text:
Bihorac E.
Çekmen N.
Ersoy Z.
Tuç Ö.
The Greek E-Journal of Perioperative Medicine 2022;21(d): 31-36
ARCHIVED AS: 2022, 2022d, Case Reports, Current issue
KEYWORDS: anesthetic management, dexmedetomidine, fresh frozen plasma, Hereditary angioedema, icatibant
DOI: The Greek E-Journal of Perioperative Medicine 2022;21(d): 31-36
Anesthesia management of a patient with hereditary angioedema under Dexmedetomidine: A Case Report.
Authors: Tuç Ö1*, Bihorac E1, Ersoy Z1, Çekmen N2
1MD, Anesthesiology
2MD, PhD, Anesthesiology
Baskent University, Faculty of Medicine, Department of Anesthesiology, Ankara, Turkey
*Corresponding Author: Fevzi Cakmak Caddesi 10, Sokak No:45 Bahcelievler, 06490 Ankara, Turkey, Tel: 0312203 68 68- 4867, e-mail: e-mail:
Hereditary angioedema (HAE) is a life-threatening rare autosomal dominant (AD) disorder caused by C1-esterase inhibitor (C1-INH) deficiency or dysfunction. HAE is not related to mast cell and histamine pathway; as a result, it does not respond to antihistamines, glucocorticoids, or epinephrine. Attacks may occur spontaneously or after a trauma. The upper airway swelling and laryngeal edema cause asphyxia, which can be life-threatening. Treatment of HAE includes C1-INH concentrate, recombinant human C1-INH, bradykinin B2-receptor antagonists, recombinant plasma kallikrein inhibitors, fresh frozen plasma (FFP) and androgen steroids. In this case we report anesthetic management of a 62 years old female patient with HAE, undergoing endoscopy and colonoscopy, for which highly selective α2 adrenergic receptor agonist dexmedetomidine intravenous (IV) infusion was used. We administered icatibant (bradykinin B2-receptor antagonist) for prophylaxis, and FFP was prepared in case of use. Anesthetic management and preoperative preparation are critical for the patient with HAE. Difficult airway management should be kept in mind in case of airway edema and early intubation.
Hereditary angioedema (HAE) is a life threatening rare AD disorder caused by C1-esterase inhibitor (C1-INH) deficiency or dysfunction1. The estimated prevalence of HAE is 1:60.000, with ranging from 1:10.000 to 1:150.000, and it has been reported in all sexes and races2-4. C1-INH deficiency results in excessive bradykinin production, a potent vasodilatory molecule, and vascular permeability-enhancing effects5. HAE is not related to mast cell and histamine pathway; as a result, it does not respond to antihistamines, glucocorticoids, or epinephrine. Attacks may occur spontaneously or after a trauma (endoscopy, intubation, dental procedures). Angiotensin-converting enzyme (ACE) inhibitors and non-steroidal anti-inflammatory drugs (NSAIDs) may trigger HAE attacks as well6,7. Clinically it most often affects the skin (without pruritus); the upper airway, which may cause laryngeal edema, asphyxia and sudden death; the gastrointestinal tract bowel wall edema causes abdominal pain, vomiting, nausea, and diarrhea.
HAE is often self-limited and resolves in two to five days without treatment but it can be life-threatening as well. The first-line therapies are C1-INH concentrate or recombinant human C1-INH. In addition, bradykinin B2-receptor antagonists (icatibant) and recombinant plasma kallikrein inhibitors can also be used as first-line therapies8-12. FFP can be used at 10-15 mL/kg as a second-line therapy if the first-line therapies are unavailable13. Prophylactic androgen steroids decrease attack frequency and severity and can be used for long-term prophlaxis4.
Dexmedetomidine is a highly selective α2 adrenergic receptor agonist, and it is frequently used in intensive care units (ICU) for sedation and prevention of delirium and provides conscious sedation and analgesia without respiratory depression14.
When left undisturbed the patient sleeps in a natural state of sleep, but the patient can be awakened with a slight stimulus.
In this case, we aim to present anesthetic management of a 62 years old female patient with HAE undergoing endoscopy and colonoscopy. Icatibant was administered subcutaneously before the procedure for prophylaxis, and FFP was prepared in case of need. We used highly selective α2 adrenergic receptor agonist dexmedetomidine IV infusion for sedation. We also discussed a prophylactic approach to HAE management accompanied by literature.
A 62 years old female patient (Weight: 74 kg, Height: 158 cm, BMI: 29.64) with a history of hypertension, bilateral mastectomy for breast cancer, primary immune deficiency and HAE, which was diagnosed at the age of 58, was admitted (April 2022) in our institution. She was receiving intravenous immunoglobulin (IVIG) treatment for primary immune deficiency every 15 days. Additional her drug treatment included candesartan cilexetil, escitalopram, esomeprazole, and icatibant (a bradykinin B2-receptor antagonist) for HAE treatment. In her medical history, she mentioned a spontaneous upper airway attack, ten days prior to a dental surgery one month before admission, and a spontaneous laryngeal edema and vocal cord edema three years before admission, which caused dyspnea and led her to the emergency hospital department. Written and verbal consent was obtained from the patient before recording the information in this report.
Her physical examination was normal. The results of preoperative laboratory examination, electrocardiography and chest radiography were normal. Her blood pressure (BP), peripheral oxygen saturation (SpO2), body temperature, respiration rate (RR) and heart rate (HR) were in a normal range. Anesthetic management was planned before the endoscopy and the colonoscopy procedure. FFP was prepared in case of use for HAE attack. After careful pre-anaesthetic evaluation and in agreement with the Immunology-allergology department, icatibant was administered 30 mg subcutaneously 10 minutes before the procedure. Standard monitoring was applied (HR, BP, RR, SpO2), and bispectral index (BIS) monitoring was used to evaluate the patient's level of consciousness. Emergency airway equipment, endotracheal tubes and video laryngoscope, fiber-optic bronchoscope, and tracheostomy set were prepared in case of use. A port catheter was used for administrating medications. Dexmedetomidine 0.5 mcg/kg IV bolus was given 10 minutes before the anesthesia induction. Lidocaine 1 mg/kg IV, midazolam 2 mg IV and propofol 0.5 mg/kg IV were used for the anesthesia induction, and granisetron 2 mg IV was administered 10 minutes before the end of the process. Dexmedetomidine 0.1-0.7 mcg/kg/h IV infusion was administered during the endoscopy and colonoscopy. We tried to keep the BIS score in 60-80 range. The gastroenterologist performed a gastric biopsy and polypectomy from the colon. She received a 500 mL isolyte – S IV solution. The procedure lasted 60 minutes, the patient remained hemodynamically stable, and no complications occurred during and after the endoscopy and colonoscopy. The patient was followed up for 1 hour at Post-Anesthesia Care Unit (PACU), and she was discharged home uneventfully.
HAE is a rare, self-limited, life-threatening AD disorder. It may be triggered by trauma, dental work, intubation or spontaneously. The mortality rate is approximately 30% from laryngeal swelling. Laryngeal edema causes asphyxia and sudden death. In our case, she had spontaneous laryngeal edema and vocal cord edema three years ago, which caused dyspnea to go to the emergency room. Replacing the C1-INH protein is the main treatment point for HAE. Hosokawa R et al. reported no complication developed during sedation with propofol and C1-INH concentrate administration 1 hour before the dental procedure15. Recombinant plasma kallikrein inhibitors and androgens can be used for long-term and short-term prophylaxis. Treatment of HAE includes FFP, which is another pre-surgical option. Bradykinin B2-receptor antagonist, icatibant, can be used for long-time and short-time prophylaxis. Bang YS et al. reported total laparoscopic hysterectomy without any airway complication. They treated the patient with danazol before the intubation and transfused three units of FFP during the surgery16. We administered 30 mg icatibant subcutaneously and prepared FFP in case of use for HAE attack.
It is crucial to have spontaneous breathing to not interfere with the airway, which may trigger HAE.
Dexmedetomidine was used for the sedation during the endoscopy and colonoscopy, and spontaneous breathing was not suppressed. The patient recovered quickly at the end of the procedure. Dexmedetomidine provides more physiological sedation, and we recommend dexmedetomidine sedation for non-operating room anesthesia (NORA).
Proper medications, a multidisciplinary appro-ach and difficult airway management are essential for successful anesthesia management and patient safety. In HAE recurrent skin swelling without pruritus or upper airway edema, which is unresponsive to antihistamines or epinephrine therapy, should suggest HAE.
Anesthetic management and preoperative preparation are critical for a patient with HAE. C1-INH concentrate, icatibant, FFP or other medicines should be readily available for prophylaxis and therapeutic purposes. Difficult airway management should be kept in mind in case of airway edema and early intubation. Drugs that do not suppress spontaneous breathing should be chosen to avoid airway manipulation. Dexmedetomidine offers more physiological sedation, and we recommend dexmedetomidine sedation for NORA.
Addittional materials: No
Authors' contributions:
TÖ collected paper's data and is the lead author. BE collected paper's data. EZ contributed to planning the paper. TÖ contributed to planning the paper. ÇN drafted the paper, contributed to planning and the critical revision of the paper. All authors read and approved the final manuscript.
Availability of supporting data:
Ethical approval and consent to participate:
No IRB approval required.
Competing interests:
Received: August 2022, Accepted: September 2022, Published: November 2022.
Cugno M, Zanichelli A, Foieni F, et al. C1-inhibitor deficiency and angioedema: molecular mechanisms and clinical progress. Trends Molecular Medicine 2009;15(2):69-78.
Nzeako UC, Frigas E, Tremaine WJ. Hereditary angioedema: a broad review for clinicians. Archives of Internal Medicine 2001;161(20):2417-2429.
Nordenfelt P, Nilsson M, Björkander J, et al. Hereditary Angioedema in Swedish Adults: Report From the National Cohort. Acta Dermato-Venereologica 2016;96(4):540-545.
Schöffl C, Wiednig M, Koch L, et al. Hereditary angioedema in Austria: prevalence and regional peculiarities. Journal der Deutschen Dermatologischen Gesellschaft 2019; 17(4):416-423.
Bork K, Frank J, Grundt B, et al. Treatment of acute edema attacks in hereditary angioedema with a bradykinin receptor-2 antagonist (Icatibant). The Journal of Allergy and Clinical Immunology 2007;119(6):1497-1503.
Yıldız E, Çölkesen F. Turkish Journal of Medical Sciences 2021;51 (1303-6165):2631-264.
Brown T, Gonzalez J, Monteleone C. Angiotensin-converting enzyme inhibitor-induced angioedema: A review of the literature. The Journal of Clinical Hypertension (Greenwich) 2017;19(12):1377-1382.
Bowen T, Cicardi M, Farkas H, et al. 2010 International consensus algorithm for the diagnosis, therapy and management of hereditary angioedema. Allergy Asthma Clinical Immunology 2010;6(1):24.
Zuraw B, Cicardi M, Levy RJ, et al. Recombinant human C1-inhibitor for the treatment of acute angioedema attacks in patients with hereditary angioedema. The Journal of Allergy and Clinical Immunology 2010;126(4):821-827.e14.
Riedl MA, Bernstein JA, Li H, et al. Recombinant human C1-esterase inhibitor relieves symptoms of hereditary angioedema attacks: phase 3, randomized, placebo-controlled trial. Annals of Allergy, Asthma & Immunology 2014;112(2):163-169.e1.
Cicardi M, Banerji A, Bracho F, et al. Icatibant, a new bradykinin-receptor antagonist, in hereditary angioedema. The New England Journal of Medicine 2010;363(6):532-541.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125277lbl. (last date accessed June 09, 2022).
Mosier M; Riddle J. Prophylaxis and Treatment of Hereditary Angioedema with Fresh Frozen Plasma: A Synthesis and Narrative Review. Anesthesia eJournal 2018;l(6):12-17.
Keating GM. Dexmedetomidine: A Review of Its Use for Sedation in the Intensive Care Setting. Drugs 2015;75(10):1119-1130.
Hosokawa R, Tsukamoto M, Nagano S, et al. Anesthetic Management of a Patient With Hereditary Angioedema for Oral Surgery. Anesthesia Progress 2019;66(1):30-32.
Bang YS, Cho J, Park C. An anesthetic experience of hereditary angioedema type I patient undertook total laparoscopic hysterectomy – A case report. Anesthesia and Pain Medicine (Seoul) 2022;17(2):235-238.
The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
Citation: Tuç Ö, Bihorac E, Ersoy Z, Çekmen N. Anesthesia management of a patient with hereditary angioedema under Dexmedetomidine: A Case Report. Greek e j Perioper Med. 2022;21(d): 31-36.
This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution – ShareAlike 4.0 International license (CC BY-SA 4.0) (https://creativecommons.org/licenses/by-sa/4.0/)
Category: 2022, 2022d, Case Reports, Current issue
Authors (a/b order): Bihorac E., Çekmen N., Ersoy Z., Tuç Ö.


