Podcasts about medex

Abogado por la Libre de Derecho de Monterrey, tiene una maestría en Política por el Colegio de Abogados de Madrid, y es también egresado del MEDEX, en el IPADE,  en donde además imparte clases como maestro invitado desde 2012. Es experto en desarrollo de nuevas empresas, innovación y estrategias de posicionamiento. En su carrera ha sido ejecutivo y también emprendedor. Fue Chief Innovation Officer en Banregio, y founder de Advenio, una compañía de guarderías corporativas para mujeres profesionistas.  Es fundador de Whitepaper, el medio digital especializado en temas de negocios que está revolucionando el modelo de revenue de los medios en México y se ha convertido en referente y fuente principal de información para las y los tomadores de decisiones en nuestro país. En Whitepaper es también el CEO, el Editor General y co-host podcaster de uno de sus productos de audio.  Su nombre es muy respetado por la comunidad empresarial del país. Este especial es patrocinado por General Motors.

Migrant Health center evoluciona a MedEx, nueva empresa de salud en 14 municipios de la zona oeste del país. Vengo con los detalles. El voto de los fallecidos vuelve a ser controversia y hoy explico cómo pretenden usar a la prensa para la propaganda pero no se lo vamos a permitir. A contar desde cero el voto a domicilio dicen los Comisionados Electorales en el escrutinio general Ahora todos cubren a Eliezer Molina, pero usted se enteró primero por la prensa independiente Más de mil familias todavía con toldos azules, admite el secretario de la vivienda Comité de transición entrante adjudica falta de interés a lento proceso de reconstrucción de viviendas Incremento en los asesinatos en Ponce, Arecibo y Aguadilla a un mes de terminar el 2024 Acusan a Bolsonaro de intentar hacer un golpe de estado en Brasil. Siguen saliendo los nominados nebulosos del gobierno de Trump y el mundo en alta tensión con las guerras en Ucrania, el genocidio en Gaza y la crisis en Haití. Estas son algunas de las noticias que tenemos hoy En Blanco y Negro con Sandra. AUDIO: Este es un programa independiente y sindicalizado. Esto significa que se transmite simultáneamente por una serie de emisoras de radio y medios que son los más fuertes en sus respectivas regiones, por sus plataformas digitales, aplicaciones para dispositivos móviles y redes sociales. Estos medios son: 1. Cadena WIAC - WYAC 930 AM Cabo Rojo- Mayagüez 2. Cadena WIAC – WISA 1390 AM Isabela 3. Cadena WIAC – WIAC 740 AM Área norte y zona metropolitana 4. WLRP 1460 AM Radio Raíces La voz del Pepino en San Sebastián 5. X61 – 610 AM en Patillas 6. X61 – 94.3 FM Patillas y todo el sureste 7. WPAB 550 AM - Ponce 8. ECO 93.1 FM – En todo Puerto Rico 9. Mundo Latino PR.com Podcast disponible en Spotify, Soundcloud, Apple Podcasts, Google Podcasts y otras plataformas https://anchor.fm/sandrarodriguezcotto También nos pueden seguir en: REDES SOCIALES: Facebook, X (Twitter), Instagram, Threads, LinkedIn, Tumblr, TikTok BLOG: En Blanco y Negro con Sandra http://enblancoynegromedia.blogspot.com SUSCRIPCIÓN: Substack, plataforma de suscripción de prensa independiente https://substack.com/@sandrarodriguezcotto OTROS MEDIOS DIGITALES: ¡Ey! Boricua, Revista Seguros. Revista Crónicas y otros --- Support this podcast: https://podcasters.spotify.com/pod/show/sandrarodriguezcotto/support

Jenny Fayette is the immediate past president of the Alaska Academy of Physician Assistants. She is a graduate of the only physician assistant training program in Alaska, the MEDEX program which is a partnership with the University of Washington and the University of Alaska Anchorage. Prior to going to PA school, Jenny was an exercise physiologist, a high school science teacher, and a professional cross-country skier. After a decade working in orthopedic surgery, she recently took a job as PA in breast surgery. We will be discussing a bill from the most recent legislative session that would have modernized the treatment of PAs in Alaska statute. Senate Bill 115 was sponsored by Senator Löki Tobin who represents downtown Anchorage; her bill never made it to the floor of the Alaska State House for a vote, and therefore it died at the end of the 33rd legislature. A new version of that bill will likely be introduced in the 34th Legislature. 

In this episode of The Geek in Review, hosts Marlene Gebauer and Greg Lambert sit down for a one-on-one conversation to catch up on their recent vacations and discuss some of the latest developments in the legal industry. Marlene shares her experience in Hawaii, where she enjoyed beautiful beaches, a nature preserve, and delicious local cuisine with her family. Greg, on the other hand, talks about his trip to South Africa, where he spent time in Kruger National Park observing wildlife and learning about the challenges of rhino poaching. The conversation then shifts to the recent lawsuits filed by The New York Times, the Center for Investigative Reporting, and Mother Jones against OpenAI and Microsoft for using their copyrighted material to train AI systems. The hosts discuss the implications of these lawsuits and draw parallels to the music industry's past struggles with Napster and the eventual rise of streaming services. Marlene introduces a new AI-powered comic maker she discovered, which allows users to generate comic strips based on their own images and descriptions. Despite some humorous mishaps with her own generated character, she sees potential in the tool for creating engaging content. Greg shares his experience with Hedra, an AI tool that animates still pictures to create talking head videos, and the two discuss the possibility of creating a fully AI-generated podcast episode. The hosts also explore practical applications of AI, such as AI Excel Bot, which generates Excel formulas based on plain text instructions and explains existing formulas in simple terms. They discuss how this tool could be beneficial for professionals who frequently work with complex spreadsheets. Lastly, Greg highlights an episode of the Technically Legal podcast featuring Brandon Epstein, Chief Forensic Officer at Medex, who discusses the challenges of detecting deep fakes and the digital fingerprints left by various recording devices. The conversation emphasizes the importance of authenticating videos, especially in the news media, and the ongoing battle between deep fake creators and forensic experts. Listen on mobile platforms:  ⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcasts⁠⁠⁠⁠⁠⁠⁠⁠ |  ⁠⁠⁠⁠⁠⁠⁠⁠Spotify⁠⁠⁠⁠⁠⁠⁠⁠ | ⁠⁠⁠⁠⁠⁠⁠YouTube⁠⁠⁠⁠⁠⁠   Contact Us:  Twitter: ⁠⁠⁠⁠⁠@gebauerm⁠⁠⁠⁠⁠, or ⁠⁠⁠⁠⁠@glambert⁠⁠⁠⁠⁠ Email: geekinreviewpodcast@gmail.com Music: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Jerry David DeCicca⁠⁠⁠⁠⁠⁠⁠ Transcript on 3 Geeks

Medex Chief Forensic Officer Brandon Epstein joins the Technically Legal Podcast to discuss the purpose built forensic tool for use in legal proceedings. The company counts legal professionals, law enforcement and journalists as its customers. Medex is used to examine digital video files to establish provenance, detect tampering and identify modifications. Users may also use Medex to identify the device type that created the video. As Brandon explains, the type of hardware used to create a digital video file leaves its own fingerprint. By examining the bits and bytes of a video file, Medex can discern whether a video file was created by, say, an iPhone, an Android based device, or even whether it was altered by posting on social media. Brandon got his start in law enforcement as a patrol officer and through that work, he became acutely aware of the importance of video evidence in helping to solve crimes. Fast forward a few years later and he met Medex's CEO at a conference they hit it off and Brandon was asked to join Medex. Learn more about Brandon.

Medtem ko v javnosti odmevajo lastniške spremembe v dveh pomembnih slovenskih agroživilskih podjetjih - Panvita in Celjske mesnine - v katere vstopa hrvaški kapital, ugotavljamo, da je država v zadnjih dveh desetletjih razprodala večino slovenskih živilskih paradnih konjev. Aktualni prodaji zato med kmete in tudi v samo živilsko dejavnost vnašajo določeno mero negotovosti. Kako na zadnja dogajanja v živilski panogi gledajo v tistih podjetjih, ki ostajajo v slovenskih rokah? Med njimi so Tovarna olja Gea d.o.o., ta letos praznuje 120 let delovanja, podjetje Medex, ki praznuje 70 let, in Skupina Jata Emona kot največji lastnik živilskih podjetij v zasebni lasti, tudi podjetje Pivka Perutninarstvo.

