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Designer Dishes on Quvenzhané Wallis' Oscar Dog Purse
What do you do when you find out one of your company's biggest fans is headed to the red carpet at the Oscars?
Well, if you're Poochie & Co., the makers of Quvenzhané Wallis' ubiquitous doggie purses, you set to work frantically designing a custom purse just for the occasion.
And that's exactly what Leslie Palmer and her team did. She is the division president of Poochie & Co., which is owned by Cudlie Accessories, a 45-year-old, family-owned company based in New York.
When Palmer found out Wallis, the young star of the film "Beasts of the Southern Wild," was going to the Oscars, the designer scrambled to manufacture a one-of-a-kind Poochie bag befitting the occasion in time for the awards.
Wallis has long been a fan of Poochie & Co.'s doggie purses and has been seen carrying them in nearly every one of her public appearances this season. But, the Oscars are different, and Palmer wanted the actress to have an extra-special purse that coordinated with her gown.
"Then I discussed with her mother making a special one for the red carpet," Palmer told BusinessNewsDaily. The designer found out which colors Wallis was considering wearing to the Oscars and made a purse for each palette. Palmer chose a Yorkie because Wallis' family has a pet Yorkie.
Palmer, whose company sells to major retailers throughout the United States, said she's never done anything like this before. She said she had a week to design the custom pooch and had to keep a sample-maker working in China through Chinese New Year to get it done.
Once the purses arrived, Palmer hand sewed the tiara and the tutu on the purse herself.
The extra effort paid off. Poochie is now practically a household name, and the company's web site and Facebook page have been inundated by Wallis wannabe's clamoring for Yorkie purses of their own.
Poochie is currently sold out, but more purses are on order, and the company expects to be back in stock at the end of April or beginning of May. And, yes, a mass-produced version of Wallis' Yorkie purse will be available soon, too.


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What every physician needs to know:
A Central Sleep Apnea (CSA) is defined as a cessation of breathing of at least ten seconds duration in the absence of a ventilatory drive. This is in contrast with Obstructive Sleep Apnea, where the ventilatory drive persists but airflow ceases because of the obstruction of the upper airway. Central Sleep Apneas can be a normal occurrence or can have a pathologic etiology.
Central Sleep Apnea Syndrome (CSAS) is most commonly defined as the presence of five or more central apneas per hour of sleep.
It is commonly linked to an underlying disorder, such as congestive heart failure, stroke, renal failure, brainstem lesions or malformations (e.g., Arnold Chiari malformation), narcotic use, and endocrine disorders like hypothyroidism and acromegaly. It is important to look for such disorders, as treatment of the underlying condition will frequently result in improvement in the CSA.
CSA can be a normal occurrence during sleep when it occurs during the transition from wakefulness to sleep or after an arousal from sleep.
The International Classification of Sleep Disorders (ICSD) classifies CSA disorders into several types, some with known pathophysiology and others with unclear mechanisms:
Idiopathic CSA: This is a rare disorder of unclear etiology. It is a diagnosis of exclusion, as other causes of central sleep apnea noted below are excluded. It occurs most commonly in older males.
Cheyne-Stokes Respiration (CSR): CSR is a breathing pattern characterized by cycles of crescendo-decrescendo changes in tidal volume followed by central sleep apneas. A complete cycle of apnea, hypopnea, hyperpnea, and hypopnea leading to the next apnea usually takes about 45 seconds but may be longer. At least ten consecutive minutes of these cycles should be recorded before CSR can be diagnosed.
CSA that is due to a drug or substance: CSA has been documented in 30 percent of people who take narcotics.
High Altitude Periodic Breathing: Characterized by periods of central apnea or hypopnea cycling with periods of hyperpnea during sleep on ascent to high altitudes, high altitude periodic breathing occurs in virtually everyone at altitudes higher than 7600 meters.
CSA that is due to a medical condition other than Cheyne-Stokes: CSA without CSR occurs in persons with an underlying medical condition like vascular, neoplastic, degenerative demyelinating or traumatic injury to the brainstem; brainstem malformation, such as Arnold Chiari; myopathies; endocrine disorders, such as hypothyroidism or acromegaly; and renal failure.
Primary CSA of the Newborn (not discussed here)
Are you sure your patient has central sleep apnea syndrome? What should you expect to find?
Symptoms of CSA symptoms are similar to symptoms of other sleep-disordered breathing: mainly fragmented sleep with frequent awakenings, unrefreshing sleep, fatigue, sleepiness, snoring, sleep onset or sleep maintenance insomnia, and poor concentration. Some patients with CSA can also be asymptomatic.
Beware: there are other diseases that can mimic central sleep apnea syndrome:
The main differential diagnosis of CSA syndrome is the much more prevalent obstructive sleep apnea syndrome. The two disorders can have similar presenting symptoms, but they have different underlying pathophysiologies. Obstructive sleep apnea primarily results from collapse of the upper airway, resulting in cessation or decrease in airflow despite continuous and even increased respiratory muscle effort. In contrast, CSA and hypopnea result from a cessation or decrease in the respiratory effort and respiratory drive, leading to the drop in airflow with a usually patent airway.