text:
\section{Introduction}

Recent work on `deconfined quantum critical points'\cite{senthil}
between superfluid and insulating phases has pointed out the central
role played by the quantum fluctuations of the vortex excitations of
the superfluid state.\cite{BBBSS05a,BBBSS05b,BBBSS05c,BBS06}
However, this work has largely been carried out using
convenient model Hamiltonians, with little direct connection to the
microscopic Bardeen-Cooper-Schrieffer (BCS) theory of the
superconducting state. It is the purpose of this paper to begin an
exploration of the quantum fluctuations of vortices in the BCS
theory. We will examine the theory of a single vortex in an $s$-wave
superconductor, fluctuating harmonically in a trapping potential.
Our primary focus will be on the influence of this quantum motion on
the electronic local density of states (LDOS). Modern scanning
tunneling microscopy (STM) can provide detailed measurements of the
LDOS in the vicinity of a vortex, and so can, in principle, detect
signatures of vortex fluctuations.

Existing $s$-wave superconductors have a large coherence length,
$\xi$, and consequently a large effective mass which is expected to
scale as the cross-section area of the vortex core $\sim \xi^2$. As
a result, the vortex zero-point motion is small, and its signatures
in the LDOS are probably indetectable. However, should a small
coherence length $s$-wave superconductor be discovered in the
future, the results here should be useful.

We will also develop some basic formalism for application to
$d$-wave superconductors. Naturally, the cuprate superconductors are
prime candidates for observing vortex zero-point motion with their
small values of $\xi$, and also indications of proximity to a
superconductor-insulator transition (possibly of the `deconfined' or
`Landau-forbidden' variety) at finite doping. However, the
application of the formalism of the present paper to $d$-wave
superconductors is far from straightforward: the anisotropic gap and
loss of rotational invariance makes the numerics much more
demanding, and the presence of gapless nodal quasiparticles leads to
new physics. We therefore defer full discussion of the $d$-wave case
to a second paper\cite{paper2} (hereafter referred to as II).

In a general sense, our analysis can be viewed as a study of the
influence of the phase of the superconducting order parameter on the
vortex LDOS. However, rather than integrating over the phase
fluctuations explicitly, we are encapsulating them in a collective
co-ordinate, the position of the vortex.

An important limitation of the calculation presented here is that,
in determining the coupling between the moving vortex and the
electronic excitations, we expand in gradients of the pairing
amplitude of the electrons. The applicability of such an expansion
places a lower bound on the value of the coherence length,
and so we are not able to properly explore the limit of extremely
short coherence lengths.
A separate computation which does not make this
gradient expansion, while working in an effective low energy theory,
will be presented in paper II.

We will begin in Section~\ref{sec:gen} by setting up the general
formalism which couples a moving vortex to the electronic
quasiparticles. Rather than considering a vortex lattice and its
oscillations, we will use a simple Einstein model for the vortex
lattice phonons, and so work with a single vortex moving in a
harmonic potential. The electronic self-energy corrections from the
vortex motion will be computed in Section~\ref{sec:swave} for an
$s$-wave superconductor. The rotation symmetry of this case is an
important aide in our numerical computations, and we are able to
obtain good numerical convergence for a significant range of
parameters.

\section{General formalism}
\label{sec:gen}

We will develop the general formalism for a two dimensional $s$- or
$d$-wave superconductor. In principle, similar considerations apply
to three-dimensional superconductors, but we will not present them
here. Complete numerical results for $s$-wave superconductors appear
in the following section, while those for $d$-wave superconductors
appear in paper II.

To model the zero-point fluctuations of a vortex in a superconductor
with either $s$- or $d$-wave symmetry we use the following
Bogoliubov-de Gennes like action as a starting point:
\begin{align}
        \mathcal{S} = &  \int d^2 r\, d\tau\,(\bar \psi_{\uparrow},\psi_{\downarrow})
        \left(\partial_{\tau} +         \mathcal{H}_{\text{BdG}} \right)
        \left(\begin{array}{c}
        \psi_{\uparrow} \\
        \bar \psi_{\downarrow}
        \end{array} \right) \nonumber \\
        & + \int d\tau\, V({\bf R}(\tau)) \;,
        \label{eq:Sinit}
\end{align}
where (with $\hbar = 1$)
\begin{equation}
\mathcal{H}_{\text{BdG}} = \left(
          \begin{array}{cc}
      \left(-\frac{1}{2 m_e} \partial_{\bf r}^2 - E_F \right) & \hat \Delta\left({\bf r} - {\bf R}(\tau) \right) \\
      \hat \Delta^{\ast}\left({\bf r} - {\bf R}(\tau) \right) & - \left(-\frac{1}{2 m_e} \partial_{\bf r}^2  - E_F \right)
    \end{array}
        \right) \;.
        \label{eq:HBdG}
\end{equation}
Here $\psi({\bf r},\tau)$ and $\bar \psi({\bf r},\tau)$ are
conjugate Grassman fields for electrons with mass $m_e$, $E_F =
k_F^2/2m_e = m_e v_F^2/2$ is the Fermi energy and $\hat \Delta({\bf
r} - {\bf R}(\tau))$ is the gap operator for superconducting
electrons in the presence of a vortex at position ${\bf R}(\tau)$ in
the plane. The vortex is allowed to move in imaginary time $\tau$
and to account for the interaction between vortices in a vortex
lattice we put our vortex in a harmonic oscillator potential $V({\bf
R})$ with equilibrium position ${\bf R} = 0$.

For a superconductor with $s$-wave symmetry the gap operator can be
taken to be a simple scalar $\Delta({\bf r})$. Assuming there is a
vortex at the center of the plane we can choose a gauge such that
the phase of the order parameter is equal to the polar angle of the
position vector, i.e. (with a slight abuse of notation) $\Delta({\bf
r}) = \Delta(r) e^{i\theta}$.

The $d$-wave case is more difficult and it is customary to express
the gap operator in terms of a non-local order parameter with a
center of mass coordinate ${\bf r}$ and a relative coordinate ${\bf
r}'$. Expanding in powers of ${\bf r}'$ and keeping only terms up to
second order we can eliminate ${\bf r}'$ and write the gap operator
with $d_{x^2 - y^2}$ symmetry (see Appendix \ref{Appendix:gauge}) as
\begin{equation}
  \hat\Delta = \frac{\{\partial_x,\{\partial_x,\Delta({\bf r})\}\}}{k_F^2}
  - \frac{\{\partial_y,\{\partial_y,\Delta({\bf r})\}\}}{k_F^2} \;,
  \label{eq:DeltaSL}
\end{equation}
where $\{a,b\}=(ab+ba)/2$. This equation is equivalent to a gap
operator with $d_{xy}$ symmetry as derived by Simon and
Lee.\cite{Simon97} For a vortex at the origin we again take
$\Delta({\bf r}) = \Delta(r) e^{i\theta}$.
In Appendix~\ref{Appendix:gauge} we will discuss issues of
gauge invariance associated with the above expressions and the important
comments made on
this issue in Ref.~\onlinecite{Vafek01}. A choice of gauge is made
in Eq.~(\ref{eq:DeltaSL}), and no additional term is needed to
preserve gauge invariance of the Bogoliubov-de Gennes equations.

Integrating out the electronic degrees of freedom in the action
given in Eq.~(\ref{eq:Sinit}) one obtains an effective action for
the vortex degrees of freedom. Expanding in powers of the velocity
of the vortex we obtain for the effective vortex action (for
simplicity at zero temperature) in the imaginary frequency formalism
(see Appendix \ref{app:vortexaction})
\begin{equation}
  \mathcal{S}_{\text{eff}}^{\text{Vortex}} = \frac{m_v}{2} \int \frac{d \omega}{2\pi}\,
  {\bf R}^{\dagger} (i\omega)
  \left( \begin{array}{cc}
      \omega^2 + \omega_0^2 & \omega_c \omega \\
      -  \omega_c \omega & \omega^2 + \omega_0^2
    \end{array} \right) {\bf R} (i\omega) \;.
  \label{eq:Vortex}
\end{equation}
While the term proportional to $\omega$ can be identified to be the
Magnus force, the term proportional to $\omega^2$ is just the vortex
kinetic energy and defines the mass of the vortex, $m_v$. For a
BCS-superconductor with $s$-wave symmetry $m_v$ is of the order of
$m_e (k_F \xi)^2$. With $m_v$ given, we have defined $\omega_0$ by
$V({\bf R}) = m_v \omega_0^2 {\bf R}^2 /2$. For a vortex in a vortex
lattice, the characteristic frequency is the plasma frequency
\begin{equation}
\omega_p = \sqrt{4\pi^2 \rho_s/m_v A_0} \;,
\end{equation}
where $\rho_s$ is the superfluid stiffness and $1/A_0$ is the
density of vortices. The frequency $\omega_0$ is approximately given
by $\omega_0 \approx (5/2) \omega_p$.\cite{BBS06} Finally, in a
Galilean invariant superfluid, $\omega_c = 2\pi \rho_s/m_v$ and in a
dual picture can be identified to be the `cyclotron' frequency. For
a superfluid on a lattice, however, it has recently been argued that
$\omega_c$ is reduced and the density of the Mott insulator has to
be subtracted from the superfluid stiffness when the superfluid is
close to a nearby Mott insulating
state.\cite{BBBSS05a,BBBSS05b,BBBSS05c,BBS06}

