writing, kind of like what we do, but she's also trying to sell a book and get people to hire her. And she's also giving a masterclass, principles of neuroscience for coaches, therapists, educators, health and wellness professionals. Maybe, yeah, maybe. I don't know. I mean, since she's teaching teachers, maybe it's a, I don't know, but basically, there might be fine information in the blog, but it's a blog, and the purpose is not just to talk about science, but to sell her product. So take it all with a grain of salt. And she might be a perfectly fine writer as well. Perfectly fine scientist, but what? Take the whole salt shaker. Yes, replicant. Take the whole salt shaker. Yeah. Oh, Dave Freidel, were you here for the interview? You're not supposed to take the whole cooler of ketamine. Yeah, strengths had the link. Electrovestibulography. Yeah, so that's a completely different area. So I didn't ask Enrique about it because it's not, oh, that's a download. Hello. Where are you? I'm just going to, vestibular field potentials. Interesting. I've heard a little bit about this before. I don't know enough about it, though, to comment on it. And let's see, conclusions, valid and clinically useful diagnostic tool. So it's a tool for objectively diagnosing brain changes associated with mental illnesses. Cool. Interesting. And it is a vestibular driven response. Interesting. I don't know. I honestly don't know anything about this. I will look into it. Why vestibular? That's what I'm going to have to, why? Why vestibular? What? I got to look into that. Thanks, strengths. I'll check it out. Check, check, check it. Special case cereal. I like special case cereal, actually. Where'd Blair go? Yeah, because Justin's not here. Someone has to go smoke a celic cigarette. I know, Ben Rothig. If you ever have a baby, you don't want to dingo eating it totally. I don't really have a crock pot. I have a really old crock pot, but I lost it when we moved. I don't really know where it is anymore. It's in a cabinet somewhere. I haven't used it. My ear's red. My headphones are hurting it. My headphones are making my ears tired. Identity. So when I have guests, do they call into the YouTube Hangout? I call them or I send them the link and then they join the Hangout. Yeah. So I don't know if that makes a difference. They don't like call into it technically. Fada, did I get your email? I did get your email and I'm so sorry I didn't write back. I did get your email. Yes. She's coming back. Why are you telling Fibs about Blair? I mean, I don't know. Maybe she does, actually. I have no idea, actually. I won't even say anything. I don't know. There are no phones involved in the making of twists. It's true. I mean, I guess sometimes we text each other, but no, it was totally helpful. Fada, it was great. Interesting. That would kind of make sense. I'm going to guess that absolutely happens that when somebody with a lower bandwidth joins to compensate, I would guess that it would make sense for Google's algorithm to match the lowest bandwidth. If you have ideas about how to get around that, let me know because I would have no idea. I will, Fada. Thank you. Oh, is that the honey flow is on now? Awesome. I went and I videoed with during, let's see, I did honey bee and flow beehive videotaping during the tour de hives here in Portland, which is a yearly tour of people's backyard hives. I went and did that, but I am three videos behind in editing. I just yesterday started editing our San Francisco Zoo pieces. I was going to ask you about this. Yeah. I finally have gotten on that. The San Francisco, my goal is to get the San Francisco Zoo piece done by Friday so that we can, so I can post it by like Monday or something. So which one? The wolf one? The wolf one first. Nice. And then the other one. Yeah. That sounds complicated at any four. It would probably work, but it sounds complicated. Yeah. Why don't you get like a tech intern? Like an engineering intern. I am using Adobe Premiere Pro to edit the videos. What are you saying for? Hi, Dale Poco. The idea of an engineering intern. Right. Like literally just have a show engineer. You don't have to run the sound. You don't have to deal with people that call in. That's like all somebody else. All you have to do is actually host the show. That would be pretty awesome. Right? Yep. We need an engineering intern. We need a social media intern. We need a website intern. So many things. So many interns. So many interns. I know. It's amazing. Like when you start thinking about all the little things to do, it's like, man, just little