Ahh, the beach… the sound of the waves crashing to the shore, the wind in your hair, the sun on your face and the sand; who doesn't love a vacation by the sea – well, we don't. Born and raised in Miami, Florida those are shocking words I never thought I would say, but I have learned that sand and wheelchairs don't mix. As a child while sand had some redeeming qualities, like building sand castles or burying your brother in it, in reality, sand was annoying, especially when it got in your eye. As an adult it mostly irritated as it mysteriously made its way into crevices previously unreached but as a chair user this previously manageable surface becomes detestable. Typically, my husband and I try to avoid the beach at all costs. But one time we were visiting my hometown with some friends and thought we'd brave it since I had some extra help. Just so you can get the full visual effect, let me describe what it normally looks like when my husband and I go to the beach.
We load up our gear, jump in our car and drive as slow as it takes with our heads sticking out the window for a better view, till we find the location with the absolute closest pavement to water ratio and make a bee- line for it. We park unload the gear and head to the pavement. When the pavement runs out, my husband takes one push into the sand and his casters go about 4 inches under. We then proceed to dump all of our gear in the sand while I pull out a towel and my husband transfers to it. Then we make the 'however many feet' pull/ drag/ push with him on a towel scooting with his arms while I pull/ drag the rest of him until we reach our prime beach going spot. Which means we have left all of our stuff, and his very expensive chair, just sitting there, out in the open until I get him to our spot and I can run back to get our stuff. So now that you have the visual you can better understand the ordeal that we were preparing to do in Miami for our friends. Though the thought of having friends to help definitely made it seem more appealing. We were walking down the sidewalk trying to eye that perfect aforementioned ratio when one of those fitness jocks who obviously lives at the beach showing off his chiseled bronzed pecs walked over to us and said (please insert best muscle man voice here) "Hey, they have free beach chairs over there at the office". Who said Miami was lacking in its southern hospitality? So we walk over to the office and sure enough in exchange for his chair they would lend us a beach chair for the day free of charge. While the thought of leaving his chair in someone else's hand made me nervous, we decided to go for it even though it didn't seem like an even exchange. If something happened to their chair we borrowed it would simply be unable to rent for a bit, but if something happened to my husband's chair I would be giving him piggy-back rides everywhere until we could order a new one, which by the way would be physically impossible for me. But those were their rules and so we followed them and we got to enjoy a fabulous day at the beach. My husband was even able to easily get to the water. Though he wasn't so fond of me being in control of where he went.
One of our funniest beach experiences was on our honeymoon. We stayed at one of those all-inclusive resorts in Jamaica. We couldn't have asked for better accessibility (minus the fact that he couldn't close the bathroom door with his chair in there – talk about a quick reality call to no more privacy). But the staff went out of their way to make things more accessible for us. In fact, one night we were perusing the dinner options for the night and saw that they were having a buffet on the beach. As previously mentioned we avoid sand at all costs so we weren't planning on staying but I decided to walk over and see what they were having. By the time I got back to my husband to share what I saw, the wait staff had set up our own little table on pavement complete with table cloths and silverware. That night we enjoyed a lovely candlelight dinner by the ocean! While at this all-inclusive resort, we spent most of our time by the pool, but one day decided to venture out to the beach. So we proceeded with the aforementioned towel drag/ pull through the sand to the water. Typically the beaches were empty as they were when we got there but apparently some watch guard must have put an A.P.B. out on the 'guy in the chair' because by the time we made it to the water, three lifeguards were standing watch over us. They even joined us in the water watching my husband like a lion ready to pounce on his prey. I assured them that my husband could swim very well in fact and that I, too, was a trained lifeguard but to no avail as they continued to stare from their posts. So after about 5 minutes of feeling like we were actors in the Truman movie, we decided we had had enough and started to head back to the less 'like baby-sitting' pool. When we got to the sand the lifeguards descended like vultures. I didn't even get a chance to attempt the towel drag/pull scenario. With no words exchanged to us the three guards swept him up in their arms carried him to the dock where they proceeded to shower him off while I stood idly by (possibly laughing). When they started to towel dry him off we decided to put an end to it all and told them we could handle it from here… and just like they appeared, they disappeared into the beautiful sun shiny day. Later we were told that they, too, had a free beach chair and instead of having to check it out every day we could just keep it with us for the duration of our stay – though after our initial beach experience we decided to stay away from the beaches for the rest of our trip and stick to the pools!
All in all a place with sand is not somewhere we choose to go. But occasionally we are surprised with the local hospitality when we do venture to the beaches. And on a final note if you thought sand getting in all the wrong crevices was bad as an able- bodied adult, it is multiplied 10-fold as a spinal cord injury that has to drag his body through it!
When we were in Kauai, the lifeguards ran the beach wheelchair (with me in it) under the shower – I felt like I was going through a carwash!
Enjoy reading your blogs. You and Raymond are an inspiration. And, by the way we missed you at our Pullen Christmas party. My daughter thinks you are just a figment of Ann and Raymond's imagination!!! Ha! Happy New Year!


text:
Bronchopulmonale Dysplasie (BPD) ist eine chronische Lungenkrankheit, die vor allem bei frühgeborenen Kindern mit geringem Geburtsgewicht auftritt, wenn diese Kinder über längere Zeit künstlich beatmet werden, um zum Beispiel das Neugeborenen-Atemnotsyndrom (IRDS) zu behandeln. Sie kann zu einer langwierigen Schädigung der Lunge bis ins frühe Erwachsenenalter bzw. bei fortschreitender Lungenveränderung zum Tode führen. In Abhängigkeit von Schweregrad und Wirksamkeit der Behandlung kann vielfach im Laufe des 1. Lebensjahres eine Besserung erreicht werden.

Häufigkeit
Die Häufigkeit von BPD nimmt mit zunehmendem Gestationsalter der Kinder ab. Ca. 15–30 % der Frühgeborenen mit einem Geburtsgewicht < 1000 g oder < 32 Schwangerschaftswochen erkranken an einer BPD, bei Frühgeborenen oberhalb von 32 Schwangerschaftswochen tritt BPD kaum auf.  Eine unreife Lunge mit Mangel an Surfactant ist wesentlicher Risikofaktor für das Auftreten von BPD. Hoher Beatmungsdruck, hohe Sauerstoffkonzentrationen und lange Dauer der künstlichen Beatmung, ein nicht verschlossener Ductus arteriosus, sowie Infektionen der Lunge sind weitere Faktoren. Die Entstehung der BPD ist das Resultat von Umbauvorgängen mit entzündlicher Bildung von Bindegewebe nach anfänglicher Wassereinlagerung in einer unreifen Lunge, die chemischen (Sauerstoffradikale), mechanischen (Drucktrauma, Volumentrauma) und biologischen (mikrobielle Erreger) Schädigungen ausgesetzt ist. Betroffen sind die Lungenbläschen, die Atemwege und die Blutgefäße der Lunge, die sich verengen und damit dann auch zu einem erhöhten Druck im Lungenkreislauf und einer Belastung für die rechte Herzkammer führen können.

Diagnose

Klinische Symptome können erhöhte Atemfrequenz, vertiefte angestrengte Atmung mit Einziehungen am Brustkorb, vermehrtes Bronchialsekret, Husten, Wachstumsverzögerung und livide Haut- und Schleimhaut sein. Im Röntgenbild der Lunge finden sich u. a. diffus Überblähungsbezirke neben unzureichend belüfteten Bereichen (Atelektasen).
Diagnose und Einteilung erfolgen anhand des zu einer ausreichenden Sauerstoffsättigung des Blutes notwendigen Sauerstoffbedarfs zu einem festgelegten Alter des Kindes. Definitionsgemäß ist dabei der Bedarf zum Zeitpunkt eines korrigierten Alters von 36 Schwangerschaftswochen (SSW) maßgebend. Man unterscheidet zwischen einer milden (mit 36 SSW kein erhöhter Sauerstoffbedarf mehr), moderaten (weniger als 30 % Sauerstoff in der Einatemluft notwendig) und schweren Verlaufsform (mehr als 30 % und/oder Beatmung bzw. Atemunterstützung durch CPAP notwendig).

Vorbeugung

Maßnahmen zur Vorbeugung gegen BPD sind: Vermeidung von Frühgeburtlichkeit, Lungenreifeinduktion vor der Geburt mit Gabe von Kortikosteroiden an die Mutter, Vermeidung von Infektionen, schonende möglichst kurzzeitige Beatmung unter Inkaufnahme auch von erhöhten Kohlendioxid-Blutgaswerten, frühzeitige Diagnose und Verschluss eines offen gebliebenen Ductus arteriosus, eventuell Vitamin-A-Gaben an das Kind.

Die Anwendung von Surfactant bei Frühgeborenen mit Atemnotsyndrom, die Ende der 1980er Jahre eingeführt wurde, hat die Überlebenschancen frühgeborener Kinder mit BPD erheblich verbessert, verhindert allerdings nicht das Auftreten von BPD.

Die Behandlung mit systemischen Kortikosteroiden wie Dexamethason führt zu einer schnellen Verbesserung der Lungenfunktion und kann bei sehr früher Gabe (in den ersten 96 Lebensstunden) auch zu einer Verringerung des Auftretens von BPD führen, allerdings sind bei frühzeitiger Gabe auch die Nebenwirkungen schwerer und häufiger.
Eine systemische Kortikoidbehandlung begünstigt das Auftreten von Zerebralparesen.

Therapie

Die Gabe von Sauerstoff zur Aufrechterhaltung einer Sauerstoffsättigung des Blutes von > 92 % ist die vordergründige Therapie. Kortikosteroide (systemisch bzw. Inhalation) wirken dem chronisch-entzündlichen Prozess entgegen, dürfen aber nicht unkritisch eingesetzt werden. Auf die Nebenwirkungen wie z. B. Hyperglykämien, Magengeschwüre und Darmblutungen, Entwicklung einer Osteoporose usw. ist dabei zu achten. Entwässernde Medikamente (Diuretika) sollen ein Lungenödem behandeln. Bei Verengung der Atemwege kommt die Inhalation mit Bronchospasmolytika in Frage. Eine physiotherapeutische Behandlung sollte frühzeitig und kontinuierlich durchgeführt werden. Gefäßerweiternde Medikamente können ggf. einen erhöhten Druck im Lungenkreislauf senken. Wegen des erhöhten Energiebedarfs der erkrankten Kinder ist auf eine energiereiche Ernährung zu achten. Vor Entlassung aus der Klinik sind die ersten Impfungen gegen Keuchhusten, Pneumokokken- und Hämophilus influenzae-Infektionen durchzuführen. Da Kinder mit BPD durch RSV-Infektionen stark gefährdet sind, ist in den Wintermonaten im ersten Lebensjahr bei schweren Verlaufsformen auch die vorbeugende Gabe von monoklonalen Antikörpern gegen diese Virusinfektion zu erwägen. Ab dem 6. Lebensmonat ist die Impfung gegen Influenza empfehlenswert.