The only way to differentiate between the two is to perform an overnight polysomnogram during which both airflow and chest and abdominal respiratory efforts are recorded. A more sensitive way to measure respiratory efforts is by inserting an esophageal pressure probe during the polysomnography to measure intrathoracic pressure swings. However, this procedure is rarely done outside of research labs.
How and/or why did the patient develop central sleep apnea syndrome?
The pathophysiology of altitude induced CSA, CSA/CSR in heart failure, and possibly idiopathic CSA is thought to be due to hyperventilation during wakefulness with resultant hypocapnia (caused by different known or unknown factors in each disorder) that leads to central apneas during sleep.
To understand this pathophysiology, one must understand the normal control of ventilation. During wakefulness, ventilation is controlled by multiple parameters:
the wakefulness respiratory drive
emotional, behavioral and volitional cues
central and peripheral chemoreceptors
Peripheral chemoreceptors, which are located mainly in the carotid body, sense oxygen concentration and carbon dioxide concentrations, while central receptors, which are located in the medulla, sense changes in carbon dioxide. The ventilatory response is normally much more sensitive to carbon dioxide changes (which are maintained in a very tight range) than to changes in oxygen level, which have to vary much more to elicit a change in ventilation.
During sleep, there is a loss of the wakefulness drive to breathe and the emotional, volitional and behavioral inputs. Therefore, chemoreceptors become the main regulators of breathing, with the carbon dioxide level as the main stimulus. Sleep onset unmasks the apnea threshold, which is the carbon dioxide level below which the ventilatory drive ceases.
Patients with the CSA syndromes mentioned above have a relative hypocapnia while awake, which means that, when they fall asleep, their CO2 level is below the apneic threshold, and that generates a central sleep apnea event.
The reason for the hypocapnia is different in each disorder. In idiopathic CSA, the cause is not known, but it is thought to be due to an acquired increased sensitivity of the chemoreceptors.
In high altitude CSA, the hypoxia present at high altitude is thought to lead to hyperventilation and resultant hypocapnia.
In congestive heart failure, it is thought that the elevated left-side pressures result in some pulmonary congestion and stimulate pulmonary vagal afferent C fibers, which in turn stimulate respiration and drive the CO2 down. This generates central sleep apneas during sleep because of the unmasking of the apneic threshold. The typically long cycle time and alternation between central sleep apnea and hyperventilation typically seen in Cheyne Stokes breathing in congestive heart failure is a direct result of the prolonged circulation time that occurs in these patients. The change in circulating CO2 levels takes more time to reach the central chemoreceptors, which results in constant overshooting of the target CO2 levels and leads to cycles of central sleep apneas followed by crescendo-decrescendo ventilation.
In opioid-related CSA, there is a direct effect of the medication on the central respiratory centers thought to be mediated by the opioid μ receptor. This effect results in blunting of the respiratory drive. Opioids also change the chemoreceptor sensitivity by blunting the hypercapnic drive. The effect on the hypoxic drive has been controversial, with some studies showing blunting and others showing increased sensitivity to hypoxia.
Strokes and other neurologic disorders are thought to decrease respiratory drive by directly affecting the brainstem respiratory centers.
The mechanism for CSA in hypothyroidism and acromegaly is not known.
Which individuals are at greatest risk of developing central sleep apnea syndrome?
Risk Factors for CSA include:
Congestive Heart failure: 25-40 percent of patients with heart failure develop CSA/CSR.
Ascent to high altitude
Stroke patients: 10-28 percent of stroke patients have been reported to have CSA.
Narcotic use: 30 percent of opioid users develop CSA.
Age: CSA is more prevalent in older individuals.
Gender: Male hormones elevate the apneic threshold closer to eupneic levels and make males are more susceptible than females to developing CSA. In the general population, women's relative chance of developing CSA is 0.04 (95%, p=0.05).
Other medical conditions, including Arnold Chiari malformation, hypothyroidism, acromegaly, renal failure, myopathies, neurodegenerative disorders, brainstem disorders, and atrial fibrillation in CHF
What laboratory studies should you order to help make the diagnosis, and how should you interpret the results?
Three laboratory values can be useful in looking for conditions associated with CSA and determining the etiology of the disorder: serum TSH, serum creatinine, and serum or arterial carbon dioxide levels.
What imaging studies will be helpful in making or excluding the diagnosis of central sleep apnea syndrome?
If a central nervous system disorder is suspected, brain imaging can be useful in ruling out disorders like Arnold Chiari malformation, demyelinating diseases, and tumors.
An echocardiogram should be ordered to evaluate heart function in patients with Cheyne Stokes respiration in particular but also in those with otherwise unexplained CSA.