Diagrammatically, the above propagator to the effective vortex
action is just the RPA propagator which includes the Berry phase
term. To determine the effect of the vortex motion on the electronic
spectrum we can use the RPA propagator and calculate the self energy
correction to the electronic eigenstates in the
GW approximation.\cite{Hedin65}
Let us first expand the gap operator $\hat \Delta \left({\bf r} -
{\bf R}(\tau) \right)$ in Eq.~(\ref{eq:Sinit}) to leading order in
${\bf R(\tau)}$. Then $\mathcal{S}$ can be written as $\mathcal{S}
\approx \mathcal{S}_0 + \mathcal{S}_{int}$ with
\begin{equation}
        \mathcal{S}_0 = \int d\tau\, d^2 r\, (\bar \psi_{\uparrow},\psi_{\downarrow})
        \left(\partial_{\tau} +         \mathcal{H}_{\text{BdG}}^0 \right)
        \left(\begin{array}{c}
        \psi_{\uparrow} \\
        \bar \psi_{\downarrow}
        \end{array} \right)
        \label{eq:S0}
\end{equation}
and $\mathcal{H}_{\text{BdG}}^0$ obtained from Eq.~({\ref{eq:HBdG})
by setting ${\bf R} =0$. To leading order the coupling of the vortex
to the electronic degrees of freedom is described by
\begin{equation}
        \mathcal{S}_{int} = - \int d\tau\, d^2 r \,
        {\bf R(\tau)} \cdot (\bar \psi_{\uparrow},\psi_{\downarrow})
        \left(\begin{array}{cc}
        0 & {\bf \partial}_{\bf r} \hat \Delta \\
        {\bf \partial}_{\bf r} \hat \Delta^{\ast} & 0
        \end{array} \right)
        \left(\begin{array}{c}
        \psi_{\uparrow} \\
        \bar \psi_{\downarrow}
        \end{array} \right) \;.
\end{equation}
Let us now go to a basis which diagonalizes the Bogoliubov-de Gennes
Hamiltonian $\mathcal{H}_{\text{BdG}}^0$: It is well-known that if
$\Psi_{\ell}({\bf r}) \equiv [u_\ell({\bf r}),v_\ell({\bf r})]^T$
(with, say, $\ell > 0$) is an eigenstate of
$\mathcal{H}_{\text{BdG}}^0$ with eigenvalue $\epsilon_\ell$, then
$[-v_\ell^{\ast}({\bf r}),u_\ell^{\ast}({\bf r})]^T$ is an
eigenstate of $\mathcal{H}_{\text{BdG}}^0$ with eigenvalue
$-\epsilon_\ell$.\cite{deGennes:Book} Defining
\begin{equation}
        U_\ell({\bf r}) = \left(\begin{array}{cc}
        u_\ell({\bf r}) & -v_\ell^{\ast}({\bf r}) \\
        v_\ell({\bf r}) & u_\ell^{\ast}({\bf r})
        \end{array} \right)
\end{equation}
we can write
\begin{equation}
        \left(\begin{array}{c}
        \psi_{\uparrow} ({\bf r},\tau)\\
        \bar \psi_{\downarrow} ({\bf r},\tau)
        \end{array} \right)
        = \sum_{\ell>0} U_{\ell}({\bf r})
        \left(\begin{array}{c}
        \chi_{+\ell} (\tau)\\
        \chi_{-\ell} (\tau)
        \end{array} \right)
\end{equation}
such that
\begin{equation}
  \int d^2r \, U_\ell^{\dagger} ({\bf r}) \mathcal{H}_{\text{BdG}}^0 U_{\ell^{\prime}}({\bf r}) = \sigma_z \, \epsilon_\ell \, \delta_{\ell,\ell^{\prime}} \; ,
\end{equation}
where $\sigma_z$ (like $\sigma_x$ which we will use below) is just a usual Pauli matrix.
While it is customary to restrict the energies $\epsilon_\ell$ to
values greater zero\cite{deGennes:Book} (for which we use quantum
numbers $\ell > 0$), we prefer to subsume the `spin' index into the
index $\ell$ and define for $\ell > 0$ $\Psi_{-\ell}({\bf r}) \equiv
[u_{-\ell}({\bf r}),v_{-\ell}({\bf r})]^{T} \equiv
[-v_\ell^{\ast}({\bf r}),u_\ell^{\ast}({\bf r})]^{T}$ such that
$\epsilon_{-\ell} = -\epsilon_\ell$. With this notation,
\begin{equation}
  \left(\begin{array}{c}
      \psi_{\uparrow} ({\bf r},\tau)\\
      \bar \psi_{\downarrow} ({\bf r},\tau)
    \end{array} \right)

  = \sum_{\ell} \Psi_{\ell}({\bf r})\, \chi_{\ell}(\tau)
      \label{eq:psitochi}
\end{equation}
and $\mathcal{S}_0$ reduces to
\begin{equation}
        \mathcal{S}_0 = \int d\tau\, \sum_\ell \bar \chi_\ell (\partial_{\tau} + \epsilon_\ell) \chi_\ell \;,
        \label{eq:S0II}
\end{equation}
where the sum is now over all quantum numbers $\ell$ including the
`spin' index.
 In the new basis, $\mathcal{S}_{int}$ can be written as
\begin{equation}
        \mathcal{S}_{int} = - \int d\tau \, \sum_{\ell \ell^{\prime}}
        {\bf R(\tau)} \cdot  {\bf M}_{\ell;\ell^{\prime}}
        \bar \chi_{\ell} \chi_{\ell^{\prime}} \;,
\end{equation}
where the transition matrix elements
\begin{equation}
        {\bf M}_{\ell;\ell^{\prime}} =
        \int d^2r \,\left( u_\ell^{\ast} \partial_{\bf r} \hat \Delta v_{\ell'} + v_\ell^{\ast} \partial_{\bf r} \hat \Delta^{\ast} u_{\ell'} \right)
\end{equation}
are like ${\bf R}(\tau)$ vectors in the two-dimensional plane. It is
convenient to also define $M^{\pm} \equiv (M^{x} \pm i M^{y})/2$
such that
\begin{equation}
        M_{\ell;\ell^{\prime}}^{+} = \left(M_{\ell^{\prime};\ell}^{-}\right)^{\ast} =
        \int d^2r \,\left( u_\ell^{\ast} \partial_{\bar z} \hat \Delta v_{\ell'} + v_\ell^{\ast} \partial_{\bar z} \hat \Delta^{\ast} u_{\ell'} \right) \;,
        \label{eq:Mplusminus}
\end{equation}
with
$\partial_{\bar z} \equiv (\partial_x + i \partial_y)/2$. We can now
calculate the self energy in the GW approximation\cite{Hedin65} for
which we
obtain
\begin{equation}
  \Sigma_{\ell} (i \tilde \omega) =
  \sum_{\ell^{\prime} \alpha}
  \frac{A_{\ell;\ell'}^{\alpha}} {i \tilde \omega - [\omega_v \, \text{sgn} \,(\epsilon_{\ell'}) + \epsilon_{\ell'} ]
    - \alpha \omega_c/2} \;,
\label{eq:SelfEnergy}
 \end{equation}
with
\begin{equation}
  \label{eq:A}
  A_{\ell;\ell'}^{\alpha} = \frac{ | M_{\ell;\ell^{\prime}}^{\alpha} |^2}{m_v \omega_v} \; .
\end{equation}
 Here, $\alpha = \pm$ and $\omega_v = \sqrt{\omega_0^2 + \omega_c^2/4}$ is the vortex (`magnetoplasma') frequency in an Einstein model. As should be expected, the self energy satisfies $\Sigma_{-\ell}(i\tilde\omega) = -\Sigma_{\ell}(-i\tilde\omega)$.

If our system is infinitely large and  boundary effects can be
neglected we can make use of the Hellmann-Feynman theorem
\begin{equation}
  \label{eq:HellFey}
  \int d^2 r\, \Psi_{\ell}^{\dagger} \, \partial_{\bf r} \mathcal{H}_{BdG}^0\, \Psi_{\ell'} = (\epsilon_{\ell'} - \epsilon_{\ell}) \int d^2 r\, \Psi_{\ell}^{\dagger} \partial_{\bf r} \Psi_{\ell'}
\end{equation}
and write $M_{\ell,\ell'}^{\alpha}$ as
\begin{equation}
  \label{eq:MWII}
  M_{\ell,\ell'}^{\alpha} = (\epsilon_{\ell'} - \epsilon_{\ell}) U_{\ell,\ell'}^{\alpha} \;,
\end{equation}
with
\begin{equation}
  \label{eq:def:W}
  U_{\ell,\ell'}^{+} = \left( U_{\ell',\ell}^{-} \right)^{\ast} =
  \int d^2 r\, \Psi_{\ell}^{\dagger} \partial_{\bar z} \Psi_{\ell'} \;.
\end{equation}
In our numerical calculation presented below, however, we will, of
course, consider a system of finite size such that boundary effects
need to be included. We will see that
calculating $M_{\ell,\ell'}^{\alpha}$ using the
Hellmann-Feynman theorem will turn out to be easier than
calculating these transition matrix elements directly.

\section{Vortex in an $s$-wave superconductor}
\label{sec:swave}

 For a vortex in an $s$-wave superconductor centered at the origin we choose $\Delta({\bf r}) = \Delta(r)\,e^{i\theta}$ with $\Delta(r) = \Delta_0 \tanh(r/\xi)$ where $\Delta_0$ is the bulk gap and $\xi = v_F/\pi \Delta_0$ is the coherence length.
$\mathcal{H}_{\text{BdG}}^0$ is rotationally invariant such that
angular momentum is a good quantum number. Following Caroli, de
Gennes, and Matricon, \cite{Caroli64} we denote angular momentum by
$\mu = \pm 1/2, \pm 3/2,\dots$ and write
 \begin{equation}
        \left(\begin{array}{c}
                u_\mu^n ({\bf r}) \\ v_\mu^n ({\bf r})
        \end{array}\right) =
        \frac{\exp\left[ -i(\mu - \sigma_z /2) \theta \right]}{\sqrt{2\pi}}
        \left(\begin{array}{c}
                f_{\mu,+}^n (r) \\ f_{\mu,-}^n (r)
        \end{array}\right) \;.
\label{eq:uf}
\end{equation}
There is only one bound state for each angular momentum $\mu$, but
there are also extended states, such that we also include a radial
quantum number $n$.\footnote{Actually, $\mu$ is minus the angular
momentum of a given eigenstate. The minus sign is due to the fact
that we are considering a vortex of positive vorticity but prefer to
have $\epsilon_{\mu}$ positive if $\mu$ is positive.} It should be
noted that while $\ell$ is a collective label for $\mu$ and $n$,
$-\ell$ collectively labels $-\mu$ and $n$. Making the above ansatz,
the Bogoliubov-de Gennes equations reduce to
\begin{widetext}
\begin{align}
& \left\{ \sigma_z \frac{1}{2 m_e} \left( -\left(\frac{d}{d
r}\right)^2 - \frac{1}{r} \frac{d}{dr} + \frac{(\mu -
\sigma_z/2)^2}{r^2} - k_F^2 \right)
+ \sigma_x \Delta(r) \right\} \left(
  \begin{array}{c}
    f_{\mu,+}^{n} (r) \\ f_{\mu,-}^{n} (r)
  \end{array}
\right) = \epsilon_{\mu}^n \left(
  \begin{array}{c}
    f_{\mu,+}^{n} (r) \\ f_{\mu,-}^{n} (r)
  \end{array}
\right) \;. \label{eq:HBdGf}
\end{align}
\end{widetext}

Before solving these equations numerically, it is worthwhile to
first consider the bound states with energies $\epsilon_{\mu}$ much
smaller than the bulk gap $\Delta_0$ and large coherence lengths
$\xi$. As was shown by Caroli, de Gennes, and Matricon
\cite{Caroli64}, the bound state energies are then given by
\begin{equation}
  \label{eq:epsilon_mu}
  \epsilon_{\mu} = E_1 \, \mu \;,\quad
  \text{with} \quad E_1 \approx \frac{\Delta_0^2}{E_F} \;.
\end{equation}
Also, the radial part of the wave function is well approximated by

\begin{equation}
  \label{eq:f_mu}
  f_{\mu,\pm}(r) = C_{\mu} \exp\left(
    -2 \int_0^r dr' \, \frac{\Delta(r')}{v_F} \right) J_{\mu \mp 1/2} (k_F r) \;,
\end{equation}
where $J_m(x)$ are ordinary Bessel functions of the first kind and
integer order $m=\mu \mp 1/2$. The constants $C_{\mu}$ are
independent of the $\pm$ index and are all of order
$\sqrt{k_F/\xi}$. It should be noted that $f_{\mu+1,+}(r) \approx
f_{\mu,-}(r)$ which we will use for an estimate of the matrix
elements $A_{\mu;\mu'}^{+} \equiv \delta_{\mu',\mu+1} A_{\mu}^{+}$.
With the radial quantum number included we have
\begin{widetext}
\begin{align}
  M_{\mu n;\mu' n'}^{+} = \frac{1}{2} & \delta_{\mu',\mu+1} \int_0^{\infty} dr\,
  \left\{ \left[ r \partial_r \Delta - \Delta(r) \right]
    f_{\mu,+}^{n}(r)
f_{\mu',-}^{n'}(r) + \left[ r \partial_r \Delta + \Delta(r) \right]
    f_{\mu,-}^{n}(r)
 f_{\mu',+}^{n'}(r)
\right\} \;.
\end{align}
\end{widetext}
Using the above, we obtain $A_{\mu}^{+} \approx v_F^2/(4\pi^2 m_v
\omega_v \xi^4)$. Since the mass of a vortex in a BCS
superconductor, $m_v$, is of the order $m_e (k_F \xi)^2$, it follows
\begin{equation}
  \label{eq:Amu}
  A_{\mu}^{+} \approx A \equiv \frac{1}{4\pi v_F m_e^3 (\omega_v/\Delta_0) \xi^5} \;.
\end{equation}
The fact that if we keep $\omega_v/\Delta_0$ constant, the self
energy increases with the fifth power of $1/\xi$ as $\xi$ decreases
is quite remarkable. For large $\xi$, the self energy correction is
very small and the motion of the vortex obviously has practically no
influence on the spectrum. However, as $\xi$ decreases, the self
energy correction becomes more and more important and we expect a
dramatic change of the spectrum within a small range of the
coherence length $\xi$.