Siehe auch
 Wilson-Mikity-Syndrom

Einzelnachweise

Krankheitsbild in der Kinderheilkunde
Neonatologie
Krankheitsbild in der Pneumologie

redpajama_set_name: RedPajamaWikipedia


text:
Children's Illustrated Bible Atlas
Wanting to see the lands of the Bible through the eyes of the young, Martin Gilbert took Natalie, his
eleven-year-old daughter, with him to the Holy Land. They travelled together from northern-most
Galilee to Mount Sinai.
For both of them it was a voyage of discovery. They were struck by the
enormous contrasts in the landscape of so small a country – desert and sea, fertile plain and bare
mountain, gentle valleys and foreboding canyons.
Through the lavish use of colour maps, his own photographs and biblical quotations, Martin Gilbert
gives the reader a splendid opportunity to share this voyage, and many of the journeys of the Bible.
Author's comments
Book Excerpt:
"Most of the Bible stories, both of the Old Testament and the New, took place in this small land,
between the Mediterranean Sea and the Jordan River, bounded in the north by Mount Hermon, and
in the south by the Negev and Sinai deserts.
"This atlas is a guide to the events which took place in that Holy Land. It opens with the coming of
Abraham to the Promised Land, and follows the story, first of the Jews and their struggles, and then
of Jesus and his disciples."
What the author says
"I am grateful to my daughter, Natalie, who not only accompanied me to the Biblical sites, but who
also helped me both to take and to select the photographs, and to prepare the maps for the
cartographer. This atlas is, in every way, as much hers as mine."
"It is an excellent atlas for educational study. All the maps are in a variety of contrasting colours
without being cluttered with irrelevant material, with routes and place names clearly marked. Each
map has its own scale, so that it is just as easy to follow the advance of Saul's armies in miles, as it
is to measure in yards (or metres) the distance associated with the details leading up to the death of
Jesus. … Each map is marked with a star showing the place from which the accompanying
photograph on the opposite page was taken. Biblical quotations are used as captions to the
photographs." J. Geoffrey M. Thorne, The Testimony
For Map Permissions please contact info@martingilbert.com
Maps: 29
Formats: Hardcover
Buy Children's Illustrated Bible Atlas by Sir Martin Gilbert on

redpajama_set_name: RedPajamaCommonCrawl


text:
Remember the Name
Juventus F.C. | United States
What do you know about Alaska?
I don't know much about it.
It's cold. Anchorage is there. It's beautiful.
But I almost ended up knowing everything about it. When I was six, my family nearly moved there. That's crazy for me to think about — like for real, it legit blows my mind. How would I be different if I spent three years in Alaska instead of Germany — where we actually ended up moving.
Who would I be?
Even back then, as just a regular kid, I loved to commit to stuff. Like if I was going to play football, like American football, I wanted to be the best at it. Or basketball. Or whatever it was.
So what if I went to Alaska? Maybe this story would have been about Weston the snowboarder. I could see it. Or maybe … I don't know, I'd be a world class dogsledder. I'd win a bunch of Iditarods. You know, that big dogsled race in Alaska? I really do think about that from time to time. Because life is weird, and sometimes you just have to make the most out of what you have.
Sam Robles/The Players' Tribune
That's what I tried to do when we moved to Germany. I didn't know much about the city of Kaiserslautern. My family moved there because my dad was in the military and he was stationed there after being stationed in Fort Lee in Virginia. My brother, sister and I kind of got thrown into a whole new world. We didn't have the things we were used to, the things we loved.
There were no more pickup American football games against kids at the bus stop before school. No sneaking out of the house, down our cul-de-sac street and going to the playground. Everything in Germany was new. So we adjusted. And I don't know exactly how it all started … but John, my older brother, got into football. Or as we knew it, soccer. But our new friends called it football. We started to play a lot — like a lot a lot.
I think I loved the freedom of it. I had so much energy as a boy, and football was an excuse to go run around and be physical for an afternoon or evening. I didn't have to put on pads or a helmet. The game didn't stop every few minutes. It felt good. I remember following John one day to a game he was playing with some friends. He was 14, I was six. I kicked the ball around a bit on the sidelines and in warmup. My memory is a bit hazy, but there was a coach named David Müller at the park. He came up to John afterwards.
"Hey, you're little brother … he's not so bad. You should bring him out to the tryouts for the under-six team I coach"
We went home and talked to my mom. She gave the green light. Dad said it was fine, too. We gave him a "Yes, sir," as was customary in our house. And we went off to practice. A few days later I remember going to tryouts in a polo shirt, khaki shorts and American football cleats because that's all I had. I didn't have a football kit. I'd only learned of the sport a few months before. But none of that mattered. Because I was fast. Like even for a five-year-old I was fast. Mom told me I blew everybody away with how quick I could move.
I made the team. And got real shorts and boots.
And in my first game — and this is true because David was my first coach, and I'm pretty sure he'd never lie to me — I scored eight goals. Eight.
That was my last game with the U-6s.
I went to play with the U-8s after that.
Not bad for an American!
A few years later, in 2006, the World Cup came to Germany. I saw the U.S. beat Poland in a pretournament match. I met Carlos Bocanegra, Landon Donovan and a few of the other players. Man … I was hooked after that. Representing your country? How cool is that? They don't have that in the American football.
When we moved back to the States, I played both footballs at first. Sometimes on the same day. I'd swap shoulder pads for shin guards in the car as Mom handed me a snack on the way to our match. That's the way it went.
Gradually I moved away from one sport after I started to see a future in another. Football felt like such a gift — a gift that I never would have received if it weren't for our time in Germany. And one I couldn't have benefited from if it weren't for the sacrifices of my parents. That's why when I got a call from my agent, Cory Gibbs, in 2016 telling me that Schalke was interested in signing me, it felt like it was meant to be. I had started something all those years ago in Germany — and now it was time to go back to where it all began.
I only knew three clubs in Germany at the time. Schalke, Bayern and one other one. But when I started doing some reading on Schalke and the city of Gelsenkirchen, I fell in love. The fans were my type of people. Hardworking, passionate and loyal. That meant a lot to me.
Now I've been here for three years, just like when I was a boy. And all those things I read about Schalke are true. They've also become a part of my identity. From the supporters, to my teammates and coaches — Schalke is family.
And I can't wait to see what's next for our family.
FootballSoccerBasketball
Dear England
Gareth Southgate
1,834 Days
I knew it was over. But I still had to know.
When I put on our U.S. kit … I do it for every single American girl out there who wants to see someone who looks like them — someone whose story reminds them of
I wrote this for my dad. For my mom. For my brothers. I wouldn't be me without them, I owe them everything.


Last year I started using Before Five in a Row with Rachel. It is a wonderful curriculum that brings real books to life through activities involving math, science, crafts, music, and more. Plus it is just a fun way to spend some special time with your little one while reading some wonderful books!
Essentially, you read the selected book once a day for 5 days in a row. After each reading, you do a couple of activities that somehow relate to the story. The Before Five in a Row book lists many great activities for each book but I've also collected many more on my Before Five in a Row Pinterest board.
To plan, I start with locating the books that we will read. Many of them can be found at our local libraries. Others I buy used at library book sales or from friends whose kiddos have outgrown them. All of the suggested books are really great pieces of children's literature so I do try to buy them when I can so that we can read them over and over at anytime.
I then look through the books and decide on the best time of the year to read them based on things like if the story takes place during a particular season or if there is a theme to the story that ties in with something else we will be doing later in the year.
To help me plan the activities we do each day, I created this weekly planning page that I fill out for each book. It lets me keep track of which activities we will do on which day, the subjects covered, and which supplies I need to have on hand.
I hope these forms will help you with planning Before Five in a Row activities for your child.
Although we started this curriculum last year, we still have some books that we didn't get around to reading. We will continue to work through the books at the beginning of this year and then we will move on the next level which is Five in a Row, Volume 1.