What non-invasive pulmonary diagnostic studies will be helpful in making or excluding the diagnosis of central sleep apnea syndrome?
No non-invasive pulmonary diagnostic studies are helpful in making or excluding the diagnosis of CSA syndrome.
What diagnostic procedures will be helpful in making or excluding the diagnosis of central sleep apnea syndrome?
An overnight polysomonogram (PSG), the gold standard for the diagnosis of CSA, should be ordered in all patients. The PSG will help differentiate CSA from the more common obstructive sleep apnea, which can have a very similar presentation.
What pathology/cytology/genetic studies will be helpful in making or excluding the diagnosis of central sleep apnea syndrome?
No pathology/cytology/genetic studies are helpful in making or excluding the diagnosis of CSA syndrome.
If you decide the patient has central sleep apnea syndrome, how should the patient be managed?
The goal of treatment in CSA is to normalize breathing patterns during sleep and to improve symptoms. With the exception of CSA/CSR in CHF, there is little long-term prognostic data about the different CSA syndromes, so symptomatic improvement is the most important goal.
Idiopathic Central Sleep Apnea: Because this is a rare disorder, there is little data on treatment, and available data is mostly derived from small series. After the diagnosis is made, a trial of CPAP is warranted that may result in improvement of the AHI in some patients. If this trial is not effective, supplemental oxygen can be attempted. A small series showed improvement in the AHI with the administration of oxygen by nasal cannula at 2 to 4 L/min. However, this approach is not uniformly successful. Other treatments that have been tried with variable success include acetazolamide administration, inhaled CO2, and zolpidem administration.
Cheyne-Stokes Respiration (CSR) and CSA associated with CHF: In comparison with the other types of CSA, when associated with CHF, CSA and CSR portend a worse prognosis. There is emerging data that treatment of CSA/CSR in CHF can improve cardiac function, quality of life, and transplant-free survival.
The mainstay of therapy in CHF is medical optimization of the underlying heart condition. If CSA persists despite optimized medical therapy for CHF, therapy with positive airway pressure (PAP) ventilation should be initiated. PAP therapy in CHF was first studied in the form of CPAP. An initial randomized controlled study performed in Canada showed no change in survival and possible harm with CPAP use, but in a post hoc analysis the subgroup of patients who had an effective reduction in AHI with CPAP appeared to have an improvement in transplant-free survival.
Another form of PAP has been better studied in CSA/CSR with CHF: adaptive servoventilation (ASV). ASV devices evaluate the patient's breathing pattern on a breath-to-breath basis and aim to maintain stable ventilation by varying the amount of pressure support and ventilatory rate support delivered. This approach is intended to stabilize the circulating CO2 levels and reduce both central apneas and ventilatory overshoots.
ASV has been shown to control CSA and CSR better than CPAP and to improve left ventricular ejection fraction, quality of life, and in some studies, six-minute walk distance. Therefore, it is reasonable to recommend treatment with ASV after an overnight titration study is done. However, some guidelines still require that failure of CPAP be demonstrated before ASV is initiated.
Other treatments of CSA/CSR include supplemental oxygen if other treatments have failed. Although theophylline and acetazolamide have been shown in small case series to improve CSA in CHF, their use cannot be recommended at this time. There are anecdotal reports that cardiac resynchronization therapy can result in improvement of CSA in CHF patients. Cardiac valve replacement in patients with CHF secondary to valvular disease is associated with an improved AHI.
Central Sleep Apnea that is due to a drug or substance, most commonly opioid medications: The mainstay of treatment is to discontinue or reduce the dose of narcotics used, which usually eliminates CSA. However. when this approach is not possible or is ineffective, treatment with PAP should be attempted using an overnight titration study. CPAP is not always effective, and it often fails to result in normalization of the AHI. In these cases, treatment with bilevel PAP with a back-up rate or ASV have been reported with variable success.
High Altitude Periodic Breathing: The best treatment for high-altitude-induced periodic breathing is to descend to sea level or to a lower altitude. Acetazolamide, supplemental oxygen and temazepam have also been reported to improve this condition.
Central Sleep Apnea that is due to a medical condition other than Cheyne-Stokes: Treatment if the underlying condition is the mainstay of treatment. Otherwise, the PAP therapies described above could be used.
What is the prognosis for patients managed in the recommended ways?
With the exception of CSA/CSR in congestive heart failure, there is no long-term data regarding the prognosis for the different types of CSA syndromes. Therefore, therapy is aimed at relieving symptoms.
In congestive heart failure, the presence of CSA/CSR portends a poor prognosis. Treatment with CPAP, when effective in reducing the AHI, can improve ejection fraction and transplant-free survival, but there is no definite proof for improved overall mortality rates.
Treatment with ASV can improve quality of life, hemodynamic parameters like left ventricular ejection fraction, and exercise capacity. There is no evidence of a mortality benefit.