things, lots of little things. Neshcom. Yeah. So I've been thinking about the 2017 calendar. Fada wants to intern awesome. Oh, nice. Okay. You've been thinking about the calendar. I know. So I'm almost halfway done with the art. And I can really kick it into second gear and like try to churn it out faster. But I'm also thinking that we could potentially take pre-orders if I'm not done yet. So I could release pictures of what I have. So and then and take pre-orders if we wanted to starting pretty soon. I don't know when ideal calendar time is like October, right? September, October? I don't know. But we could do like a pre-order price and then a later price. And then we would know, you know, how many in bulk to order. And then we have to, if we had to make a second order, we could or whatever. I don't know. It's something to think about. So we don't have to make a bunch of decisions really fast. Yeah. Yeah, it's good to start thinking about it. At least put a deadline on it for deciding because probably when did we start last year, October? Yeah, I think I started assembling it in October, but I don't think we had, we started selling till Thanksgiving, I think. Yeah, so we should start selling earlier. Yeah, I think we could sell. Yeah, because it was like, are we going to sell all of them by the end of the year? And if people have already gotten their calendars and all that kind of stuff? Yeah. So I think we could start pre-orders even before that. I think we could start pre-orders in September if we wanted to. Because I don't think it'll be done. I'm thinking it'll be done in October. But I think we can, but I have, I'll have six pieces of art after this weekend. So I'll be halfway done. So it's enough to start at least, I think. Okay. If we want to do it, I mean, I don't know, we could gauge interests too. Yeah, I mean, I think people like the calendar this year. We sold it. Yeah. Yeah, we can have a different price for a signed calendar too. Dave, if you really think people would want that, but I don't know. Special signed calendars, which we could potentially sign if we end up getting, doing a show together or a visit at some point prior to the end of the year, and then we can send them out. Well, it's a reason for me to come visit. Exactly. I need to talk with the podcast guy up here to do a live show from up here in Portland, get you and Justin up here. And I, which reminds me, I have to contact the Maryland Science Festival people because they haven't contacted me back in a while. I don't know what happened. They went silent on me. Oh yeah. I'm curious. Only I would have to use OBS. Well, that would make it easier. Okay. Everyone else just needs Skype. Oh, if it worked. Yeah, but we would need to make sure that one of us has it, like that I would need it too for when you can't be here, which, I mean, doesn't happen often, but it happens like once or twice a year. Right. So we would still have to have a way that we could broadcast if you weren't here. Well, something like OBS. What does OBS stand for? It's an open broadcasting system or something like it's not a, they're like, there are others like Wirecast and others that I know that are, you know, it's like $500 to $1,000 to have like a virtual software that can fake in multiple inputs. Yeah, I got it right. Thanks, Gord. Gold star. Yeah. For audio, there are plenty. Yeah. But, you know, I think because it's open, it's something that you just download and install if you have the bandwidth for it. Nice. The processor power for it. For the calendar, we should start, we should open up the, we should get the link to the shared document that we had last year for the different dates that we put on it. Yeah, yeah, yeah. Just confirm the dates for next year. Yep. And we can get people to add new dates to the calendar because it was, it was fun. But I thought that, you know, that would have been potentially fun to have more stuff on here. Yeah. Like I was worried about it being too much, but now I know I think we could have more for sure. We could definitely have more. Yeah. I think that would be totally fine. My birthday. Okay. And right now, hold on, I'm going to try to not or an extra $10. You too can have your birthday on the twist calendar. $10. This is why I don't make any money. I underprice everything. So, okay. So everything I've done so far is horizontal. So I think the shape might not have to be square this time. I think it can be like more rectangular because I'm a rabbit. I like rectangular. That's good. I have my blue bellied roller. It's cute. I have my red eye tree frog. And