Our next 2 big events are AI UX and the World's Fair. Join and apply to speak/sponsor!Due to timing issues we didn't have an interview episode to share with you this week, but not to worry, we have more than enough “weekend special” content in the backlog for you to get your Latent Space fix, whether you like thinking about the big picture, or learning more about the pod behind the scenes, or talking Groq and GPUs, or AI Leadership, or Personal AI. Enjoy!AI BreakdownThe indefatigable NLW had us back on his show for an update on the Four Wars, covering Sora, Suno, and the reshaped GPT-4 Class Landscape:and a longer segment on AI Engineering trends covering the future LLM landscape (Llama 3, GPT-5, Gemini 2, Claude 4), Open Source Models (Mistral, Grok), Apple and Meta's AI strategy, new chips (Groq, MatX) and the general movement from baby AGIs to vertical Agents:Thursday Nights in AIWe're also including swyx's interview with Josh Albrecht and Ali Rohde to reintroduce swyx and Latent Space to a general audience, and engage in some spicy Q&A:Dylan Patel on GroqWe hosted a private event with Dylan Patel of SemiAnalysis (our last pod here):Not all of it could be released so we just talked about our Groq estimates:Milind Naphade - Capital OneIn relation to conversations at NeurIPS and Nvidia GTC and upcoming at World's Fair, we also enjoyed chatting with Milind Naphade about his AI Leadership work at IBM, Cisco, Nvidia, and now leading the AI Foundations org at Capital One. We covered:* Milind's learnings from ~25 years in machine learning * His first paper citation was 24 years ago* Lessons from working with Jensen Huang for 6 years and being CTO of Metropolis * Thoughts on relevant AI research* GTC takeaways and what makes NVIDIA specialIf you'd like to work on building solutions rather than platform (as Milind put it), his Applied AI Research team at Capital One is hiring, which falls under the Capital One Tech team.Personal AI MeetupIt all started with a meme:Within days of each other, BEE, FRIEND, EmilyAI, Compass, Nox and LangFriend were all launching personal AI wearables and assistants. So we decided to put together a the world's first Personal AI meetup featuring creators and enthusiasts of wearables. The full video is live now, with full show notes within.Timestamps* [00:01:13] AI Breakdown Part 1* [00:02:20] Four Wars* [00:13:45] Sora* [00:15:12] Suno* [00:16:34] The GPT-4 Class Landscape* [00:17:03] Data War: Reddit x Google* [00:21:53] Gemini 1.5 vs Claude 3* [00:26:58] AI Breakdown Part 2* [00:27:33] Next Frontiers: Llama 3, GPT-5, Gemini 2, Claude 4* [00:31:11] Open Source Models - Mistral, Grok* [00:34:13] Apple MM1* [00:37:33] Meta's $800b AI rebrand* [00:39:20] AI Engineer landscape - from baby AGIs to vertical Agents* [00:47:28] Adept episode - Screen Multimodality* [00:48:54] Top Model Research from January Recap* [00:53:08] AI Wearables* [00:57:26] Groq vs Nvidia month - GPU Chip War* [01:00:31] Disagreements* [01:02:08] Summer 2024 Predictions* [01:04:18] Thursday Nights in AI - swyx* [01:33:34] Dylan Patel - Semianalysis + Latent Space Live Show* [01:34:58] GroqTranscript[00:00:00] swyx: Welcome to the Latent Space Podcast Weekend Edition. This is Charlie, your AI co host. Swyx and Alessio are off for the week, making more great content. We have exciting interviews coming up with Elicit, Chroma, Instructor, and our upcoming series on NSFW, Not Safe for Work AI. In today's episode, we're collating some of Swyx and Alessio's recent appearances, all in one place for you to find.[00:00:32] swyx: In part one, we have our first crossover pod of the year. In our listener survey, several folks asked for more thoughts from our two hosts. In 2023, Swyx and Alessio did crossover interviews with other great podcasts like the AI Breakdown, Practical AI, Cognitive Revolution, Thursday Eye, and Chinatalk, all of which you can find in the Latentspace About page.[00:00:56] swyx: NLW of the AI Breakdown asked us back to do a special on the 4Wars framework and the AI engineer scene. We love AI Breakdown as one of the best examples Daily podcasts to keep up on AI news, so we were especially excited to be back on Watch out and take[00:01:12] NLW: care[00:01:13] AI Breakdown Part 1[00:01:13] NLW: today on the AI breakdown. Part one of my conversation with Alessio and Swix from Latent Space.[00:01:19] NLW: All right, fellas, welcome back to the AI Breakdown. How are you doing? I'm good. Very good. With the last, the last time we did this show, we were like, oh yeah, let's do check ins like monthly about all the things that are going on and then. Of course, six months later, and, you know, the, the, the world has changed in a thousand ways.[00:01:36] NLW: It's just, it's too busy to even, to even think about podcasting sometimes. But I, I'm super excited to, to be chatting with you again. I think there's, there's a lot to, to catch up on, just to tap in, I think in the, you know, in the beginning of 2024. And, and so, you know, we're gonna talk today about just kind of a, a, a broad sense of where things are in some of the key battles in the AI space.[00:01:55] NLW: And then the, you know, one of the big things that I, that I'm really excited to have you guys on here for us to talk about where, sort of what patterns you're seeing and what people are actually trying to build, you know, where, where developers are spending their, their time and energy and, and, and any sort of, you know, trend trends there, but maybe let's start I guess by checking in on a framework that you guys actually introduced, which I've loved and I've cribbed a couple of times now, which is this sort of four wars of the, of the AI stack.[00:02:20] Four Wars[00:02:20] NLW: Because first, since I have you here, I'd love, I'd love to hear sort of like where that started gelling. And then and then maybe we can get into, I think a couple of them that are you know, particularly interesting, you know, in the, in light of[00:02:30] swyx: some recent news. Yeah, so maybe I'll take this one. So the four wars is a framework that I came up around trying to recap all of 2023.[00:02:38] swyx: I tried to write sort of monthly recap pieces. And I was trying to figure out like what makes one piece of news last longer than another or more significant than another. And I think it's basically always around battlegrounds. Wars are fought around limited resources. And I think probably the, you know, the most limited resource is talent, but the talent expresses itself in a number of areas.[00:03:01] swyx: And so I kind of focus on those, those areas at first. So the four wars that we cover are the data wars, the GPU rich, poor war, the multi modal war, And the RAG and Ops War. And I think you actually did a dedicated episode to that, so thanks for covering that. Yeah, yeah.[00:03:18] NLW: Not only did I do a dedicated episode, I actually used that.[00:03:22] NLW: I can't remember if I told you guys. I did give you big shoutouts. But I used it as a framework for a presentation at Intel's big AI event that they hold each year, where they have all their folks who are working on AI internally. And it totally resonated. That's amazing. Yeah, so, so, what got me thinking about it again is specifically this inflection news that we recently had, this sort of, you know, basically, I can't imagine that anyone who's listening wouldn't have thought about it, but, you know, inflection is a one of the big contenders, right?[00:03:53] NLW: I think probably most folks would have put them, you know, just a half step behind the anthropics and open AIs of the world in terms of labs, but it's a company that raised 1. 3 billion last year, less than a year ago. Reed Hoffman's a co founder Mustafa Suleyman, who's a co founder of DeepMind, you know, so it's like, this is not a a small startup, let's say, at least in terms of perception.[00:04:13] NLW: And then we get the news that basically most of the team, it appears, is heading over to Microsoft and they're bringing in a new CEO. And you know, I'm interested in, in, in kind of your take on how much that reflects, like hold aside, I guess, you know, all the other things that it might be about, how much it reflects this sort of the, the stark.[00:04:32] NLW: Brutal reality of competing in the frontier model space right now. And, you know, just the access to compute.[00:04:38] Alessio: There are a lot of things to say. So first of all, there's always somebody who's more GPU rich than you. So inflection is GPU rich by startup standard. I think about 22, 000 H100s, but obviously that pales compared to the, to Microsoft.[00:04:55] Alessio: The other thing is that this is probably good news, maybe for the startups. It's like being GPU rich, it's not enough. You know, like I think they were building something pretty interesting in, in pi of their own model of their own kind of experience. But at the end of the day, you're the interface that people consume as end users.[00:05:13] Alessio: It's really similar to a lot of the others. So and we'll tell, talk about GPT four and cloud tree and all this stuff. GPU poor, doing something. That the GPU rich are not interested in, you know we just had our AI center of excellence at Decibel and one of the AI leads at one of the big companies was like, Oh, we just saved 10 million and we use these models to do a translation, you know, and that's it.[00:05:39] Alessio: It's not, it's not a GI, it's just translation. So I think like the inflection part is maybe. A calling and a waking to a lot of startups then say, Hey, you know, trying to get as much capital as possible, try and get as many GPUs as possible. Good. But at the end of the day, it doesn't build a business, you know, and maybe what inflection I don't, I don't, again, I don't know the reasons behind the inflection choice, but if you say, I don't want to build my own company that has 1.[00:06:05] Alessio: 3 billion and I want to go do it at Microsoft, it's probably not a resources problem. It's more of strategic decisions that you're making as a company. So yeah, that was kind of my. I take on it.[00:06:15] swyx: Yeah, and I guess on my end, two things actually happened yesterday. It was a little bit quieter news, but Stability AI had some pretty major departures as well.[00:06:25] swyx: And you may not be considering it, but Stability is actually also a GPU rich company in the sense that they were the first new startup in this AI wave to brag about how many GPUs that they have. And you should join them. And you know, Imadis is definitely a GPU trader in some sense from his hedge fund days.[00:06:43] swyx: So Robin Rhombach and like the most of the Stable Diffusion 3 people left Stability yesterday as well. So yesterday was kind of like a big news day for the GPU rich companies, both Inflection and Stability having sort of wind taken out of their sails. I think, yes, it's a data point in the favor of Like, just because you have the GPUs doesn't mean you can, you automatically win.[00:07:03] swyx: And I think, you know, kind of I'll echo what Alessio says there. But in general also, like, I wonder if this is like the start of a major consolidation wave, just in terms of, you know, I think that there was a lot of funding last year and, you know, the business models have not been, you know, All of these things worked out very well.[00:07:19] swyx: Even inflection couldn't do it. And so I think maybe that's the start of a small consolidation wave. I don't think that's like a sign of AI winter. I keep looking for AI winter coming. I think this is kind of like a brief cold front. Yeah,[00:07:34] NLW: it's super interesting. So I think a bunch of A bunch of stuff here.[00:07:38] NLW: One is, I think, to both of your points, there, in some ways, there, there had already been this very clear demarcation between these two sides where, like, the GPU pores, to use the terminology, like, just weren't trying to compete on the same level, right? You know, the vast majority of people who have started something over the last year, year and a half, call it, were racing in a different direction.[00:07:59] NLW: They're trying to find some edge somewhere else. They're trying to build something different. If they're, if they're really trying to innovate, it's in different areas. And so it's really just this very small handful of companies that are in this like very, you know, it's like the coheres and jaspers of the world that like this sort of, you know, that are that are just sort of a little bit less resourced than, you know, than the other set that I think that this potentially even applies to, you know, everyone else that could clearly demarcate it into these two, two sides.[00:08:26] NLW: And there's only a small handful kind of sitting uncomfortably in the middle, perhaps. Let's, let's come back to the idea of, of the sort of AI winter or, you know, a cold front or anything like that. So this is something that I, I spent a lot of time kind of thinking about and noticing. And my perception is that The vast majority of the folks who are trying to call for sort of, you know, a trough of disillusionment or, you know, a shifting of the phase to that are people who either, A, just don't like AI for some other reason there's plenty of that, you know, people who are saying, You Look, they're doing way worse than they ever thought.[00:09:03] NLW: You know, there's a lot of sort of confirmation bias kind of thing going on. Or two, media that just needs a different narrative, right? Because they're sort of sick of, you know, telling the same story. Same thing happened last summer, when every every outlet jumped on the chat GPT at its first down month story to try to really like kind of hammer this idea that that the hype was too much.[00:09:24] NLW: Meanwhile, you have, you know, just ridiculous levels of investment from enterprises, you know, coming in. You have, you know, huge, huge volumes of, you know, individual behavior change happening. But I do think that there's nothing incoherent sort of to your point, Swyx, about that and the consolidation period.[00:09:42] NLW: Like, you know, if you look right now, for example, there are, I don't know, probably 25 or 30 credible, like, build your own chatbot. platforms that, you know, a lot of which have, you know, raised funding. There's no universe in which all of those are successful across, you know, even with a, even, even with a total addressable market of every enterprise in the world, you know, you're just inevitably going to see some amount of consolidation.[00:10:08] NLW: Same with, you know, image generators. There are, if you look at A16Z's top 50 consumer AI apps, just based on, you know, web traffic or whatever, they're still like I don't know, a half. Dozen or 10 or something, like, some ridiculous number of like, basically things like Midjourney or Dolly three. And it just seems impossible that we're gonna have that many, you know, ultimately as, as, as sort of, you know, going, going concerned.[00:10:33] NLW: So, I don't know. I, I, I think that the, there will be inevitable consolidation 'cause you know. It's, it's also what kind of like venture rounds are supposed to do. You're not, not everyone who gets a seed round is supposed to get to series A and not everyone who gets a series A is supposed to get to series B.[00:10:46] NLW: That's sort of the natural process. I think it will be tempting for a lot of people to try to infer from that something about AI not being as sort of big or as as sort of relevant as, as it was hyped up to be. But I, I kind of think that's the wrong conclusion to come to.[00:11:02] Alessio: I I would say the experimentation.[00:11:04] Alessio: Surface is a little smaller for image generation. So if you go back maybe six, nine months, most people will tell you, why would you build a coding assistant when like Copilot and GitHub are just going to win everything because they have the data and they have all the stuff. If you fast forward today, A lot of people use Cursor everybody was excited about the Devin release on Twitter.[00:11:26] Alessio: There are a lot of different ways of attacking the market that are not completion of code in the IDE. And even Cursors, like they evolved beyond single line to like chat, to do multi line edits and, and all that stuff. Image generation, I would say, yeah, as a, just as from what I've seen, like maybe the product innovation has slowed down at the UX level and people are improving the models.[00:11:50] Alessio: So the race is like, how do I make better images? It's not like, how do I make the user interact with the generation process better? And that gets tough, you know? It's hard to like really differentiate yourselves. So yeah, that's kind of how I look at it. And when we think about multimodality, maybe the reason why people got so excited about Sora is like, oh, this is like a completely It's not a better image model.[00:12:13] Alessio: This is like a completely different thing, you know? And I think the creative mind It's always looking for something that impacts the viewer in a different way, you know, like they really want something different versus the developer mind. It's like, Oh, I, I just, I have this like very annoying thing I want better.[00:12:32] Alessio: I have this like very specific use cases that I want to go after. So it's just different. And that's why you see a lot more companies in image generation. But I agree with you that. If you fast forward there, there's not going to be 10 of them, you know, it's probably going to be one or[00:12:46] swyx: two. Yeah, I mean, to me, that's why I call it a war.[00:12:49] swyx: Like, individually, all these companies can make a story that kind of makes sense, but collectively, they cannot all be true. Therefore, they all, there is some kind of fight over limited resources here. Yeah, so[00:12:59] NLW: it's interesting. We wandered very naturally into sort of another one of these wars, which is the multimodality kind of idea, which is, you know, basically a question of whether it's going to be these sort of big everything models that end up winning or whether, you know, you're going to have really specific things, you know, like something, you know, Dolly 3 inside of sort of OpenAI's larger models versus, you know, a mid journey or something like that.[00:13:24] NLW: And at first, you know, I was kind of thinking like, For most of the last, call it six months or whatever, it feels pretty definitively both and in some ways, you know, and that you're, you're seeing just like great innovation on sort of the everything models, but you're also seeing lots and lots happen at sort of the level of kind of individual use cases.[00:13:45] Sora[00:13:45] NLW: But then Sora comes along and just like obliterates what I think anyone thought you know, where we were when it comes to video generation. So how are you guys thinking about this particular battle or war at the moment?[00:13:59] swyx: Yeah, this was definitely a both and story, and Sora tipped things one way for me, in terms of scale being all you need.[00:14:08] swyx: And the benefit, I think, of having multiple models being developed under one roof. I think a lot of people aren't aware that Sora was developed in a similar fashion to Dolly 3. And Dolly3 had a very interesting paper out where they talked about how they sort of bootstrapped their synthetic data based on GPT 4 vision and GPT 4.[00:14:31] swyx: And, and it was just all, like, really interesting, like, if you work on one modality, it enables you to work on other modalities, and all that is more, is, is more interesting. I think it's beneficial if it's all in the same house, whereas the individual startups who don't, who sort of carve out a single modality and work on that, definitely won't have the state of the art stuff on helping them out on synthetic data.[00:14:52] swyx: So I do think like, The balance is tilted a little bit towards the God model companies, which is challenging for the, for the, for the the sort of dedicated modality companies. But everyone's carving out different niches. You know, like we just interviewed Suno ai, the sort of music model company, and, you know, I don't see opening AI pursuing music anytime soon.[00:15:12] Suno[00:15:12] swyx: Yeah,[00:15:13] NLW: Suno's been phenomenal to play with. Suno has done that rare thing where, which I think a number of different AI product categories have done, where people who don't consider themselves particularly interested in doing the thing that the AI enables find themselves doing a lot more of that thing, right?[00:15:29] NLW: Like, it'd be one thing if Just musicians were excited about Suno and using it but what you're seeing is tons of people who just like music all of a sudden like playing around with it and finding themselves kind of down that rabbit hole, which I think is kind of like the highest compliment that you can give one of these startups at the[00:15:45] swyx: early days of it.[00:15:46] swyx: Yeah, I, you know, I, I asked them directly, you know, in the interview about whether they consider themselves mid journey for music. And he had a more sort of nuanced response there, but I think that probably the business model is going to be very similar because he's focused on the B2C element of that. So yeah, I mean, you know, just to, just to tie back to the question about, you know, You know, large multi modality companies versus small dedicated modality companies.[00:16:10] swyx: Yeah, highly recommend people to read the Sora blog posts and then read through to the Dali blog posts because they, they strongly correlated themselves with the same synthetic data bootstrapping methods as Dali. And I think once you make those connections, you're like, oh, like it, it, it is beneficial to have multiple state of the art models in house that all help each other.[00:16:28] swyx: And these, this, that's the one thing that a dedicated modality company cannot do.[00:16:34] The GPT-4 Class Landscape[00:16:34] NLW: So I, I wanna jump, I wanna kind of build off that and, and move into the sort of like updated GPT-4 class landscape. 'cause that's obviously been another big change over the last couple months. But for the sake of completeness, is there anything that's worth touching on with with sort of the quality?[00:16:46] NLW: Quality data or sort of a rag ops wars just in terms of, you know, anything that's changed, I guess, for you fundamentally in the last couple of months about where those things stand.[00:16:55] swyx: So I think we're going to talk about rag for the Gemini and Clouds discussion later. And so maybe briefly discuss the data piece.[00:17:03] Data War: Reddit x Google[00:17:03] swyx: I think maybe the only new thing was this Reddit deal with Google for like a 60 million dollar deal just ahead of their IPO, very conveniently turning Reddit into a AI data company. Also, very, very interestingly, a non exclusive deal, meaning that Reddit can resell that data to someone else. And it probably does become table stakes.[00:17:23] swyx: A lot of people don't know, but a lot of the web text dataset that originally started for GPT 1, 2, and 3 was actually scraped from GitHub. from Reddit at least the sort of vote scores. And I think, I think that's a, that's a very valuable piece of information. So like, yeah, I think people are figuring out how to pay for data.[00:17:40] swyx: People are suing each other over data. This, this, this war is, you know, definitely very, very much heating up. And I don't think, I don't see it getting any less intense. I, you know, next to GPUs, data is going to be the most expensive thing in, in a model stack company. And. You know, a lot of people are resorting to synthetic versions of it, which may or may not be kosher based on how far along or how commercially blessed the, the forms of creating that synthetic data are.[00:18:11] swyx: I don't know if Alessio, you have any other interactions with like Data source companies, but that's my two cents.[00:18:17] Alessio: Yeah yeah, I actually saw Quentin Anthony from Luther. ai at GTC this week. He's also been working on this. I saw Technium. He's also been working on the data side. I think especially in open source, people are like, okay, if everybody is putting the gates up, so to speak, to the data we need to make it easier for people that don't have 50 million a year to get access to good data sets.[00:18:38] Alessio: And Jensen, at his keynote, he did talk about synthetic data a little bit. So I think that's something that we'll definitely hear more and more of in the enterprise, which never bodes well, because then all the, all the people with the data are like, Oh, the enterprises want to pay now? Let me, let me put a pay here stripe link so that they can give me 50 million.[00:18:57] Alessio: But it worked for Reddit. I think the stock is up. 40 percent today after opening. So yeah, I don't know if it's all about the Google deal, but it's obviously Reddit has been one of those companies where, hey, you got all this like great community, but like, how are you going to make money? And like, they try to sell the avatars.[00:19:15] Alessio: I don't know if that it's a great business for them. The, the data part sounds as an investor, you know, the data part sounds a lot more interesting than, than consumer[00:19:25] swyx: cosmetics. Yeah, so I think, you know there's more questions around data you know, I think a lot of people are talking about the interview that Mira Murady did with the Wall Street Journal, where she, like, just basically had no, had no good answer for where they got the data for Sora.[00:19:39] swyx: I, I think this is where, you know, there's, it's in nobody's interest to be transparent about data, and it's, it's kind of sad for the state of ML and the state of AI research but it is what it is. We, we have to figure this out as a society, just like we did for music and music sharing. You know, in, in sort of the Napster to Spotify transition, and that might take us a decade.[00:19:59] swyx: Yeah, I[00:20:00] NLW: do. I, I agree. I think, I think that you're right to identify it, not just as that sort of technical problem, but as one where society has to have a debate with itself. Because I think that there's, if you rationally within it, there's Great kind of points on all side, not to be the sort of, you know, person who sits in the middle constantly, but it's why I think a lot of these legal decisions are going to be really important because, you know, the job of judges is to listen to all this stuff and try to come to things and then have other judges disagree.[00:20:24] NLW: And, you know, and have the rest of us all debate at the same time. By the way, as a total aside, I feel like the synthetic data right now is like eggs in the 80s and 90s. Like, whether they're good for you or bad for you, like, you know, we, we get one study that's like synthetic data, you know, there's model collapse.[00:20:42] NLW: And then we have like a hint that llama, you know, to the most high performance version of it, which was one they didn't release was trained on synthetic data. So maybe it's good. It's like, I just feel like every, every other week I'm seeing something sort of different about whether it's a good or bad for, for these models.[00:20:56] swyx: Yeah. The branding of this is pretty poor. I would kind of tell people to think about it like cholesterol. There's good cholesterol, bad cholesterol. And you can have, you know, good amounts of both. But at this point, it is absolutely without a doubt that most large models from here on out will all be trained as some kind of synthetic data and that is not a bad thing.[00:21:16] swyx: There are ways in which you can do it poorly. Whether it's commercial, you know, in terms of commercial sourcing or in terms of the model performance. But it's without a doubt that good synthetic data is going to help your model. And this is just a question of like where to obtain it and what kinds of synthetic data are valuable.[00:21:36] swyx: You know, if even like alpha geometry, you know, was, was a really good example from like earlier this year.[00:21:42] NLW: If you're using the cholesterol analogy, then my, then my egg thing can't be that far off. Let's talk about the sort of the state of the art and the, and the GPT 4 class landscape and how that's changed.[00:21:53] Gemini 1.5 vs Claude 3[00:21:53] NLW: Cause obviously, you know, sort of the, the two big things or a couple of the big things that have happened. Since we last talked, we're one, you know, Gemini first announcing that a model was coming and then finally it arriving, and then very soon after a sort of a different model arriving from Gemini and and Cloud three.[00:22:11] NLW: So I guess, you know, I'm not sure exactly where the right place to start with this conversation is, but, you know, maybe very broadly speaking which of these do you think have made a bigger impact? Thank you.[00:22:20] Alessio: Probably the one you can use, right? So, Cloud. Well, I'm sure Gemini is going to be great once they let me in, but so far I haven't been able to.[00:22:29] Alessio: I use, so I have this small podcaster thing that I built for our podcast, which does chapters creation, like named entity recognition, summarization, and all of that. Cloud Tree is, Better than GPT 4. Cloud2 was unusable. So I use GPT 4 for everything. And then when Opus came out, I tried them again side by side and I posted it on, on Twitter as well.[00:22:53] Alessio: Cloud is better. It's very good, you know, it's much better, it seems to me, it's much better than GPT 4 at doing writing that is more, you know, I don't know, it just got good vibes, you know, like the GPT 4 text, you can tell it's like GPT 4, you know, it's like, it always uses certain types of words and phrases and, you know, maybe it's just me because I've now done it for, you know, So, I've read like 75, 80 generations of these things next to each other.[00:23:21] Alessio: Clutter is really good. I know everybody is freaking out on twitter about it, my only experience of this is much better has been on the podcast use case. But I know that, you know, Quran from from News Research is a very big opus pro, pro opus person. So, I think that's also It's great to have people that actually care about other models.[00:23:40] Alessio: You know, I think so far to a lot of people, maybe Entropic has been the sibling in the corner, you know, it's like Cloud releases a new model and then OpenAI releases Sora and like, you know, there are like all these different things, but yeah, the new models are good. It's interesting.[00:23:55] NLW: My my perception is definitely that just, just observationally, Cloud 3 is certainly the first thing that I've seen where lots of people.[00:24:06] NLW: They're, no one's debating evals or anything like that. They're talking about the specific use cases that they have, that they used to use chat GPT for every day, you know, day in, day out, that they've now just switched over. And that has, I think, shifted a lot of the sort of like vibe and sentiment in the space too.[00:24:26] NLW: And I don't necessarily think that it's sort of a A like full you know, sort of full knock. Let's put it this way. I think it's less bad for open AI than it is good for anthropic. I think that because GPT 5 isn't there, people are not quite willing to sort of like, you know get overly critical of, of open AI, except in so far as they're wondering where GPT 5 is.[00:24:46] NLW: But I do think that it makes, Anthropic look way more credible as a, as a, as a player, as a, you know, as a credible sort of player, you know, as opposed to to, to where they were.[00:24:57] Alessio: Yeah. And I would say the benchmarks veil is probably getting lifted this year. I think last year. People were like, okay, this is better than this on this benchmark, blah, blah, blah, because maybe they did not have a lot of use cases that they did frequently.[00:25:11] Alessio: So it's hard to like compare yourself. So you, you defer to the benchmarks. I think now as we go into 2024, a lot of people have started to use these models from, you know, from very sophisticated things that they run in production to some utility that they have on their own. Now they can just run them side by side.[00:25:29] Alessio: And it's like, Hey, I don't care that like. The MMLU score of Opus is like slightly lower than GPT 4. It just works for me, you know, and I think that's the same way that traditional software has been used by people, right? Like you just strive for yourself and like, which one does it work, works best for you?