text:
You try to get that song out of your head after the ride. Go on, I dare you.
Overall, it was a fabulous but totally exhausting week. And when I say exhausted, I mean I was totally and utterly spent. Feet hurting, mind dimming, dizzy and weak type of fatigue. At times I wasn't sure I was going to make it back to the hotel. I'm not sure if it was the Florida summer humidity and heat, the pregnancy, or maybe some raging infection of Disney Magic, but something conspired to drain me of all energy.
I read in a guide that a typical Disney visitor can walk from 5-12 miles a day touring the parks. I'd say we were definitely on the high end of that. I went to http://mapmyrun.com and plotted out just one hour of park trotting on two different occasions and found that we went 1.2 miles on one, and 1.52 miles on the other. And we spent 6-8 hours in the park each time, not to mention trips back for dinner, or to go see a nighttime parade/display. It...was...brutal.
The kids, believe it or not, kept up with us the whole time. They walked every step we walked. There was one afternoon at Animal Kingdom where we rented a stroller but that was it. And we only spent 3-4 hours there anyway.
1. Getting on the plane. Orbitz totally screwed up our seat assignments and USAirways never got it. So when we checked in, they assigned the only seats left, which put me and the kids in three separate middle seats all over the plane. (Brian was flying separately that evening after work.) The gate agent told us just to get on the plane and "take row 21." When I got on, I was relieved to see three frocked priests sitting in row 21. I smiled nicely and explained the issue to the priest sitting in the aisle seat. Priest one looked up from his book and said, "oh, that's a shame." The other two just kept their noses buried in their newspapers and pretended not to be listening. WTF? A pregnant mom traveling alone with two small kids in tow with a problem they could solve immediately? I took row 20 (where my seat was) and decided to wait for the aisle and window seat people to show up and ask them nicely. The college kid who was supposed to sit in the window seat graciously took Maddy's middle seat in front of us, and the nice attorney-looking woman who was assigned to the aisle took Maddy's window seat right behind the priests. I told the flight attendant to offer them a glass of wine or beer or a "snack box" and I would pay for it.
2. Disney Magic also has a sarcastic edge to it. I guess when you have to smile and be incredibly nice all day, you also better have a sarcastic edge. And, frankly, I found it really refreshing. We were at Animal Kingdom and there were a few Disney cast members handing out hula hoops and playing music. Abby runs up and declares really loudly so all the Disney employees standing there turn around to look, "HULA HOOPS! I'm so good at this!" And with that, she takes a hoop, swings it around her waist and it...clatters directly to the ground. The Disney guy handing out the hoops leans to his colleague and, unheard to Abby, makes one of those "wah wah" failure sounds. I cracked up.
One evening (Extra Magic Hours at Epcot, so well after 10 pm, Maddy in tow while Brian, my father, and Abby did Soarin') we walked up to Circle of Life: An Environmental Fable in our quest to find something to do while they waited in a 90 minute line. My mom leans in to the guy holding open the door and asks, "how long is this show?" The guy says, "about 13 minutes." My mom responds, in this business-like tone as she waves her hand dismissively (she didn't really mean it that way), "that will be fine." The guy clearly can't help himself and retorts immediately in the same tone, "really? So, that will be feasible for you?"
3. Disney Magic also inured to our benefit at times. Also at Animal Kingdom, right at the absolute nadir of our central-florida-in-summer fatigue, a Disney employee walks up and asks if we need any help. (Did we look that lost and dazed?) We said we were fine, we were just taking a break because we were so hot. She said, "I think I know what will help. Have you been on Kali River Rapids?" We hadn't, because it, along with every other headline attraction, had lines more than 60-90 minutes long. She winked and walked us through this employee-only path to the front of the line and left us off with a breezy "enjoy!" It was really wet and just the thing we needed to rejuvenate. And then, later, dh and my dad asked how to get to Expedition Everest (another long-line headliner ride) and the Disney employee told them and also gave them "Fast Pass" tickets for it, which bring you to the front of the line as well!
4. Smoked turkey legs are delicious.
5. The Bippity Boppity Boutique baited and switched us, which was really annoying, especially for something that expensive. The price for the "Castle Package" went up $10 between the time we called to confirm our appointments (the day we arrived) and the day of our appointment, which was two days later. When we arrived, we checked the brochure, which still reflected the old price, but at checkout, the price "magically" had gone up. The cashier explained that the prices sometimes go up with little or no warning, and it had only happened the day before, even before they could get new brochures, and wasn't that just a shame for us. I looked at her evenly and asked if there was anything prior to this point in the transaction that I could have reasonably discovered the price hike, given that I'd called two days prior and even checked the price list upon arrival, and she frowned condescendingly and said, "I suppose not." But she still charged us the new price. I didn't want to make a stink in front of the kids (mine plus the throngs of tiny princesses milling about) but I fully intend to take this up with Disney now that I'm back.
That being said, the experience was incredible and the kids got such amazing attention all day (and the next, since the hairstyle was made from some industrial strength glue-like hair product that I'm sure we'll discover, along with the pixie dust, is toxic to children.)
6. Speaking of pixie dust, it started to pour at one point, and when I said, "run for the monorail, kids, it's raining!" Maddy exclaimed, "don't worry Mommy, in Disney World it's only pixie dust!"
7. Most overheard thing said by parents at Disney: "There's no crying at Disney World."
8. When one of your children is scared primarily of two things, dinosaurs and lightning, don't take her on a ride called Ellen's Energy Adventure, no matter how far from dinosaurs and lightning you think it would have to be. Because the ride is, in contravention of all reason, primarily about dinosaurs and lightning.
How about giving kudos to the 60 something parents keeping up also! You guys are really fast!
Where do you think we learned it from?
Just one ride on "It's a Small World"? Try getting it out of your head after 4 rides in a row...
Petunia said...
So, did you get any resolution with Disney about the price hike?
Old and Irrelevant said...
Vuntz I had a kendy store
Bizniss vas so bad,
I asked mein vife vat to do
And dis is vat she said:
Take yourself some kerosene
Pour it on de floor
Take a match
Give a Scratch
No more kendy store, HEY!
Cara Russell said...
We just took our kids to Disney for the first time. We rented a stroller the whole time - I don't know how yours walked all that way! Ours got tired (translation: cranky) really quick from the combination of heat, lots of walking and wanting to get to the "next ride" as quickly as possible. Apparently Mom and Dad are too slow for their liking. Kudos to you guys! Next time I may have to rent a jogging stroller to keep up with my kids!
Smiling Happy People
Abby, Maddy, and Henry Grow Up
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You like these blogs? I like, too.
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Welcome To My Closet, Here's A Black Dress
Shiny Happy Mama
Samara & Doran - Try to Keep Up
Who Else Wants To Live In My House
Slideshow (Double-Click to Play)


text:
Kawai Wong (born Wong Ka Wai (黃家惠) ; 4 February 1986) is a magazine editor, writer and fashion stylist. She started her Hong Kong journalism career with Time Out Hong Kong in 2010 and went on to edit the Shopping & Style section. Wong helped to re-invent the section by adding new regular fixtures such as Things We Love About... and Style Agenda. Her notable works include a one-on-one interview with Tom Ford in 2011 and a six-hour interview with the "King of Asian Pop" Eason Chan in 2012. Wong also contributed to the official website of Hong Kong Tourism Board and translated articles for the arts webzine City Reborn. She had worked with Sasha Slater at London Evening Standard and Hilary Alexander at The Daily Telegraph. Wanderlister+ dubbed Wong a "tough as nail interviewer" in 2012.

Early life and background
Wong was born in Hong Kong and was educated at New Territories Heung Yee Kuk Yuen Long District Secondary School. She was briefly exchanged to Singapore's Zhonghua Secondary School in 2000. After spending a year as the chairperson of her Hong Kong school's Student Association, Wong won a scholarship to study in the UK before reading Biochemistry at Imperial College London. She became the fashion editor of the college's weekly newspaper Felix, where she creative directed a fashion photoshoot in association with Oxfam and Toni&Guy. She also interviewed Bruce Pask (of The New York Times T Magazine), Harold Tillman and Hilary Alexander for the student newspaper. Wong was the editor of the college's annual arts magazine, Phoenix.

Career
At Time Out Hong Kong, Wong interviewed fashion figures Tom Ford, Victoria Beckham, Anna Dello Russo, Gareth Pugh, Henry Holland, Richard Nicoll, Christian Audigier, Georgina Goodman, Kevin Carrigan, as well as helping to expand the Made in Hong Kong section to put hitherto little known design talents on the Hong Kong media map. Wong was the first in the English media to write feature length articles about Hong Kong fashion icon Joey Ma and fashion designer Singchin Lo of Plotz.  Wong also pioneered new fixtures in the magazine, including Things We Love About... and Style Agenda. Wong creative directed fashion shoots involving notable Chinese celebrities including Sammi Cheng, Wyman Wong and Eason Chan.

Apart from entertainment and fashion related works, Wong also participates in cultural and political writing. In 2010, Wong interviewed comic artist Lau Wan Kit about his top-selling pop-up book. In 2011, Wong wrote an article documenting the verbal gaffes of Henry Tang, one of the three candidates running for the 2012 Hong Kong Chief Executive election. Political blog Biglychee dubbed the writing "hilarious". In 2012, Wong mediated a question and answer session with celebrity jeweller Stephen Webster at Liberatum Hong Kong. Wong has also interviewed Pablo Ganguli, editorial director of Vogue China Angelica Cheung amongst many other social/cultural figures.

Tom Ford
Wong's Time Out interview with Tom Ford in 2011 was reprinted in Dubai, Beirut, Beijing, Amsterdam and London. The interview courted internet controversy, leading to a widespread online debate
. The interview was discussed on Vogue, Huffington Post and many other online media outlets.

References

1986 births
Living people
Fashion stylists
Chinese fashion journalists
Alumni of Imperial College London
Hong Kong journalists
Hong Kong women journalists
Chinese journalists
Chinese women journalists


text:
Information Technology Law: The Law and Society (4th edn)
Guide to the online resources
Table of legislation
Part I The information society
1. The world of bits
2. The network of networks
3. Net neutrality
4. Regulating the information society
Part II Content and the information society
5. Cyber-speech
6. Social networking and antisocial conduct
7. Defamation
Part III Digital content and intellectual property rights
8. Intellectual property rights and the information society
10. Digital creatives and copyright law
11. Copyright in the digital environment
12. Copyright infringement in the digital environment
13. Databases
14. Branding, trademarks, and domain names
15. Brand identities, search engines, and secondary markets
Part IV E-commerce
16. Electronic contracts
17. Electronic payments and cryptocurrency
18. Consumer protection
Part V Criminal activity in the information society
19. Computer misuse
20. Obscenity in the information society
21. Crime and law enforcement in the information society
Part VI Data privacy
22. Data protection: the legal framework
23. Data protection: rights and obligations
24. The international trade in personal data
25. State surveillance and data retention
p. 30512. Copyright infringement in the digital environment
Andrew MurrayAndrew MurrayProfessor of Law, London School of Economics and Political Science
This chapter analyses cases of copyright infringement in the online environment. It begins by analysing some early cases regarding file-sharing technologies, including A&M Records, Inc. v Napster, Inc., MGM Studios, Inc. v Grokster, Ltd, and Sweden v Neij et al. (the Pirate Bay case). It assesses new techniques for fighting illegal file-sharing, such as blocking access to websites offering file-sharing technology or indexes with a focus on the operation of s. 97A website blocking orders. It examines the recent Supreme Court decision in Cartier International v British Sky Broadcasting which will have substantial implications for costs in these orders. Finally, it describes the slightly controversial process known as speculative invoicing.
blocking injunctions
free-riding
speculative invoicing


text:
Karthick Ramakrishnan
public policy, public opinion, immigration, race
CV as of January 2019.
Short bio: Karthick Ramakrishnan is professor of public policy and political science at the University of California, Riverside, and founding director of the Center for Social Innovation. He holds a BA in international relations from Brown University and a PhD in politics from Princeton.
Ramakrishnan is also a Board Member of The California Endowment, Chair of the California Commission on APIA Affairs, and Director of the Inland Empire Census Complete Count Committee. Ramakrishnan directs the National Asian American Survey and is founder of AAPIData.com, which publishes demographic data and policy research on Asian Americans and Pacific Islanders. He has published many articles and 6 books, including most recently, Framing Immigrants (Russell Sage, 2016) and The New Immigration Federalism (Cambridge, 2015), and has written dozens of opeds and appeared in over 1,000 news stories. He was recently named to the Frederick Douglass 200 and is currently writing a book on state citizenship in the United States. More information at http://karthick.com.
Long bio: Karthick Ramakrishnan is professor of public policy and political science at the University of California, Riverside, and founding director of the Center for Social Innovation. He is also a Board Member of The California Endowment, Chair of the California Commission on APIA Affairs, Director of the Inland Empire Census Complete Count Committee, and adjunct fellow at the Public Policy Institute of California (PPIC). He received his Ph.D. in politics from Princeton University, and has held fellowships at the Russell Sage Foundation and the Woodrow Wilson International Center for Scholars.
Ramakrishnan's research focuses on civic participation, immigration policy, and the politics of race, ethnicity, and immigration in the United States. He directs the National Asian American Survey and is founder of AAPIData.com, which publishes demographic data and policy research on Asian Americans and Pacific Islanders. He has published many articles and 6 books, including most recently, Framing Immigrants (Russell Sage, 2016) and The New Immigration Federalism (Cambridge, 2015).
Ramakrishnan has received many grants from sources such as National Science Foundation, James Irvine Foundation, Weingart Foundation, and the Carnegie Corporation, and has provided consultation to public officials at the federal and local levels.
In addition, Ramakrishnan was founding editor of the Journal of Race, Ethnicity, and Politics (JREP), an official section journal of the American Political Science Association, director of the UC-wide program on AAPI Policy, and an Assembly appointee to the California Commission on APIA Affairs (2014-2017). He has written dozens of opeds and appeared in over 1,000 news stories, many in major news outlets such as the New York Times, Economist, Los Angeles Times, National Public Radio, PBS Newshour, MSNBC, CBS Evening News, and CNN.
He was recently named to the Frederick Douglass 200 and is currently writing a book on state citizenship in the United States. More information at http://karthick.com.