What other considerations exist for patients with central sleep apnea syndrome?
No other considerations exist for patients with central sleep apnea syndrome.
What's the evidence?
Dempsey, JA. "Crossing the apnoeic threshold: causes and consequences". Exp Physiol. vol. 90. 2005. pp. 13-24. Review of the physiology of the control of breathing during non-REM sleep and the role of the apnea threshold in generating a central sleep apnea.
Javaheri, S. "Sleep disorders in systolic heart failure: a prospective study of 100 male patients. The final report". Int J Cardiol. vol. 106. 2006. pp. 21-8. Prospective review of one hundred consecutive patients with heart failure showing a prevalence of CSA of 37 percent.
Oldenburg, O, Lamp, B, Faber, L, Teschler, H, Horstkotte, D, Topfer, V. "Sleep-disordered breathing in patients with symptomatic heart failure: a contemporary study of prevalence in and characteristics of 700 patients". Eur J Heart Fail. vol. 9. 2007. pp. 251-7. Large prospective study of seven hundred patients with heart failure who were on medical therapy, including ACE inhibitors and beta blockers, and who underwent screening sleep studies. The prevalence of CSA was found to be 40 percent. Patients with CSA had more severe disease.
Nopmaneejumruslers, C, Kaneko, Y, Hajek, V, Zivanovic, V, Bradley, TD. "Cheyne-Stokes respiration in stroke: relationship to hypocapnia and occult cardiac dysfunction". Am J Respir Crit Care Med. vol. 171. 2005. pp. 1048-52. Prospective study of 93 patients who had had a stroke. CSA was found to be associated with hypocapnia and occult cardiac dysfunction, but not with the location or type of stroke.
Sin, DD, Fitzgerald, F, Parker, JD, Newton, G, Floras, JS, Bradley, TD. "Risk factors for central and obstructive sleep apnea in 450 men and women with congestive heart failure". Am J Respir Crit Care Med. vol. 160. 1999. pp. 1101-6. Observational study of 450 patients with heart failure referred to a sleep center. CSA was associated with male gender, age greater than sixty years, atrial fibrillation, and hypocapnia during wakefulness.
Hanly, PJ, Zuberi-Khokhar, NS. "Increased mortality associated with Cheyne-Stokes respiration in patients with congestive heart failure". Am J Respir Crit Care Med. vol. 153. 1996. pp. 272-6. Prospective study of sixteen male patients with chronic CHF who underwent a polysomongram. Nine were found to have nocturnal Cheyne Stokes Respiration (CSR), and these nine had a higher mortality rate over a 3.1-4.5-year follow-up than did the group of patients who did not have CSR.
Lanfranchi, PA, Braghiroli, A, Bosimini, E. "Prognostic value of nocturnal Cheyne-Stokes respiration in chronic heart failure". Circulation. vol. 99. 1999. pp. 1435-40. Prospective study of 62 patients with CHF followed for 28 months plus or minus 13 months that found that the AHI in CSR, as well as the left atrial area, were powerful independent predictors of mortality.
Sin, DD, Logan, AG, Fitzgerald, FS, Liu, PP, Bradley, TD. "Effects of continuous positive airway pressure on cardiovascular outcomes in heart failure patients with and without Cheyne-Stokes respiration". Circulation. vol. 102. 2000. pp. 61-6. Randomized controlled study of 66 patients with CHF with and without CSR who received CPAP or were assigned to a control arm. CPAP treatment improved LVEF in patients with CSR but not in those without CSR. There was a suggestion that CPAP could reduce the combined mortality-cardiac transplantation rate in those CHF patients with CSR-CSA who comply with therapy.
Pepperell, JC, Maskell, NA, Jones, DR. "A randomized controlled trial of adaptive ventilation for Cheyne-Stokes breathing in heart failure". Am J Respir Crit Care Med. vol. 168. 2003. pp. 1109-14. Thirty patients with CHF with CSR were randomized to adaptive servo ventilation (ASV) treatment or subtherapeutic ASV treatment. The therapeutic ASV arm showed improvement in excessive daytime sleepiness, circulating brain natriuretic peptide, and secretion of urinary metadrenaline.
Philippe, C, Stoica-Herman, M, Drouot, X. "Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne-Stokes respiration in heart failure over a six month period". Heart. vol. 92. 2006. pp. 337-42. Twenty-five patients with CHF and CSA-CSR were randomly assigned to ASV or CPAP. ASV was better at normalizing the AHI. At six months, compliance and improvement in quality of life were higher with ASV, and only ASV induced a significant increase in LVEF.
Andreas, S, Weidel, K, Hagenah, G, Heindl, S. "Treatment of Cheyne-Stokes respiration with nasal oxygen and carbon dioxide". Eur Respir J. vol. 12. 1998. pp. 414-9. Cross-over, single-blind, placebo-controlled trial of nine patients with CHF and CSA-CSR: nocturnal O2 plus CO2 improved Cheyne-Stokes respiration but increased sympathetic activation.