Let us now consider the local density of states (LDOS) which (in the
more general case and with $\ell$ including the `spin' index) is
given by
\begin{equation}
  \label{eq:lDOS}
  \rho({\bf r},\omega) = -\frac{1}{\pi}\, \text{Im}\, \sum_{\ell}
  \frac{|u_{\ell}({\bf r})|^2}{\omega - \epsilon_{\ell} - \Sigma_{\ell}(\omega) + i0^{+}} \;.
\end{equation}
For the case of an $s$-wave order parameter as considered here, the
only bound state wave function which does not vanish at $r=0$ is
$u_{\mu=1/2}(r)$. We can therefore actually calculate the LDOS
at the vortex center and obtain
\begin{align}
  \label{eq:DOSat0}
  \rho(r&=0,\omega) = \frac{|u_{\mu=1/2}(0)|^2}{\omega_1^2} \big\{
(\omega_v + \omega_c + E_1)^2 \,
    \delta(\omega-\epsilon_{1/2}) \nonumber \\
  & + A \,
    \delta(\omega-\epsilon_{1/2} - \omega_1)
    + A \,
    \delta(\omega-\epsilon_{1/2} + \omega_1) \big\} \;,
\end{align}
with $\omega_1 = \sqrt{(\omega_v + \omega_c + E_1)^2 + 2A}$ which
for large coherence lengths $\xi$ is close to the vortex frequency
$\omega_v$. While there is just a peak with weight
$|u_{\mu=1/2}(0)|^2$ at the unperturbed energy $\epsilon_{1/2}$ in
the absence of the matrix element $A$, as $\xi$ decreases $A$
increases and we also find two satellite peaks shifted from this
position by $\pm \omega_1$.

To obtain the LDOS away from the vortex center and to calculate
the LDOS at arbitrary energy we follow Gygi and Schl\"uter
\cite{Gygi91} and evaluate  the eigenenergies and eigenvectors of
$\mathcal{H}_{\text{BdG}}^0$ numerically. First we replace the
system of infinite size by a disk of finite radius $R_0$. We then
expand the quasi-particle amplitudes $f_{\mu,\pm}^{n}$ into
Fourier-Bessel series: Denoting the $j$'th zero of the ordinary
Bessel function $J_m$ by $\alpha_{mj}$, we introduce the functions
\begin{equation}
  \label{eq:phi}
  \phi_{mj}(r) = \frac{\sqrt{2}}{R_0 |J_{m+1}(\alpha_{mj})|} J_m(\alpha_{mj}r/R_0) \;,
\end{equation}
which are eigenfunctions to the kinetic energy operator and satisfy
the normalization condition
\begin{equation}
  \label{eq:phinormalization}
  \int_0^{R_0} dr \, r \, \phi_{mj}(r) \phi_{mj'}(r) = \delta_{j j'} \;.
\end{equation}
Truncating the Fourier-Bessel series for the quasi-particle
amplitudes $f_{\mu,\pm}^n$ at large $N_0$, we have
\begin{equation}
  \label{eq:fFourierBessel}
  \left(\begin{array}{c}
      f_{\mu,+}^n (r) \\ f_{\mu,-}^n (r)
    \end{array}\right) = \sum_{j=1}^{N_0} \left(
    \begin{array}{c}
      c_{\mu j}^n \phi_{\mu + 1/2,j} (r) \\
      d_{\mu j}^n \phi_{\mu - 1/2,j} (r)
    \end{array}\right)
\end{equation}
With these approximations the Bogoliubov-de Gennes equations can be
solved by solving the following matrix eigenvalue problem:
\begin{equation}
  \label{eq:BdGMatrix}
  \left(
    \begin{array}{cc}
      T^{-} & \Delta \\
      \Delta^T & T^{+}
    \end{array}
  \right) \Psi_{\mu}^n = \epsilon_{\mu}^n \Psi_{\mu}^n \;.
\end{equation}
Here $T^{\pm}$ and $\Delta$ are $N_0 \times N_0$ matrices with
matrix elements
\begin{align}
  \label{eq:T}
  T_{j j'}^{\pm} = & \, \mp \frac{1}{2m_e} \left(
    \frac{\alpha_{\mu\pm 1/2,j}^2}{R_0^2} - k_F^2 \right) \delta_{j j'}\;,  \\
  \Delta_{j j'} = & \int_0^{R_0} dr\, r \, \phi_{\mu-1/2,j}(r)\, \Delta(r)\, \phi_{\mu+1/2,j'}(r) \;,
\end{align}
and $\Psi_{\mu}^{n}$ is given by $\Psi_{\mu}^{n} = (c_1 \cdots
c_{N_0},d_1 \cdots d_{N_0})^T$. Having calculated these eigenvectors
we can express the matrix elements $M_{\mu,n;\mu+1,n'}^{+}$ which
determine the $A_{\mu;n n'}^{+}$ as
\begin{equation}
  \label{eq:MKL}
  M_{\mu,n;\mu+1,n'}^{+} =
  \frac{1}{2} \sum_{j j'}
  \left( c_{\mu j}^n K_{j j'}^{(\mu)} d_{\mu+1,j'}^{n'} +
    d_{\mu j}^n L_{j j'}^{(\mu)} c_{\mu+1,j'}^{n'} \right) \;,
\end{equation}
where we have defined
\begin{equation}
  K_{j j'}^{(\mu)} = \int_0^{R_0} dr\, [r \partial_r \Delta - \Delta(r)] \,
  \phi_{\mu-1/2,j}(r) \,
  \phi_{\mu+3/2,j'}(r) \;,
\end{equation}
and
\begin{equation}
  L_{j j'}^{(\mu)} = \int_0^{R_0} dr\, [r \partial_r \Delta + \Delta(r)] \,
  \phi_{\mu+1/2,j}(r) \,
  \phi_{\mu+1/2,j'}(r) \;.
\end{equation}
Alternatively, as discussed at the end of the preceding section, we
can also make use of the Hellmann-Feynman theorem which when
including boundary terms reads for the $s$-wave case considered
here\cite{Han05}
\begin{equation}
  \label{eq:Hellmannswave}
  M_{\ell,\ell'}^{+} = (\epsilon_{\ell'} - \epsilon_{\ell}) U_{\ell;\ell'}^{+} - \frac{R_0}{2 m_e} \int_0^{2\pi} d\theta\, \partial_r \Psi_{\ell}^{\dagger} \sigma_3 \partial_{\bar z} \Psi_{\ell'} \Big|_{r = R_0} \;.
\end{equation}
Expressing all wave functions in terms of their Fourier-Bessel
components both integrals can be done analytically and we obtain
\begin{align}
  \label{eq:MKK}
  & \!\!\!\!M_{\mu,\mu+1}^{n n'} =  \nonumber \\
 & \frac{1}{2}
  \sum_{j j'}
  c_{\mu j}^n \left[(\epsilon_{\mu+1}^{n'} - \epsilon_{\mu}^{n}) \mathcal{K}_{j j'}^{(\mu-1/2)} - \mathcal{L}_{j j'}^{(\mu-1/2)} \right] c_{\mu+1,j'}^{n'} \nonumber \\
  + & \frac{1}{2}
  \sum_{j j'}
  d_{\mu j}^n \left[(\epsilon_{\mu+1}^{n'} - \epsilon_{\mu}^{n}) \mathcal{K}_{j j'}^{(\mu+1/2)} + \mathcal{L}_{j j'}^{(\mu+1/2)} \right] d_{\mu+1,j'}^{n'} \;,
\end{align}
with the matrix elements $\mathcal{K}_{j j'}^{(m)}$ and
$\mathcal{L}_{j j'}^{(m)}$ given by
\begin{align}
  \label{eq:def:K}
  \mathcal{K}_{j j'}^{(m)} & = \text{sign}\,(m+1/2)\,(-1)^{j-j'}\,\frac{2 \alpha_{mj} \alpha_{m+1,j'}}{R_0(\alpha_{m+1,j'}^2 - \alpha_{mj}^2)} \;, \\
  \label{eq:def:L}
  \mathcal{L}_{j j'}^{(m)} & = \text{sign}\,(m+1/2)\,(-1)^{j-j'}\,\frac{\alpha_{mj} \alpha_{m+1,j'}}{m_e R_0^3} \;.
\end{align}
For simplicity and to avoid too many parameters which do not change
the essential physics, we have neglected the electromagnetic vector
potential in our above considerations and will not calculate the
pair potential self-consistently. Neglecting the vector potential is
safe in the extreme type II case where the London penetration length
is much larger than the coherence length which we are considering
here. Although there are significant deviations from the
$\tanh$-behavior of $\Delta(r)$ for small temperatures, corrections
to the LDOS are expected to be small and can easily be
incorporated. Once all eigenenergies and eigenvectors of
$\mathcal{H}_{\text{BdG}}^0$ are determined, the matrix elements
$A_{\mu;nn'}^{+}$ and then the LDOS can be calculated.

In STM experiments the local tunneling conductance $G=\partial I/
\partial V$ can be measured as a function of gate voltage $V$. If we
are at very low temperature and have a tip with a constant density of states (DOS) the
tunneling conductance is essentially equal to the LDOS of the
probe. At finite temperature, each peak in the LDOS becomes
broadened with the derivative of the Fermi function $f(\omega) =
1/(e^{\omega/T}+1)$ such that
\begin{equation}
  \label{eq:G}
  G({\bf r},\omega=eV) = -\frac{G_0}{\rho_0} \int d\omega' \,\rho({\bf r},\omega+\omega')\,f^{\prime}(\omega') \;.
\end{equation}
Here we have expressed the normalization constant in terms of the
DOS of a free 2-dimensional electron gas (per spin direction),
$\rho_0 = m_e/2\pi$, and the corresponding tunneling conductance,
$G_0$.