text:
Cologix gains entry into Jacksonville, Fla. Market via JAX acquisition
Cologix, a neutral interconnection and data center provider, has added Jacksonville, Fla. to its growing list of markets by acquiring the JAX Meet Me Room (JMMR) located in the carrier hotel at 421 W. Church Street.
By acquiring JNMR, Cologix adds a key meet me room and data center in a market that appears to be on the verge of becoming a key interconnection point in the Southeastern U.S.
Having a meet me room in Jacksonville means it can become an entry points for other service providers and businesses looking for a route into Latin America.
"The submarine cables slated to land in Jacksonville create an opportunity for networks to deliver traffic directly to South America without the additional cost, latency and hurricane risk that comes with traversing through Miami," said Grant van Rooyen, President and Chief Executive Officer of Cologix, in a release announcing the deal.
Already delivering services to over 20 service providers and a number of financial, cloud and enterprise customers, the JAX Meet Me Room operates over 9,000 square feet in the 421 W. Church Street carrier hotel as well as the building's meet me room.
Through this acquisition, Cologix now operates 16 neutral data centers in six markets, including Dallas, Jacksonville, Minneapolis, Montreal, Toronto and Vancouver.
Cologix's investment comes at a time when incumbent telcos and competitive providers such as CenturyLink (NYSE: CTL) and Zayo have been allocating capital to expand their fiber networks in Jacksonville.
CenturyLink in May connected its metro fiber network to third-party data centers and enabled business customers in the area to get access to a broader array of data and cloud-based services, including Internet access, IP-VPN and Optical Wavelength service. Leveraging the USCarrier assets it purchased in 2012, Zayo announced in February that it would expand its overall network into the market.
Cologix introduces new data center, connectivity bundle
XO extends service reach into the Toronto market