Javaheri, S, Parker, TJ, Wexler, L, Liming, JD, Lindower, P, Roselle, GA. "Effect of theophylline on sleep-disordered breathing in heart failure". N Engl J Med. vol. 335. 1996. pp. 562-7. Small cross-over, placebo-controlled series of fifteen men with CHF and CSR who received theophylline or placebo for five days. Theophylline therapy reduced the number of episodes of apnea and hypopnea and the duration of arterial oxyhemoglobin desaturation during sleep.
Hanly, PJ, Millar, TW, Steljes, DG, Baert, R, Frais, MA, Kryger, MH. "The effect of oxygen on respiration and sleep in patients with congestive heart failure". Ann Intern Med. vol. 111. 1989. pp. 777-82. Randomized, single-blind, placebo-controlled crossover study of nine patients with heart failure and CSR who received oxygen at 2-3L/min. Nocturnal oxygen therapy reduced Cheyne-Stokes respiration, corrected hypoxemia, and consolidated sleep by reducing arousals caused by the hyperpneic phase of Cheyne-Stokes respiration.
Lorenzi-Filho, G, Rankin, F, Bies, I, Douglas Bradley, T. "Effects of inhaled carbon dioxide and oxygen on Cheyne-Stokes respiration in patients with heart failure". Am J Respir Crit Care Med. vol. 159. 1999. pp. 1490-8. Small prospective study of ten patients with CHF and CSR showing that inhalation of CO2 increased circulating CO2 levels and reversed central apneas.
Javaheri, S. "Acetazolamide improves central sleep apnea in heart failure: a double-blind, prospective study". Am J Respir Crit Care Med. vol. 173. 2006. pp. 234-7. Double-blind cross-over study of twelve male patients with CHF and CSA given acetazolamide or placebo prior to an overnight polysomnogram. Acetazolamide significantly improved CSA and related daytime symptoms.
Bradley, TD, Logan, AG, Kimoff, RJ. "Continuous positive airway pressure for central sleep apnea and heart failure". N Engl J Med. vol. 353. 2005. pp. 2025-33. CANPAP study: Randomized controlled study of 258 patients with CHF and CSA randomized to CPAP therapy or no therapy. Although CPAP improved central sleep apneas, nocturnal oxygenation, ejection fraction, and six-minute walk distances, there were no differences between the control group and the CPAP group in terms of the number of hospitalizations, the quality of life, or atrial natriuretic peptide levels. An early divergence in survival rates without heart transplantation favored the control group, but after eighteen months the divergence favored the CPAP group so the overall event rates (death and heart transplantation) did not differ. There was no evidence of improved survival with CPAP.
Arzt, M, Floras, JS, Logan, AG. "Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure: a post hoc analysis of the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure Trial (CANPAP)". Circulation. vol. 115. 2007. pp. 3173-80. This was a post-hoc analysis of the CANPAP study that divided a group of patients on CPAP into those who had an adequate suppression of the central apneas with CPAP to an AHI lower than 15 and those who did not. The two groups were compared them to a control arm. Despite similar CPAP pressure and hours of use in the two test groups, CPAP-CSA-suppressed subjects experienced a greater increase in left ventricular ejection fraction at three months (P=0.001) and significantly better transplant-free survival (hazard ratio at 95% confidence interval 0.371 [0.142 to 0.967], P=0.043) than control subjects did, whereas the CPAP-CSA-unsuppressed group did not (for left ventricular ejection fraction, P=0.984, and for transplant-free survival, hazard ratio 1.463 [95% confidence interval 0.751 to 2.850], P=0.260).
Kasai, T, Usui, Y, Yoshioka, T. "Effect of flow-triggered adaptive servo-ventilation compared with continuous positive airway pressure in patients with chronic heart failure with coexisting obstructive sleep apnea and Cheyne-Stokes respiration". Circ Heart Fail. vol. 3. 2010. pp. 140-8. Randomized study of 31 patients with CHF and CSR who were randomized to be treated with CPAP or ASV. ASV resulted in significantly better control of the respiratory events, improved quality of life, and improved left ventricular ejection fraction than CPAP did.
Leung, RS, Huber, MA, Rogge, T, Maimon, N, Chiu, KL, Bradley, TD. "Association between atrial fibrillation and central sleep apnea". Sleep. vol. 28. 2005. pp. 1543-6. Observational study that compared the prevalence of atrial fibrillation in sixty consecutive patients with idiopathic CSA, sixty patients with obstructive sleep apnea and sixty patients without sleep apnea (apnea-hypopnea index < 10), matched for age, sex, and body mass index. The prevalence was found to be much higher in idiopathic CSA than in the other two groups (27%, 1.7%, and 3.3%, respectively, P < .001).