then I have my nautilus. Which is my favorite. And then the two I have to finish this weekend. So it'll be at six. Is this California redwood? I like that. And then also California kelp forest. That's pretty. So I have to put aminols in those two. And then I'll be halfway. But I have to go back to cankos again. They keep scanning them wrong. Like I keep telling them like just scan the whole thing. I'll crop it when I get home if there's excess. They're like, okay, okay, okay. But then they try to do extra work for me for free. And they try to crop it. But they always end up cropping too much. And they crop an edge off and my signature is missing or something. And I'm like, guys, you cropped it wrong. Just let me crop it. Let me crop it. It's uh, yeah, I feel like it's harder for them because it's kind of it's textured and everything. So it's like, it's also because it's on canvas. It's like thick. Right. They keep messing it up because of that. And I keep saying, give me the highest quality scan you have. And they're like, so like how high? Like the highest quality one. Oh my goodness. Yeah. Just make it good. Just can you do the thing? Do it. Do it and do it well. Come on. Okay. So we're going to be thinking calendar. Oh, and the originals of all of those that you guys just saw are still up for grabs. So anyone currently in the chat room, you can own those originals through Patreon. How long ago did I start doing I can, Patreon. You can have originals. All right. I got questions. You probably set up an actual price for them too on the website in case people want to just give them direct money. I don't know. What? We could set an actual price to just flat out buy them if we wanted to. What do you mean? The arts. Oh yeah. If we wanted to. That's a good idea. I don't know. I don't know if it's worth it or if we want to keep it at just the Patreon premium. Yeah. That's a good question. Dave Friedel said $4,800. $4,800. Yeah, I don't think. Oh yeah. I should do the next, I should put a Charmander in one of those, right? A Squirtle. A Squirtle. Definitely a Squirtle. And I've just said all of the Pokemon I know. I don't know any of them either. Charmander, Squirtle. Well, Pikachu, I guess. I think that's all the ones I know. $48. There we go. No, more than that. In the middle, Dave. That's a lot I done it before. What's happening? What are people trying to figure out now? Aren't all days the same length? Well, 24 hour day and night altogether. Yeah. Yeah, 24 the calendar worked pretty well last year. I did have some issues with postage and shipping and all that kind of stuff because that ended up being expensive. At first I didn't get it right and then I had to change the shipping price as it went on so I could actually get it right. Yeah, so hopefully, yeah, with adjusted shipping metrics this year, it'll be better. Hopefully, yeah. Gonna figure that out. Yeah, so maybe a $20, what's it called? Pre-order price? And then we could do like a 25 later. Identity for $15, I think, is the Patreon level for art? Yeah, USS Rover. It was complicated because I had to figure out in the U.S., it was pretty standard, but then the shipping, international shipping is what really kind of broke me. It was a fun thing to do last year, but I don't think we made very much money because of the way that worked out. Which one? Say it again. International shipping. Oh, yeah. That didn't work out as well as I wanted it to. Yeah, a couple of my friends from Israel bottom and I think that was a problem. Well, when it first happened, I didn't have the right, I kind of guesstimated the prices, and then when I actually went to pay for it, I was like, oh, that's a lot more than I even thought it was going to be, huh? Yeah, it's pricey. It's pricey to ship over there. Yeah. Yeah, and I was like, wait, I'm $20 calendar and I'm paying for the $12 in shipping. Wait, what? No. No. Yes. But yeah, it says there's one patron at the $15 level. That's right. We have one patron at the $15 level. We might owe them a piece of my art, then if they haven't already gotten one. I think he may have gotten one, but we could send him another. I need to do a hangout. I need to set up. I owe people like three hangouts at this point in time. I got to make some hangouts happen this next week, don't I? We're going to do that. Yeah, exactly. $20 for the calendar, $85 for shipping to Kazakhstan. Yeah, there has to be some sort of metric that you can use. I thought PayPal would do the math for you somehow, but I guess not. Well, they do, but it wasn't an easy way to predict what it was going