text:
Delirium in the Emergency Setting
Stephen K. Sponagle, MD
, Thomas W. Heinrich, MD
Thomas W. Heinrich, MD
Psychiatric Issues in Emergency Care Settings, Psychiatric Issues in Emergency Care Settings Vol 6 No 1, Volume 6, Issue 1
The following case histories illustrate some of the clinical aspects of delirium that were described in the preceding article. Each case is followed by a discussion of the diagnosis, identification of the etiology, and subsequent treatment of an episode of delirium.
A 34-year-old woman with unknown medical history presented to the emergency department (ED) with "emotional disturbance." The patient was brought in by police, who noticed her "wandering and confused" in a local shopping mall. The police reported to the triage nurse that the patient was not making sense when they attempted to question her. The police became even more concerned when she told them, "My angel has dropped me here, but now he has returned to salvation."
In the ED, she struggled to find words, frequently stopping in mid sentence. The only truly coherent complaints that could be elicited on review of systems were that she was nauseated, had a headache, and felt "fuzzy." She was unable to provide any medical or psychiatric history because of her confusion.
On presentation to the ED's triage nurse, her vital signs were temperature, 36.1°C (97.0°F); pulse rate, 97 beats per minute; and blood pressure, 165/95 mm Hg. Her blood glucose level was 98 mg/dL on finger stick. Pulse oximetry revealed a normal oxygen saturation of 98% on room air. Her weight was 300 lb and height was 64 in. She was disorientated to day, date, and name of hospital and appeared disheveled, confused, and lethargic. The patient was then taken to an ED bed and told to wait with police for the doctor.
Shortly after admission to the ED and before further evaluation could commence, she experienced a generalized tonic-clonic seizure. Intravenous diazepam was given and the seizure quickly remitted. While the laboratory evaluation was under way, a physical examination revealed a gravid uterus and moderate bilateral lower extremity edema.
An initial laboratory test for urine b-human chorionic gonadotropin was positive, indicating that she was pregnant. Furthermore, the results of her hepatic panel were abnormal, with an alanine aminotransferase level of 340 IU/L, an aspartate aminotransferase level of 320 IU/L, and an albumin level of 2.6 g/dL. Other findings of a comprehensive metabolic panel were normal. Results of a urinalysis showed a protein finding of 2+. Complete blood cell count revealed an abnormal platelet count of 80,000/mL. Results of a urine drug screen were negative.
The patient was subsequently transferred to the labor and delivery unit of a nearby tertiary care center.
Differential diagnosis. The ED staff was working under the assumption that the patient had a chronic psychiatric disorder and her symptom presentation most probably represented a psychotic decompensation of her chronic condition. She received routine supportive care on presentation and was triaged to a bed in the ED. Unfortunately, her problem turned out to be much more medically acute.
In the evaluation of patients presenting with altered mental status, it is prudent to consider delirium before relegating the symptoms and signs to a psychiatric condition such as schizophrenia. When this case is more closely examined, there are several signs and symptoms present that would help differentiate delirium from psychosis, despite the aspects of the patient's history that are suggestive of a chronic psychiatric disorder. She was delusional, her thinking was disorganized, she was wandering in a public place, and she made bizarre statements to police. However, she also had an altered level of consciousness (lethargy), trouble sustaining attention (could not give a medical history), and cognitive changes (language disturbance).
An altered level of consciousness is not seen in chronic psychiatric disorders, such as schizophrenia, unless there is superimposed toxicity from medications or substances of abuse. Cognitive deficits and decreased attention are sometimes symptoms of psychosis but are hallmarks of delirium. Her relatively unremarkable findings during the review of symptoms and vital signs are somewhat reassuring but certainly do not rule out all of the causes of delirium or even all of the imminently dangerous ones.
To definitively establish the diagnosis of delirium, the symptoms must develop quickly and be the result of a medical condition. Collateral information to establish this and the patient's baseline mental status would be helpful. Initially, however, time is often better spent searching for possible medical conditions that may explain the patient's symptoms. By quickly recognizing her presentation as delirium, or at least proceeding as if this were the case, staff could have ensured that she was seen immediately by the physician so that all of the potentially life-threatening causes of delirium could be quickly ruled out.
Etiology. A reminder of 7 of the most dangerous causes of delirium is the acronym WHHHHIMP--Wernicke encephalopathy or withdrawal, hypoxemia, hypertensive encephalopathy, hypoperfusion, hypoglycemia, intracranial bleed or infection, meningitis or encephalitis, and poisons or medications.1 Many of them are effectively ruled out in ED triage, but not all of them. For example, Wernicke encephalopathy may not be associated with abnormal vital signs or obvious intoxication with alcohol. Intracerebral hemorrhage may not present with obvious neurologic signs, and poisoning may not be easily recognized. One could think that a relatively modest elevation in blood pressure would not be associated with encephalopathy. However, this patient had preeclampsia that subsequently evolved into eclampsia.
Preeclampsia is not an uncommon cause of mental status changes in pregnant women who are nearing term.2 It would have been an easy diagnosis to make had it been known that the patient was pregnant. Because of her obesity, this was not obvious but could have been discovered by an earlier physical examination or an immediate urine pregnancy test on admission. In addition to confusion, women with preeclampsia can present with right upper quadrant pain and lower extremity edema. Laboratory findings include elevated transaminase levels, proteinuria, and thrombocytopenia.
Convulsions are a late development and define the transition into full-blown eclampsia. Eclampsia is a medical emergency that is life-threatening to the fetus as well as the mother.
Treatment. The definitive treatment of eclampsia is delivery of the fetus. Other interventions can help prevent additional seizures and further complications until this can be achieved.3 Once the patient was medically stabilized, transfer to a center with a fully equipped labor and delivery unit for delivery and specialized care by an obstetric team was the appropriate way to proceed.
A 74-year-old man was brought to the ED by ambulance from his assisted living facility (ALF). Staff at the ALF reported that for the past 12 hours the patient was increasingly anxious, agitated, and confused. He woke up early on the morning of presentation in a cold sweat, complaining that red spiders were crawling all over the floor.
According to the limited ALF records that accompanied the patient, he had "mild dementia, hypertension, and gastroesophageal reflux disease." While he was at the ALF, the following medications were prescribed: propranolol, 20 mg tid; hydrochlorothiazide, 25 mg/d; and pantoprazole, 40 mg/d. The patient had moved to the ALF 2 days before presenting in the ED, because his wife had become ill and was no longer able to care for him at home.
Attempts to gather a history and review of systems from the patient were limited because of the patient's cognitive impairment. He did complain of continued visual hallucinations, anxiety, nausea, and a mild headache. The patient's vital signs were temperature, 36.4°C (97.5°F); blood pressure, 135/95 mm Hg; pulse rate, 85 beats per minute; respiration rate, 18 breaths per minute; and oxygen saturation rate, 95% on 2 L of oxygen via nasal canula. His blood glucose level was 80 mg/dL.
Physical examination revealed a thin man who appeared older than his stated age. The patient was noticeably flushed, anxious, and irritable. He would frequently get out of his bed and walk around the ED making loud and threatening demands of the staff to get him cigarettes and send him back to his "real home." He was oriented to self only; he believed he was in jail and was off by several months when giving the date. The patient exhibited a mild coarse tremor in the bilateral upper extremities, and his skin was damp to the touch. Other physical examination findings were unremarkable.
As a result of the patient's behavioral problems and staff concerns about dangerousness, the patient was given 20 mg of intramuscular ziprasidone to allow for completion of the medical evaluation. Benzodiazepines were considered but not given because of a concern that these medications would worsen his confusional state, considering the documented history of dementia.
Laboratory evaluation revealed normal urinalysis findings and mild macrocytic anemia; a hepatic panel was remarkable only for decreased albumin and total protein levels. A CT scan of the head showed generalized cerebral atrophy but no bleeding or mass. His symptoms failed to improve with ziprasidone therapy.
When the ED physician was able to talk to the patient's son, the son reported that he had found dozens of empty liquor bottles at his father's house when he was cleaning it out. As a consequence of this new information, the ED physician began a more focused workup and initiated treatment with intravenous thiamine and benzodiazepines. After this workup, the patient received a diagnosis of alcohol withdrawal delirium and was transferred to a medical floor for detoxification.
Differential diagnosis. In this case, the ED physician quickly recognized that the patient was delirious and appropriately began a workup to discover the cause.
Etiology. Because there initially was a low index of suspicion for alcohol withdrawal in this patient, the diagnosis of alcohol withdrawal delirium was missed and treatment was delayed. The low suspicion was a result of several factors: difficulty obtaining pertinent medical and psychiatric history in the ED setting, the patient's age, the patient's residence in a supervised setting, and his relatively unremarkable autonomic symptoms. Although alcohol abuse among the elderly is not uncommon, it often is not diagnosed.4 In addition, spouses are frequently quiet enablers of the problem. It is likely that the patient's transfer to the ALF was the event that precipitated his withdrawal, since alcohol would be harder to obtain there and he was therefore probably abstinent from alcohol since admission 2 days before presentation.
Delirium tremens, or alcohol withdrawal delirium, usually has its onset within 48 to 72 hours following cessation of alcohol use.5 Although the patient's relatively unremarkable autonomic symptoms also argued against the diagnosis of alcohol withdrawal, he was taking propranolol for blood pressure control, and b-blockers can mask (or blunt) the tachycardia and elevation in blood pressure that is usually seen with this condition. Nonetheless, his tremor, visual hallucinations, flushing, nausea, and headache were all suggestive of alcohol withdrawal. The same symptoms in a younger patient would probably have led to an earlier consideration of alcohol withdrawal delirium as the source of this patient's altered mental status.
The more focused workup that the ED physician began at the end of the case history included evaluation of serum cyanocobalamin (vitamin B12), folate, and ammonia levels. Deficiencies in vitamin B12 and folate represent potentially reversible causes of dementia and delirium and may be found in long-term alcohol users who have poor nutrition. Hepatic encephalopathy represents another potential cause of altered mental status in patients with liver disease; this patient's normal transaminase levels do not rule out liver disease, especially if it is advanced.
Another concern in patients who abuse alcohol is Wernicke encephalopathy. This patient should be carefully assessed for symptoms of this potentially disabling condition with the classic findings of altered mental status, ataxia, and ophthalmoplegia.6 Thiamine deficiency is the cause of Wernicke encephalopathy, and thiamine was appropriately given, after determination of glucose level, to prevent this very serious complication of alcohol abuse.
Treatment. Benzodiazepines are the treatment of choice for managing alcohol withdrawal delirium. There are many different protocols for their administration that can broadly be divided into 2 categories. One approach is to give benzodiazepines on a fixed schedule that tapers off over the course of a few days. Another approach is to give them on a symptom-triggered basis. The symptom-triggered approach results in less medication being given and shorter hospital stays.7
All benzodiazepines are effective in the management of alcohol withdrawal. Longer-acting agents such as diazepam are favored because of their long half-life, which allows for fewer doses to be given and less risk of benzodiazepine withdrawal. On the other hand, shorter-acting agents, such as lorazepam, that do not depend on the cytochrome P-450 system for metabolism may be safer for patients with severe liver failure. Regardless of the approach, this patient requires an inpatient setting for detoxification because of his inability to comply with a complex outpatient regimen of medication and because of the severity of his symptoms.
A 54-year-old man presented to the ED with his wife. She reported that for the past week, her husband had been spending most of his time in bed. He would sleep off and on during the day and then remain awake for most of the night, flipping through the television channels. Her husband had been struggling with depression, and she initially attributed his behavior to this and hoped that things would improve over time because he was getting treatment. The psychiatrist had told them not to expect much improvement for the first few weeks of antidepressant treatment.
The patient's wife became very concerned when his symptoms became progressively worse over the 3 days before ED presentation. His sleep became nearly continuous; when he woke up, he seemed confused. On the morning of the day that he presented to the ED, the patient briefly opened his eyes and called his wife "mother"; the patient's mother had been dead for several years. He also told his wife that someone had stolen the remote control for the television and was using it to "control the news." He then fell asleep again. He had not showered or eaten in 2 days.
One month before presentation, the patient was treated by a psychiatrist, who diagnosed major depression. The psychiatrist presribed paroxetine and titrated the dosage to 40 mg/d. The patient's symptoms, which included sadness, hopelessness, restlessness, insomnia, and ruminations about poor performance at work, remained unchanged. One week before his arrival in the ED, he called his primary care physician and complained of continued terrible insomnia. His primary care physician prescribed amitriptyline, 25 mg at bedtime, to help him sleep at night.
The patient was able to provide very little history, and his responses to questions were consistently off topic. He kept perseverating on asking for water, regardless of the question posed. Coherent responses to review of systems were difficult to obtain but seemed negative except for a complaint of constipation. His wife, who was a very good historian, clearly stated that the patient had no significant medical history and that he had never abused alcohol or illicit substances. His only medications were amitriptyline and paroxetine. His wife had the pill bottles with her, and they both had the proper amount of medication in them.
Vital signs were all within normal limits. On physical examination, the patient was very lethargic and slow to arouse from apparent sleep. His hygiene was poor, and he was malodorous. His skin was dry. Other findings of his physical examination were unremarkable.
The patient was disorientated to place and time. He believed he was in "the basement" and that the year was 1967 (more than 20 years earlier than the actual date.) When asked to do serial 7s in an attempt to gauge his attention, he responded very slowly, "100 . . . 97 . . . 7 . . . 7 . . . 7 . . . ." The patient failed to recall any of 3 objects after 5 minutes, instead stating, "1967, 7, and I forget the other one."
Results of routine laboratory studies, including electrolyte levels, complete blood cell count, urinalysis, and a urine drug screen, were unremarkable. Serum was negative for acetaminophen and salicylates but positive for tricyclic antidepressants. A CT scan of the head was unremarkable as well. An ECG revealed normal sinus rhythm. The patient was subsequently admitted to the ICU with telemetry.
The patient's paroxetine and amitriptyline were withheld, and a psychiatric consultation was sought. An electroencephalogram (EEG) showed diffuse slowing. Treatment with haloperidol was started by the psychiatry team, and his symptoms improved somewhat. The treatment team continued to withhold his other medications. Over the course of 2 days, his confusion, lethargy, and disorientation resolved. He and his wife agreed that he was "back to his usual self," except for ongoing complaints of depression, hopelessness, and insomnia. As a result, the psychiatrist started antidepressant treatment with mirtazapine and carefully assessed him for suicidality. The assessment was reassuring, and the treatment team discharged him home.
Differential diagnosis. In this case, the main question was whether the patient's symptoms were a result of his depression or new-onset delirium. Many symptoms of hypoactive delirium are the same as those of depression. This patient was sleeping erratically and had low energy, poor appetite, and little motivation to do anything. He also had delusional thinking.
The correct diagnosis was made in this case because a good mental status examination was performed. A decreased level of consciousness is rare in depression, although it can be confused with profound lack of motivation. Although depressed patients may lose track of the exact day and date, disorientation as severe as this patient's is not seen in pure depression. Depressed patients can become delusional, but the delusions are usually mood-congruent. This patient's delusions were disorganized and loose and not necessarily depressive in their content.
Cognitive testing may be abnormal in depression, but this is usually because of poor effort and not cognitive failure. For example, patients will either not answer or say they do not know the answer without ever really trying. This patient was slow to respond, but he did try to answer the questions. Despite his attempts, the responses he gave were incorrect and preservative.
The timing of the patient's symptoms is also suggestive of delirium. His profound lethargy began shortly after beginning a new medication and evolved over a course of just a few days. Based on these findings, the ED physician correctly diagnosed delirium. Diffuse slowing on an EEG obtained after admission to the ICU confirmed the diagnosis.
Etiology. In a young and healthy patient, drug effects are a common cause of mental status changes, whether the drugs are illicit or prescribed by a physician. This patient's wife denied that he had any problem with illicit drugs. Because of his history of depression, the physician considered an intentional overdose and checked for aspirin and acetaminophen in the blood. An overdose of tricyclic antidepressants was a real possibility, but there were no missing pills.
Perhaps there was an interaction between his medications to explain his symptoms. Amitriptyline and paroxetine can interact in 2 different ways: pharmacodynamically and pharmacokinetically. First, pharmacodynamically, multiple serotonergic agents can produce serotonin syndrome, which is characterized by confusion, mydriasis, myoclonus, and autonomic instability.8 This patient lacked some of the features of this disorder. Second, paroxetine pharmacokinetically increases levels of amitriptyline by strongly inhibiting the P-450 enzyme 2D6.9,10 Both amitriptyline and paroxetine have anticholinergic activity, and the addition of amitriptyline probably precipitated anticholinergic delirium because the patient's liver was unable to metabolize it quickly enough to prevent it from building to toxic levels.
Treatment. Several important and appropriate decisions were made regarding this patient's treatment. Admission to the ICU was appropriate because he needed close monitoring for possibly toxic levels of amitriptyline. It was very important that this patient was not admitted to a general psychiatric inpatient unit with an incorrect diagnosis of depression based on the history of the patient recently being treated for major depression. Tricyclic antidepressant toxicity can produce life-threatening cardiac arrhythmias and profound hypotension; either event is a potential catastrophe on a mental health unit.
The most important intervention after transferring the patient to the appropriate treatment setting was to address the underlying cause of the patient's delirium. In this case, it was a simple matter of withholding the offending medications. The patient's symptoms then were managed while waiting for his medications to clear.
Haloperidol is an effective therapy for the symptoms of delirium.11 It has little if any anticholinergic activity and thus was a good choice for this patient with suspected anticholinergic delirium. Also, it is available for intravenous administration, an important consideration when a patient is too lethargic or confused to swallow pills. Treatment of his symptoms was appropriate because delirium is terrifying for patients and families both, and prolonged delirium is associated with poor outcomes. After the delirium cleared, mirtazapine was a good choice for a new antidepressant because it is helpful for decreased appetite and insomnia and has very little anticholinergic activity.12	*
1. Wise MG, Hilty DM, Cerda GM, Trzepacz PT. Delirium (confusional states). In: Wise MG, Rundell JR, eds.
Textbook of Consultation Liaison Psychiatry.
2nd ed. Washington, DC: American Psychiatric Publishing; 2002:257-272.2. Royburt M, Seidman DS, Serr DM, Mashiach S. Neurologic involvement in hypertensive disease of pregnancy.
Obstet Gynecol Surv.
1991;46:656-664.	3. ACOG Committee on Practice Bulletins--Obstetrics. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002.
Obstet Gynecol.
2002;99:159-167.4. Wiseman EJ. Psychiatric disorders of late life--drug and alcohol abuse. In: Sadock BJ, Sadock VA, eds.
Kaplan and Sadock's Comprehensive Textbook or Psychiatry.
8th ed. Philadelphia: Lippincott Williams and Wilkins; 2005:3711-3715.5. Turner RC, Lichstein PR, Peden JG Jr, et al. Alcohol withdrawal syndromes: a review of pathophysiology, clinical presentation, and treatment.
J Gen Intern Med.
1989;4:432-444.6. Victor M, Adams RD, Collins GH. The Wernicke-Korsakoff syndrome. A clinical and pathological study of 245 patients, 82 with post-mortem examinations.
Contemp Neurol Ser.
1971;7:1-206.7. Mayo-Smith MF. Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol Withdrawal.
JAMA.
1997;278:144-151.8. Boyer EW, Shannon M. The serotonin syndrome.
N Engl J Med.
2005;352:1112-1120.9. Mellstrom B, Sawe J, Bertilsson L, Sjoqvist F. Amitriptyline metabolism: association with debrisoquin hydroxylation in nonsmokers.
Clin Parmacol Ther.
1986;39:369-371.10. Brosen K, Hansen JG, Nielsen KK, et al. Inhibition by paroxetine of desipramine metabolism in extensive but not in poor metabolizers of sparteine.
Eur J Clin Pharmacol.
1993;44:349-355.11. Breitbart W, Marotta R, Platt MM, et al. A double-blind trial of haloperidol, chlorpromazine, and lorazepam in the treatment of delirium in hospitalized AIDS patients.
Am J Psychiatry.
1996;153:231-237.	12. Holm KJ, Markham A. Mirtazapine: a review of its use in major depression.
Drugs.
1999;57:607-631.
Addiction & Substance Use | Alcohol Abuse | Major Depressive Disorder | Psychiatric Emergencies | Schizophrenia/Psychosis | Delirium


It is with great sadness that we lost a close friend and ex trustee on Thursday, Darren Bennet.
Darren dedicated a great deal of his time to the Stan Bowley Trust during his 6 years as a Trustee.
His resolve and business acumen pushed the Charity to a new level, which was all done with a smile on his face despite personal heartache.
The SBT send their deepest & heartfelt condolences to both Tom, Hayden and Lisa at this very difficult time.