Parra, O, Arboix, A, Bechich, S. "Time course of sleep-related breathing disorders in first-ever stroke or transient ischemic attack". Am J Respir Crit Care Med. vol. 161. 2000. pp. 375-80. Prospective study of 161 patients with acute stroke. In the acute phase, there was a high prevalence of both obstructive and central apneic events. as well as Cheyne-Stokes respiration. Three months later the central events improved spontaneously, but the obstructive events remained unchanged, suggesting that OSA might have predated the stroke, whereas the central apneas might have been caused by the stroke.
Wang, D, Teichtahl, H, Drummer, O. "Central sleep apnea in stable methadone maintenance treatment patients". Chest. vol. 128. 2005. pp. 1348-56. Prospective study of fifty patients on a stable methadone program compared to matched controls. Methadone patients had a prevalence of central sleep apnea of 30 percent versus 0 percent in the control group.
Javaheri, S, Malik, A, Smith, J, Chung, E. "Adaptive pressure support servoventilation: a novel treatment for sleep apnea associated with use of opioids". J Clin Sleep Med. vol. 4. 2008. pp. 305-10. Small case study of five patients on chronic opioids with sleep-disordered breathing who failed CPAP because of an increase in central events. ASV resulted in a significant reduction in both central and obstructive events.
Farney, RJ, Walker, JM, Boyle, KM, Cloward, TV, Shilling, KC. "Adaptive servoventilation (ASV) in patients with sleep-disordered breathing associated with chronic opioid medications for non-malignant pain". J Clin Sleep Med. vol. 4. 2008. pp. 311-9. Retrospective review of 22 patients on chronic opioids who underwent titration studies for sleep-disordered breathing with CPAP and ASV. ASV improved obstructive events but not central events or hypopneas. ASV did not improve oxygenation or Biot's breathing.
Luks, AM, van Melick, H, Batarse, RR, Powell, FL, Grant, I, West, JB. "Room oxygen enrichment improves sleep and subsequent day-time performance at high altitude". Respir Physiol. vol. 113. 1998. pp. 247-58. Randomized, double-blind trial of eighteen subjects taken from sea level to 3800 meters of altitude. Supplementation with 24 percent oxygen improved apneas, periodic breathing, and sleep quality.
Nickol, AH, Leverment, J, Richards, P. "Temazepam at high altitude reduces periodic breathing without impairing next-day performance: a randomized cross-over double-blind study". J Sleep Res. vol. 15. 2006. pp. 445-54. A double-blind, randomized, cross-over trial of 33 healthy volunteers who took 10 mg of temazepam and placebo in random order on two successive nights soon after arrival at five thousand meters of altitude, following a seventeen-day trek from 410 meters of altitude. Temazepam significantly reduced periodic breathing and resulted in a 2 percent drop in mean oxygen saturations overnight but did not affect next day performance levels.
Fischer, R, Lang, SM, Leitl, M, Thiere, M, Steiner, U, Huber, RM. "Theophylline and acetazolamide reduce sleep-disordered breathing at high altitude". Eur Respir J. vol. 23. 2004. pp. 47-52. Randomized, double-blind, placebo-controlled study of thirty males at high altitude who were given theophylline, acetazolamide, or placebo. Both theophylline and acetazolamide normalized periodic breathing and improved oxygenation compared to placebo.
Franklin, KA, Eriksson, P, Sahlin, C, Lundgren, R. "Reversal of central sleep apnea with oxygen". Chest. vol. 111. 1997. pp. 163-9. Prospective study of twenty patients with non-hypercapnic central sleep apnea, eighteen with Cheyne-Stokes associated with either heart failure or stroke, and two with idiopathic CSA. Administration of supplemental oxygen significantly reduced the number of central events and related arousals.
Thomas, RJ, Daly, RW, Weiss, JW. "Low-concentration carbon dioxide is an effective adjunct to positive airway pressure in the treatment of refractory mixed central and obstructive sleep-disordered breathing". Sleep. vol. 28. 2005. pp. 69-77. Small series of six patients with mixed obstructive and central apneas without renal or heart failure. Administration of carbon dioxide with CPAP was effective at reducing the treatment-resistant mixed and central events during a titration night with no adverse events reported.
Xie, A, Rankin, F, Rutherford, R, Bradley, TD. "Effects of inhaled CO2 and added dead space on idiopathic central sleep apnea". J Appl Physiol. vol. 82. 1997. pp. 918-26. Increasing PaCO2 by increasing dead space or rebreathing CO2 abolished central apneic events in patients with idiopathic CSA.
Quadri, S, Drake, C, Hudgel, DW. "Improvement of idiopathic central sleep apnea with zolpidem". J Clin Sleep Med. vol. 5. 2009. pp. 122-9. Case series of twenty patients with idiopathic CSA who were treated with zolpidem 10 mg at bedtime. Overnight polysonogram showed a significant reduction in the AHI that was mainly due to a reduction in central events. Subjects also had improved sleep continuity and decreased subjective daytime sleepiness, in the majority of cases without a worsening of oxygenation or obstructive events.