[00:25:48] Alessio: Like nobody looks at benchmarks outside of like sales white papers, you know? And I think it's great that we're going more in that direction. We have a episode with Adapt coming out this weekend. I'll and some of their model releases, they specifically say, We do not care about benchmarks, so we didn't put them in, you know, because we, we don't want to look good on them.[00:26:06] Alessio: We just want the product to work. And I think more and more people will, will[00:26:09] swyx: go that way. Yeah. I I would say like, it does take the wind out of the sails for GPT 5, which I know where, you know, Curious about later on. I think anytime you put out a new state of the art model, you have to break through in some way.[00:26:21] swyx: And what Claude and Gemini have done is effectively take away any advantage to saying that you have a million token context window. Now everyone's just going to be like, Oh, okay. Now you just match the other two guys. And so that puts An insane amount of pressure on what gpt5 is going to be because it's just going to have like the only option it has now because all the other models are multimodal all the other models are long context all the other models have perfect recall gpt5 has to match everything and do more to to not be a flop[00:26:58] AI Breakdown Part 2[00:26:58] NLW: hello friends back again with part two if you haven't heard part one of this conversation i suggest you go check it out but to be honest they are kind of actually separable In this conversation, we get into a topic that I think Alessio and Swyx are very well positioned to discuss, which is what developers care about right now, what people are trying to build around.[00:27:16] NLW: I honestly think that one of the best ways to see the future in an industry like AI is to try to dig deep on what developers and entrepreneurs are attracted to build, even if it hasn't made it to the news pages yet. So consider this your preview of six months from now, and let's dive in. Let's bring it to the GPT 5 conversation.[00:27:33] Next Frontiers: Llama 3, GPT-5, Gemini 2, Claude 4[00:27:33] NLW: I mean, so, so I think that that's a great sort of assessment of just how the stakes have been raised, you know is your, I mean, so I guess maybe, maybe I'll, I'll frame this less as a question, just sort of something that, that I, that I've been watching right now, the only thing that makes sense to me with how.[00:27:50] NLW: Fundamentally unbothered and unstressed OpenAI seems about everything is that they're sitting on something that does meet all that criteria, right? Because, I mean, even in the Lex Friedman interview that, that Altman recently did, you know, he's talking about other things coming out first. He's talking about, he's just like, he, listen, he, he's good and he could play nonchalant, you know, if he wanted to.[00:28:13] NLW: So I don't want to read too much into it, but. You know, they've had so long to work on this, like unless that we are like really meaningfully running up against some constraint, it just feels like, you know, there's going to be some massive increase, but I don't know. What do you guys think?[00:28:28] swyx: Hard to speculate.[00:28:29] swyx: You know, at this point, they're, they're pretty good at PR and they're not going to tell you anything that they don't want to. And he can tell you one thing and change their minds the next day. So it's, it's, it's really, you know, I've always said that model version numbers are just marketing exercises, like they have something and it's always improving and at some point you just cut it and decide to call it GPT 5.[00:28:50] swyx: And it's more just about defining an arbitrary level at which they're ready and it's up to them on what ready means. We definitely did see some leaks on GPT 4. 5, as I think a lot of people reported and I'm not sure if you covered it. So it seems like there might be an intermediate release. But I did feel, coming out of the Lex Friedman interview, that GPT 5 was nowhere near.[00:29:11] swyx: And you know, it was kind of a sharp contrast to Sam talking at Davos in February, saying that, you know, it was his top priority. So I find it hard to square. And honestly, like, there's also no point Reading too much tea leaves into what any one person says about something that hasn't happened yet or has a decision that hasn't been taken yet.[00:29:31] swyx: Yeah, that's, that's my 2 cents about it. Like, calm down, let's just build .[00:29:35] Alessio: Yeah. The, the February rumor was that they were gonna work on AI agents, so I don't know, maybe they're like, yeah,[00:29:41] swyx: they had two agent two, I think two agent projects, right? One desktop agent and one sort of more general yeah, sort of GPTs like agent and then Andre left, so he was supposed to be the guy on that.[00:29:52] swyx: What did Andre see? What did he see? I don't know. What did he see?[00:29:56] Alessio: I don't know. But again, it's just like the rumors are always floating around, you know but I think like, this is, you know, we're not going to get to the end of the year without Jupyter you know, that's definitely happening. I think the biggest question is like, are Anthropic and Google.[00:30:13] Alessio: Increasing the pace, you know, like it's the, it's the cloud four coming out like in 12 months, like nine months. What's the, what's the deal? Same with Gemini. They went from like one to 1. 5 in like five days or something. So when's Gemini 2 coming out, you know, is that going to be soon? I don't know.[00:30:31] Alessio: There, there are a lot of, speculations, but the good thing is that now you can see a world in which OpenAI doesn't rule everything. You know, so that, that's the best, that's the best news that everybody got, I would say.[00:30:43] swyx: Yeah, and Mistral Large also dropped in the last month. And, you know, not as, not quite GPT 4 class, but very good from a new startup.[00:30:52] swyx: So yeah, we, we have now slowly changed in landscape, you know. In my January recap, I was complaining that nothing's changed in the landscape for a long time. But now we do exist in a world, sort of a multipolar world where Cloud and Gemini are legitimate challengers to GPT 4 and hopefully more will emerge as well hopefully from meta.[00:31:11] Open Source Models - Mistral, Grok[00:31:11] NLW: So speak, let's actually talk about sort of the open source side of this for a minute. So Mistral Large, notable because it's, it's not available open source in the same way that other things are, although I think my perception is that the community has largely given them Like the community largely recognizes that they want them to keep building open source stuff and they have to find some way to fund themselves that they're going to do that.[00:31:27] NLW: And so they kind of understand that there's like, they got to figure out how to eat, but we've got, so, you know, there there's Mistral, there's, I guess, Grok now, which is, you know, Grok one is from, from October is, is open[00:31:38] swyx: sourced at, yeah. Yeah, sorry, I thought you thought you meant Grok the chip company.[00:31:41] swyx: No, no, no, yeah, you mean Twitter Grok.[00:31:43] NLW: Although Grok the chip company, I think is even more interesting in some ways, but and then there's the, you know, obviously Llama3 is the one that sort of everyone's wondering about too. And, you know, my, my sense of that, the little bit that, you know, Zuckerberg was talking about Llama 3 earlier this year, suggested that, at least from an ambition standpoint, he was not thinking about how do I make sure that, you know, meta content, you know, keeps, keeps the open source thrown, you know, vis a vis Mistral.[00:32:09] NLW: He was thinking about how you go after, you know, how, how he, you know, releases a thing that's, you know, every bit as good as whatever OpenAI is on at that point.[00:32:16] Alessio: Yeah. From what I heard in the hallways at, at GDC, Llama 3, the, the biggest model will be, you 260 to 300 billion parameters, so that that's quite large.[00:32:26] Alessio: That's not an open source model. You know, you cannot give people a 300 billion parameters model and ask them to run it. You know, it's very compute intensive. So I think it is, it[00:32:35] swyx: can be open source. It's just, it's going to be difficult to run, but that's a separate question.[00:32:39] Alessio: It's more like, as you think about what they're doing it for, you know, it's not like empowering the person running.[00:32:45] Alessio: llama. On, on their laptop, it's like, oh, you can actually now use this to go after open AI, to go after Anthropic, to go after some of these companies at like the middle complexity level, so to speak. Yeah. So obviously, you know, we estimate Gentala on the podcast, they're doing a lot here, they're making PyTorch better.[00:33:03] Alessio: You know, they want to, that's kind of like maybe a little bit of a shorted. Adam Bedia, in a way, trying to get some of the CUDA dominance out of it. Yeah, no, it's great. The, I love the duck destroying a lot of monopolies arc. You know, it's, it's been very entertaining. Let's bridge[00:33:18] NLW: into the sort of big tech side of this, because this is obviously like, so I think actually when I did my episode, this was one of the I added this as one of as an additional war that, that's something that I'm paying attention to.[00:33:29] NLW: So we've got Microsoft's moves with inflection, which I think pretend, potentially are being read as A shift vis a vis the relationship with OpenAI, which also the sort of Mistral large relationship seems to reinforce as well. We have Apple potentially entering the race, finally, you know, giving up Project Titan and and, and kind of trying to spend more effort on this.[00:33:50] NLW: Although, Counterpoint, we also have them talking about it, or there being reports of a deal with Google, which, you know, is interesting to sort of see what their strategy there is. And then, you know, Meta's been largely quiet. We kind of just talked about the main piece, but, you know, there's, and then there's spoilers like Elon.[00:34:07] NLW: I mean, you know, what, what of those things has sort of been most interesting to you guys as you think about what's going to shake out for the rest of this[00:34:13] Apple MM1[00:34:13] swyx: year? I'll take a crack. So the reason we don't have a fifth war for the Big Tech Wars is that's one of those things where I just feel like we don't cover differently from other media channels, I guess.[00:34:26] swyx: Sure, yeah. In our anti interestness, we actually say, like, we try not to cover the Big Tech Game of Thrones, or it's proxied through Twitter. You know, all the other four wars anyway, so there's just a lot of overlap. Yeah, I think absolutely, personally, the most interesting one is Apple entering the race.[00:34:41] swyx: They actually released, they announced their first large language model that they trained themselves. It's like a 30 billion multimodal model. People weren't that impressed, but it was like the first time that Apple has kind of showcased that, yeah, we're training large models in house as well. Of course, like, they might be doing this deal with Google.[00:34:57] swyx: I don't know. It sounds very sort of rumor y to me. And it's probably, if it's on device, it's going to be a smaller model. So something like a Jemma. It's going to be smarter autocomplete. I don't know what to say. I'm still here dealing with, like, Siri, which hasn't, probably hasn't been updated since God knows when it was introduced.[00:35:16] swyx: It's horrible. I, you know, it, it, it makes me so angry. So I, I, one, as an Apple customer and user, I, I'm just hoping for better AI on Apple itself. But two, they are the gold standard when it comes to local devices, personal compute and, and trust, like you, you trust them with your data. And. I think that's what a lot of people are looking for in AI, that they have, they love the benefits of AI, they don't love the downsides, which is that you have to send all your data to some cloud somewhere.[00:35:45] swyx: And some of this data that we're going to feed AI is just the most personal data there is. So Apple being like one of the most trusted personal data companies, I think it's very important that they enter the AI race, and I hope to see more out of them.[00:35:58] Alessio: To me, the, the biggest question with the Google deal is like, who's paying who?[00:36:03] Alessio: Because for the browsers, Google pays Apple like 18, 20 billion every year to be the default browser. Is Google going to pay you to have Gemini or is Apple paying Google to have Gemini? I think that's, that's like what I'm most interested to figure out because with the browsers, it's like, it's the entry point to the thing.[00:36:21] Alessio: So it's really valuable to be the default. That's why Google pays. But I wonder if like the perception in AI is going to be like, Hey. You just have to have a good local model on my phone to be worth me purchasing your device. And that was, that's kind of drive Apple to be the one buying the model. But then, like Shawn said, they're doing the MM1 themselves.[00:36:40] Alessio: So are they saying we do models, but they're not as good as the Google ones? I don't know. The whole thing is, it's really confusing, but. It makes for great meme material on on Twitter.[00:36:51] swyx: Yeah, I mean, I think, like, they are possibly more than OpenAI and Microsoft and Amazon. They are the most full stack company there is in computing, and so, like, they own the chips, man.[00:37:05] swyx: Like, they manufacture everything so if, if, if there was a company that could do that. You know, seriously challenge the other AI players. It would be Apple. And it's, I don't think it's as hard as self driving. So like maybe they've, they've just been investing in the wrong thing this whole time. We'll see.[00:37:21] swyx: Wall Street certainly thinks[00:37:22] NLW: so. Wall Street loved that move, man. There's a big, a big sigh of relief. Well, let's, let's move away from, from sort of the big stuff. I mean, the, I think to both of your points, it's going to.[00:37:33] Meta's $800b AI rebrand[00:37:33] NLW: Can I, can[00:37:34] swyx: I, can I, can I jump on factoid about this, this Wall Street thing? I went and looked at when Meta went from being a VR company to an AI company.[00:37:44] swyx: And I think the stock I'm trying to look up the details now. The stock has gone up 187% since Lamo one. Yeah. Which is $830 billion in market value created in the past year. . Yeah. Yeah.[00:37:57] NLW: It's, it's, it's like, remember if you guys haven't Yeah. If you haven't seen the chart, it's actually like remarkable.[00:38:02] NLW: If you draw a little[00:38:03] swyx: arrow on it, it's like, no, we're an AI company now and forget the VR thing.[00:38:10] NLW: It's it, it is an interesting, no, it's, I, I think, alessio, you called it sort of like Zuck's Disruptor Arc or whatever. He, he really does. He is in the midst of a, of a total, you know, I don't know if it's a redemption arc or it's just, it's something different where, you know, he, he's sort of the spoiler.[00:38:25] NLW: Like people loved him just freestyle talking about why he thought they had a better headset than Apple. But even if they didn't agree, they just loved it. He was going direct to camera and talking about it for, you know, five minutes or whatever. So that, that's a fascinating shift that I don't think anyone had on their bingo card, you know, whatever, two years ago.[00:38:41] NLW: Yeah. Yeah,[00:38:42] swyx: we still[00:38:43] Alessio: didn't see and fight Elon though, so[00:38:45] swyx: that's what I'm really looking forward to. I mean, hey, don't, don't, don't write it off, you know, maybe just these things take a while to happen. But we need to see and fight in the Coliseum. No, I think you know, in terms of like self management, life leadership, I think he has, there's a lot of lessons to learn from him.[00:38:59] swyx: You know he might, you know, you might kind of quibble with, like, the social impact of Facebook, but just himself as a in terms of personal growth and, and, you know, Per perseverance through like a lot of change and you know, everyone throwing stuff his way. I think there's a lot to say about like, to learn from, from Zuck, which is crazy 'cause he's my age.[00:39:18] swyx: Yeah. Right.[00:39:20] AI Engineer landscape - from baby AGIs to vertical Agents[00:39:20] NLW: Awesome. Well, so, so one of the big things that I think you guys have, you know, distinct and, and unique insight into being where you are and what you work on is. You know, what developers are getting really excited about right now. And by that, I mean, on the one hand, certainly, you know, like startups who are actually kind of formalized and formed to startups, but also, you know, just in terms of like what people are spending their nights and weekends on what they're, you know, coming to hackathons to do.[00:39:45] NLW: And, you know, I think it's a, it's a, it's, it's such a fascinating indicator for, for where things are headed. Like if you zoom back a year, right now was right when everyone was getting so, so excited about. AI agent stuff, right? Auto, GPT and baby a GI. And these things were like, if you dropped anything on YouTube about those, like instantly tens of thousands of views.[00:40:07] NLW: I know because I had like a 50,000 view video, like the second day that I was doing the show on YouTube, you know, because I was talking about auto GPT. And so anyways, you know, obviously that's sort of not totally come to fruition yet, but what are some of the trends in what you guys are seeing in terms of people's, people's interest and, and, and what people are building?[00:40:24] Alessio: I can start maybe with the agents part and then I know Shawn is doing a diffusion meetup tonight. There's a lot of, a lot of different things. The, the agent wave has been the most interesting kind of like dream to reality arc. So out of GPT, I think they went, From zero to like 125, 000 GitHub stars in six weeks, and then one year later, they have 150, 000 stars.[00:40:49] Alessio: So there's kind of been a big plateau. I mean, you might say there are just not that many people that can start it. You know, everybody already started it. But the promise of, hey, I'll just give you a goal, and you do it. I think it's like, amazing to get people's imagination going. You know, they're like, oh, wow, this This is awesome.[00:41:08] Alessio: Everybody, everybody can try this to do anything. But then as technologists, you're like, well, that's, that's just like not possible, you know, we would have like solved everything. And I think it takes a little bit to go from the promise and the hope that people show you to then try it yourself and going back to say, okay, this is not really working for me.[00:41:28] Alessio: And David Wong from Adept, you know, they in our episode, he specifically said. We don't want to do a bottom up product. You know, we don't want something that everybody can just use and try because it's really hard to get it to be reliable. So we're seeing a lot of companies doing vertical agents that are narrow for a specific domain, and they're very good at something.[00:41:49] Alessio: Mike Conover, who was at Databricks before, is also a friend of Latentspace. He's doing this new company called BrightWave doing AI agents for financial research, and that's it, you know, and they're doing very well. There are other companies doing it in security, doing it in compliance, doing it in legal.[00:42:08] Alessio: All of these things that like, people, nobody just wakes up and say, Oh, I cannot wait to go on AutoGPD and ask it to do a compliance review of my thing. You know, just not what inspires people. So I think the gap on the developer side has been the more bottom sub hacker mentality is trying to build this like very Generic agents that can do a lot of open ended tasks.[00:42:30] Alessio: And then the more business side of things is like, Hey, If I want to raise my next round, I can not just like sit around the mess, mess around with like super generic stuff. I need to find a use case that really works. And I think that that is worth for, for a lot of folks in parallel, you have a lot of companies doing evals.[00:42:47] Alessio: There are dozens of them that just want to help you measure how good your models are doing. Again, if you build evals, you need to also have a restrained surface area to actually figure out whether or not it's good, right? Because you cannot eval anything on everything under the sun. So that's another category where I've seen from the startup pitches that I've seen, there's a lot of interest in, in the enterprise.[00:43:11] Alessio: It's just like really. Fragmented because the production use cases are just coming like now, you know, there are not a lot of long established ones to, to test against. And so does it, that's kind of on the virtual agents and then the robotic side it's probably been the thing that surprised me the most at NVIDIA GTC, the amount of robots that were there that were just like robots everywhere.[00:43:33] Alessio: Like, both in the keynote and then on the show floor, you would have Boston Dynamics dogs running around. There was, like, this, like fox robot that had, like, a virtual face that, like, talked to you and, like, moved in real time. There were industrial robots. NVIDIA did a big push on their own Omniverse thing, which is, like, this Digital twin of whatever environments you're in that you can use to train the robots agents.[00:43:57] Alessio: So that kind of takes people back to the reinforcement learning days, but yeah, agents, people want them, you know, people want them. I give a talk about the, the rise of the full stack employees and kind of this future, the same way full stack engineers kind of work across the stack. In the future, every employee is going to interact with every part of the organization through agents and AI enabled tooling.[00:44:17] Alessio: This is happening. It just needs to be a lot more narrow than maybe the first approach that we took, which is just put a string in AutoGPT and pray. But yeah, there's a lot of super interesting stuff going on.[00:44:27] swyx: Yeah. Well, he Let's recover a lot of stuff there. I'll separate the robotics piece because I feel like that's so different from the software world.[00:44:34] swyx: But yeah, we do talk to a lot of engineers and you know, that this is our sort of bread and butter. And I do agree that vertical agents have worked out a lot better than the horizontal ones. I think all You know, the point I'll make here is just the reason AutoGPT and maybe AGI, you know, it's in the name, like they were promising AGI.[00:44:53] swyx: But I think people are discovering that you cannot engineer your way to AGI. It has to be done at the model level and all these engineering, prompt engineering hacks on top of it weren't really going to get us there in a meaningful way without much further, you know, improvements in the models. I would say, I'll go so far as to say, even Devin, which is, I would, I think the most advanced agent that we've ever seen, still requires a lot of engineering and still probably falls apart a lot in terms of, like, practical usage.[00:45:22] swyx: Or it's just, Way too slow and expensive for, you know, what it's, what it's promised compared to the video. So yeah, that's, that's what, that's what happened with agents from, from last year. But I, I do, I do see, like, vertical agents being very popular and, and sometimes you, like, I think the word agent might even be overused sometimes.[00:45:38] swyx: Like, people don't really care whether or not you call it an AI agent, right? Like, does it replace boring menial tasks that I do That I might hire a human to do, or that the human who is hired to do it, like, actually doesn't really want to do. And I think there's absolutely ways in sort of a vertical context that you can actually go after very routine tasks that can be scaled out to a lot of, you know, AI assistants.[00:46:01] swyx: So, so yeah, I mean, and I would, I would sort of basically plus one what let's just sit there. I think it's, it's very, very promising and I think more people should work on it, not less. Like there's not enough people. Like, we, like, this should be the, the, the main thrust of the AI engineer is to look out, look for use cases and, and go to a production with them instead of just always working on some AGI promising thing that never arrives.[00:46:21] swyx: I,[00:46:22] NLW: I, I can only add that so I've been fiercely making tutorials behind the scenes around basically everything you can imagine with AI. We've probably done, we've done about 300 tutorials over the last couple of months. And the verticalized anything, right, like this is a solution for your particular job or role, even if it's way less interesting or kind of sexy, it's like so radically more useful to people in terms of intersecting with how, like those are the ways that people are actually.[00:46:50] NLW: Adopting AI in a lot of cases is just a, a, a thing that I do over and over again. By the way, I think that's the same way that even the generalized models are getting adopted. You know, it's like, I use midjourney for lots of stuff, but the main thing I use it for is YouTube thumbnails every day. Like day in, day out, I will always do a YouTube thumbnail, you know, or two with, with Midjourney, right?[00:47:09] NLW: And it's like you can, you can start to extrapolate that across a lot of things and all of a sudden, you know, a AI doesn't. It looks revolutionary because of a million small changes rather than one sort of big dramatic change. And I think that the verticalization of agents is sort of a great example of how that's[00:47:26] swyx: going to play out too.[00:47:28] Adept episode - Screen Multimodality[00:47:28] swyx: So I'll have one caveat here, which is I think that Because multi modal models are now commonplace, like Cloud, Gemini, OpenAI, all very very easily multi modal, Apple's easily multi modal, all this stuff. There is a switch for agents for sort of general desktop browsing that I think people so much for joining us today, and we'll see you in the next video.[00:48:04] swyx: Version of the the agent where they're not specifically taking in text or anything They're just watching your screen just like someone else would and and I'm piloting it by vision And you know in the the episode with David that we'll have dropped by the time that this this airs I think I think that is the promise of adept and that is a promise of what a lot of these sort of desktop agents Are and that is the more general purpose system That could be as big as the browser, the operating system, like, people really want to build that foundational piece of software in AI.[00:48:38] swyx: And I would see, like, the potential there for desktop agents being that, that you can have sort of self driving computers. You know, don't write the horizontal piece out. I just think we took a while to get there.[00:48:48] NLW: What else are you guys seeing that's interesting to you? I'm looking at your notes and I see a ton of categories.[00:48:54] Top Model Research from January Recap[00:48:54] swyx: Yeah so I'll take the next two as like as one category, which is basically alternative architectures, right? The two main things that everyone following AI kind of knows now is, one, the diffusion architecture, and two, the let's just say the, Decoder only transformer architecture that is popularized by GPT.[00:49:12] swyx: You can read, you can look on YouTube for thousands and thousands of tutorials on each of those things. What we are talking about here is what's next, what people are researching, and what could be on the horizon that takes the place of those other two things. So first of all, we'll talk about transformer architectures and then diffusion.[00:49:25] swyx: So transformers the, the two leading candidates are effectively RWKV and the state space models the most recent one of which is Mamba, but there's others like the Stripe, ENA, and the S four H three stuff coming out of hazy research at Stanford. And all of those are non quadratic language models that scale the promise to scale a lot better than the, the traditional transformer.[00:49:47] swyx: That this might be too theoretical for most people right now, but it's, it's gonna be. It's gonna come out in weird ways, where, imagine if like, Right now the talk of the town is that Claude and Gemini have a million tokens of context and like whoa You can put in like, you know, two hours of video now, okay But like what if you put what if we could like throw in, you know, two hundred thousand hours of video?[00:50:09] swyx: Like how does that change your usage of AI? What if you could throw in the entire genetic sequence of a human and like synthesize new drugs. Like, well, how does that change things? Like, we don't know because we haven't had access to this capability being so cheap before. And that's the ultimate promise of these two models.[00:50:28] swyx: They're not there yet but we're seeing very, very good progress. RWKV and Mamba are probably the, like, the two leading examples, both of which are open source that you can try them today and and have a lot of progress there. And the, the, the main thing I'll highlight for audio e KV is that at, at the seven B level, they seem to have beat LAMA two in all benchmarks that matter at the same size for the same amount of training as an open source model.[00:50:51] swyx: So that's exciting. You know, they're there, they're seven B now. They're not at seven tb. We don't know if it'll. And then the other thing is diffusion. Diffusions and transformers are are kind of on the collision course. The original stable diffusion already used transformers in in parts of its architecture.[00:51:06] swyx: It seems that transformers are eating more and more of those layers particularly the sort of VAE layer. So that's, the Diffusion Transformer is what Sora is built on. The guy who wrote the Diffusion Transformer paper, Bill Pebbles, is, Bill Pebbles is the lead tech guy on Sora. So you'll just see a lot more Diffusion Transformer stuff going on.[00:51:25] swyx: But there's, there's more sort of experimentation with diffusion. I'm holding a meetup actually here in San Francisco that's gonna be like the state of diffusion, which I'm pretty excited about. Stability's doing a lot of good work. And if you look at the, the architecture of how they're creating Stable Diffusion 3, Hourglass Diffusion, and the inconsistency models, or SDXL Turbo.[00:51:45] swyx: All of these are, like, very, very interesting innovations on, like, the original idea of what Stable Diffusion was. So if you think that it is expensive to create or slow to create Stable Diffusion or an AI generated art, you are not up to date with the latest models. If you think it is hard to create text and images, you are not up to date with the latest models.[00:52:02] swyx: And people still are kind of far behind. The last piece of which is the wildcard I always kind of hold out, which is text diffusion. So Instead of using autogenerative or autoregressive transformers, can you use text to diffuse? So you can use diffusion models to diffuse and create entire chunks of text all at once instead of token by token.[00:52:22] swyx: And that is something that Midjourney confirmed today, because it was only rumored the past few months. But they confirmed today that they were looking into. So all those things are like very exciting new model architectures that are, Maybe something that we'll, you'll see in production two to three years from now.[00:52:37] swyx: So the couple of the trends[00:52:38] NLW: that I want to just get your takes on, because they're sort of something that, that seems like they're coming up are one sort of these, these wearable, you know, kind of passive AI experiences where they're absorbing a lot of what's going on around you and then, and then kind of bringing things back.[00:52:53] NLW: And then the, the other one that I, that I wanted to see if you guys had thoughts on were sort of this next generation of chip companies. Obviously there's a huge amount of emphasis. On on hardware and silicon and, and, and different ways of doing things, but, y