I believe Alex has the new range extenders, so one of us will have to go pick those up. Didn't Joe have the boxes? I thought he brought them to our meeting. I have the computer. As for the rest, no idea. Might be worth a trip to the van to see what's there.
Russ may have the box?
I have the event box with the money bag. I do not have the three drawer file box which I assume must be in the van.
Jmudge wrote: I believe Alex has the new range extenders, so one of us will have to go pick those up. Didn't Joe have the boxes? I thought he brought them to our meeting. I have the computer. As for the rest, no idea. Might be worth a trip to the van to see what's there.
So, small issue with the antennas... I finally opened the boxes a couple of days ago, and discovered that they only shipped me the tri-pods, not the actual antennas! I emailed SPS and they said they would get them shipped ASAP, but I'm not sure how soon that is.
That's unfortunate. Not the end of the world if they don't come.


[NEWS] Iwata Satoru Dies at 55.
What awful news to hear this morning. It wouldn't have been as shocking if Iwata was honest about his condition. We were led to believe that he had gotten better after not appearing at E3 in 2014 and having surgery. Iwata continued to work while he was sick and it's sad to think that only the people closest to him knew. .
The best memory that I have of Iwata is hearing that he personally compressed Pokemon Gold and Silver to make space for Kanto. One of my favourite childhood memories was defeating the Elite Four and then realising that I can explore Kanto and earn sixteen badges. On top of that I had the ability to fight Red.. Which I did over and over again. I was also impressed that he learnt the program for the battle system from Red and Blue in a week and had it working in Pokemon Stadium. Iwata was an amazing programmer.
Iwata always seemed so honest and humble. From giving himself a fifty percent pay cut instead of laying people off to being open in the numerous Iwata Asks, Nintendo Directs and other media he participated in. He felt less like a CEO and more like just another gamer.
He had highs with the Nintendo DS and the Nintendo Wii and lows with the Nintendo 3DS and the Nintendo WiiU. He was gracious even with the lows. Offering customers free games to compensate for the lack of titles (3DS). In general though I believe he has definitely been advantageous to Nintendo. I can not imagine anyone else in the chair. Partly due to the fact that Iwata has been CEO for so long. I was still in primary school when he took the position.
I wonder where Nintendo will go from here. I see a lot of people say that Iwata is running Nintendo into the ground. Though that opinion may change now. I hope that they can get someone just as inspirational, down to earth and personable as Iwata. Whoever they get has big shoes to fill, that's for sure.
Very sad news. More video game companies should have CEOs like him.


text:
Top CLASS energy project to save £100m for customers
CLASS substation
[T]he region's network power operator has found a way to reduce demand for electricity across the North West, without anyone noticing a difference to their supply.
As part of its award-winning CLASS project, Electricity North West has found that installing cutting edge 'voltage controllers' in its substations could save customers in the North West around £100 million over the next 25 years – and £300 million across Great Britain.
During a 12-month trial, the new voltage controllers were installed at 60 substations which each serve around 10,000 customers. Detailed research carried out during the trial showed that customers didn't notice any change in their electricity supply.
Electricity North West has now awarded a contract to Schneider Electric to supply enhanced voltage controllers which will be installed at up to 260 substations across the North West.
Steve Cox, engineering and technology director for Electricity North West, said: "We are always looking at ways we can use new technology to improve service and reduce costs for our customers. By reducing the voltage across the whole network at tiny levels which are unnoticeable to end users, we can save a significant amount of power for the region.
"This ground-breaking approach can be used to help balance electricity supply and demand for the whole of Great Britain. This makes the network more flexible and importantly, helps save customers money."
James Allen, operations director for Schneider Electric, said: "Schneider Electric is delighted to be working with Electricity North West on this innovative project using modern technology to make their power networks dynamic, responsive to customer needs and to reduce costs.
"This initiative fits with our underlying mission of making the very best of our energy for all concerned and we will strive to make this project a success for all involved."
You can find out more about CLASS on Electricity North West's website at www.enwl.co.uk/class.
Electricity North WestfoundGreat BritainSchneider Electric0
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Found property – Eden Festival
Appeal after woman, 21, found in distressed state in Lancaster
Man found unanimously not guilty of alleged rape of woman in Penrith
Drunk man who flashed knife at Carlisle shop worker is jailed
Police renew appeal to find missing Workington man, 91


text:
\section{Introduction}

Noncommutative (NC) theories are built on spaces whose coordinates do not commute and therefore one cannot localize their points with an arbitrary precision. This is believed to be an artifact of quantum gravity and results into a plenty of novel properties, for example a natural UV cutoff. A certain theory of NC quantum mechanics (QM) was studied in \cite{ncqmLRL, ncqmHatom1,ncqmHatom2,ncqmVelo} and this paper aims to analyze its possible physical consequences.

Among the objects sensible to introducing a short scale structure are microscopic black holes. In the classical theory, as they evaporate by Hawking radiation \cite{Hawking} their radius eventually becomes infinitely small and their temperature becomes infinitely high. It is interesting to study how is this behavior affected by introducing a NC structure to 3-space. The appropriate theory to investigate this is the one of quantum gravity, which is yet to be found, or at least properly understood. Therefore we settle for a semiclassical description and implement some of the results from NC QM into the classical theory of gravity.

This method was developed by Nicolini \cite{Nicolini}, who dubbed it 'NC inspired'. More details on NC inspired cosmology and gravity could be found \cite{infl1, ncmbh1,ncmbh2,ncmbh3,ncmbh4,ncmbh5,ncmbh6}, the concept of generalized uncertainty principle in a similar context has been analyzed as well \cite{Arraut1, Arraut2}{}.

This paper is organized as follows. In Section \ref{sec:NC} we derive a NC delta function (which describes a (nearly) singular matter density), complete it into stress-energy tensor $T^\mu _\nu$ and solve the Einstein field equations (EFE) for it. This solution is analyzed, focusing mostly on the event horizon(s) and the Hawking temperature, in Section \ref{sec:ehhr}. Section \ref{sec:PC} contains physical consequences of the model and final conclusions.

\section{Noncommutative space, (blurred) delta function and EFE}
\label{sec:NC}
We will study a model of 3 dimensional rotational invariant NC space described by
\begin{equation} \label{NCrel}
[\hat{x}_i, \hat{x}_j] = 2 i \lambda \hat{x}_k \varepsilon^{ijk}\, ,
\end{equation}
where $\varepsilon^{ijk}$ is the Levi-Civita symbol and $\lambda$ is a constant with the dimension of length, describing the scale of noncommutativity. It is not fixed within our model, but could be expected to be (approximately) the Planck length.

There are several ways how to satisfy \eqref{NCrel}, see \cite{Berezin,Bosonic,Grosse,ncqmHatom1,Madore,Presnajder}{}. We will employ the bosonic operator approach which was previously used in \cite{ncqmLRL,ncqmHatom1,ncqmHatom2,ncqmVelo} and is well suited for 3 dimensional rotational invariant problems.

Let us define two sets of bosonic creation and annihilation operators satisfying
\begin{equation} \label{bos}
[\hat{a}_\alpha , \hat{a}^+_\beta] = \delta_{\alpha \beta}\, ; \, \alpha,\beta =1,2 \, ,
\end{equation}
and acting in an auxiliary Fock space $\mathcal{F}$ spanned on normalized states $| n_1, n_2 \rangle = \frac{(\hat{a}_1^+)^{n_1}(\hat{a}_2^+)^{n_2}}{\sqrt{n_1!n_2!}}| 0,0 \rangle$, where $| 0,0\rangle = |0\rangle$ is the vacuum state annihilated by both $\hat{a}_\alpha$. It is convenient to define their dimensional versions as $\hat{z}_\alpha = \sqrt{\lambda} \hat{a}_\alpha, \, \hat{z}_\alpha^+ = \sqrt{\lambda}\hat{a}^+_\alpha$. Using these (and Pauli matrices $\sigma^i$), we can define the (Cartesian) coordinates satisfying \eqref{NCrel} and the radial coordinate \footnote{Their relation is $\hat{r}^2 -\hat{x}^2 = \lambda^2$, as can be easily checked.} as
\begin{equation} \label{NCx}
\hat{x}_i =  \sigma^i_{\alpha \beta} \hat{z}^+_\alpha\hat{z}_\beta , \ \hat{r}= \hat{z}^+_\alpha \hat{z}_\alpha +\lambda \ .
\end{equation}

Fock space states $| n_1, n_2 \rangle$ are $\hat{r}$ eigenstates with eigenvalues of $\lambda (n_1+n_2 +1)$, the vacuum state $|0,0\rangle \equiv |0\rangle$ is the state with the minimal eigenvalue, it corresponds to the origin of the coordinate system. Space described by NC coordinates \eqref{NCx} can be looked upon as quantized Euclidean 3-space, see \cite{mm}{}.

Coherent states play an important role in the ordinary quantum mechanics and are crucial in NC theories as well \cite{cs1,cs2,cs3,cs4,cs5}{}. A coherent state is well localized wave packet which minimizes the uncertainty relation and is defined as an annihilation operator eigenstate $\hat{a} |\alpha\rangle = \alpha |\alpha\rangle$. Such states can be generated as $|\alpha\rangle = e^{- \frac{|\alpha|^2}{2}} e^{\alpha \hat{a}^+} |0\rangle $ and used as an  overcomplete sets of states in $\mathcal{F}$,  \cite{Perolomov}{}. Overlap of two such states is $\langle \alpha|\beta \rangle = e^{ -\frac{|\alpha|^2 + |\beta|^2}{2} +\bar{\alpha}\beta}$. We are interested in a state well localized at the origin, which follows from
\begin{equation} \label{rho0}
\tilde{\rho}(z) = | \langle z|0 \rangle |^2 =  e^{-\frac{|z|^2}{\lambda}} = e^{-\frac{r-\lambda}{\lambda}}\, .
\end{equation}

Let us pause for a moment to make a few remarks here. First of all, we define taking $\lambda \rightarrow 0$ as the commutative limit (RHS of \eqref{NCrel} vanishes, as in the ordinary QM). It is easy to see that in this limit the RHS of \eqref{rho0} vanishes everywhere but at the point $r=0$, it resembles Dirac delta distribution with the source located at the coordinate origin. It is therefore natural to call $\tilde{\rho} \propto e^{-\frac{r}{\lambda}}$ an almost delta distribution or a blurred delta distribution (located at the coordinate origin).