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
- What every physician needs to know:
- Classification:
- Are you sure your patient has central sleep apnea syndrome? What should you expect to find?
- Beware: there are other diseases that can mimic central sleep apnea syndrome:
- How and/or why did the patient develop central sleep apnea syndrome?
- Which individuals are at greatest risk of developing central sleep apnea syndrome?
- What laboratory studies should you order to help make the diagnosis, and how should you interpret the results?
- What imaging studies will be helpful in making or excluding the diagnosis of central sleep apnea syndrome?
- What non-invasive pulmonary diagnostic studies will be helpful in making or excluding the diagnosis of central sleep apnea syndrome?
- What diagnostic procedures will be helpful in making or excluding the diagnosis of central sleep apnea syndrome?
- What pathology/cytology/genetic studies will be helpful in making or excluding the diagnosis of central sleep apnea syndrome?
- If you decide the patient has central sleep apnea syndrome, how should the patient be managed?
- What is the prognosis for patients managed in the recommended ways?
- What other considerations exist for patients with central sleep apnea syndrome?
- What's the evidence?

subset: commoncrawl


text:
Sunday, 27 October 2013
Mix CD: November 2013
Still no baby! Everything's ready for her (including us), but no birth over the weekend. Instead, I made a couple of Mix CDs. Yes, actual, physical CDs. Yes, I still do that sometimes, though it has actually been a couple of years since I've done so. So because it's been so long, I decided to make a double-disc. I also threw out my rule about trying to have only one repeat from previous discs (there are a lot of repeats on these).
For this set I just arranged my collection alphabetically by artist and started at the top. I tried not to use more than 2 songs for any given artist chosen. I got down to the "P" artists before I filled up two discs! I fudged the order a couple of times (Julia Massey shouldn't be on the first disc, for example), but whatever.
So here are the track lists. Wherever possible I tried to link to somewhere where you could download the song, or at least to a place where you can listen to the song. I was actually able to find them all… except for the songs that I wrote myself…
Anyway, enjoy! There are some good stuffs on these:
Disc 1
- Ducktails – Moon by The Advantage
- Black Velvet by Alannah Myles
- Paradise by Ana Laan
- Airbrushed by Anamanaguchi
- All the Same to Me by Anya Marina
- Title Screen Music from the Animal Crossing OST
- Around the Bend by The Asteroids Galaxy Tour
- Search for the Giant Squid by Ballzack
- Draw a Crowd by Ben Folds Five
- Stay the Same by Bonobo with Andreya Triana
- Avantcore by Busdriver
- The Story of the Earth, So Far by Julia Massey & the Five Finger Discount
- The Factory by The Crazy Boy Floyds
- Photograph by Def Leppard
- Mercy by Duffy
- Lazy Bones by Esquivel
- Take Me Out by Franz Ferdinand
- The Frug by Rilo Kiley
- Little Fighter X by Fighter X
- Skeleton by Jimes
- Queen of Wishful Thinking by Saucecore
- Me and My Brother by Ballzack
- Haunted House by The Crazy Boy Floyds
Disc 2
- Spin Around by Josie & The Pussycats
- Spaceships by Julia Massey & The Five Finger Discount
- Take It Like a Man by Kay Hanley
- LonLon Ranch by Koji Kondo
- Awake by Leeni
- Nice Weather for Ducks by Lemon Jelly
- Chemistry by Locust Street Taxi
- Just Another Day from the Lost Viking OST
- Bucky Done Gun by M.I.A.
- Good Morning Moon by Marian Call
- Over and Over by Leeni
- Crashman Stage from Mega Man 2 OST
- Don't Worry 'Bout Us by Julia Massey & The Five Finger Discount
- Daybreak by Michael Haggins
- No Myth by Michael Penn
- Lollipop by Mika
- Zanac – Area 2 by Miyamo Shant
- Taste the Bass by Mono Puff
- Dear Carbon Nanotubes by Locust Street Taxi
- Starry Eyed Surprise by Oakenfold
- Experimental Dream FLCL by Open Mike Eagle
- Things I Think About On Planes by Palmdale


text:
St. Daniel (a.d. 1261-1303) was the youngest son of the celebrated St. Alexander of Nevsky. His father died when Daniel was just two years old. St. Alexander had specified that Daniel would inherit Moscow, then the poorest principality of his, when he came of age in 1272. St. Daniel was wise, humble, peaceful, and fair, and through these means he built up his inheritance in 30 years from a small and unimportant city, to its first rise in prominence for the Russian land. In a short time after his death, it became the central administrative city of a renewed and unified Russian empire.