Bertram Lyons, CEO of MedEx Forensics, discusses the challenges and impact of AI-generated content and the need for authentication and provenance analysis. Lyons explains MedEx Forensics' methodology, which focuses on analyzing the internal structure of digital multimedia files. He also discusses the rise of synthetic media and the need for tools to authenticate and analyze it. The conversation explores the nuances of real, original, and authentic content, and the role of institutions and initiatives in addressing the issue. The conversation explores the impact of AI on misinformation and victim data, the balance between privacy and content moderation, the legal landscape of manipulated content, the implications for various industries, the difference between deepfake and cheap fake, the impact on corporations, and the future of multimedia attribution and AI.

This episode came together at ~4 hrs notice since Dylan had just landed in SF and we had to setup quickly; you might notice some small audio issues in some segments, we apologize. We're currently building our own podcast studio for 2024!

How can you know if video evidence is valid or has been altered? By analyzing a file's metadata without accessing personal information or video footage, Medex can identify if it has been tampered with and flag it for further investigation.  As videos can be easily manipulated, authenticating them is becoming legally necessary. The digital forensic community should apply more pressure to ensure that files can be evaluated earlier in their lifecycle.

Ce jeudi 10 novembre 2022, dans Bruxelles vit !, Clara est au MEDEX museum pour l'exposition "Parle moi Bruxelles".

As farmacêuticas e as empresas de saúde suplementar começam a se relacionar com mais intensidade com tecnologia e dados. Os objetivos são simplificar a vida do cliente e otimizar os negócios nesses setores. Apresentação: Cassio Politi https://www.linkedin.com/in/cassiopoliti/. Convidado: Paulo Campos (fundador e CEO da Medex). Perfil do convidado no LinkedIn: https://www.linkedin.com/in/paulo-campos-b0051b46. Site da empresa: https://medex.net.br/. Anote algumas outras referências citadas no podcast. Dados do Governo sobre saúde suplementar no Brasil: https://www.gov.br/ans/pt-br/assuntos/noticias/sobre-ans/ans-faz-retrospectiva-de-2021-na-saude-suplementar.

The post MedEx Academy 2022 appeared first on Ology of Kelly.

This special episode features the Medical Experience Academy or MedEx Academy. A one-of-a-kind program developed to create more interest among young people in pursuing careers in health care. Students accepted into the academy have the unique opportunity to explore health care. Three advisors from the program (Alycia, Sarah and Victoria) join to chat about MedEx Academy and incredible opportunity the program provides for high school and college students in South Carolina. This episode is a MUST listen for students applying to professional school. Learn about the 4-tiers of the program We cover the Top 10 Requirements for Graduate/Professional School applications. Learn how Underrepresented Minority applicants can best define and discuss the "diversity" they bring to programs. *Applications for the 2022 program close January 9th, however the program opens up again in October. Click here to apply: Application or visit their website to learn more: **This episode was sponsored by Picmonic . Visit their website and mention the podcast when you subscribe. If you enjoyed this episode, please share with a friend and leave a comment and rating on iTunes. TBDP is a volunteer passion project with the goal of inspiring all who listen. In-house music and audio production, so any ideas for improvements or suggestions for future guests are welcome. Visit www.StevenBradleyMD.com to learn more about our host. He is available for consultations or speaking engagements regarding health equity and medical ethics.

Can you afford your medical prescriptions? This episode shows you how to get free or cheaper prescriptions based on your situation and explains all you need to know about a prescription prepayment certificate.

Mr. Terry Scott, MPA, PA-C, DFAAPA is the Program Director and Section Head of MEDEX Northwest, the PA Program at the University of Washington (UW) in Seattle. Terry and I discuss our passion for diversity, equity, and inclusion and the historic roots of the MEDEX Northwest PA Program including some of the historic work their founding father Dr. Richard Smith led in his career. We also talk about the "why" behind the applicant and the importance of knowing your why before applying to any PA program.

Everyone needs to listen to today's episode. From a low GPA to acceptance as a reapplicant at University of Washington - MEDEX, Sydney is the epitome of hope and persistence. With tons of clinical experience as a medical assistant, Sydney shares her story of how she overcame doubt to reach her goal of becoming a PA student. Northeastern Pre-PA Conference - 7/25 - https://bit.ly/2wMTBCj Mock Interviews LIVE Part 2 - July 24 8 PM EST - www.prepaconference.comGet a free eBook! - audibletrial.com/thepaplatform Leave a voicemail question for The Pre-PA Club Podcast - https://www.speakpipe.com/ThePAplatform Physician Assistant School Interview Guide Affiliate Link - https://amzn.to/2JctZ2CThe Pre-PA Club Facebook Group - facebook.com/groups/theprepaclub/Discount for www.myPAresource.com - “prepaclub”Discount for http://www.PAschoolPrep.com - FUTURE PA for $35 off The PA Platform onInstagram - @thePAplatformMedelita 20% off code - PAPLATFORM1 - Link to get $20 off first purchase over $70 - https://www.medelita.com/?ref=aEJqZjZWSUsyWkE9FRE Skincare 15% off - SAVANNA1 - https://www.freskincare.com/SAVANNA1 Try Amazon Prime Student and get 50% off - https://amzn.to/2RxBQjd

Our most recent podcast was about the new Physician Assistant Training Program being established in South Kona, with Dr. Misbah Keen and Mr. Terry Scott from University of Washington School of Medicine MEDEX program.  This discussion is the moving story of the program's founder, Dr. Richard Smith, who has longtime Hawaii connections.  Photo:  Dr. Smith with Pres. Barack Obama...courtesy University of Washington School of Medicine Post date:  March 1, 2020

The University of Washington School of Medicine has MEDEX, a Physician Assistant Training Program, serving Washington, Wyoming, Alaska, Montana and Idaho (the WWAMI medical education region) -- and now it's adding Hawaii!  Dr. Misbah Keen and Mr. Terry Scott, both on the faculty at UW School of Medicine, talk with host Sherry Bracken about the program.  Photo is Sherry with Dr. Keen and Mr. Scott on Jan. 15, 2020. Air date:  March 1, 2020

This episode features Claudia Williams, the CEO of Manifest MedEx and a former Senior Advisor of Health Innovation and Technology in the Obama White House. Here she discusses her passion for unlocking health data, how her not-for-profit information network fits in with other well-known technology giants, and her experience working for the Obama Administration.

Andrei Yakovenko is the owner and operator of New Element Training in Toronto, Canada. NET has been open since November 2013 and blends mindfulness with MedEx resistance training. In this contemplative episode Jesse and Liam take a deep dive with Andrei into the meaning of success as a business owner, achieving life-long health, and building a fitness brand.  To get in touch with Andrei visit his website at: https://www.newelementtraining.com/

Michael Petrella is the owner of STG Strength and Power in Ontario, Canada. He trains world champion powerlifters, pre-teens, and octogenarians on over 100 pieces of MedEx, Nautilus, Pendulum, and more.  In this episode we discuss powerlifting, the mental side of training, and eating nutrient-dense food among other topics.  Visit Michael at http://stgstrengthandpower.com/

Jim Flanagan got in with Arthur Jones and Nautilus on the ground floor selling equipment and working trade shows. He used the education he got from Arthur to start his own gym business, but he stayed involved with Nautilus and then later, MedEx.  In this episode Big Jim tells us what it was like when Nautilus took the fitness world by storm and what it was like working with the enigmatic Arthur Jones.  Spend a day with Jim by signing up for the Real HIT Experience at http://therealhit.com/

Patricia is a PhD researcher at Waterford Institute of Technology in Ireland. Patricia is finishing up her dissertation, where she looked at a physical activity program to improve symptoms of cancer-related fatigue.   In this episode, we focus on cancer-related fatigue, what it is, how it’s different from regular tiredness and how it can affect different people. We chat about Patrica’s dissertation work and how physical activity can improve fatigue. We also chat about the state of cancer rehabilitation in Ireland and what services are out there for cancer patients/survivors.   You can find Patricia on twitter @FERNTRI or through email at patricia.sheehan@postgrad.wit.ie   You can also find the MedEx program in Waterford here: https://www.wit.ie/schools/health_sciences/medexwit.   Find me on twitter at @CiaranFairman or go to reachbeyondcancer.com to find out more about what we do.   This episode doesn’t have an intro, I came down with a devastating case of the man-flu over the weekend, so I’m not able to speak to put one up. This episode is sponsored by Lampstrong.com. The LampStrong Foundation is a non-profit organization founded by Major League Soccer Goalkeeper and Stage Four Hodgkin Lymphoma Survivor Matt Lampson. The mission of The LampStrong Foundation is to provide difference-making financial, emotional and motivational support to cancer patients and families in all the stages of cancer treatment and recovery as well as to fund proven cancer researchers. For more information and regular updates on the LampStrong Foundation follow the LampStrong Foundation on Facebook or visit LampStrong.com.       1.00 – What is Cancer Related Fatigue, what are the symptoms, how long does it last, what causes it etc.   5.00 – Where should exercise advice for cancer patients/survivors come from?   7.00 – Different dimensions of cancer-related fatigue, whether its emotional, cognitive or physical fatigue, and how those patterns fluctuate during treatment.   11.29 – The transition from active treatment to survivorship and how patients/survivors can feel lost and isolated.   15.35 – Patricia’s study looking at physical activity and cancer-related fatigue.   28.45 – Fit and active cancer patients – dealing with exercise tolerance going down.   36.00 – Turning her research into a public service program at Waterford Institute of Technology.   44.00 – State of cancer rehab in Ireland. Where the field is and what is available for patients/survivors.   51.00 – The influence of policy on establishing exercise oncology as a standard of care. 