Note that $\tilde{\rho}$ in \eqref{rho0} is dimensionless, a dimensional one will be denoted $\rho$. Since the rest of calculations will be done using the ordinary (not NC) calculus, we will normalize $\rho$ with respect to ordinary integration instead of trace norm, yielding
\begin{equation} \label{rho}
 \rho (r)= \frac{M}{8\pi\lambda^3}e^{-\frac{r}{\lambda}} \, .
\end{equation}

In the paper by P. Nicolini \cite{Nicolini}, which served as a main inspiration for ours, a similar line of reasoning was used. The starting point was a two dimensional NC space and the resulting density was generalized into three dimensional only afterwards, yielding $\rho \propto  e^{ - \frac{r^2}{\lambda^2}}$. As we have shown, a direct three dimensional derivation based on \eqref{NCrel} gives different result.

We will take \eqref{rho} as the matter density of a (blurred) point and complete it into stress-energy tensor. We focus on uncharged nonrotating black holes, so we expect the solution to become Schwarzschild-like in the $\lambda \rightarrow 0$ limit. This encourages us to use a diagonal ansatz for the metric tensor with $g_{00}=-g_{rr}^{-1}$, therefore we seek only a single function $f(r)$ such that $g_{\mu \nu} = \mbox{diag} \left( f, -f^{-1}, r^2, r^2 \sin^2 \theta \right)$ (with coordinates  $(0,r,\theta,\varphi)$ and signature $(-,+,+,+)$. We often set uninteresting constants equal to $1$ and omit writing arguments).

For the same reason we are expecting a diagonal $T^\mu_\nu$ with $T^0_0 = - \rho$ and $T^r_r=T^0_0$ (which follows from the EFE). Because of the chosen ansatz, $T^r_r=T^0_0$ is fixed as well (this also can be seen from the EFE). The other two components follow from the conservation law $T^{\mu \nu}{}_{;\nu}=0$. For $\mu=\theta$ we get $ T^\theta_\theta= T^\varphi_\varphi =: p_\perp$, for $\mu=r$ we get $p_\perp = - \frac{r}{2}(\partial _r \rho + \frac{2}{r}\rho)= -\rho - \frac{r}{2} \partial _r \rho$. Adding this we obtain $ T^\mu_\nu= \left( -\rho, p_r, p_\perp, p_\perp \right)$, where $p_r = -\rho$ and $p_\perp$ defined above.

Since we are looking for a single function $f(r)$ we only need one of the EFE, let us take $G_0^0 = 8 \pi T_0^0$. From it the solution follows as
\begin{equation} \label{eqForF}
\frac{ 1 + f(r) + r f'(r)}{r^2}=\frac{M}{\lambda^3}e^{-\frac{r}{\lambda}} \rightarrow f(r) = -1 - e^{-\frac{r}{\lambda}}\frac{M}{r}\left( \frac{r^2}{\lambda^2}+\frac{2r}{\lambda}+2 \right)+\frac{C}{r} \, .
\end{equation}

Recall that $g_{00}=f$, therefore if we want the solution to approach Schwarzschild solution for $r \gg \lambda$, we need to set $C=2M$. For the rest of this paper we will be needing only the time component of the metric tensor,
\begin{equation}\label{G}
g_{00}(r;\lambda,M) =  -1 + \frac{2M}{r} - e^{-\frac{r}{\lambda}}\frac{M}{r}\left( \frac{r^2}{\lambda^2}+\frac{2r}{\lambda}+2 \right) \, .
\end{equation}

Let us pause for a brief comment. The stress-energy tensor violates the weak energy condition (see \cite{Carroll}) for $r<2\lambda$, which signalize a quantum repulsion (preventing the matter from collapsing into a singularity). The strong energy condition is violated between black hole horizons. This might either be an artifact of the semiclassical approach, or a signal of negative energies present. In \cite{Barcelo} it is argued that the energy conditions are becoming obsolete, being violated even in classical theory; namely, local conditions are not satisfied for scalar fields with nonminimal coupling to gravity, and even averaged conditions do not always hold if the field reaches transplanckian values.

The particular form of the stress-energy tensor followed from the postulate of $T_{00}$ and from the requirement of Schwarzschild-like form of $g_{\mu \nu}$. However since we will be using only the $g_{00}$ component our results hold also for different completions of $T_{\mu \nu}$, which might be free of (strong condition) violations.

\section{Event horizon(s) and Hawking radiation}
\label{sec:ehhr}
Event horizons are solutions of the equation $g_{00}(r) = 0$. For an ordinary Schwarzschild black hole there is only a single solution $r=2M$, now there are two, one or zero solutions, depending on the value of $M$ (see Figure 1). In the case there are two, let us denote them $r_-, r_+$ ($r_- < r_+$).

\begin{figure}[b]\label{figure1}
 \includegraphics[width=1\textwidth]{1.pdf}
 \caption{$g_{00}(r)$ for  $\lambda=1$ and different values of $M$.}
\end{figure}

When the mass is large ($M\gg\lambda$), there are two horizons, one near the singularity ($r_- \approx 0$) and the other near the classical horizon ($r_+ \approx 2M$). As $M$ gets smaller, these two surfaces move towards each other and meet for $M=:M_0$ at $r=:r_0$. We call a black hole with the mass $M_0$ and a single horizon at $r_0$ minimal, since for any smaller $M$ there is no horizon at all, minimal black hole is the smallest (and lightest) possible black hole. The values of $M_0,r_0$ can be obtained numerically
\begin{equation}\label{Mr}
M_0 \stackrel{.}{=}  2.57 \lambda, \, r_0 \stackrel{.}{=}  3.38 \lambda\,.
\end{equation}

The Hawking temperature of a minimal black hole is zero. This follows from the fact that it is proportional to the surface gravity at the (outer) horizon $\kappa = - \frac{g_{00}'(r_0)}{2}$, which has to be zero, since $g_{00}(r)$ reaches its maximum there. The black hole becomes frozen and evaporation ceases when the minimal mass $M=M_0$ is reached.

\begin{figure}[!b] \label{fig2}
 \includegraphics[width=1\textwidth]{3.pdf}
 \caption{The Hawking temperature as a function of black hole's mass.}
\end{figure}

Note that infinite temperatures are avoided (Figure 2). From a dimensional analysis we can see that the maximal reached temperature (denoted $T_m$) is proportional to $\lambda^{-1}$.  To find the constant of proportionality, let us first factorize out the mass from $g_{00}$
\begin{equation} \label{Tg}
g_{00}(r;\lambda,M) = -1 + M \tilde{g}(r;\lambda) \, ,
\end{equation}
where $\tilde{g}(r)$ does not depend on $M$. At the (outer) horizon $\tilde{g}(r_+) = \frac{1}{M}$, and
\begin{equation} \label{tg}
g'_{00}(r_+)= M \tilde{g}'(r_+) = \frac{\tilde{g}'(r_+)}{\tilde{g}(r_+)}\, .
\end{equation}
This is, up to a multiplicative constant, equal to the Hawking temperature. To find $r_+$, for which this achieves extremum we need to solve $\partial_{r_+} g'_{00}(r_+) =0$. This can be, again, done numerically (choosing $\lambda=1$), finding that the extremum is reached as $g'_{00}(r_+ \stackrel{.}{=}6.54) \stackrel{.}{=} - 0.12$. Plugging this into the relation for the temperature we obtain
\begin{equation} \label{Tm}
T_{m} \stackrel{.}{=} \frac{\hbar c}{4 \pi k_B}\frac{0.12}{\lambda} , \, \frac{\hbar c}{4 \pi k_B}\stackrel{.}{=}0.18 \times 10^{-3}m K.
\end{equation}

It can be observed in Figure 2 that the temperature grows very rapidly for $M \gtrsim M_0$. It is therefore interesting to investigate what happens after adding a small mass $\delta M \ll M_0$ into a minimal black hole.

To answer this question we use the decomposition \eqref{Tg}. Let us denote the increment in radius $\delta r$, horizon condition after adding a small mass $\delta M$ reads
\begin{equation}\label{hor1}
 -1 + (M_0 + \delta M) \tilde{g}(r_0 + \delta r;\lambda) = 0.
\end{equation}
Truncating the Taylor expansion of \eqref{hor1} we obtain
\begin{equation}
\tilde{g}(r_0 + \delta r;\lambda) \stackrel{.}{=} \underbrace{\tilde{g}(r_0;\lambda)}_{M_0^{-1}} + \delta r \underbrace{\partial_r \tilde{g}(r_0;\lambda) }_0 + \frac{1}{2}\delta r ^2\partial_r^2 \tilde{g}(r_0;\lambda) \, .
\end{equation}
Inserting this back into \eqref{hor1} we arrive to
\begin{equation} \label{Dr}
\delta r \stackrel{.}{=} \pm \sqrt{\frac{-2 \delta M }{M_0^2\partial_r^2 \tilde{g}(r_0;\lambda)  }} \, .
\end{equation}
Evaluating for $M_0$ and $r_0$ as given in \eqref{Mr} yields $\delta r \stackrel{.}{=} \pm 2.54 \sqrt{ \lambda \delta M}$ (there are two symmetric solutions because we have truncated the Taylor expansion after the quadratic term).

We can now determine the temperature of the resulting black hole
\begin{equation}
T(r_0 + \delta r) \stackrel{.}{=} \overbrace{T (r_0)}^0 + \partial_r T(r_0) \delta r
\end{equation}
\begin{equation*}
= - \frac{M_0 \tilde{g}''(r_0)}{4 \pi} \delta r   \stackrel{.}{=} \frac{1}{4 \pi}\frac{1}{M_0} \frac{2\delta M}{\delta r} \stackrel{.}{=}\frac{1}{2\pi} \frac{\sqrt{\delta M}}{ \ 6.53\ \lambda^{3/2} } \, ,
\end{equation*}
 Recovering constants for a moment
\begin{equation}
T(M_0 + \delta M) \stackrel{.}{=} \frac{\sqrt{\delta M}}{41.01\ \lambda^{3/2} }\frac{\hbar c}{k_B} \, .
\end{equation}
It is useful to express this with respect to the maximal temperature
\begin{equation} \label{THTM}
\frac{T(M_0 + \delta M)}{T_m} \stackrel{.}{=}2.55 \sqrt{\frac{\delta M}{\lambda}}\stackrel{.}{=}4.09 \sqrt{\frac{\delta M}{M_0}} \, .
\end{equation}
We can see that for $\delta M \ll M_0$ the black hole does not reach its maximum temperature, only a small fraction of it (which is, absolutely speaking, still huge).

The last question of this section will be whether does the temperature reach the maximum value if we merge two minimal black holes together? When we have $M=2M_0$ we are in a region where we can safely take $r_+ = 2M = 4M_0 \stackrel{.}{=} 10.28 \lambda$. This is larger than the value $r_+ = 6.54 \lambda$ for which the temperature reaches maximum, therefore the maximum will be reached, when the new black hole evaporates from the radius of $10.28 \lambda$ to $6.54 \lambda$.