In our numerical calculations we have chosen $k_F R = 400$. For the
vortex (Einstein) frequency we use $\omega_v = 0.2\, \Delta_0$ and
for simplicity we set $\omega_c=0$. Setting the temperature equal to
$T=0.006\,E_F$ we obtain smooth curves for the tunneling conductance
with well distinguished bound state peaks. In Fig.~\ref{fig:xi=10}
\begin{figure}[tb]

  \includegraphics[width=8cm]{Figxi10M100}
  \caption{Tunneling conductance $G=\partial I / \partial V$ for a superconductor with
  $s$-wave symmetry as a function of $\omega$ at the vortex center $r=0$ (upper curve)
  and $k_F r = 4,8,\dots,20$ for $k_F \xi=10$ and $m_v = m_e(k_F\xi)^2 = 100\, m_e$.
  Each curve is offset by $2$ units for clarity. We have chosen $\omega_v = 0.2\, \Delta_0$
  and have for simplicity set $\omega_c=0$. The temperature is $T=0.006\, E_F$ and
  this finite temperature leads to a broadening of the conductance peaks.
  As can be seen in the figure, there are no satellite peaks. For these parameters, the tunneling conductance
  of the static vortex case, without the self energy correction, has an almost identical appearance.}
\label{fig:xi=10}
\end{figure}
\begin{figure}[tb]
  \centering
  \includegraphics[width=8cm]{Figxi5M25}
  \caption{Tunneling conductance $G=\partial I / \partial V$ for a smaller value of $\xi$ than that
    in Fig.~\ref{fig:xi=10}, $k_F \xi=5$ and $m_v = m_e(k_F \xi)^2 = 25\, m_e$. The tunneling conductance
    is plotted as a function of $\omega$ at the
    vortex center $r=0$ (upper curve) and $k_F r = 4,8,\dots,20$.
    All other parameters are chosen as in Fig~\ref{fig:xi=10}. The two
    satellite peaks shifted from the central peak by $\pm \omega_1$ can
    clearly be seen in the curve for $r=0$.\\ \\ \\ \\ {}} \label{fig:xi=5}
\end{figure}
\begin{figure}[tb]
  \centering
  \includegraphics[width=8cm]{Figxi5static}
  \caption{Tunneling conductance $G=\partial I / \partial V$ for the same parameters as in Fig.~\ref{fig:xi=5}, but with a static vortex. }
  \label{fig:xi=5:static}
\end{figure}
we show plots of the tunneling conductance $G({\bf r},\omega)$ at
the vortex center and at several distances away from it for $k_F \xi
= 10$ and $m_v = m_e (k_F \xi)^2 = 100\,m_e$. The plots are almost
indistinguishable from plots for the tunneling conductance with the
same parameters but a static vortex (this amounts to taking the
limit $m_v \to \infty$).\cite{Gygi91} As we decrease the coherence
length (and/or the vortex mass) the influence of the moving vortex
on the electronic spectrum becomes more and more pronounced. In
Fig.~\ref{fig:xi=5} we show the tunneling conductance for $k_F \xi =
5$ and $m_v = m_e(k_F \xi)^2 = 25\,m_e$. Now one can clearly see two
satellite peaks at the center of the vortex, shifted from the
central peak by $\pm \omega_1$ which is of the order of the vortex
frequency $\omega_v$. In units of the Fermi energy the temperatures
chosen in Figs.~\ref{fig:xi=10} and \ref{fig:xi=5} are the same.
However, in units of the bulk gap $\Delta_0$, the temperature in the
latter figure is smaller than that in the former by a factor of two.
As a result of this, the hight of the zero bias peak is actually
larger in Fig.~\ref{fig:xi=5} than in Fig.~\ref{fig:xi=10} even
though spectral weight is shifted to the satellite peaks in
Fig.~\ref{fig:xi=5}. In fact, the quantum zero-point motion does
lead to a reduction of the zero bias conductance peak as can be seen
by comparing the results of Fig.~\ref{fig:xi=5} with those
calculated for the same parameters, but with a static vortex. This
case is shown in Fig.~\ref{fig:xi=5:static}.

\section{Conclusions}
\label{sec:conc}

We presented a first determination of the influence of the vortex
zero-point motion in a simple model based upon BCS theory. For
$s$-wave superconductors, a comprehensive computation was possible,
with good convergence of finite-size effects, and the ability to
explore a wide range of parameters as $T \rightarrow 0$. We found
two important effects in the electronic LDOS: ({\em i\/}) a
suppression in the strength of the zero-bias peak at the vortex
core, and ({\em ii\/}) the appearance of satellite peaks at
frequencies of order $\pm \omega_v$, where $\omega_v$ is the vortex
oscillation frequency.

An extension of our results to $d$-wave superconductors appears in
paper II. There we will introduce a model designed specifically to
study the influence of the low energy quasiparticles, and present
implications for experiments on the cuprate supercondutors.

\acknowledgments

We thank J.~Hoffman, P.~Nikoli\'c, and Z.~Te\v sanovi\'c for useful
discussions. This research was supported by the NSF under grant
DMR-0537077 and the Deutsche Forschungsgemeinschaft under grant BA
2263/1-1 (L.~B.).