You might recall in our last episode, Adam shared the very intimate details of his lifelong struggle with lower back pain and how he's conquering it by combing slow motion, high-intensity strength training with a positive attitude.Here in episode 24, we get into some of the psychological aspects of a negative diagnosis, such as a lower back problem, and how that diagnosis alone can prolong an illness or injury.Conversely, we'll share some interesting data that supports the notion that a simple attitude adjustment can change the course of your rehabilitation towards a faster recovery.Dr. Louis Fierro who is a chiropractor and works with the InForm Fitness Active Rehabilitation program joins Adam Zickerman to offer up his suggestions and solutions for those experiencing back pain.Below is a link to the book Adam mentioned in this episode: Foundation: Redefine You Core, Conquer Back Pain, and Move with Confidence: Below is a link to the article Adam mentioned in this episode: http://bit.ly/FoundationRedefineYourCoreA Rational Approach to the Treatment of Low Back Pain by Brian W. Nelson, MD http://www.medxonline.com/pdf/rationalapproachtotreatment.pdfDon't forget Adam's Zickerman's book, Power of 10: The Once-a-Week Slow Motion Fitness Revolution.  You can purchase Adam's book in Amazon by  clicking here: http://bit.ly/ThePowerofTenTo find an Inform Fitness location nearest you to give this workout a try, please visit www.InformFitness.com.  At the time of this recording we have locations in Manhattan, Port Washington, Denville, Burbank, Boulder, Leesburg and Resten.If you'd like to ask Adam, Mike or Sheila a question or have a comment regarding the Power of 10. Send us an email or record a voice memo on your phone and send it to podcast@informfitness.com. For information regarding the production of your own podcast just like The Inform Fitness Podcast, please email Tim Edwards at tim@InBoundPodcasting.comTranscription to this episode is below:Motion is Great Joint LotionLouis: People get diagnosed, and then they go into this sick syndrome if you will as Adam described and their anxiety levels go through the roof. They're told to take [Inaudible] and medication and immobilize, rest, don't actively engage and really here at InForm Fitness, it's the opposite. The patients are clients with the clients and taught to enthusiastically actively engage in not only an exercise program of high-intensity, but a healthy lifestyle.Tim: InForm Nation, good to have you back with us here on the InForm Nation podcast. 20 minutes with New York Times bestselling author, Adam Zickerman, and friends. I'm Tim Edwards with the InBound Podcasting Network and a client of InForm Fitness. You just heard the voice of Dr. Louis Fierro, he's a chiropractor who works with Adam in the InForm Fitness Active Rehabilitation program. Now in this episode, Dr. Lou as he's affectionally called, will offer up his suggestions and solutions for those experiencing back pain, much like Adam has. You might recall on the last episode, Adam shared the very intimate details of his lifelong struggle with lower back pain, and how he's conquering it by combing slow motion, high-intensity strength training with his attitude. Here on episode 24, we get into some of the psychological aspects of a negative diagnoses such as a back problem, and how that alone can prolong an illness or injury. Conversely, we'll share some interesting data that supports the notion that a simple attitude adjustment can change the course of your rehabilitation towards a faster recovery. Joined as always by Sheila Melody, the co-owner and general manager of the Burbank location, and Mike Rogers, the general manager of the Manhattan location. Here is the founder of InForm Fitness, Adam Zickerman.Adam: I read this article a couple of years ago which really resonated with me, written by some doctors that treat lower back problems, non-surgically, the way we're actually doing it here and the way we recommend people do it, but it's not just a physical program of exercise that he was talking about. There was another aspect about people getting better, and that was the mental side of it which I found really interesting. For years and years and years, people kept telling me you've got to do something about your back. Every so often you're getting these spasms, you've got to get some MRIs and some interventions, like surgical type of interventions. At the very least, get injections into the facets of your spine, all these techniques that I was very resistant to because in my mind, my back problem was a temporary thing that I had to solve. I didn't really believe that I had a back problem, I thought that there were some muscular things that weren't being dealt with and putting me into spasm, it wasn't a structural thing with my back, I was convinced of that, and therefore I never accepted the fact that I was somebody with back problems. Obviously when I had a spasm I had to accept the fact that I had a back problem, but the chronic pain that came and went from a one to a four, back to a one, I was just saying I need to do something in a nonsurgical way, I just haven't figured it out yet, and then the article talked about that. He was saying that a lot of patients, they fall into this sick role when they're told they have a back problem and it becomes a self-fulfilling prophecy and now they have a back problem, and they just accept the fact that they have this back problem, and there's a huge psychological component to this. I realized that one of the reasons why I wasn't debilitated long term is because I never accepted the fact that I had this back problem and it's because of that nonacceptance if you will that I am where I am right now, but my attitude towards this whole thing is what I'm saying is what got me through this and there are a lot of people that kind of feel when they have a back problem, that's it and you rely on these surgical methodologies because there's no other way to fix it. Even though they have MRIs that are less remarkable than mine, so Dr. Lou Fierro, chiropractor that works out of our studio here in Manhattan and is involved in our active rehabilitation program and uses some of our equipment to help patients, is here with us today and I want him to talk about this idea that people play this sick role when all of a sudden they're told by a doctor that they have a back problem. Do you find that to be true?Lou: Absolutely, and you shared this article with me several months ago, and I thought the title said a lot [Inaudible: 00:05:10]. Adam: Brian Nelson, exactly.Lou: A rational approach to the treatment of lower back pain, and after I read it, I said this is really a proactive approach and that's the model we've always taken. Whether we had an elite level athlete, a professional athlete, a weekend warrior, the de-conditioned mother that's caring for kids that have so much anxiety when they're given an MRI and shown the results of a herniation, and the reality is if we took 100% of the population and gave them an MRI, specifically in the lumbar region, about 82% studies show, there would some shape or form of a degenerative change or a herniation between the ages of 22 and 65. Only about 30% of that population has a subjective complaint to follow and mirror that objective finding, so people get diagnosed and then they get into this sick syndrome, if you will as Adam described, and their anxiety levels go through the roof. They're told take [Inaudible: 00:06:02], take medication, immobilize, rest, don't actively engage, and really here at InForm Fitness, it's the opposite. The patients are educated, the clients are taught to enthusiastically actively engage, not only in an exercise program of high-intensity, but a healthy lifestyle. Once they're shown that I can BLT, bend, lift, and twist, and not exacerbate my condition, now I can walk up a flight of stairs. I can care for my children, I can be a good spouse. They just really decrease in their pain threshold, and inflammation in their body, because there have been studies to show that inflammation is not only caused by poor diet, overactive activities, but by stress levels. Cortisol —Adam: Lack of sleep.Lou: Side effects of medication, so I don't know the exact date that I first met Adam, but once I really saw the program that they were doing here, I kind of had to look twice at it and I realized wow, he's onto something. He's onto something more than most medical doctors have doing for the last twenty-five years. Tim: He's the guru, I keep telling you.Lou: I think as recently as last week in [Inaudible: 00:07:56], I said Adam you've got to come in here, I've got a patient that actually had a three level laminectomy and she's got rotational scoliosis in her back, and she has had nagging, nagging pain. I cannot remember [Inaudible: 00:08:13] may be the medication she's on, but without that medication, it's hard for her to function. I said you know what, we're going to throw her on the MedEx machine here, lumbar extension machine. This is after I did a little bit of what I call white knuckling, trigger point release into one of her spinal muscles that was contracted. Put her on that machine, she stood up, and she said I'm pain-free. Holy crap, I'm pain-free.Adam: It's like one of those evangelists that touch you.Lou: I said to her listen, marching orders are go leave now, live your life, don't do anything out of the ordinary, and she says I'm going to see my trainer tonight that's going to come to my house. I said you never told me you had a home trainer, what do you do with the trainer? She started demonstrating rotational chops, high force activities, high load activities, high back torque, loading the spine in ways that really aren't necessary. So she said do you mind talking to my trainer, I said not a problem. So I spoke to her and I have a patient the person and trainer may listen to this podcast, which is all cool but anyway. I spoke to the trainer, and I said let's just remove certain of those BLTs for right now, no bent over single arm rows and just keep it very linear, very static if you will. She was feeling good and I didn't want to say don't train at all because I didn't want to impede on her lifestyle. She came back in today, and she had discomfort, and I said when did the discomfort start? She said from the time I left you guys all the way up until I had my training session, I was pain-free, and then after my training session, it started to exacerbate again. I'm going to give a little bit of a time out, I don't know how comfortable I am giving this admission from her testimonial today because I don't want to offend her trainer.Anyway we put her back on that machine today, and once again she felt phenomenal. So this machine, essentially what is allows someone to do that is in an active back spasm or even or has a neurological deficit from a disc compression, locks down the pelvis in such a way that when you actively extend, the only muscles being engaged and being recruited are the lumbar and rector, and even some of the deep spinal rotators have to engage in straight extension. So it allows for a term that I like to use, instead of traction it's called decoaptation, where it's a joint segment that's being lengthened without cavitation of the joint.Adam: So for those of you that don't speak science, what he's saying here is that by fixing the hips in place and by doing a back extension but pushing yourself back, you're actually opening up the spaces of the vertebrae which gives you relief. Lou: On the note, it also gives kind of a self-massage into those spinal segments. The only time — I'm starting to question some of the traditional medical research, the only time where they say don't put a patient into extension is if they have facet arthrosis or facet arthritis, degeneration of the joints. Lately, I've kind of taken Adam's approach a little bit and said I'm going to test this, and I'm put a patient or two on there with facet arthrossi as diagnosed by a radiologist and confirmed by a surgeon, and they came out of it feeling better. So it goes back to my principle of motion is great joint lotion, and if we can actively engage a patient, not passively. The difference there is passively is the therapist is moving the patient, actively is them moving themselves and us assisting as a coach, making sure they're in the bio mechanical correct position. They feel better, not only from a physiological point of view, but from an emotional and social wellbeing. I can do this, I can exercise. Guess what, we do that for two or three sessions and then we move them to a leg press. As you mentioned earlier, I don't remember who said that they were struggling with it but then you just altered your position and you were pain-free.Adam: The leg press actually — I don't want to give the leg press a bad name, the leg press is actually very good for the lower back because it's strengthening your hip extensors which are your glutes. Those primary moves are also very important to work, matter of fact one of my mentors, Rob Francis told me that it's very important. Once you start doing some lower back extensions and you're starting to feel that relief, that it's important to start doing some of the major hip movements like leg press.Mike: Dr. Lou you can add onto this. There are probably sometimes, like if you wanted to do a leg press, there may be some conditions or just a status that a person is in, a client is in, where they're just not ready to perform a certain movement pattern and I guess the low back machine can prepare you for a leg press, or manual therapy of some kind. Is that what's necessary sometimes?Lou: Absolutely. Even when we had the patient in today, she was saying that she was getting some burn in her quads while doing the back extension.Adam: There's some static contraction in there.Lou: Exactly, but it's just a progression physiologically but it's also a progression mentally where hey, I just did that pain-free. Not only pain-free, I'm not in pain anymore therefore I'm going to do something else, and there have been many times where I've had a patient that's gotten acute lower back exacerbation. We get them through the back extension pain-free, and you say you know what, you're going to do one of the safe chest presses here. I'm going to add that in, what does that have to do with their back? Maybe not a lot but everything to do with their psychological profile about themselves, and years ago, I'm trying to remember the first time. I don't think I've ever shared this with Adam, but he actually probably knew. In 2002, I had opened up a rehab facility as part of my practice, and around that time I had a really bad, acute lower back condition and it was in the summer, and mine came — it was actually on a tractor. I was cutting my lawn, and the tractor went into an old kind of stump hole, it went down, I went up, and we met somewhere in the middle. It created an avulsion fracture on my left hip, and some secondary lower back issues. I went to see a doctor and they said take an epidural, have these pills, I didn't want to do that. I wanted to let my body heal, and I was in such excruciating back pain one morning that I said I'm going to get up and do some deep knee bends, and I did and it immediately increased my range of motion. So I started testing on patients, I started having patients who had acute lower back pain doing kind of wall squats if you will. We were loading the muscles, strengthening and opening up the spinal segments, and now that I really think about it, probably as Adam just said, it had a lot to do with the mental approach of them actually being able to exercise. After being told immobilize, bed rest, don't do anything and I was doing the opposite. Fast forward to now, I've met Adam and he's created this circuit where I look at InForm Fitness and in my mind, people ask me how to describe it and I say it's probably one of the hardest forms of exercise that I've ever come across, while being the safest form of exercise. Adam: That sums it up pretty well.Lou: It really does. Recently I had the pleasure of bringing in what I consider an elite level athlete. Not a professional yet but an elite level athlete who just finished his two years of junior hockey and he's going own to play at a high level one collegiate hockey. This guy is about as conditioned as anyone that I know. I had him do the protocol here, and he said that was by far the hardest twenty-five minutes of exercise I've ever done. I just don't understand why it was only twenty-five because he was so mind conditioned that it has to an hour, or hour and a half. As opposed to being able to get it done in what I call short duration, high intensity.Mike: Real quick, we've had a few pro athletes here over the years and they've all made the same comment in regards to this strength training program, as opposed to any other strength training they've been a part of.Adam: I want to bring it back to first of all, I want to summarize on kind of what we just said. So these passive modalities of back treatment, taking medication, inactivity, some of these things that physical therapists do on a passive level such as electric stem, heat packs, so the thing about those is they're all well and good for acute situations but they're not going to help an overall situation for long term. I think the takeaway from this is one, inactivity is not what you should be doing if you have some back problems. First of all, don't accept your back problems, and know that most people, if they don't have something really serious going on like a spinal tumor or some kind of neurological deficiency, you have to move that joint, but you have to do it safely. There are ways of doing it safely, I don't want people just running out there now and just doing all this crazy stuff because they listened to this episode of our podcast and they just said move, so all of your sudden you're doing all these crazy things like doing Crossfit or some of the things we were talking about with Lou's patient. It has to be controlled, but this idea that you have to immobilize and not do anything, and be very, very careful, you have a back problem. That has not been working.Lou: No, and on that point Adam, this article by Dr. Nelson does a great job about utilize the science that's there, utilize the diagnostic studies, the MRIs. If there's a space occupying a spinal tumor, something that needs surgical intervention, you go for it, but what Adam is saying is very similar to this article is go through the correct markers and then actively engage and take an active role in getting your body mobile.Adam: The second thing besides just knowing that you should not be inactive just because you have a back problem, and not give up life, is doing some very specific things for your lower back. Dr. Lou is mentioning our program here, and we have some very special equipment. It does, it fixes the hips in place and allows somebody to go into a type of back extension that you cannot do without a machine like this, without something that can actually keep the hips fixed. So to plug InForm Fitness, we all have these machines in our gyms at InForm Fitness, so if you're fortunate enough to be near to one of our locations, it'd be great to try one of these machines. These MedEx, lumbar extension machines. Having said that, and knowing that most people listening to this episode are not going to have access to these machines, all is not lost, and I want Mike, since he does a lot of work with people on these types of movements, I want Mike to talk about some of the things that you can do should you not have access to this type of machine.Mike: It starts with a few mobility exercises, and they don't take long at all to do, and the first thing I would recommend people to do is just to get down on all fours on a mat and get into a little child pose. You sit on your heels with your feet tucked underneath, and you tilt your body all the way over as if you're bowing towards the sun. Just stay there for about twenty seconds or so, and for a lot of people who are dealing with acute pain or just some ordinary tightness, that often times gives some simple relief. After that, Adam mentioned before, pelvic tilts. They can be done from many different positions, from all fours once again to on your back, to standing up. Basically from an all fours position, you are doing what's called an anterior pelvic tilt and a posterior pelvic tilt. The posterior sort of feels like you're, while being on all fours, you arch your lower back up a little bit and you're creating what feels like an ab crunch, and then the anterior tilt is when you do the exact opposite movement. After that, I usually guide people through doing another child's pose for about twenty seconds, and then come back to all fours, and then a more extended version of what that last pose was which is cat cow, which is recommended by every chiropractor and physical therapist. It's a full tilt of spine, the whole thoracic spine to the lumbar spine, and then a full arch as well. Followed by that a bird dog, so once again, being on all fours and where you extend your left arm forward in front of you, and then the opposing leg, the right leg back, and hold the position for ten to twenty seconds and then switch off. After that, some glute bridges, which are just lying on your back with your feet placed down on the mat, and your hips will come off the floor, and you just do some very, very light bridging off the floor and then coming back down to the floor. So these can all be demonstrated online, it's a little difficult sometimes to say them without a visual, but it starts with simple stuff like that, and then a few more beyond that. I think if someone is dealing with some back tightness, it's generally safe. Without any diagnosis, it's probably safe to go down and give these little things a try. Obviously, if you're dealing with some acute pain while trying these very simple movements, then you definitely some advice from a professional.Adam: There's a good book on the subject. There's a lot of books on the subject, but a good one that I like, it's well written and has great pictures, it's called Foundation, subtitle Redefine Your Core, Conquer Back Pain, and Move With Confidence. I like the subtitle because we were just talking about moving with confidence, this confidence thing keeps coming up doesn't it. It's by Dr. Eric Goodman and Peter Park. Not Peter Parker. Foundation.Tim: We'll have links to that in the show notes as well.Mike: I personally loved this book and there are a lot of different exercises. It gives a great explanation of the anatomy of the low back, some of the common problems that can happen to the low back, and it goes into several different exercises but it revolves around one fundamental exercise which they call the founder, which is essentially a back extension, and they show you how to do it in that book.Adam: So my final thoughts are, and the takeaway I'd like you to have and I mentioned this, is one, don't accept your back pain, and use surgical methodology really as a last resort, and really try some of these — hire somebody or try some of these movements, therapies if you will, to help with this. Movement is so important, movement is really important, and I can tell you from my own experience that I've never thought of somebody who has back problems. I always thought of myself as somebody who had muscular problems in my lower back, and I think I might be right. What I'd like to do is come back to this in six months to a year, and let you know how I'm doing. I'm going to continue doing what I've been doing, and I'll let you know because let me tell you something. If it doesn't come back after another six months and I've been doing what I started doing six months ago, almost a year ago actually, and I don't have these episodes going forward for the next six months or a year, I think my conclusion is going to be right because nothing else ever worked, short of doing surgical types of things which I'm not going to do. So stay tuned. The other thing that we're going to be talking about on our next episode is the second thing I did which I feel contributed to a lot of the alleviation of my lower back problems, and that is my diet. That is what we're going to be talking about in our next episode, the diet that I undertook in the last ninety days and how it's changed me forever.Tim: So there you have it. In next week's episode as Adam just mentioned, we will be talking about a diet plan that Adam has been participating in for the last three months. A plan that Adam credits for assisting with successfully managing the lower back issues that he's been dealing with for most of his life. Coming back in the next couple of weeks, we will be speaking with Gretchen Rubin. Gretchen's books have sold more than two million copies in thirty different languages. She has a popular podcast of her own, it's called Happier with Gretchen Rubin, and she's also a client and has been for many years of InForm Fitness. Also on the way we have a terrific conversation with Dr. Martin Gaballa, author of The One Minute Workout. We will contrast and compare high-intensity strength training with high-intensity interval training. Looking forward to this one. Hey if you'd like to find an InForm Fitness location nearest you to give this workout a try for yourself, please visit informfitness.com. At this time of this recording we have locations in Manhattan, Port Washington, Denville, Burbank, Boulder, Leesburg, and Restin. If you are not near an InForm Fitness location, you can always pick up Adam's book, Power of Ten, the Once a Week Slow Motion Revolution. Included in Adam's book are several exercises that support this protocol that you can actually perform on your own. We'll have a link to Adam's book here in the show notes. For Sheila Melody, Mike Rogers, and Adam Zickerman, I'm Tim Edwards, with the InBound Podcasting Network.     