to be. Yeah, actually, no, they didn't do the math for me. Then I would have to go print the shipping labels, because I was printing shipping labels at home. I weighed the packages, and I'd print the shipping labels at home, and then it would tell me that I can buy the shipping labels directly from the USPS through PayPal, which is awesome. But it was only after doing that a few times that I was like, oh, that shipping price, wow, I'm really off. Oh, shipping. Darn you, shipping. Yeah, we'll figure it out. I'll figure it out. I got better at it as it went along, but it wasn't easy at first. If you don't do something every day, just making it work in the PayPal system was kind of weird. And so then people who were just giving us donations all of a sudden were having to pay shipping prices. And it was like, okay, wait, no, no, no. Yeah, how much to ship it to the moon? That's a good question for Phil. Find out what Phil has to say. I think we'll have a good conversation with him next week. I'm tired. Me too. I'm yawning. Shipping to Jamaica cost 70. Wow, replicant. That's a funny story. $12.70. Wow. Yeah, they have the postage calculator. Yeah, it's just finding it for the also because of the size of the calendar. It wasn't like a simple mailing like it was a it didn't fit in the ounce for first class postage and it didn't like the side that the weight put it in a strange category. Yeah, maybe this time. And then it was a factor of finding out which mailing category I had to use. I don't know. I went through all sorts of jump through. I feel like maybe this will be that is what I needed. That's what I need an intern for. Yeah, figuring out that stuff for me. Maybe the part of the goal now with these rectangular pieces of art that will all be the same orientation is that maybe we can make it so that it fits in a manila envelope. And if it does, perhaps we'll make everything easier. Maybe. Yeah. Yeah. That was a good goal. Stamp size calendar. That's a fabulous idea. What is it? It's like we have we got a this last weekend. We got a micro kite. A micro kite. It's it's it's not even it's it's that big. It's like it's like that big. It's this tiny diamond of really light tissue paper with little toothpicks on it. And the string is like this really light gauge plastic fishing wire. And it's like you go outside and it's the tiniest little breeze and it's like it just flies there. It's the they're the cutest little things. Micro kites. They're awesome. So cute. That's right. Learning something new. I'm always learning something new. I have to figure out and we'll have a new size calendar this year and I'll figure out something new again this year again. Freaking postal service. All right. Yeah. Parcel post. That's how I had to send it. The calendars were sent. Parcel post. The Canadian post office has a wood cutout. It's a wood plank with a hole in it to see if it fits. That's awesome. Right. The micro kite stuck in a bonsai tree. I got it tangled. That's really funny visual. Oh my god. The makings of a stand up bit. Stuck in a tree. I mean a bonsai tree. All right you guys. I'm tired. Calendars postage. We're going to be thinking about that. I got to think about scheduling some hangouts for the next week so that we can have a Patreon sponsor hangout which will be awesome. I'm going to get that video out. We're going to get a new episode of Twist out and then next Wednesday we'll have a whole new episode to do next Wednesday and start all over again. Super fun. Super fun. Thank you so much for joining us tonight. Blair thank you for a good show tonight. Of course thank you. I miss Justin but still had a great time. I know. Me too. It was good. Now I'm tired. I'm like yeah. I'm going to go to play. It's like we just ran a mile. I know. I've just been standing here you know. I want to see. Atchoo. Gesundheit. Or as my friend Johnny says. Science. Every time somebody sneezes that's what he says. Is that is that guinea pig Johnny? Yep. Nice. Guinea pig Johnny. Yeah. Tell him that's his name now. Guinea pig Johnny. That's your name. Guinea pig Johnny. What's your name? Guinea pig Johnny. Guinea pig Johnny. Science. Thanks for listening. Thanks for watching everybody. Thanks for all the conversation after the show. We do hope that we'll see you again next week. Tell your friends to subscribe to us on YouTube. Tell them to just subscribe to us wherever but you know it's not it's not so distractible right now. It's definite sign that I'm tired when I'm not easily distracted. You guys are awesome. We'll see you next week. We hope that you join us again.