redpajama_set_name: RedPajamaArXiv


text:
Stevenson Welcomes Digital Packs for North-East Schools
Banffshire and Buchan Coast MSP Stewart Stevenson has welcomed a digital donation to help support secondary school pupils in the north-east.
It comes after supermarket Asda announced it was working with Dell Technologies to donate 7,000 laptops to partner schools across the UK to help tackle digital exclusion.
Fraserburgh North School and Peterhead Academy will both receive 10 laptop bundles each.
Each tech bundle includes a headset and dongle and laptops will include a one-year warranty and technical support.
According to Ofcom, around 9% of children in the UK - between 1.1million and 1.8million - do not have access to a laptop, desktop or tablet at home.
Commenting, Stewart Stevenson MSP said:
"I welcome this funding from Asda to help support schools in the north-east which will help to close the gap in digital poverty.
"The coronavirus pandemic has emphasised the very real challenges and disparity across society in access to digital technologies. This support will go a long way to help pupils in their learning both in school and at home."
Stevenson Welcomes Update on Place of Worship
Banffshire and Buchan Coast MSP Stewart Stevenson has welcomed a Scottish Government announcement on attending places of worship.
From Friday 26 March people living in all parts of Scotland will be able to attend places of worship in gatherings of up to 50 where there is space for physical distancing.
And the updated guidance will also allow people to travel between Level 4 areas to attend their usual place of worship.
"I welcome the return of collective worship which I know is of great importance to many constituents. This is a positive change I know it will be especially welcome as we head towards religious festivals over the next few weeks.
"This has been an incredibly tough year for so many people and I am thankful to everyone in my constituency and across the north-east who have shown solidarity, compassion and love to one another by sticking to incredibly tough rules and restrictions.
"To lift restrictions in the future, we still need to suppress the virus just now, so please stay within the rules in the coming weeks – stay at home for now, unless for an allowed reason; do not meet people from other households indoors; and follow the FACTS advice when you are out and about."
MSPs Welcome Funding for Green Jobs
North-east MSPs has welcomed funding to help support Scotland's economic recovery and stimulate the creation of new green jobs following the coronavirus pandemic.
The £4million Green Jobs Call from Scottish Enterprise is part of a three-year £27million package of green funding and applications will go live in May.
The move has been welcomed by Aberdeenshire East MSP Gillian Martin and Banffshire and Buchan Coast MSP Stewart Stevenson.
Grants of between £50,000 to £500,000 will be awarded on a competitive basis.
Supported through the Scottish Government's Green Jobs Fund, the funding call is part of Scottish Enterprise's wider commitment to supporting Scotland's net zero transition that delivers benefits for our environment, people and economic prosperity.
The call aims to support business to create jobs that produce goods or provide services that benefit the environment or conserve natural resources and jobs that help drive more environmentally friendly processes in Scottish businesses.
Picture taken pre-COVID and social distancing
Commenting, Gillian Martin MSP said:
"As we continue to tackle to Covid-19 crisis and support the economy both here in the north-east and across Scotland, it is also crucial we lay the foundations for a green recovery and I welcome the work of Scottish Enterprise in helping to support this.
"This first call for the new green jobs fund is a really positive step and will help us to rebuild a fairer, stronger and greener country."
"I would urge businesses to apply for this funding which will help support companies as we emerge from the coronavirus pandemic. Scotland's net-zero ambitions are impressive and funding opportunities such as this from Scottish Enterprise help us to work solidly towards this."
Stevenson Welcomes UN Rights of the Child Bill Becoming Law
Banffshire and Buchan Coast MSP Stewart Stevenson has welcomed Scotland becoming the first country in the UK to put the UN Conventions on the Rights of the Child (UNCRC) into law.
It comes after MSPs vote unanimously to pass the Bill at Stage Three and the Bill will now commence six months from Royal Assent.
The move means public authorities will have to comply with children's rights and Scotland is one of only a small number of nations who have directly incorporate the UNCRC into domestic law.
It sets out the specific rights that all children have to help fulfil their potential, including rights relating to health and education, leisure and play, fair and equal treatment, protection from exploitation and the right to be heard.
The Bill makes it unlawful for public authorities and anyone undertaking functions or providing services to children with public money to act incompatibly with the incorporated UNCRC requirements
It also gives power to the Children's Commissioner to take legal action in relation to children's rights and requires Ministers to produce a Children's Rights Scheme setting out how they comply with children's rights and to report annually.
A £2.1 million programme over three years will help public authorities implement the legislation.
"This is a landmark Bill which is the most significant piece of legislation since devolution, delivering a revolution in children's rights. That is a major cause for celebration.
"The Bill will deliver the highest protection possible for children's rights across the north-east and Scotland and within the powers of this Parliament.
"It will ensure that a rights-respecting approach is at the heart of our recovery from the pandemic.
"Parliament passing this Bill means that Scotland stands amongst a small number of nations like Norway, Belgium and Finland, and I am proud the Scottish Parliament's work will encourage other countries to follow suit.
"But it does not represent the end of the journey in making children's rights real. It is now incumbent upon us all to ensure the Bill's ambitions are translated into real-life improvements which transform the lives and life chances of our children and young people."
Children and Young People's Commissioner for Scotland Bruce Adamson said: "Scotland has shown real human rights leadership in incorporating the UNCRC into Scots law. It is the most important thing we can do to protect and uphold the rights of children and young people.
"Exactly 18 years ago, the Scottish Parliament showed its commitment to children's rights by creating the office of the Children's Commissioner and today it has reinforced that commitment by passing the Scottish Government's world-leading children's human rights legislation. This will improve life for all children but children whose rights are most at risk will feel the biggest impact."
Stevenson Welcomes Funding for Ports and Harbours
Banffshire and Buchan Coast MSP Stewart Stevenson has welcomed funding from the Scottish Government for the fishing industry.
The move has been made to support up to 20 ports and harbours that have lost income from landing fees due to the disruption caused by Brexit.
They will receive share of a £1.8million fund including more than half a million pounds for repair works at Fraserburgh, Peterhead and Macduff.
The funding was announced by Fisheries Secretary Fergus Ewing ahead of the third meeting of the Scottish Seafood Exports Taskforce where he called on the UK Government to improve collaboration on border and customs process for the EU.
Limited, complex guidance and the requirement to use multiple systems for catch and export certification and customs controls is leading to a number of EU vessels choosing to land into other countries like Norway, Denmark and Ireland.
EU flagged vessels account for around 7% of all landings by value into Scottish ports in 2019 and were worth £35.5 million, however there is more of a reliance on them in smaller communities like Ullapool where around 13% of landings by value were estimated to be from EU vessels.
Funding has been allocated to Fraserburgh for numerous repairs, to Peterhead for various improvements ranging from collection and disposal of waste from fishing fleet to quay cleaning and to Macduff Aberdeenshire for additional improvements.
"This is necessary investment to help mitigate against the very real impact of Brexit for the fishing communities across the north-east of Scotland.
"Many of which are losing key landing fees from vessels and as a result essential investment they need for business.
"I am grateful for the Scottish Government's commitment to step in to help with this financial support.
"It is obvious there needs to be clearer guidance too for EU vessels and their agents so they can have confidence and continue to land in our ports and I support the Fisheries Secretary's efforts to encourage this."
Stevenson Delivers Final Address to Scottish Parliament
Banffshire and Buchan Coast MSP Stewart Stevenson has made his final speech to the Scottish Parliament after a career spanning two decades.
Mr Stevenson, who previously worked in Information Technology for the Bank of Scotland for 30 years before pursuing a career in politics, has been a campaigner for independence and a member of the SNP since 1961.
After standing as a candidate he became the constituency MSP for the Banff and Buchan from 2001 till 2011.
Following boundary changes he has been the MSP for Banffshire and Buchan Coast since 2011.
Mr Stevenson has also held Ministerial roles during his time in the Scottish Parliament including as the Minister for Environment and Climate Change and as Minister for Transport, Infrastructure and Climate Change.
He announced his plans to retire last year and will now continue with a number of personal projects as well as the newly-elected National Secretary for the SNP following his election in October 2020.
In his final speech to the Scottish Parliament Mr Stevenson spoke in the Environment, Climate Change and Land Reform Committee Debate on the Scottish Government's Climate Change plan.
Mr Stevenson paid tribute to a number of colleagues including former Scottish Conservatives MSPs Alex Fergusson and Alex Johnstone who "departed before their time".
In his final speech – which was his 853rd since becoming an MSP – Mr Stevenson said he would continue to remain passionate about climate change and called for work to ensure a transition from oil and gas which would ensure an equal jobs market.
He also called for support for other countries across the globe who would be impacted by the western world's use of fossil fuels and its global impact on climate change.
And Mr Stevenson, who has been a keen genealogist for six decades, revealed he and Scottish Government Minister Jenny Gilruth are distantly related after making the discovery during research.
"It has been the greatest honour of my life to serve as the MSP for Banff and Buchan and latterly Banffshire and Buchan Coast.
"My time in the Scottish Parliament has never had a dull moment and I have been honoured to represent the Scottish Government as both the Minister for Environment and Climate Change and the Minister for Transport.
"I would like to pay tribute to my colleagues past and present - both those who have gone on to other things and those who are sadly no longer with us.
"The role of an MSP is to challenge and change and represent the people of your constituency with determination to improve their lives for the better.
"We should encourage more people from all walks of life to pursue a role in politics including the continued encouragement of women, ethnic minorities and people with disabilities so that the Parliament is one which represents us all.
"I know I leave the Scottish Parliament in good hands in the pursuit of a fairer, more equal society for all and one that we can be proud to leave for the future generations to come.
"To the people of Banffshire and Buchan Coast who have made this job what it is I would like to say thank you and farewell for now."
Stevenson Welcomes Review into COVID-19 Impact on Deposit Return Scheme
Banffshire and Buchan Coast MSP Stewart Stevenson has welcomed plans for an independent gateway review to assess the impact of the coronavirus pandemic on the roll-out of Scotland's Deposit Return Scheme (DRS).
The DRS had been expected to launch in July next year and will make it easier for everyone to recycle their used bottles and cans.
People pay a small deposit of 20p when they buy a drink in a single-use container and then get the deposit back when they return the empty bottle or can.
Mr Stevenson had called on the Scottish Government to ask what progress there has been in implementing it deposit return scheme.
Minister for Rural Affairs and the Environment Ben Macpherson said the Scottish Government was aware of the "unique and significant pressures that COVID-19 and EU Exit have placed on industry over the past year."
He said this included the businesses which would be responsible for implementing the scheme.
Mr Macpherson said:
"Despite this, industry has made good progress towards implementing the scheme, including the recent establishment of Circularity Scotland Ltd as a not-for-profit industry body seeking to operate as a DRS scheme administrator. This is a significant step forward, which demonstrates the industry's collective commitment to move ahead with the scheme.
"At the time that the DRS Regulations were passed, the Scottish Government committed to closely monitor the impact of the pandemic on implementation of DRS. Given the significant disruption caused to relevant sectors over the past year, we have decided to commission an independent gateway review to assess the impact of the pandemic on the go-live date for the scheme."
"I welcome the Scottish Government's review to assess the impact of the pandemic on the deposit return scheme.
"Despite Covid-19 and the impact it is had on all aspects of life, it is clear the government is determined to meet its target for the launch of the scheme next year.
"It is important we continue to look at ways we can reduce litter, protect our environment and tackle throwaway culture."
Stevenson Congratulates North-East Business for Vaccination Support
Banffshire and Buchan Coast MSP Stewart Stevenson has congratulated a north-east business for its actions to support local people during the Covid-19 pandemic.
Regency Car Sales in Buckie has made more than 50 cars available to help assist people from the area getting to the Fiona Elcock Vaccination Centre in Elgin to be vaccinated.
Mr Stevenson has commended the support in a motion to the Scottish Parliament.
The generous move has meant many people eligible for their vaccine have been able to get to their appointments reducing the stress of those who are required to travel farther distances.
"Regency Car Sales has shown the kind of incredible community spirit and generosity which is exemplary of care which has been shown across the north-east during the coronavirus pandemic.
"Many people eligible for the vaccine could have trouble travelling to their nearest vaccination centre without access to transport which can be particularly difficult for those living in rural areas.
"This has allowed many people to not have the additional stress or worry about getting to their appointment.
"I would like to say a very big thank you to Regency Car Sales for hard work."
Stevenson Welcomes Suspension of Scotch Whisky Tarriff
Banffshire and Buchan Coast MSP Stewart Stevenson has welcomed a suspension on tariffs on Scotch whisky and other goods by the new US administration.
The move – which will last for four months – comes after repeated calls for the UK Government to put pressure on the US to seek a new long-term agreement.
Former US President Donald Trump had imposed a 25 percent tariff in October 2019 on imports of single malt Scotch whisky.
It is understood the UK and US governments will seek to reach an agreement during the four-month suspension period.
Earlier this year it was revealed the UK's Scotch whisky export has been reduced by a staggering 22.6% in 2020 – with losses exceeding £500million.
"This is very welcome news for the sector which employs more than 11,000 people including 7,000 people in rural areas.
"The financial loss that our whisky exports have faced is eye-watering and simply not sustainable and I am glad there will be time now to look at this in more detail.
"Real damage has been caused by this 16-month long tariff on Scotch whisky causing a detrimental impact on the industry.
"I hope this announcement today will bring some relief and I hope moving forward there will be a resolution that is reasonable and fair."
Stevenson Welcomes New Heating Payment to Help People with Bills
Banffshire and Buchan Coast MSP Stewart Stevenson has welcomed a new home heating support fund launched to help people struggling with their energy bills as a result of the coronavirus pandemic.
The £4million Scottish Government scheme – which will be administered by national advice service Advice Direct Scotland – is designed to prevent households falling into fuel poverty.
The Home Heating Support Fund is open until March 31 and applications can only be made on behalf of individuals by referral partners.
This includes local authorities and third sector organisations, with payments then made directly to energy suppliers on behalf of their customers.
Eligibility is based on households which have been faced with rationing their energy usage, meaning those who are deliberately limiting their energy use so that they can afford to spend money on other goods or services.
In 2019, an estimated 24.6 percent of all households were in fuel poverty - around 613,000 households – and the pandemic has increased financial hardship for many.
"I welcome this funding which will help families who have had additional financial costs due to the increased bills from being at home because of the coronavirus pandemic.
"This fund will help to assist in helping support households from the impact of fuel poverty which is a reality for many families just now.
"It is important the Scottish Government is able to support people by tackling inequality and ensuring people are not left making choices between different household costs."
Commenting, Chief Executive of Advice Direct Scotland Andrew Bartlett said:
"No household should suffer in fuel poverty or have to ration fuel to get by.
"The Covid pandemic has increased financial hardship and many Scots have been left struggling as a result of increased energy costs while working from home or home-schooling.
"We are working hard to administer this new fund from the Scottish Government to ensure that fewer Scots are struggling with their energy bills.
"As well as working closely with partner organisations, our own expert debt advisers can also directly help individuals who have financial worries."
More information on the Home Heating Support Fund is available here: https://homeheatingadvice.scot/
Stevenson Backs Scot Gov Calls on Green Ports
Banffshire and Buchan Coast MSP Stewart Stevenson has backed a call by the Scottish Government to ensure green ports have access to the same level of set-up of funding as freeports in England.
Trade Minister Ivan McKee has written to the UK Government calling for two green ports to be focused on fair and sustainable economic development to be established in Scotland.
The green port model will adapt the UK government's freeport proposals, offering a package of tax and customs reliefs.
Earlier this year, proposals were put forward by the Scottish Government to establish green ports which would be more sustainable and require operators and businesses to pay the real living wage, adopt the Scottish Business Pledge and commit to supporting sustainable and inclusive growth in local communities.
Operators and beneficiaries will be required to commit to adopting Fair Work First criteria and contribute to Scotland's just transition to net zero.
"I welcome the Scottish Government's call to the UK Government regarding green ports having access to the same level of seed funding which is being offered to freeports in England.
"It is clear there is support from businesses for green ports and it is important the UK Government supports the development of these ports right across the country and I look forward to the UK Government's response on this issue.
"The Scottish Government's proposals to take the freeport model and apply this country's priorities from a green recovery from the coronavirus pandemic is one I wholeheartedly support.
"By diverging from the wider UK proposals, we can use a different freeport model to meet out net zero ambition and a wellbeing economy which upholds the highest standards of environmental protections and fair work practices."
▼ Mar 2021 (11)
Stevenson Welcomes Digital Packs for North-East Sc...
Stevenson Welcomes UN Rights of the Child Bill Bec...
Stevenson Delivers Final Address to Scottish Parli...
Stevenson Welcomes Review into COVID-19 Impact on ...
Stevenson Congratulates North-East Business for Va...
Stevenson Welcomes Suspension of Scotch Whisky Tar...
Stevenson Welcomes New Heating Payment to Help Peo...

redpajama_set_name: RedPajamaCommonCrawl


text:
THE KING OF FIGHTERS ALLSTAR OFFERS HUGE BENEFITS AND FEATURES BY JUNE'S UPDATE
New Opportunities to Collect the Powerful Orochi,
Alongside New 'Ruby Refund Event' Now Open for Players
Today's update for Netmarble's popular mobile action role-playing game (RPG) THE KING OF FIGHTERS ALLSTAR introduces 'Ruby Refund Event' and an all-new core mechanic for players eager to further strengthen their collection of characters with the Awakening Update.
The limited-time 'Ruby Refund' event awards players additional Rubies depending on how much they used previously, and a variety of events for daily mission, access and new entry offers further – for a potential total of 30,000 rubies for new players and up to 40,000 for existing players. The
Another new addition to THE KING OF FIGHTERS ALLSTAR is the 'Awakening Feature'. Players can now awaken fighters who have reached Level 90 with new 'Awakening' and 'Imprint' materials earned from the recently introduced 'Awaken Dungeons'. Once awakened, fighters will have access to powerful Awakening skills, further stat boosts, and other benefits, with a maximum rank of five awakenings possible for each fighter.
As part of this update, new and old players will also have the opportunity to collect Orochi from THE KING OF FIGHTERS 97 through special reward which is provided for a limited period of time till June 30. Further details of this special reward is given at the official forum of THE KING OF FIGHTERS ALLSTAR.
THE KING OF FIGHTERS ALLSTAR boasts fast-paced fighting action as players battle through waves of enemies, giant bosses, and rival fighter teams. The excitement is paired with cutting edge graphics, bold colors, and lightning-fast animations. In addition, this game features all of KOF's classic fighters from '94 to XIV, with more than 130 fighters available to collect, along with more to come with seasonal events, collaborations with popular IP such as TEKKEN 7 and SAMURAI SHODOWN, and additional content updates for players to enjoy.
THE KING OF FIGHTERS ALLSTAR is available to download on Google Play and the App Store in more than 175 countries and comes with support for English, Taiwanese, Indonesian, Thai, Spanish, Italian, French, Portuguese, Russian, and German languages.
For more information, please visit THE KING OF FIGHTERS ALLSTAR's website. Also, please follow THE KING OF FIGHTERS ALLSTAR on Facebook, Twitter, YouTube, Instagram, Discord, Reddit, and forum on Netmarble.com.
Please see below details for further understanding. You're free to localize this paragraph to make it more understandable in you language
From June 4~25, all players get back some of the ruby they used. A maximum of 20,000 Rubies potentially awarded to players based on the amount of Rubies they spent.
From June 5-July 14, players will also earn Rubies each day by accessing the game, for a potential total of 10,000 Rubies earned if players log in regularly
From June 4-July 14, players can earn up to 10,000 Rubies by completing Daily Missions
All new players starting THE KING OF FIGHTERS ALLSTAR during the event period will also receive 10,000 rubies
Posted in Genel