Adam Zickerman and Mike Rogers interview author, weight lifter, and personal trainer Bill DeSimone.  Bill penned the book Congruent Exercise: How To Make Weight Training Easier On Your Joints  Bill is well known for his approach to weight lifting which, focuses on correct biomechanics to build strength without undue collateral damage to connective tissue and the rest of the body.So, whether you are an aspiring trainer, serious weight lifter, or even an Inform Fitness client who invests just 20-30 minutes a week at one of their seven locations this episode is chock full of valuable information regarding safety in your high-intensity strength training.  A paramount platform of which the Power of Ten resides at all InForm Fitness locations across the country.To find an Inform Fitness location nearest you visit www.InformFitness.comIf you'd like to ask Adam, Mike or Sheila a question or have a comment regarding the Power of 10. Send us an email or record a voice memo on your phone and send it to podcast@informfitness.com. Join Inform Nation and call the show with a comment or question.  The number is 888-983-5020, Ext. 3. To purchase Adam Zickerman's book, Power of 10: The Once-a-Week Slow Motion Fitness Revolution click this link to visit Amazon:http://bit.ly/ThePowerofTenTo purchase Bill DeSimone's book Congruent Exercise: How To Make Weight Training Easier On Your Joints click this link to visit Amazon:http://bit.ly/CongruentExerciseIf you would like to produce a podcast of your own just like The Inform Fitness Podcast, please email Tim Edwards at tim@InBoundPodcasting.comBelow is the transcription for Episode 20 - Author Bill DeSimone - Congruent Exercise20 Author Bill DeSimone - Congruent ExerciseAdam: So there's not a day that goes by that I don't think by the way that I don't think of something Bill has said to me when I'm training people. Bill is basically my reference guide, he's my Grey's Anatomy. When I try an exercise with somebody, I often find myself asking myself, what would Bill do and I take it from there. Without further ado, this is Bill, and we're going to talk about all good stuff. Joint friendly exercises, what Bill calls it now, you started out with congruent exercises, technical manual for joint friendly exercise, and now you're rephrasing it.Bill: Well actually the first thing I did was [Inaudible: 00:00:43] exercise, but the thing is I didn't write [Inaudible: 00:00:45] exercise with the idea that anybody other than me was going to read it. I was just getting my own ideas down, taking my own notes, and just to flesh it out and tie it up in a nice package, I actually wrote it and had it bound it up and sent it off to Greg Anderson and McGuff and a couple others, and it hit a wave of interest.Adam: A wave, they were probably blown away.Bill: Yeah well, a lot of those guys went out of their way to call me to say boy, a lot of what I suspected, you explained here. But when I read it now, it's pretty technical, it's a challenge.Mike: There's a lot of, I think, common sense with an experienced trainer when you think about levers in general, and I think what you did in that manual was make it very succinct and very clear. I think it's something that maybe we didn't have the full story on, but I think we had some — if you have some experience and you care about safety as a trainer, I think you are kind of looking at it and you saw it observationally, and then I think when we read this we were like ah, finally, this has crystalized what I think some of us were thinking.Adam: Exactly. You know what I just realized, let's explain, first and foremost. You wrote something called Moment Arm Exercise, so the name itself shows you have technical — that it probably is inside, right? So moment arm is a very technical term, a very specific term in physics, but now you're calling it joint friendly exercise, and you called it also congruent exercise at one point. All synonymous with each other, so please explain, what is joint friendly exercise or fitness?Bill: It's based more on anatomy and biomechanics than sports performance. So unlike a lot of the fitness fads that the attitude and the verbiage comes out of say football practice or a competitive sport, what I'm doing is I'm filtering all my exercise instruction through the anatomy and biomechanics books, to try to avoid the vulnerable — putting your joints in vulnerable positions, and that's so complicated which is why I struggled with so much to make it clearer. So I started with moment arm exercise, and then I wrote Congruent Exercise, which is a little broader but obviously the title still requires some explanation. And then — how it happened, as for my personal training in the studio, I would use all this stuff but I wouldn't explain it because I was only dealing with clients, I wasn't dealing with peers. Since it's a private studio and not a big gym, I don't have to explain the difference between what I'm doing and what somebody else is doing, but in effect, I've been doing this every day for fifteen years.Adam: I have to say, when you say that, that you didn't explain it to clients, I actually use this information as a selling point. I actually explain to my clients why we're doing it this way, as opposed to the conventional way, because this is joint friendly. I don't get too technical necessarily, but I let them know that there is a difference of why we're doing it this way, versus the conventional way. So they understand that we are actually a cut above everybody else in how we apply exercise, so they feel very secure in the fact that they're doing what they're supposed to be doing, but I digress.Bill: Generally what I do is any signage I have, a business card, website, Facebook presence, all lays out joint friendly and defines it and kind of explains itself. I would say most of the clients I have aren't coming from being heavily engaged in another form of fitness. They're people who start and drop out programs or they join a health club in January and drop out. It's not like I'm getting somebody who is really intensely into Crossfit, or intensely into Zumba or bodybuilding, and now they're banged up and need to do something different. The joint friendly phrasing is what connects me with people that need that, I just find that they don't need the technical explanation as to why we're not over stretching the joint capsule in the shoulder. Why we're not getting that extra range of motion on the bench press, because again, they haven't seen anybody doing otherwise, so I don't have to explain why I'm doing it this way.Adam: Yeah but they might have had experience doing it themselves. Let's take an overhead press for example, having your arms externally rotating and abducted, versus having them in front of you. There's an easy explanation to a client why we won't do one versus the other.Bill: But I have to say I do not get people who do not even know what a behind the neck press is. Now in Manhattan is a little bit different, more denser.Adam: So for this conversation, let's assume some people know, or understand in a way what the conventional is, but we can kind of get into it. What is conventional and what's not conventional. So it's joint friendly, how is it joint friendly, what are you actually doing to make it joint friendly?Bill: Well the short answer is that I use a lot less range of motion than we've got accustomed to, when we used to use an extreme range of motion. If bodybuilders in the 60s were doing pumping motions, and then you wanted to expand that range of motion, for good reason, and then that gets bastardized and we take more of a range of motion and turn it into an extreme range of motion — just because going from partial motions to a normal range of motion was good, doesn't make a normal range of motion to an extreme range of motion better. And in fact —Adam: What's wrong with extreme range of motion?Bill: Well because —Adam: Don't say that you want to improve flexibility.Bill: Well the HIIT guys who would say that you're going to improve flexibility by using —Adam: HIIT guys means the high intensity training sect of our business.Bill: So the line about, you're going to use the extreme range of motion with a weight training exercise to increase flexibility. First of all, either flexibility is important or it's not, and that's one of those things where HIIT has a little bit of an inconsistency, and they'll argue that it's not important, but then they'll say that you can get it with the weights. That's number one. Number two, a lot of the joint positions that machines and free weight exercises put us in, or can put us in, are very vulnerable to the joints, and if you go to an anatomy and biomechanics textbook, that is painfully obvious what those vulnerable positions are. Just because we walk into a gym or a studio and call it exercise instead of manual labor or instead of — instead of calling it submission wrestling and putting our joints or opponents' joints in an externally rotated abduct and extended position, we call it a pec fly, it's still the same shoulder. It's still a vulnerable position whether it's a pec fly stretching you back there, or a jiujitsu guy putting you in a paintbrush, but I don't know, for most of the pop fitness books though, if anybody else is really looking at this. Maybe not in pop fitness, maybe Tom Pervis —Adam: What's pop fitness?Bill: If you walk into a bookstore and look in the fitness section for instance, any of those types. No offense, but celebrity books, glossy celebrity fitness books, but I don't know that anybody — and the feedback that I've gotten from experienced guys like [Inaudible: 00:08:26] or the guys we know personally, is — even McGuff said yeah, I never associated the joint stuff with the exercise stuff.Adam: Let's talk about these vulnerabilities that you're talking about and extreme ranges of motion. So we have to understand a little bit about muscle anatomy to understand what we mean by the dangers of these extreme ranges of motion. So muscles are weaker in certain positions and they're stronger in other positions. Maybe talk about that, because that's where you start getting into why we do what we do, like understanding that muscles don't generate the same amount of force through a range of motion. They have different torque potentials.Mike: And is there a very clear and concise way of communicating that to a lay person too, like we have practice at it, but in here, we're over the radio or over the podcast, so it's like describing pictures with words.Bill: The easiest way to show it to a client who may not understand what muscle torque is, is to have them lock out in an exercise. Take a safe exercise, the barbell curl, where clearly if you allow your elbows to come forward and be vertically under the weight, at the top of the repetition, clearly all of a sudden the effort's gone. There's no resistance, but if you let your elbows drop back to rib height, if you pin your elbows to the sides through the whole curl, now all of a sudden your effort feels even. Instead of feeling like — instead of having effort and then a lockout, or having a sticky point and then a lockout, now it just feels like effort.Adam: Or a chest press where your elbows are straight and the weights are sitting on those elbows, you're not really working too hard there either.Bill: Same thing. If you have a lockout — what's easy to demonstrate is when the resistance torque that the machine or exercise provides doesn't match your muscle torque. So if your muscle torque pattern changes in the course of a movement, if you feel a lockout or a sticking point, then it's not a line. If all you feel is effort, now it matches pretty evenly. Now here's the thing, all that really means, and part of what I got away for a moment on — all that really means is that that set is going to be very efficient. Like for instance, the whole length of the reputation you're working. It's not like you work and lockout and rest, all that means is that it's going to be a very efficient set. You can't change a muscle torque curve, so if you were just to do some kind of weird angled exercise, you wouldn't get stronger in that angle. All you would do is use a relatively lower weight. Nobody does like a scott bench curl, nobody curls more than a standing curl. You can't change the muscle torque curve, you might change the angle, which means the amount of weight that your hand has change, to accommodate the different torque at that joint angle, but you're not changing where you're strongest. If you could, you would never know you had a bad [Inaudible: 00:11:36], because if the pattern — if the muscle torque pattern could change with a good [Inaudible: 00:11:44], it would also change with a bad [Inaudible: 00:11:47], and then you would never know. Take a dumbbell side raise, everybody on the planet knows it's hardest when your arms are horizontal. Your muscle torque curve can never change to accommodate what the resistance is asking. Now if you go from a machine side raise, which has more even — like where those two curves match, that set feels harder because you don't have to break. You do a set of side raises with dumbbells to failure, if it feels — if it's a difficulty level of ten, of force out of ten, and then you go to a machine side raise and go to failure, it's like a ten, because you didn't have that break built into the actual rep. So the moment arms, knowing how to match the resistance required by the exercise and the muscle torque expressed by your limbs, that makes for a more efficient exercise. In terms of safety, it's all about knowing what the vulnerable positions of the joints are and cutting the exercise short, so that you're not loading the joint into an impingement, or into like an overstretched position.Mike: How different are these…. like thinking about limitation and range of motion on them, we mentioned that before and I think it's kind of adjacent to what you're talking about is — we also want to help people understand that if they're on their own exercising or there are other trainers who want to help their clients, and for our trainers to help our clients… troubleshooting, we know generally how the joints work, where the strength curves exist, but how to discern where those limitations are. Like you said before, that one of the things you do is you limit range of motion and get much more stimulus and muscle.Bill: I'm saying limit range of motion because that might be the verbiage that we understand and maybe listeners would understand, but it's really a lot more complicated than just saying, use this range of motion. So for instance, in a lower back exercise, say a stiff leg or dead lift, which, when I used to misinterpret that by using a full range of motion, I'd be standing on a bench with a barbell, and the barbell would be at shoe level. My knees would be locked, my lower back would be rounded, my shoulders would be up my ears as I'm trying to get the bar off the ground, and so yes, I was using a full range of motion.Adam: That's for sure.Mike: That can be painted for that description.Bill: It's also pretty much a disaster on your lower back waiting to happen, at least on your lower back.Adam: I've got to go to a chiropractor just listening to that.Bill: Exactly, but you still see it all the time. You see it all the time on people using kettle bells, you see that exact posture. The kettle bell is between their legs, their knees are locked, their lower back is rounded, and now they're doing a speed lift. At least I was doing them slow, they're doing speed dead lifts, so if I was going to do an exercise like that, it wouldn't be an extreme range of motion, I'd be looking to use a correct range of motion. So for instance, I wouldn't lock the knees, and I would only lower the person's torso so that they could keep the curve in the lower back. Which might require a rep or two to see where that is, but once you see where that is, that's what I would limit them to.Mike: Do you do it at first with no weight with the client?Bill: That'd be one way of lining it up.Mike: Just sort of seeing what they can just do, make sure they understand the position and stuff.Bill: So for instance, the chest press machine I have in the studio is a Nitro —Adam: [Inaudible: 00:15:37] Nitro.Bill: And it doesn't — the seat doesn't adjust enough for my preference, so the person's elbows come too far back. So for instance, to get the first rep off the ground, the person's elbows have to come way behind the plane of their back, which —Adam: So you've come to weigh stack themBill: Weigh stack, right.Mike: It's like our pull over, you know how we had to pull it over at one point?Bill: So what I'll do is I'll help the person out of the first repetition, help them out of the bottom, and then I'll have my hand to the clipboard where I want their elbow to stop. So as soon as they touch my hand with their elbow, they start to go the other way.Adam: So they're not stretching their pecs too far.Bill: Well more specifically, they're not rotating their shoulder capsule. So that's another thing we tend to do, we tend to think of everything in terms of the big, superficial muscles — right, those are the ones that don't get hurt, it's the joints that [do]. That was one thing of all the stuff I read, whether it was CSCS or Darton's stuff or Jones' stuff, there was always a little murkiness between what was the joint and what was the muscle. That stuff was always written from the point of view of the muscle.Adam: What's a joint capsule, for those that don't know what a joint capsule is. A shoulder capsule.Bill: It's part of the structure of what holds your shoulder together, and so if the old [Inaudible: 00:17:06] machines, 1980 vintage, that bragged about getting such an extreme range of motion, some of them… it really took your shoulder to the limit of where it could go to start the exercise, and we were encouraged to go that far.Adam: And what would happen?Bill: Eventually it just adds to the wear and tear that you were going to have in your shoulder anyway. And that's if people stayed with it, I think a lot of people ended up dropping out.Mike: Often times exacerbating what was going on.Bill: You rarely see, it's occasional that we have that sort of catastrophic event in the gym, it's occasional —Mike: Almost never happens.Bill: A lot of the grief that I take for my material is well, that never happens, people do this exercise all the time, people never explode their spine. Well a) that's not true, they do, just not in that persons' awareness, and b) but the real problem is unnecessarily adding to life's wear and tear on your joints. So it's not just what we do in the gym that counts, if somebody plays tennis or somebody has a desk job or manual labor job — let's say a plumber or some other manual labor guy has to go over his head with his arms a lot, that wear and tear on his shoulder counts, and just because they walk into your gym, and you ask them about their health history, do you have any orthopedic problems and they say no, yes. I'm on the verge of an orthopedic problem that I don't know about, and I've worn this joint out because of work, but no I have no orthopedic problems at the moment. So my thing is, the exercise I'm prescribing isn't going to make that worse.Adam: Well you don't want to make it worse, and that's why you're limiting range of motion, that's why you're matching the strength curve of the muscle with the resistance curve of the tool you're using, whether it's free weight or machine or the cam.Bill: Yeah, we're supposed to be doing this for the benefits of exercise. I do not — I truly do not understand crippling yourself over the magical benefit of exercise. I mean there's no — in 2014, there was a lot of negative publicity with Crossfit, with some of the really catastrophic injuries coming about. There's no magic benefits just because you risk your life, you either benefit from exercise or you don't, but you don't get extra magic benefit because you pushed something to the brink of cracking your spine or tearing your shoulder apart.Adam: Well they talk about them being functional or natural movements, that they do encourage these full ranges of motion because that's what you do in life.Bill: Where? Mike: Well I mean like in sports for example, you're extending your body into a range of motion — and also there are things in life, like for example, like I was saying to Adam, for example, sometimes you have to lift something that's heavy and you have to reach over a boundary in front of you to do so.Bill: Like… putting in the trunk of a car, for example.Mike: Things like that, or even —Adam: So shouldn't you exercise that way if that's what you're doing in every day life?Mike: If your daily life does involve occasional extreme ranges of motion, which that's the reason why your joints of kind of wearing and tearing anyway, is there something you can do to assist in training that without hurting it? Or exacerbating it?Bill: You know it's interesting, 25 years ago, there was a movement in physical therapy and they would have back schools, and they would — it was sort of like an occupational oriented thing, where they would teach you how to lift, and at the time, I thought that was so frivolous. I just thought, get stronger, but lifting it right in the first place is really the first step to not getting injured. Mike: Don't life that into the trunk unless —Bill: Well unless you have to, right? For instance, practicing bad movements doesn't make you invulnerable to the bad movements, you're just wearing out your free passes. Now sport is a different animal, yes you're going to be — again, I don't think anyone is doing this, but there's enough wear and tear just in your sport, whether it's football, martial arts, running, why add more wear and tear from your workout that's there to support the sport. The original [Inaudible: 00:21:52] marketing pitch was look how efficient we made weight training, you can spend more time practicing. You don't have to spend four hours a day in the gym, you can spend a half hour twice a week or three times a week in the gym, and get back to practicing.Adam: I remember Greg [Inaudible: 22:06] said to a basketball coach that if his team is in his gym more than 20 minutes or so a week, that he's turning them into weight lifters and not basketball players.Bill: Well there you go. Now —Mike: The thing is the training and the performance goals in getting people stronger, faster, all that kind of stuff, is like unbelievable now a days, but I've never seen more injuries in sports in my entire life than right now.Bill: It's unbelievably bogus though is what it is. You see a lot of pec tears in NFL training rooms. Adam: So why aren't they learning? Why is it so hard to get across then?Bill: Well for starters, you're going to churn out — first of all you're dealing with twenty year olds. Adam: So what, what are you saying about twenty year olds?Bill: I was a lot more invincible at twenty than I am at sixty.Mike: Physically and psychologically.Bill: The other thing for instance. Let's say you've got a college level, this is not my experience, I'm repeating this, but if you have a weight room that's empty, or, and you're the strength and conditioning coach, because you're intensely working people out, briefly, every day. Versus the time they're idle, they're off doing their own thing. Or, every day the administrators and the coaches see people running hoops and doing drills, running parachutes and every day there is an activity going. What looks better? What is more job security for that strength and conditioning coach? Adam: Wait a second. What is Jim the strength training coach doing? He's working one day a week and what's he doing the rest of the week?Mike: And what's the team doing the rest of the week?Bill: But again, don't forget, if you're talking about twenty something year old athletes, who knows what that's going to bring on later.Adam: You are seeing more injuries though.Bill: Right. A couple of years ago, ESPN had a story on a guy. He had gotten injured doing a barbell step up, so a barbell step up, you put a barbell on your back, you step onto a bench, bring the other foot up. Step back off the bench, four repetitions. Classic sports conditioning exercise, in this guys case either he stepped back and twisted his ankle and fell with the bar on his back, or when he went to turn to put the bar back on the rack, when he turned, it spun on him and he damaged his back that way. Either way, he put his ability to walk at risk, so the ESPN story was, oh look how great that is he's back to playing. Yes, but he put his ability to walk at risk, to do an exercise that is really not significantly — it's more dangerous than other ways of working your legs, but it's not better.Adam: The coaches here, the physical trainers, they don't have evidence that doing step ups is any more effective in the performance of their sport, or even just pure strength gains. Then lets say doing a safe version of a leg press or even squats for that matter.Bill: And even if you wanted to go for a more endurance thing, running stadium steps was a classic exercise, but stadium steps are what, three or four inches, they made them very flat. Even that's safer because there's no bar on your back. So on the barbell step up, which I think is still currently in the NSCA textbooks, the bar is on your back. If the bench is too high, you have to bend over in order to get your center of gravity over the bench, otherwise you can't get off the floor. So now you're bent over with one foot in front of you, so now you don't even have two feet under you like in a barbell squat to be more stable. You have your feet in line, with the weight extending sideways, and now you do your twenty repetitions or whatever and you're on top of the bench, and your legs are burning and you're breathing heavy, and now you've got to get off. How do you get off that bench when your legs are gassed, you're going to break and lock your knee, and the floor is going to come up — nobody steps forward, they all step backwards where you can't see. Mike: Even after doing an exercise, let's say you did it okay or whatever and whether it was congruent or not congruent, sometimes, if it's a free weight type of thing, just getting the weight back on the floor or on the rack. After you've gone to muscle failure or close to muscle failure —Adam: So are these things common now, like still in the NFL they're doing these types of training techniques? Bill: I don't really know what's happening in the NFL or the college level, because frankly I stopped my NSCA membership because I couldn't use any material with my population anyway. So I don't really know what they are — I do know that that was a classic one, and as recently as 2014 — in fact one other athlete actually did lose his ability to walk getting injured in that exercise. Adam: It's cost benefit, like how much more benefit are you getting —Bill: It's cost. My point is that the benefit is — it's either or.Mike: That's the thing, people don't know it though, they think the benefit is there. That's the problem.Bill: They think that for double the risk, you're going to get quadruple the benefit. What, what benefit? What magic benefit comes out of putting your ability to walk at risk?Mike: One of my clients has a daughter who was recruited to row at Lehigh which is a really good school for that, and she, in the training program, she was recruited to go. She was a great student but she was recruited to row, and in the training program, she hurt her back in the weight room in the fall, and never, ever was with the team. This was a very, very good program — Bill: Very good program, so it's rowing, so a) it's rough on your lower back period, and b) I'm completely guessing here, but at one time they used to have their athletes doing [Inaudible: 00:28:22] and other things —Adam: Explain what a clean is —Bill: Barbells on the floor and you either pull it straight up and squat under the bar, which would be like an olympic clean, or you're a little more upright and you just sort of drag the bar up to your collarbones, and get your elbows underneath it. Either way it's hard on the back, but at one time, rowing conditioning featured a lot of exercises like that to get their back stronger, that they're already wearing out in the boat. They didn't ask me, but if I was coaching them, I would not train their lower backs in the off season. I would let the rowing take care of that, I would train everything around their back, and give their back a break, but they didn't ask.Adam: I don't know why they didn't ask you, didn't they know that you're a congruent exerciser?Bill: You've got to go to a receptive audience.Mike: I think because there are things we do in our lives that are outside, occasionally outside our range of motion or outside — that are just incongruent or not joint friendly, whether it's in sports or not. The thing is, I'm wondering are there exercises that go like — say for example you have to go — your sport asks for range of motion from one to ten, and you need to be prepared to do that, if you want to do that, the person desires to do that. Are there exercises where you go — can you be more prepared for that movement if you are doing it with a load or just a body weight load, whatever, up to say level four. Are there situations where it's okay to do that, where you're going a slight increase into that range where it's not comprising joint safety, and it's getting you a little bit more prepared to handle something that is going on.Adam: So for example, for a golf swing, when you do a golf swing, you're targeting the back probably more than you should in a safe range of motion in an exercise. I would never [Inaudible: 00:30:32] somebody's back in the exercise room to the level that you have to [Inaudible: 00:30:34] your back to play golf. So I guess what Mike is asking is is there an exercise that would be safe to [Inaudible: 00:30:41] the back, almost as much as you would have to in golf.Bill: I would say no. I would say, and golf is a good example. Now if you notice, nobody has their feet planted and tries to swing with their upper body.Mike: A lot of people do, that's how you hurt yourself.Bill: But any sport, tennis, throwing a baseball, throwing a punch. Get your hips into it, it's like standard coaching cliche, get your hips into it. What that does is it keeps you from twisting your back too much. In golf, even Tiger who was in shape for quite a while couldn't help but over twist and then he's out for quite a while with back problems.Mike: Yeah, his story is really interesting and complicated. He did get into kind of navy seal training and also you should see the ESPN article on that which really — after I read that I thought that was the big thing with his problems. Going with what you just said about putting your hips into it, I'm a golfer, I try to play golf, and I did the TPI certification. Are you familiar with that? I thought it was really wonderful, I thought I learned a lot. I wasn't like the gospel according to the world of biomechanics, but I felt like it was a big step in the right direction with helping with sports performance and understanding strength and mobility. One of the bases of, the foundation of it, they — the computer analysis over the body and the best golfers, the ones that do it very very efficiently, powerfully and consistently, and they showed what they called a [Inaudible: 00:32:38] sequence, and it's actually very similar, as you said, in all sports. Tennis, golf, throwing a punch, there's a sequence where they see that the people who do it really, really well, and in a panfry way, it goes hip first, then torso, then arm, then club. In a very measured sequence, despite a lot of people who have different looking golf swings, like Jim [Inaudible: 00:32:52], Tiger Woods, John Daley, completely different body types, completely different golf swings, but they all have the — if you look at them on the screen in slow motion with all the sensors all over their body, their [Inaudible: 00:33:04] sequence is identical. It leads to a very powerful and consistent and efficient swing, but if you say like if you have limitations in you mobility between your hips and your lumbar spine, or your lumbar spine and your torso, and it's all kind of going together. It throws timing off, and if you don't have those types of things, very