\section{Physical consequences and conclusion}
\label{sec:PC}

To be able to evaluate physical consequences let us assume that $\lambda \sim l_{\mbox{Planck}} \stackrel{.}{=} 1.62 \times 10^{-35}m$, as is usually done (scaling rules for a different choice will be included). Most sensitive to introducing the noncommutativity are microscopic black holes, with a radius of the order of a few $\lambda$. The most important case is the minimal black holes, let us denote it mBH.

According to \eqref{Mr} a mBH should have a radius  $r_0 \stackrel{.}{=} 5.48 \times 10^{-35}m$ (we can take the cross section to be $\sigma=\pi r_0^2 \stackrel{.}{=} 9.43 \times 10^{-69}m^2$) and a mass $M_0 \stackrel{.}{=} 5.59 \times 10^{-8}kg$ ($r_0,M_0$ scale as $\lambda$). Furthermore the maximal temperature $T_{\mbox{m}}$ is $1.33 \times 10^{30}K$, which is two orders below the Planck temperature (this scales as $\lambda^{-1}$).

Considering these numbers, mBH (or microscopic black holes in general) are possible cold dark matter constituents. They are cold and dark (since their radiation froze out), have extremely small cross section and are heavy enough so only a small concentration $n_{mBH} \stackrel{.}{=}4.25\times 10^{-20} m ^{-3}$ is needed to make up for the observed dark matter mass density $\rho_{DM} \stackrel{.}{=} 2.38 \times 10^{-27} kg \, m^{-3}$  (this scales as $\lambda^{-1}$). Dark matter density is uniform only on cosmological scales, there is more of it in galaxies (by factor $10^5-10^6$, see \cite{Weber}, possibly even more within solar systems). The idea of mBH as dark matter candidates has appeared as a brief comment in \cite{ncdm}, with the question of their creation left open. We propose that they might have been formed shortly after the Big Bang (perhaps from primordial inhomogeneities \cite{pbh}), cooling down afterwards, until they eventually froze out.

The cross section of mBH is small enough for them not to interact with each other, however it is still possible for them to be hit by another particle. Let us assume that a mBH gets hit by a proton and absorbs it, what would happen? Since the mass of the proton is significantly smaller than $M_0$ we can use eq. \eqref{THTM}, for this example $\frac{\delta M}{M_0} \stackrel{.}{=} 2.98 \times 10^{-20}$. The resulting microscopic black hole will warm up to $7.06 \times 10^{-10}$ of $T_m$, which is $9.39 \times 10^{20}K$ (this scales as $\lambda^{-\frac{3}{2}}$), two orders below the energy of ultra-high-energy cosmic rays which are being observed. Had the $\lambda$ been shorter than the Planck length, a radiation of a microscopic black hole after consuming a proton could account for such rays. It should be noted here that it might be more correct to consider mBH-electron or mBH-quark collision instead\footnote{Interesting questions about the confinement arise in that case.}, since the proton is significantly larger than mBH.

It is important to note that in the considered case the energy of radiation exceeds the energy of the consumed particle. The possible scenario is that the energy will be radiated in one or two quanta and the resulting object will end with $M<M_0$, it will have no horizons and stops being a black hole. Then it will be moving through the space as an extremely dense lump of matter and collect additional mass until it reaches mass $M_0$ and becomes mBH again.

Such object, let us name it \textit{gravimond}, lives in cycles: first it is a mBH with mass $M_0$. Then, after it absorbs a particle its radiation is reignited as $M>M_0$. Shortly after it stops being a black hole, since so much energy has been radiated that $M<M_0$, it becomes an extremely dense object (almost a black hole), which needs to capture additional mass to become mBH again. The period of these cycles is unknown and largely depends on the location of such object (how often does it get to interact with other matter).

\textbf{Conclusion:} The paper analyzed (microscopic) black holes with a blurred mass density, instead of a singular one. Such matter density originated from considering a NC structure of 3-space, yet the following calculations have been done using the ordinary calculus and the general theory relativity\footnote{This is why the objects in question are sometimes referred to as NC-inspired black holes instead of just NC black holes.}. There are many cases in the history of physics advocating for a semiclassical approach, just recall the Bohr's derivation of the Rydberg's formula. We do not expect our results to be as exact, but merely to give a hint of what to expect from a proper quantum theory of gravity. Since some of the features persist also in full NC approach (for example existence of the minimal possible event horizon radius can be compared to the minimal event horizon area $A\approx 4\pi l_{\mbox{Planck}}^2$ in \cite{Dolan}) it is plausible that other features will hold in a full NC approach as well.

The emphasis of our analysis was on the radius of event horizon(s) and the Hawking temperature of such black holes. The principal results of this paper are:

\begin{itemize}
\item Investigating the effects of blurring the matter singularity on the behavior of (microscopic) black holes. Showing the existence of a minimal possible black hole radius $r_0 \stackrel{.}{=} 3.38 \lambda$ and $M_0  \stackrel{.}{=}  2.57 \lambda$.
\item Derivating the temperature dependency on the black hole mass, which is close to the ordinary case for $M \gg M_0$, drops to zero for $M=M_0$ and grows rapidly for $M \gtrsim M_0$.
\item Conjecture that microscopic black holes could be dark matter constituents (and are also capable of generating  high energy radiation).
\end{itemize}

\subsection*{Acknowledgment}

I would like to thank P. Pre\v{s}najder (my PhD supervisor) and V. Balek for their valuable comments and corrections. This work was partially supported by COST Action MP1405 and UK/92/2015.

\section*{References}
\bibliographystyle{ws-mpla}

redpajama_set_name: RedPajamaArXiv


text:
The Uncertain Future of the Enlightenment Stupa in Moscow. By Lyudmila Klasanova
The Enlightenment Stupa in Moscow
The Enlightenment Stupa in Moscow, also known as the Three Jewels Stupa, was consecrated on 18 June 2008 on the grounds of Lopoukhin Mansion, where the International Center of the Roerichs and its non-governmental museum named after the Russian artist, scholar, thinker, and public figure Nicholas Roerich (1874–1947) were located until 28 April 2017. The stupa was built on the initiative of and with the blessing from His Holiness Dujom Sangye Pema Shepa Rinpoche, head of the Dujom Tersar lineage of the Nyingma school of Tibetan Buddhism. The stupa was an invaluable gift from the Buddhist lamas to the Nicholas Roerich Museum of the International Centre of the Roerichs as a testimony to Roerich's exceptional contribution to the understanding the ancient culture and philosophy of Central Asia.
The Enlightenment Stupa was the first and, until 2017, the only Buddhist stupa in the Russian capital, constructed in accordance with all canonical rules. It holds the relics of 200 eminent Buddhist teachers brought to Russia from different parts of the world, as well as relics of Shakyamuni Buddha and Kashyapa Buddha and, giving a particular cultural and historical significance to the stupa and its location.
Since its creation, Buddhists from all over the world have visited the grounds of the Nicholas Roerich Museum to worship at or simply to visit the stupa. Among them, are a number of eminent Buddhist teachers, such as Venerable Geshe Lhakdor, director of the Library of Tibetan Works and Archives, Kathog Getse Rinpoche, and Namgyal Ati Sherab Nyima Rinpoche, in addition to official delegations from Drepung Gomang Monastery and Jonang Monastery, as well as repected Buddhist scholars such as Glenn Mullin and Robert Thurman.
Attempts to destroy the Enlightenment Stupa began in 2015, when management of Lopoukhin Mansion was transferred to the State Museum of Oriental Art by the Russian Ministry of Culture. The management of the state museum joined hands with the Ministry of Culture to call for thestupa's demolition.
Lopoukhin Mansion with the stupa
The first attempt to remove the Enlightenment Stupa was undertaken in 2016. The management of the State Museum of Oriental Art and the Russian Ministry of Culture tried to present it as an illegal construction and raised the issue of its demolition. That same year, Telo Tulku Rinpoche, the shadjin lama (head lama) of the Kalmyk people and Lopsan Chamzy, khamby lama (head lama) of the Republic of Tuva, spoke in defense of the stupa and opposed its destruction. They sent a letter to Russian president Vladimir Putin to ask his help in the preservation of this unique cultural site with important historic and religious significance. In a response, Putin gave personal instructions to the mayor of Moscow and the minister of culture to preserve the monument.
However, attempts to destroy the stupa continued. Before being deprived of access to Lopoukhin Mansion and the stupa, the International Center of the Roerichs and representatives of the Buddhist community in Moscow maintained the stupa in excellent condition. But in the spring of 2017, the State Museum of Oriental Art blocked all the access after the Ministry of Culture of the Russian Federation and the State Museum of Oriental Art took over Lopoukhin Mansion in April 2017 and the destroyed the Nicholas Roerich Museum. These actions are now being challenged in court by the International Centre of the Roerichs. As a result, thousands of Buddhists who had visited Lopoukhin Mansion for years were deprived of this opportunity to worship at the Buddhist sanctuary. Representatives of the Buddhist community in Moscow have also been refused access. Their requests for urgent reconstruction have been denied by the State Museum of Oriental Art, and the stupa has now fallen into distressing disrepair.
In April 2018, the International Center of the Roerichs – as the institution to which the stupa was donated and was entrusted – sought permission from the State Museum of Oriental Art for Buddhists to be allowed to repair and maintain the monument. For that purpose, the International Center of the Roerichs legally transferred temporary use of the stupa to the Buddhist community of Moscow, but the situation remained unchanged.
On 19 September 2018, the State Museum of Oriental Art asked the International Center of the Roerichs to remove the Enlightenment Stupa from the grounds of the mansion. After protests by Buddhist groups, the director of the State Museum promised to allow the Buddhist community to organize the necessary repairs for the stupa before the winter, but reconstruction was again postponed under the pretext that the repairs needed to be coordinated with the Ministry of Culture, despite the precarious condition of the Buddhist sanctuary.
Blessing the stupa
The current condition of the stupa
Telo Tulku Rinpoche made the following statement after being informed of the situation: "I am deeply aware that the place of the stupa should not be changed. It should stay where it was built. The stupa is not a piece of furniture that we can move from one building to another. Before its construction, extensive rituals of blessing were performed according to the Buddhist canon to determine where the stupa should be built. Over the years, numerous Buddhist followers and people who simply have an interest in the cultural heritage of the East visited this place, offered their prayers and wishes at the stupa, which made this place special and holy. I sincerely hope that the parties involved will show respect to the feelings of the believers and will find a way to keep the stupa where it was erected." (Золотая обитель Будды Шакьямуни)
The situation, as of yet, remains unresolved.
Source: Buddhistdoor Global. 24/10/2018
Преднамеренные действия Музея Востока ведут к разрушению буддийской ступы в Москве
В Москве погибает буддийская ступа
Верховный лама Калмыкии высказался по поводу требования Музея Востока убрать буддийскую святыню с территории усадьбы Лопухиных.
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