Copyright: DEPO Zona, zabranjeno kopiranje i reupload! Sve sadržaje (filmove i TV serije) DEPO Zone/TV možete uz naknadu gledati svojim računarima, Smart TV, mobilnim telefonima i tabletima na. https://vimeo.com/ondemand/orientexpress DEPO Zona je naša digitalna palforma sa premium filmskim sadržajima iz BiH i Balkana. Možete na nas na: http://depo.ba/depo-tv. Pretplatite se na DEPO Zona/TV i uživajte u filmskim i tv sadržajima ekskluzivnog kvaliteta.
Copyright: DEPO Zona, zabranjeno kopiranje i reupload! DEPO TV je video platforma istoimenenog DEPO Portala i razvija svoju video produkciju digitalnih sadržaja. Možete na nas na: http://depo.ba/depo-tv. DEPO PREMIUM je naša video platforma za pretplatničko gledanje premium i ekskluzivnih filmskih i tv sadržaja iz BiH i Balkana. Možete na gledati na: https://www.youtube.com/use... Pretplatite se ODMAH!
"Dobrodošli u Orient Express" gledajte premijerno na sljedećem linku: https://vimeo.com/ondemand/orientexpress Seriju "Dobrodošli u Orient Express" realizuje producentska kuća DEPO iz Sarajeva, po ideji i konceptu Jasmina Durakovića, reditelja i producenta poznatog po pokretanju nekih od najuspješnijih tv projekata u posljednjih 15-tak godina (Viza za budućnost, Pozitivna geografija, Lud zbunjen normalan). Glavni junaci ove serije su sarajevski hotelijer Sudo (Mirvad Kurić) i turistički radnik Hoki (Emir Hadžihafizbegović) u borbi za opstanak u vremenu socijalne krize. Pored ove dvojice izuzetnih glumaca, u seriji velike uloge igraju: Bojana Gregorić, Vanesa Glođo, Ivo Gregurević, Saša Petrović, Andrea Aković, Haris Burina, Slaven Knezović, Klara Mučibabić, Edhem Husić, Armin Omerović, Staša Dukić, Nedim Malkočević i mnogi drugi. O Seriji "Dobrodošli u Orient Express" možete gledati i sve saznati o njoj na DEPO TV (http://depo.ba/depo-tv.) Za sve informacije i dodatne upite o seriji možete nas kontaktirati mailom na adresu: depozona@depo.ba FACEBOOK page : https://www.facebook.com/depozona DEPO TV – Mediji za novi ritam života! DEPO TV je video platforma istoimenenog DEPO Portala i razvija svoju video produkciju digitalnih sadržaja. Možete na nas na: http://depo.ba/depo-tv. DEPO PREMIUM je naša video platforma za pretplatničko gledanje premium i ekskluzivnih filmskih i tv sadržaja iz BiH i Balkana. Možete na gledati na: https://www.youtube.com/use... Pretplatite se ODMAH!
****** Please feel free to subscribe to my channel for more video's ******* A work of art in itself and a true Art Deco icon, the legendary Venice Simplon-Orient-Express is one of the world's most famous luxury trains. Step aboard and experience truly elegant travel, wrapped in timeless romance. Adventure and style are all intimately bound in journeys that crisscross Europe, rolling through sublime scenery to some of the continent's most alluring cities. Delightful vintage cabins, gastronomic cuisine and lively onboard entertainment make a journey on this luxury train one of the world's finest travel experiences.The golden age of travel may have been in the Roaring Twenties, but the art of journeying in style is still alive and well today. That sense of wonder can still be felt with the variety of journeys offered aboard the Venice Simplon-Orient-Express. UK to France and Italy on overnight trips, extended voyages to Istanbul and Budapest… Whichever the destination, your time on the rails is guaranteed to provide unforgettable memories.Savour the beautiful surroundings. Marvel at the opulent interiors, sparkling crystal, plush fabrics and polished woods. Relax in your own cabin as you look out over stunning landscapes. Connect with fascinating people—like-minded adventurers who share your joy for travel.
The Orient Express was the name of a long-distance passenger train service created in 1883 by Compagnie Internationale des Wagons-Lits (CIWL).
The route and rolling stock of the Orient Express changed many times. Several routes in the past concurrently used the Orient Express name, or slight variants thereof. Although the original Orient Express was simply a normal international railway service, the name has become synonymous with intrigue and luxury travel. The two city names most prominently associated with the Orient Express are Paris and Constantinople (Istanbul), the original endpoints of the timetabled service.
The Orient Express was a showcase of luxury and comfort at a time when travelling was still rough and dangerous. CIWL soon developed a dense network of luxury trains all over Europe, whose names are still remembered today and associated with the art of luxury travel – the Blue Train, the Golden Arrow, North Express and many more.
In 1977, the Orient Express stopped serving Istanbul. Its immediate successor, a through overnight service from Paris to Vienna, ran for the last time from Paris on Friday, June 8, 2007. After this, the route, still called the "Orient Express", was shortened to start from Strasbourg instead, occasioned by the inauguration of the LGV Est which affords much shorter travel times from Paris to Strasbourg. The new curtailed service left Strasbourg at 22:20 daily, shortly after the arrival of a TGV from Paris, and was attached at Karlsruhe to the overnight sleeper service from Amsterdam to Vienna.
Orient Express was the name of a long-distance passenger train service that ran from 1883 to 2009.
Orient Express is a 1953 anthology drama television series filmed in Europe and syndicated in the United States. Each episode ties-in with a story connected to the famed railroad from which the series takes its name.
Orient Express was a steel roller coaster at Worlds of Fun amusement park in Kansas City, Missouri. The Orient Express was introduced to Worlds of Fun in 1980. The red-orange track was in between the two entrances of the park. The station house is still visible, and contains the park's haunted attraction Lore of the Vampire and Club Blood.
The Orient Express was the first coaster ever to have a "Kamikaze Curve" element, which was later termed a "boomerang" by Arrow Dynamics and a "batwing" by Bolliger & Mabillard. This element consists of a 90-degree rise to the right or left (similar to half a corkscrew), followed by half of a traditional loop element, then a rising half loop, then a final 90-degree dive sending the track in the same direction it entered the element. This element was later often used on Arrow's larger looping coasters, as well as on the Vekoma designed Goudurix at Parc Astérix, where it was known as a "Double Sidewinder", and on B&M's inverted roller coasters. The Orient Express also featured a tunnel prior to the lift hill that housed the Orient Express Dragon, a wooden sign that had the ride's logo illuminated.
The Orient Express was a professional wrestling tag team in the World Wrestling Federation in the early 1990s composed of Pat Tanaka and Akio Sato, who was later replaced by Kato.
In early 1990, manager Mr. Fuji split up the team known as The Powers of Pain (The Warlord and The Barbarian) as he sold their individual contracts to Slick who got the former and Bobby Heenan who received the latter, respectively. Fuji then brought in The Orient Express (Sato & Tanaka) as his latest threat to the WWF tag team division. While the Orient Express was supposed to represent Japan, Pat Tanaka was born in Hawaii.
The Orient Express kicked off a prolonged feud with The Rockers that started at WrestleMania VI, where Sato and Tanaka were victorious via countout, and continued off and on for well over a year. The Orient Express got involved in the Legion of Doom / Demolition feud as Mr. Fuji managed Demolition as well. Demolition was being phased out and the Orient Express began taking on the Legion of Doom instead. The Legion of Doom / Orient Express feud was extremely onesided due to the Legion of Doom's massive size advantage.
Stamboul Train (1932) is a novel by author Graham Greene. Set on an "Orient Express" train (in fact, the Ostende-Wien-Orient-Express), the book was renamed Orient Express when it was published in the United States.
The novel focuses on the lives of individuals aboard the train as it makes a trip from Ostend to Istanbul. Although the central characters are traveling for different purposes, their lives are fatefully intertwined.
Myatt is a shrewd and practical businessman. Partly out of generosity, he gives the sick Coral Musker a ticket, for which Musker feels grateful and then she falls in love with him; she spends a night with him in his compartment.
Dr. Czinner, an exiled socialist leader, wants to travel back to Belgrade, only he finds that the socialist uprising he was anticipating has already taken place and failed. He decides to go back to Belgrade nonetheless to stand trial as a political gesture. Meanwhile, he is being followed by Mabel Warren, a lesbian journalist who is travelling with her partner, Janet Pardoe. To go back to Belgrade, he has to pretend to leave the train at Vienna so that Warren will not follow him.
Murder on the Orient Express is a detective novel by Agatha Christie featuring the Belgian detective Hercule Poirot. It was first published in the United Kingdom by the Collins Crime Club on 1 January 1934. In the United States, it was published on 28 February 1934, under the title of Murder in the Calais Coach, by Dodd, Mead and Company. The U.K. edition retailed at seven shillings and sixpence (7/6) and the U.S. edition at $2.00.
The U.S. title of Murder in the Calais Coach was used to avoid confusion with the 1932 Graham Greene novel Stamboul Train which had been published in the United States as Orient Express.
Upon arriving at the Tokatlian Hotel in Istanbul, private detective Hercule Poirot receives a telegram prompting him to cancel his arrangements and return to London. He instructs the concierge to book a first-class compartment on the Orient Express leaving that night. However this becomes impossible when it is revealed that in an unusual occurrence for the time of year (December), the train is fully booked and Poirot only gets a second-class berth after the intervention of his friend M. Bouc who is a director of the train line Compagnie Internationale des Wagons-Lits and is also boarding the train. After boarding, Poirot is approached by Mr Samuel Ratchett, a malevolent, elderly American he initially saw at the Tokatlian. Ratchett believes his life is being threatened and attempts to hire Poirot but, due to his distaste, Poirot refuses. "I do not like your face, Mr. Ratchett," he says.
Wish Key - Orient Express (Original) 7"
En un lugar aislado de la antigua Yugoslavia, en plena madrugada, una fuerte tormenta de nieve obstaculiza la línea férrea por donde circula el Orient Express. Procedente de la exótica Estambul, en él viaja el detective Hércules Poirot, que repentinamente se topa con uno de los casos más desconcertantes de su carrera: en el compartimiento vecino ha sido asesinado Samuel E. Ratchett mientras dormía, pese a que ningún indicio trasluce un móvil concreto. Poirot aprovechará la situación para indagar entre los ocupantes del vagón, que a todas luces deberían ser los únicos posibles autores del crimen. Una víctima, doce sospechosos y una mente privilegiada en busca de la verdad.
vino di datteri mi versò.
c'è chi ne è vinto e non torna più.
guarda bene quello biondo laggiù in fondo.
lesse un libro fino all'alba in silenzio.
col suo saluto mi risvegliò.
la mia casa avrei rivisto non da solo.
dal suo fianco mi spostai.