slowly, or quickly, you're going to get to an injury, quicker than another person would get to an injury. The thing is, at the same time, you don't want to stop someone who really wants to be a good golfer. We have to give the information and this is a — people have to learn the biomechanics and the basic swing mechanics of a golf swing, and then there's a fitness element to it all. Are you strong enough, do you have the range of motion, is there a proper mobility between the segments of your body in order to do this without hurting yourself over time, and if there isn't, golf professionals and fitness professionals are struggling. How do I teach you how to do this, even though it's probably going to lead you to an injury down the line anyway. It's a puzzle but the final question is, what — I'm trying to safely help people who have goals with sports performance and without hurting them.Bill: First of all, any time you go from exercise in air quotes to sports, with sports, there's almost an assumption of risk. The person playing golf assumes they're going to hurt a rotator cuff or a back, or they at least know it's a possibility. It's just part of the game. Football player knows they could have a knee injury, maybe now they know they could have a concussion, but they just accept it by accepting it on the court or the turf. They walk into our studio, I don't think that expectation — they may expect it also, but I don't think it really belongs there. I don't think you're doing something to prepare for the risky thing. The thing you're doing to prepare for the risky thing shouldn't also be risky, and besides, let them get hurt on that guy's time, not on your time. I'm being a little facetious there, I don't buy the macho bullshit attitude that in order to challenge myself physically, I have to do something so reckless I could get hurt. That's just simply not necessary. If somebody says I want to be an Olympic weightlifter, I want to be a power lifter, just like if they want to be a mixed martial artist, well then you're accepting the fact that that activity is your priority. Not your joint health, not your safety. That activity is your priority, and again, nobody in professional sports is asking me, but I would so make the exercise as safe as possible. As safe as possible at first, then as vigorous as possible, and then let them take that conditioning and apply it to their sport.Adam: If a sport requires that scapulary traction at a certain time in a swing or whatever they're asking for, I don't really think that there's a way in the exercise room of working on just that. Scapular traction, and even if you can, it doesn't mean it's going to translate to the biomechanics and the neuro conditioning and the motor skill conditioning to put it all together. Bill: You can't think that much —Adam: I'm just thinking once and for all, if strong hips are what's important for this sport, a strong neck is what's important for this. If being able to rotate the spine is important and you need your rotation muscles for the spine, work your spine rotationally but in a very safe range of motion. Tax those muscles, let them recover and get strong so when you do go play your sport, lets say a golf swing, it's watching the videos and perfecting your biomechanics, but there's nothing I think you can do in the gym that is going to help you really coordinate all those skills, because you're trying to isolate the hip abductor or a shoulder retractor. Mike: Well I was going to say, I think isolating the muscles in the gym is fine, because it allows you to control what happens, you don't have too many moving parts, and this is kind of leading up to the conversational on functional training.Adam: Which is good even if you can do that. You might notice there's a weakness —Mike: Yeah but if you're going to punch, you don't think okay flex the shoulder, extend at the — Adam: There are a lot of boxers that didn't make it because they were called arm punchers. Bill: So at some point you can't train it. You need to realize gee that guy has good hip movement, let me direct him to this sport.Adam: So I think what Mike's asking is is there some kind of exercise you can do to turn an arm puncher, let's use this as an example, turn an arm puncher into a hip puncher? If you can maybe do something —Bill: I think it's practice though. Mike: I think there's a practice part of it. Going back to the golf swing, one of the things that they were making a big deal out of is, and it goes back to what we mentioned before, sitting at a desk and what's going on with our bodies. Our backs, our hips, our hamstrings. As a result of the amount of time that most of us in our lives have, and we're trainers, we're up on our feet all day, but a lot of people are in a seated position all the time. Adam: Hunched over, going forward.Mike: Their lower back is —Bill: Hamstrings are shortened, yeah.Mike: What is going on in the body if your body is — if you're under those conditions, eight to ten hours a day, five days a week. Not to mention every time you sit down in your car, on the train, have a meal, if you're in a fetal position. My point is, they made a big thing at TPI about how we spend 18-20 hours a day in hip flexion, and what's going on. How does that affect your gluten if you're in hip flexion 20 hours a day. They were discussing the term called reciprocal inhibition, which is — you know what I mean by that?Bill: The muscle that's contracting, the opposite muscle has to relax.Mike: Exactly, so if the hip is flexed, so as the antagonist muscle of the glue which is being shut off, and therefore —Bill: Then when you go to hip henge, your glutes aren't strong enough to do the hip henge so you're going to get into a bad thing.Mike: Exactly, and the thing as I said before —Adam: What are they recommending you do though?Mike: Well the thing is they're saying do several different exercises to activate the gluten specifically and —Adam: How is that different than just doing a leg press that will activate them?Mike: Adam, that's a good question and the thing is it comes back to some of the testimonials. When you deal with clients, often times if you put them on a leg press, they'll say I'm not feeling it in my glutes, I'm only feeling it in my quads, and other people will say, I'm feeling it a lot in my glutes and my hamstrings, and a little bit in my quads.Adam: But if they don't feel it in their glutes, it doesn't mean that their glutes aren't activated, for sure.Mike: Bill, what do you think about that?Bill: I think feel is very overrated in our line of work. I can get you to feel something but it's not — you can do a concentration curl, tricep kickback, or donkey kicks with a cuff, and you'll feel something because you're not — you're making the muscle about to cramp, but that's not necessarily a positive. As far as activating the glutes go, if they don't feel it on the leg press, I would go to the abductor machine. Mike: I mean okay, whether it's feel it's overrated, that's the thing that as a trainer, I really want the client to actually really make the connection with the muscle part.Bill: Well yeah, you have to steer it though. For instance, if you put somebody on the abductor machine and they feel the sides of their glutes burn, in that case, the feel matches what you're trying to do. If you have somebody doing these glute bridging exercises where their shoulders are on a chair and their hips are on the ground, knees are bent, and they're kind of just driving their hips up. You feel that but it's irrelevant, you're feeling it because you're trying to get the glutes to contract at the end of where — away from their strongest point. You're not taxing the glutes, you're getting a feeling, but it's not really challenging the strength of the glutes. So I think what happens with a lot of the approaches like you're describing, where they have half a dozen exercises to wake up the glutes, or engage them or whatever the phrase is.Mike: Activate, yeah.Bill:  There's kind of a continuity there, so it should be more of a progression rather than all of these exercises are valid. If you've got a hip abductor machine, the progression is there already.Mike: The thing is, it's also a big emphasis, it's going back to TPI and golf and stuff, is the mobility factor. So I think that's the — the strength is there often times, but there's a mobility issue every once in a while, and I think that is — if something is, like for example if you're very, very tight and if your glutes are supposed to go first, so says TPI through their [Inaudible: 00:42:57] sequence, but because you're so tight that it's going together, and therefore it's causing a whole mess of other things which might make your club hit the ground first, and then tension in the arms, tension in the back, and all sorts of things. I'm thinking maybe there are other points, maybe the mobility thing has to be addressed in relation to a golf swing, more so than are the glutes actually working or not.Bill: Well the answer is it all could be. So getting back to a broader point, the way we train people takes half an hour, twice a week maybe. That leaves plenty of time for this person to do mobility work or flexibility work, if they have a specific activity that they think they need the work in.Mike: Or golf practice.Bill:  Well that's what I'm saying, even if it's golf and even if — if you're training for strength once or twice a week, that leaves a lot of time that you can do some of these mobility things, if the person needs them. That type of program, NASM has a very elaborate personal trainer program, but they tend to equally weight every possible — some people work at a desk and they're not — their posture is fine. Maybe they just intuitively stretch during the day, so I think a lot of those programs try to give you a recipe for every possible eventuality, and then there's a continuum within that recipe. First we're going to do one leg bridges, then we're going to do two leg bridges, now we're going to do two leg bridges on a ball, now we're going to do leg bridges with an extra weight, now we're going to do two leg bridges with an elastic band. Some of those things are just progressions, there's no magic to any one of those exercises, but I think that's on a case by case basis. If the person says I'm having trouble doing the swing the way the instructor is teaching me, then you can pick it apart, but the answer is not necessarily weight training.Mike: The limitation could be weakness but it could be a mobility thing, it could be a whole bunch of things, it could be just that their mechanics are off.Bill: And it could just be that it's a bad sport for them. The other thing with postural issues, is if you get them when a person's young, you might be able to correct them. You get a person 60, 70, it may have settled into the actual joints. The joints have may have changed shape.Adam: We've got people with kyphosis all the time. We're going to not reverse that kyphosis. You have these women, I find it a lot with tall women. They grow up taller than everyone else in their class and they're shy so they end up being kyphotic because they're shy to stand up tall. You can prevent further degeneration and further kyphosis.Bill: Maybe at 20 or 25, if you catch that, maybe they can train out of it, but if you get it when it's already locked in, all you can do is not do more damage.Adam: So a lot of people feel and argue that machines are great if you want to just do really high intensity, get really deep and go to failure, but if you want to really learn how to use your body in  space, then free weights and body weight movements need to be incorporated, and both are important. Going to failure with machines in a safe manner, that might be cammed properly, but that in and of itself is not enough. That a lot of people for full fitness or conditioning if you will, you need to use free weights or body weight movements —Mike: Some people even think that machines are bad and only body weights should be done.Adam: Do you have an opinion about if one is better than the other, or they both serve different purposes and they're both important, or if you just use either one of them correctly, you're good.Bill: Let's talk about the idea that free weights are more functional than machines. I personally think it's what you do with your body that makes it functional or not, and by functional, that's —Adam: Let's talk about that, let's talk about functional training.Bill:  I'm half mocking that phrase.Adam: So before you even go into the question I just asked, maybe we can talk about this idea, because people are throwing around the expression functional training nowadays. So Crossfit is apparently functional training, so what exactly was functional training and what has it become?Bill: I don't know what they're talking about, because frankly if I've got to move a tire from point A to point B, I'm rolling it, I'm not flipping it. Adam: That would be more functional, wouldn't it.Bill: If I have to lift something, if I have a child or a bag of groceries that I have to lift, I'm not going to lift a kettle bell or dumbbell awkwardly to prepare for that awkward lift. In other words, I would rather train my muscles safely and then if I have to do something awkward, hopefully I'm strong enough to get through it, to withstand it. My thought was, when I started in 1982 or so, 84, 83, somewhere in the early 80s I started to train, most of us at the time were very influenced by the muscle magazines. So it was either muscle magazines, or the [Inaudible: 00:48:24] one set to failure type training, but the people that we were training in the early 80s, especially in Manhattan, they weren't body builders and they weren't necessarily athletes. So to train business people and celebrities and actors etc, like you would train an athlete seemed like a bad idea. Plus how many times did I hear, oh I don't want to get big, or I'm not going out for the Olympics. Okay fine, but then getting to what Mike said before, if someone has a hunched over shoulder or whatever, now you're tailoring the training to what the person is in front of you, to what is relevant to their life. 20 inch arms didn't fascinate them, why are you training them to get 20 inch arms? Maybe a trimmer waist was more their priority, so to my eye, functional training and personal training, back in the 80s, was synonymous. Somewhere since the 80s, functional training turned into this anti machine approach and functional training for sport was [Inaudible: 00:49:32] by a guy named Mike Boyle. His main point in there is, and I'm paraphrasing so if I get it wrong, don't blame him, but his point was as an athlete, you don't necessarily need to bench heavy or squat heavy or deadlift heavy, although it might be helpful, but you do need the muscles that hold your joints together to be in better shape. So all of his exercises were designed around rotator cuff, around the muscles around the spine, the muscles around the hips, the muscles around the ankles. So in his eye it was functional for sport, he was training people, doing exercises, so they would hold their posture together so that that wouldn't cause a problem on the field. That material was pretty good, went a little overboard I think in some ways, but generally it was pretty good, but then it kind of got bastardized as it got caught into the commercial fitness industry, and it just became an excuse for sequencing like a lunge with a curl with a row with a pushup, to another lunge, to a squat. It just became sort of a random collection of movements, justified as being functional, functional for what? At least Boyle was functional for sport, his point was to cut injuries down in sport. Where is the function in stringing together, again, a curl, to a press, to a pushup, to a squat, back to the curl, like one rep of each, those are more like stunts or feats of strength than they are, to me, exercise, Adam: So when you're talking about the muscles around the spine or the rotator cuffs, they're commonly known as stabilizer muscles, and when we talk about free weights versus machines, a lot of times we'll say something like, well if you want to work your stabilizer muscles, you need to use free weights, because that's how you work the stabilizer muscles. What would you say to that?Bill: I would say that if they're stabilizing while they're using the free weights, then they're using the stabilizer muscles, right?Adam: And if they're stabilizing while using a machine?Bill:  They're using their stabilizer muscles.Adam: Could you work out those stabilizer muscles of the shoulder on a machine chest press, the same way you can use strength in stabilizer muscles of the shoulder on a free weight bench press?Bill:  Yes, it's what your body is doing that counts, not the tool. So if someone is on a free weight…Mike: Is it the same though, is it doing it the same way? So you can do it both ways, but is it the same?Bill: If you want to — skill is very specific, so if you want to barbell bench press, you have to barbell bench press.Adam: Is there an advantage to your stabilizer muscles to do it with a free weight bench press, as opposed to a machine?Bill: I don't see it, other than to help the ability to free weight bench press, but if that's not why the person is training, if the person is just training for the health benefits of exercise to use it broadly, I don't think it matters — if you're on a machine chest press and you're keeping your shoulder blades down and back, and you're not buckling your elbows, you're voluntarily controlling the range of the motion. I don't see how that stabilization is different than if you're on a barbell bench press, and you have to do it the same way. Adam: You're balancing, because both arms have to work independently in a way.Bill:  To me that just makes it risky, that doesn't add a benefit.Mike: What about in contrast to lets say, a pushup. A bodyweight pushup, obviously there's a lot more going on because you're holding into a plank position which incorporates so many more muscles of your entire body, but like Adam and I were talking the other day about the feeling — if you're not used to doing pushups regularly, which Adam is all about machines and stuff like that, I do a little bit of everything, but slow protocol. It's different, one of our clients is unbelievably strong on all of the machines, we're talking like top 10% in weight on everything. Hip abduction, leg press, chest press, pull downs, everything, and this guy could barely do 8 limited range of motion squats with his body weight, and he struggles with slow pushups, like doing 5 or 6 pushups. 5 seconds down, 5 seconds up, to 90 degrees at the elbow, he's not even going past — my point is that he's working exponentially harder despite that he's only dealing with his body weight, then he is on the machines, in all categories.Bill:  So here's the thing though. Unless that's a thing with them, that I have to be able to do 100 pushups or whatever, what's the difference?Mike: The difference is —Adam: The question is why though. Why could he lift 400, 500 pounds on Medex chest press, he could hardly do a few pushups, and should he be doing pushups now because have we discovered some kind of weakness? That he needs to work on pushups?Bill: Yes, but it's not in his pecs and his shoulders.Mike: I'm going to agree, exactly.Bill:  The weakness is probably in his trunk, I don't know what the guy is built like. The weakness is in his trunk because in a pushup, you're suspending yourself between your toes and your arms.Adam: So somebody should probably be doing ab work and lower back extensions?Bill: No he should be doing pushups. He should be practicing pushups, but practicing them in a way that's right. Not doing the pushup and hyper extending his back, doing a pushup with his butt in the air. Do a perfect pushup and then if your form breaks, stop, recover. Do another perfect pushup, because we're getting back into things that are very, very specific. So for instance, if you tell me that he was strong on every machine, and he comes back every week and he's constantly pulling things in his back, then I would say yes, you have to address it.Mike: This is my observations that are more or less about — I think it's something to do with his coordination, and he's not comfortable in his own body. For example, his hips turn out significantly, like he can't put his feet parallel on the leg press for example. So if I ever have him do a limited range of motion lunge, his feet go into very awkward positions. I can tell he struggles with balance, he's an aspiring golfer as well. His coordination is — his swing is really, I hope he never listens to this, it's horrible. Adam: We're not giving his name out.Bill: Here's the thing now. You as a trainer have to decide, am I going to reconfigure what he's doing, at the risk of making him feel very incompetent and get him very discouraged, or do I just want to, instead of doing a machine chest press, say we'll work on pushups. Do you just want to introduce some of these new things that he's not good at, dribble it out to him a little bit at a time so it gives him like a new challenge for him, or is that going to demoralize him?Mike: He's not demoralized at all, that is not even on the table. I understand what you're saying, I think there are other people who would look at it that way. I think he looks at it as a new challenge, I think he knows — like we've discussed this very, very openly. He definitely — it feels like he doesn't have control over his body in a way. Despite his strength, I feel that — my instincts as a trainer, I want to see this guy be able to feel like he's strong doing something that is a little bit more — incorporates his body more in space than just being on a machine. If I'm measuring his strength based on what he can do by pressing forward or pulling back or squatting down, he's passed the test with As and great form. He does all the other exercises with pretty good form, but he's struggling with them. He has to work a lot harder in order to do it, and to be it's an interesting thing to see someone who lifts very heavy weights on the chest press and can barely do 4 slow pushups.Bill: Let's look at the pushups from a different angle. Take someone who could do pushups, who can do pushups adequately, strictly and all. Have another adult sit on their butt, all of a sudden those perfect pushups, even though probably raw strength could bench press an extra person, say, you can't do it, because someone who is thicker in the hips, has more weight around the hips, represented by the person sitting on their back, their dimensions are such that their hips are always going to be weighing them down. So that person's core — like a person with broader hips, in order to do a pushup, their core has to be much stronger than somebody with very narrow hips, because they have less weight in the middle of their body. So some of these things are a function of proportion.Adam: You can't train for it, in other words you can't improve it.Mike: Women in general have their center of gravity in their hips, and that's why pushups are very, very hard.Adam: I have an extremely strong individual, a perfect example of what you're talking about right now. I know people that are extremely, extremely strong, but some of these very, very strong individuals can do a lot of weight on a pullover machine, they can do a lot of weight on a pulldown machine, but as soon as you put them on the chin-up bar, they can't do it. Does that mean they're not strong, does that mean that they can't do chin-ups, that they should be working on chin-ups because we discovered a weakness? No, there's people for example who might have shitty tendon insertions, like you said about body weight and center of gravity, if they have really thick lower body. I notice that people who have really big, thick lower bodies, really strong people — or if they have really long arms, the leverage is different. So it begs the question, lets start doing chin-ups, yeah but you'll never proportionally get better at chin-ups, given your proportions, given your tendon insertions, given your length of your arms. So maybe Mike, this person is just not built to do push-ups and you're essentially just giving him another chest and body exercise that is not necessarily going to improve or help anything, because it's a proportional thing, it's a leverage thing. It's not a strength thing, especially if you're telling me he's so strong and everything else.Bill: The only way you'll know is to try.Mike: Well that's the thing, and that's what I've been doing. We just started it, maybe in the last month, and frankly both of us are excited by it. He's been here for a few years, and he is also I think starving to do something a little new. I think that's a piece of the puzzle as well, because even if you're coming once a week and you get results, it gets a little stale, and that's why I've tried to make an effort of making all the exercises we're doing congruent. Joint friendly, very limited range of motion, and the thing is, he's embracing the challenge, and he's feeling it too. I know the deal with soreness and stuff like that, new stimulus.Bill: In that case, the feeling counts, right? It doesn't always mean something good, it doesn't always mean something bad.Mike: Right, it is a little bit of a marketing thing. Adam: It's a motivator. It's nothing to be ashamed of for motivation. If pushups is motivating this guy, then do pushups, they're a great exercise regardless.Bill: Getting back to your general question about whether free weights lends itself to stabilizing the core better or not, if that's what the person is doing on the exercise, then it is. If the person is doing the pushup and is very tight, yes, he's exercising his core. If the person is doing the pushup and it's sloppy, one shoulder is rising up, one elbow to the side, it doesn't matter that it's a pushup —Adam: He's still not doing it right and he's still not working his core.Bill: Right, so it's really how the person is using their body that determines whether they're training their core appropriately, not the source of the resistance.Adam: I'm sorry, I've done compound rows with free weights in all kinds of ways over the years, and now I'm doing compound row with a retrofitted Medex machine, with a CAM that really represents pretty good CAM design and I challenge anyone to think that they're not working everything they need to work on that machine, because you've still got to keep your shoulders down. You've still got to keep your chest up, you still have to not hunch over your shoulders when you're lowering a weight. I mean there's a lot of things you've got to do right on a compound machine, just like if you're using free weights. I don't personally, I've never noticed that much of a benefit, and how do you measure that benefit anyway? How would you be able to prove that free weights is helping in one way that a machine is not, how do you actually prove something like that? I hear it all the time, you need to do it because you need to be able to —Mike: There's one measuring thing actually, but Bill —Bill: I was going to say, a lot of claims of exercise, a lot of the chain of thought goes like this. You make the claim, the result, and there's this big black box in the middle that — there's no  explanation of why doing this leads to this. Mike: If you made the claim and the result turns out, then yes it's correlated and therefore —Bill: I was going to say getting to Crossfit and bootcamp type things, and even following along with a DVD program, whatever brand name you choose. The problem I have with that from a joint friendly perspective is you have too many moving parts for you to be managing your posture and taking care of your joints. Especially if you're trying to keep up with the kettle bell class. I imagine it's possible that you can do certain kettle bell exercises to protect your lower back and protect your shoulders. It's possible, but what the user has to decide is how likely is it? So I know for me personally, I can be as meticulous as I want with a kettle bell or with a barbell deadlift, and at some point, I'm going to hurt myself. Not from being over ambitious, not from sloppy form, something is going to go wrong. Somebody else might look at those two exercises and say no, I'm very confident I can get this. You pay your money, you take your chance.Mike: As a measuring tool, sometimes you never know if one is better or worse but sometimes — every once in a while, even when we have clients come into our gym and you have been doing everything very carefully with them, very, very modest weight, and sometimes people say, you know Mike, I've never had any knee problems and my knees are bothering me a little bit. I think it's the leg press that's been doing it, ever since we started doing that, I'm feeling like a little bit of a tweak in my knee, I'm feeling it when I go up stairs. Something like that, and then one of the first things I'll do is like when did it start, interview them, try to draw some lines or some hypotheses as to what's going on. Obviously there might be some wear and tear in their life, almost definitely was, and maybe something about their alignment on the leg press is not right. Maybe they're right, maybe they're completely wrong, but one of the things I'll do first is say okay, we still want to work your legs. We still want to work your quads, your hamstrings, your glutes, let's try doing some limited range of motions squats against the wall or with the TRX or something like that, and then like hey, how are your knees feeling over the past couple weeks? Actually you know, much much better, ever since we stopped doing the leg press.Bill: Sometimes some movements just don't agree with some joints.Adam: There's a [Inaudible: 01:05:32] tricep machine that I used to use, and it was like kind of like —Bill: The one up here? Yeah.Adam: You karate chop right, and your elbows are stabilized on the pad, you karate chop down. It was an old, [Inaudible: 01:05:45] machine, and I got these sharp pains on my elbows. Nobody else that I trained on that machine ever had that sharp pain in their elbows, but it bothered the hell out of my elbows. So I would do other tricep extensions and they weren't ever a problem, so does that make that a bad exercise? For me it did.Bill: For you it did, but if you notice, certain machine designs have disappeared. There's a reason why those machine designs disappeared, so there's a reason why, I think in the Nitro line, I know what machine you're talking about. They used to call it multi tricep, right, okay, and your upper arms were held basically parallel, and you had to kind of karate chop down.Adam: It wasn't accounting for the carrying angle.Bill: I'll get to that. So your elbows were slightly above your shoulders, and you had to move your elbows into a parallel. Later designs, they moved it out here. They gave them independent axises, that's not an accident. A certain amount of ligament binding happens, and then —Adam: So my ligaments just were not coping with that very well.Bill: That's right. So for instance, exactly what joint angle your ligaments bind at is individual, but if you're going in this direction, there is a point where the shoulder ligaments bind and you have to do this. Well that machine forced us in the bound position, so when movement has to happen, it can't happen at the shoulder because you're pinned in the seat. It was happening in your elbow. It might not be the same with everybody, but that is how the model works.Adam: So getting back to your client on the leg press, like for instance — you can play with different positions too.Mike: Well the thing is, I'm trying to decipher some of — trying to find where the issues may be. A lot of times I think that the client probably just — maybe there's some alignment issues, IT bands are tight or something like that, or maybe there's a weak — there can be a lot of different little things, but the machines are perfect and symmetrical, but you aren't. You're trying to put your body that's not through a pattern, a movement pattern that has to be fixed in this plane, when your body kind of wants to go a little to the right, a little to the left, or something like that. It just wants to do that even though you're still extending and flexing. In my mind and

Original Aire Date: 6/2016   Bill Crawford and I discuss his start with MedEx, how and when to stretch, and where cardio comes into play. http://basictrainingscottsdale.com   Please visit http://bit.ly/fitnesscandorpodcast, click View in iTunes, go to Ratings and Reviews at the top and leave a rating and/or review! That would be helpful for both of us and get our conversation to more people!

Hello folks, This is a little different podcast set up. I apologize for the spotty quality; it was over the phone via Google Voice since Mr. Turner is in Canada. I had the pleasure of speaking with John Turner, a student of Nautilus exercise equipment and MedEx founder Arthur Jones. He hosts the website www.arthurjonesexercise.com and is the author of The Path of Most Resistance. His fitness industry and exercise knowledge is second to none and I hope everyone takes something from this podcast. Enjoy!   Please visit http://bit.ly/fitnesscandorpodcast, click View in iTunes, go to Ratings and Reviews at the top and leave a rating and/or review! That would be helpful for both of us and get our conversation to more people!

Soldiers from the Alpha, Bravo and MEDEX gather to conduct a three day mini field training exercise.

Dec 18, 2013 Podcast: Natural sunlight replacements, how to fix heel whip in runners, how to squat better, fast muscle gain tips, do calf sleeves help, what is the best workout gear, and why Africans win marathons. Have a podcast question for Ben? Click the tab on the right, use the Contact button on the app, call 1-877-209-9439, Skype “pacificfit” or use the “” form... but be prepared to wait - we prioritize audio questions over text questions. ----------------------------------------------------- News Flashes: You can get these News Flashes hot off the presses if you follow Ben on , and . Research that highlights without covering your other fat soluble bases too. Add a couple teaspoons of this to your favorite lotion and VOILA! Natural 20SPF sunscreen. Amazing: ! Pot + Phenocane anyone? ----------------------------------------------------- Special Announcements: It's Ben's birthday at the end of the week! If you want in on the birthday celebration savings/giveaways, make sure to go to and sign up. Want a done-for-you coaching package with Ben? Grab this package that comes with a tech shirt, a beanie and a water bottle. Ben's new book has been released. Order it now and get entered into a raffle for over $5000 in swag! Just visit . Don't forget to go to to get an audiobook of your choice, free, with a 30-day trial. After the trial, your paid membership will begin at $14.95 per month. And of course, this week's top iTunes review - gets some BG Fitness swag straight from Ben - ! ----------------------------------------------------- Listener Q&A: As compiled, edited and sometimes read by , the Ben Greenfield Fitness Podcast "sidekick". Natural Sunlight Replacements Anne says: She recently moved into a new office space that does not get much sunlight. Is there a sunlamp, supplement, or anything else she should take or do to minimize the negative effects of not seeing much sunlight during the day? In my response I recommend: - (look for 10,000+ lux) - How To Fix Heel Whip In Runners Celia says:She is wondering what exactly is a medial heel whip and what are some of the mechanics behind it? What can she do, without spending a bunch of money getting her gait analyzed, to remedy it? In my response I recommend: -This video on - How To Squat Better Eric says:He wants to improve his squat. He saw the video of you in a speedo and goggles doing a very deep squat and wants to know how to achieve that... is it the goggles? In my response I recommend: -My - - Fast Muscle Gain Tips Joe says: Joe is having trouble gaining weight and size. He has always been on the skinny side and he would really like to bulk up and put on some good mass. He is 5'10" and weighs 155lbs. Todd says:He is a very active, 46-year-old, 158lbs pretty active, works all day, does hot yoga 5 days a week and wants to put on 8 pounds of muscle. He rarely has time to eat enough to gain weight. Wants to know what exercises he should be doing at the gym (has limited time) and is wondering what he should be eating, when he has time to eat (he has Bulletproof Coffee every morning). In my response I recommend: -The -This -These Do Calf Sleeves Help? Nicki says: She has seen a lot of people wearing for running and is wondering if there is any research that shows any benefits from them? What do you think of them? In my response I recommend: - (use 10% discount code GREENFIELD for free shipping) What Is The Best Workout Gear Robert says:He wants to get in shape but with all the stuff out there today, he is wondering about which machines, free weights or kettle bells you favour? He has heard you mention Medex before but what else do you like? In my response I recommend: - --- - - - - - - and/or - Why Africans Win Marathons Sol says:The Kenyans (Moroccans and Ethiopians) keep sweeping the New York City Marathon on both men's and women's divisions. Everyone has their own opinion about what makes Africans marathon winning machines and would like to know our opinions. In my response I recommend: -This ----------------------------------------------------- -- And don't forget to go to -- Prior to asking your question, do a search in upper right hand corner of this website for the keywords associated with your question. Many of the questions we receive have already been answered here at Ben Greenfield Fitness! Podcast music from 80s Fitness (Reso Remix) by KOAN Sound. !

A short documentary about a mass casualty exercise at a combat support hospital or CSH during MEDEX 12 in Sagami (Army) General Depot in Sagamihara, Japan right outside of Tokyo. Participating units include: U.S. Army Pacific, 18th Medical Command, U.S. Army Japan and the soldiers from the 325th Combat Support Hospital, 139th Medical Brigade, and 807th Medical Command (Deployment Support) from Independence, Missouri. Shot and Produced by SSG Robert Ham Music by Celldweller. Also available in High Definition.

Guest: Ruth Ballweg, PA-C Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA The rate of dental disease in Alaska is the highest in the United States. In order to combat the problem, Medex has started a dental therapy program in the area called DENTEX. Ruth Ballweg, director of the MEDEX Northwest program, discusses with host Lisa Dandrea Lenell how Medex became involved with dental care, the progress of the program and their plans to expand the DENTEX program into other states.

Guest: Ruth Ballweg, PA-C Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA When PAs meet other PAs from across the country, they often ask each other, Are you a Duke-trained PA or a MEDEX PA? This question comes from the early days of the profession when a difference in training depended on whether you lived on the east coast or the west coast of the United States. Ruth Ballweg, director of the MEDEX Northwest Physician Assistant Program at the University of Washington School of Medicine, joins host Lisa Dandrea Lenell to discuss the history of the MEDEX program and what this model offers to PA students.