text:
Learning Collaboratives
HCBS Clearinghouse
Stories from the Field Contest
Environmental Scan.
The rapid expansion of Medicaid managed long term services and supports (MLTSS) and other efforts to integrate healthcare and long-term services and supports is creating new, exciting and yet challenging opportunities for CBOs seeking to work within these new program designs. These new approaches mean that CBOs need to think differently about the services they offer, the customers they serve, and the way they demonstrate the value they add to services and supports. Instead of contracting directly with government funders, CBOs are now negotiating contracts with hospitals, health systems, accountable care organizations (ACOs), health plans, and other integrated care entities.
To understand the needs of the disability network community, the HCBS Business Acumen Center conducted an environmental scan of the business acumen of the disability network from April 2017 through May 2017.
Responses were solicited from the following three categories, each with its own unique survey:
Community Based Organizations (CBOs).
Managed Care Organizations (MCOs), Accountable Care Organizations (ACOs), and other healthcare and long-term services and supports payers.
States currently operating or planning to implement a managed long-term services and supports (MLTSS) program.
See the categories below to view highlights from the environmental scan results:
WHO rESPONDED TO THE
ENVIRONMENTAL SCAN
Familiarity with Integrated
 care terminology
Experience working with
integrated health care entities
Importance and Current Skill
Level in Key Business Areas
Who Responded
Of the 474 CBOs who responded, the majority or responses came from Centers for Independent Living, Developmental Disability Organizations and Behavioral Health Organizations. Please note that our target was disability organizations with some overlap with aging organizations. In addition to our resource center, there is another ACL funded business acumen resource center that focuses more on aging organizations. View the "Who Responded" bar graph displayed below in plain text.
Familiarity with Integrated Care Terminology
How familiar are CBOs with integrated care terminology?
50% or more of the respondents were not familiar to somewhat familiar with the following concepts. View the "Familiarity with Integrated Care Terminology" table displayed below in plain text.
To improve CBO familiarity in this area, we hosted a webinar entitled, "Are We Saying the Same Thing? The Language of Long Term Services and Supports and Managed Care".
Experience Working with Integrated Health Care Entities
Do organizations have experience with contracting and negotiating with integrated care entities?
58.9% of CBOs reported that they have no experience contracting or negotiating with integrated care entities. View the "Experience with Contracting and Negotiating with Integrated Care Entities" pie chart displayed below in plain text.
Has the shift towards MLTSS changed organizations' capacity to provide services?
65.9% of Centers for Independent Living said that the shift towards MLTSS in their state did NOT change their organization's capacity to provide services; whereas 68.2% of Developmental Disability Organizations said that it did change their capacity to provide services.
View the Centers' for Independent Living capacity to provide services with the shift towards MLTSS pie chart displayed below in plain text.
View the Developmental Disability Organizations' capacity to provide services with the shift towards MLTSS pie chart displayed below in plain text.
Centers for Independent Living:
Developmental Disability Organizations:
Centers for Independent Living (CILs) reported that the shift toward MLTSS has helped them to build relationships with their managed care organization and build better supports for consumers with more complex needs. CILs are continuing to build capacity to contract with payers and providers, however, they continue to report concerns that the shift toward MLTSS causes actual and philosophical challenges due to attention on medical needs. Developmental Disability Organizations expressed concerns about changes in utilization, rates, and operational issues such as obtaining authorizations. However, they reported a desire to stay competitive and are willing to explore new opportunities to develop new services.
Importance and Current Skill Level in Key Business Areas
What factors contributed to unsuccessful attempts to partner with integrated health care entities?
CBOs report that unsuccessful attempts to partner with integrated health care entities are often a result of the perception that they don't add value to that organization and/or that they don't have the data to substantiate their value.
View the factors reported by Centers for Independent Living that contributed to unsuccessful attempts to partner with integrated health care entities pie chart displayed below in plain text.
View the factors reported by Developmental Disability Organizations that contributed to unsuccessful attempts to partner with integrated health care entities pie chart displayed below in plain text.
Developmental Disability Organizations
To improve knowledge of how CBOs may maximize partnerships with health plans, we hosted a webinar entitled, "Are They Buying What You're Selling? An Inside Look at What Health Plans Need from Community Based Organizations".
What are CBOs current skill levels in articulating their value?
65.3% of CBOs said that the ability to articulate their value to potential payers was very important; however only 18.8% said that their demonstrated capability to articulate their value was very strong. View the "CBOs Current Skill Levels in Articulating their Value" table displayed below in plain text.
What skills and expertise did community-based organizations, managed care organizations, and states report as most important when modernizing the delivery of care and services? View the "skills and expertise reported as most important" table displayed below in plain text.


The SC Brandenburg e. V. is a public club that offers a broad range of sports activities to its 650+ members.
Our Badminton department consists of 190 members of all age groups (6 - 70 years old). Training and free paly hours are offered to players in all experience levels; from recreational to competive players.


text:
'use babel';

const Promise = require('bluebird');
const readdir = Promise.promisify(require('fs').readdir);
const path = require('path');
const fuzzaldrin = require('fuzzaldrin');
const escapeRegExp = require('lodash.escaperegexp');
const internalModules = require('./internal-modules');

class CompletionProvider {
  constructor() {
    this.selector = '.source.js .string.quoted, .source.coffee .string.quoted';
    this.disableForSelector = '.source.js .comment, source.js .keyword';
    this.inclusionPriority = 1;
  }

  getSuggestions({editor, bufferPosition, prefix}) {
    const line = editor.getTextInRange([[bufferPosition.row, 0], bufferPosition]);
    if (!/require|import/.test(line)) {
      return [];
    }

    const realPrefixRegExp = new RegExp(`['"]((?:.+?)*${escapeRegExp(prefix)})`);
    try {
      const realPrefixMathes = realPrefixRegExp.exec(line);
      if (!realPrefixMathes) {
        return [];
      }

      const realPrefix = realPrefixMathes[1];

      if (realPrefix[0] === '.') {
        return this.lookupLocal(realPrefix, path.dirname(editor.getPath()));
      }

      return this.lookupGlobal(realPrefix);
    } catch (e) {
      return [];
    }
  }

  filterSuggestions(prefix, suggestions) {
    return fuzzaldrin.filter(suggestions, prefix, {
      key: 'text'
    });
  }

  lookupLocal(prefix, dirname) {
    let filterPrefix = prefix.replace(path.dirname(prefix), '').replace('/', '');
    if (filterPrefix[filterPrefix.length - 1] === '/') {
      filterPrefix = '';
    }
    const lookupDirname = path.resolve(dirname, prefix).replace(new RegExp(`${filterPrefix}$`), '');

    return readdir(lookupDirname).filter((filename) => {
      return filename[0] !== '.';
    }).map((pathname) => {
      return {
        text: this.normalizeLocal(pathname),
        displayText: pathname,
        type: 'package'
      };
    }).then((suggestions) => {
      return this.filterSuggestions(filterPrefix, suggestions);
    }).catch((e) => {
      if (e.code !== 'ENOENT') {
        throw e;
      }
    });
  }

  normalizeLocal(filename) {
    return filename.replace(/\.(js|es6|jsx|coffee)$/, '');
  }

  lookupGlobal(prefix) {
    const projectPath = atom.project.getPaths()[0];
    if (!projectPath) {
      return [];
    }

    const nodeModulesPath = path.join(projectPath, 'node_modules');
    if (prefix.indexOf('/') !== -1) {
      return this.lookupLocal(`./${prefix}`, nodeModulesPath);
    }

    return readdir(nodeModulesPath).then((libs) => {
      return libs.concat(internalModules);
    }).map((lib) => {
      return {
        text: lib,
        type: 'package'
      };
    }).then((suggestions) => {
      return this.filterSuggestions(prefix, suggestions);
    }).catch((e) => {
      if (e.code !== 'ENOENT') {
        throw e;
      }
    });
  }
}

module.exports = CompletionProvider;

redpajama_set_name: RedPajamaGithub


text:
Cd projekt red articles
GOG Galaxy 2.0: Breaking down CD Projekt's universal game launcher
Access your entire game library from one location
By Cohen Coberly, July 10, 2019, 6:03 AM 22 comments
More than 20 million copies of The Witcher 3 have been sold to date
Across all platforms
By Cohen Coberly, June 12, 2019, 4:01 PM 15 comments
Cyberpunk 2077: Everything we've learned at E3
RTX support, non-lethal playthroughs, and more confirmed at E3 2019
The Witcher 3: Wild Hunt is getting a Nintendo Switch port this year
Take CD Projekt Red's epic RPG with you on the go
By Cohen Coberly, June 11, 2019, 1:32 PM 6 comments
Cyberpunk 2077 gets April 2020 release date, check out the E3 2019 cinematic trailer
Coming April 16, 2020, featuring Keanu Reeves
By Cohen Coberly, June 9, 2019, 5:31 PM 19 comments
CD Projekt's 'GOG Galaxy 2.0' client will bring all of your PC games, achievements, and friends into one place
You can sign up for the closed beta now
By Cohen Coberly, May 23, 2019, 2:38 PM 14 comments
Geralt of Rivia falls into Monster Hunter: World next month
Hey! You got your monster hunter in my Monster Hunter
By Cal Jeffrey, April 9, 2019, 12:56 PM
CD Projekt Red will release two AAA games by 2021, employee confirms
One is Cyberpunk 2077, the other is a mystery
By Cohen Coberly, March 21, 2019, 2:51 PM 8 comments
Lady Gaga rumored to appear in Cyberpunk 2077
Cyberpunk Face
By Rob Thubron, March 14, 2019, 9:53 AM 8 comments
Cyberpunk 2077 to appear at E3 2019
Will Cyberpunk 2077 drop by the end of 2019?
By Shawn Knight, March 1, 2019, 10:59 AM
Good Old Games is killing off its 'Fair Price Package' regional pricing program
Bad news for non-North American users
By Cohen Coberly, February 26, 2019, 3:12 PM 7 comments
GOG lays off 10% of its staff, reportedly over financial problems
Is the Epic Games Store having an effect?
By Rob Thubron, February 26, 2019, 8:08 AM 7 comments
Over 400 developers are working on Cyberpunk 2077
CD Projekt Red says the game is still on schedule, which means it could arrive anytime before 2021
By Cal Jeffrey, February 5, 2019, 1:32 PM 10 comments
Cyberpunk 2077 sets its sights on Red Dead Redemption 2 as game to beat
A tough challenge ahead
By Isaiah Mayersen, November 25, 2018, 6:19 AM 8 comments
Sales of Thronebreaker: The Witcher Tales fail to meet CD Projekt's expectations
Despite being a great game
By Rob Thubron, November 16, 2018, 6:49 AM
CD Projekt reveals another little-known Witcher fact: the ghost ship
Many players are still unaware of the ghostly vision
By Rob Thubron, October 18, 2018, 8:47 AM
Witcher author demands an extra $16 million from CD Projekt for rights to license, company refuses
A difficult quest for Andrzej Sapkowski
By Rob Thubron, October 2, 2018, 9:26 AM 19 comments
Pre-orders for CD Projekt Red's standalone Gwent-themed RPG 'Thronebreaker' are now open
The game costs $29.99, and it launches on October 23
By Cohen Coberly, September 27, 2018, 5:40 PM
Gwent's massive 'Homecoming' overhaul launches October 23, alongside 'Thronebreaker' singleplayer campaign
Gwent is about to get a lot better
Cyberpunk 2077's 48-minute gameplay demo has hit the web
See the long-awaited game in action for the first time
By Cohen Coberly, August 27, 2018, 1:15 PM 19 comments
Cyberpunk 2077 previewed at Gamescom, and the game sounds awesome
Can the game live up to the hype?
By Cohen Coberly, August 23, 2018, 3:05 PM 8 comments
CD Projekt Red says there will be a new Witcher game
But it won't be The Witcher 4
By Rob Thubron, July 12, 2018, 6:32 AM
We could be waiting a few more years for Cyberpunk 2077
The E3 demo was in a pre-alpha state
By Rob Thubron, June 28, 2018, 7:59 AM 8 comments
Why is Cyberpunk 2077 taking so long? An interview with CD Projekt Red's co-founder
That spectacular E3 demo and when we'll see the game again
By Jason Schreier, June 20, 2018, 4:16 PM 13 comments
Cyberpunk 2077 will be a FPP RPG with classless character progression, wallrunning and more
Cyberpunk 2077 is shaping up to be one of the best games at E3
680K+ sign up to participate in Area 51 raid to "see them aliens"
AMD on Ryzen 3000 overclocking: "You're not going to see a whole lot of manual OC headroom"
Apple put a slower SSD in the 2019 MacBook Air to trim costs