St. Daniel established the Danilov Monastery in a.d. 1282 on the site of St. Daniel the Stylite's wooden church. By wise use of his resources and inspired rulership, by a.d. 1296 St. Daniel became the Grand Prince of All Russian Lands. Living at a time of Tartar domination and wars between the other Russian princes, St. Daniel brought peace and order to those around him, and consolidated the northern Russian lands. His sons included Yuri of Moscow and Ivan I of Moscow. Before his death at just 42 years old, St. Daniel became a monk, and was buried in Danilov Monastery.


text:
Ultimate X-Men
comic book series
Ultimate X-Men is a superhero comic book published by Marvel Comics, which started in 2001.
The Tomorrow People Edit
Issue 3 Edit
- [Toad jumps on top of Cyclops as he tries to rescue the presidents daughter.]
- Toad: Whoever told you that tight little t-shirt doesn't make you look like the team pansy was lying, Cyclops.
- [He leaps into the air just as Storm and Iceman arrive.]
- Toad: You're next, by the way, you stupid looking american cow.
- Storm: This is for calling me American, you skinny, English jerk!
- [She kicks Toad in the face.]:
- [Jean Grey has just congratulated Wolverine on saving the President's daughter.]
- Wolverine: I'm thinking of a telepathic red-headed 19-year-old. But she's wasting her time with a loser who brushes his teeth six times a day.
Issue 5 Edit
- [Magneto has explained his agenda to Cyclops.]
- Cyclops: You sound like Adolf Hitler.
Return to Weapon X Edit
World Tour Edit
Issue 16 Edit
- Opening caption: Land's End, Scotland.
- [In our universe, Land's End is in Penwith, Cornwall, England]
Issue 17 Edit
- Iceman: What the heck are the Welsh?
- Betsy Braddock: A quaint, little people just west of England, Iceman. Picture the Scots without the sex appeal or the Irish without the laughs and you've pretty much got them nailed.
- Moira McTaggart: The people who fund Charles' work hope that some of them will graduate to the Westchester facility, of course, but I'm afraid that's still a long way off for even the best of them.
- Storm: What do you mean the people fund his work? Xavier told us he paid for the school, the planes, and all the other stuff out of the money his parents left him.
- McTaggart: smirking: Really? Well, that must have been quite an inheritance, Storm. Who did he tell you his mother and father were? Bill and Melinda Gates?
- [Opening Caption, in thundering rain]: Muir Island.
- Storm: [holding an umbrella, looking annoyed] If this is Scotland, it stinks.
Hellfire and Brimstone Edit
Ultimate War Edit
Issue 3 (Ultimate War) Edit
- Captain America: Lets go kick their heads in.
Issue 4 (Ultimate War) Edit
- Storm: You think you can handle this guy all by yourself if I take care of the people outside, Peter?
- Colossus: Do not worry about me, Ororo... Nothing can hurt me when I am in solid steel form. Not even this guy.
Iron Man/Stark: GOD ALMIGHTY!
- Xavier: Beast! Why are we taking a detour through the training arena? We're supposed to be heading for the X-Jet, boy!
- Beast: Just hitting them with everything I can think of, sir! Setting the fight simulator for ninja assassin is our best bet of slowing them down!
- Hawkeye: What the hell?!
- Rabbi-Ninja Hologram: In answer to your question, my young friend, Judaism teaches that the first five books of the Bible were dictated word-for-word by God to his servant Moses.
- (The 'ninja assassin' setting releases katana wielding Orthodox Jews)
- Iron Man/Stark: Get away from me you Neanderthal! Have you any idea how much this armor actually costs?
- Wolverine: Ah, shut up Stark! You can afford it!
Return of the King Edit
- [After Jean Grey blasts the nuclear radiation into the sky]
- Civilian: You guys rule!
- [Jean Grey is confused]
- Jean Grey: I think I felt more comfortable when they were throwing the bricks and bottles at us.
Blockbuster Edit
Issue 35 Edit
- [Wolverine is being stalked by Weapon X assassins]
- Peter Parker: That's who did that to you?
- Wolverine: That is who carved me up.
- [Peter sees innocent-looking diaper vans.]
- Peter Parker: OH MY GOD!! Why are diaper deliverymen trying to kill you?
- [Wolverine and Spidey have just visited Black Widow]
- Spider-Man: She may be the hottest girl I have ever seen in my life, and I have cable!
Issue 37 Edit
- [Wolverine, Daredevil and Spider-Man are in a barrage of machinegun fire.]
- Daredevil: We have to get away from this van!
- Spider-Man: Sundance, you go first!
- Daredevil: Sundance?
- Spider-Man: Nobody gets me.
New Mutants Edit
Issue 40 Edit
- [Angel has just entered, an Adonis of a man]
- Shadowcat: Dibs.
- Storm: Stop it, Kitty.
The Tempest Edit
Issue 46 Edit
- [Angel and Nightcrawler inform Jean-Paul he is a mutant.]
- Jean-Paul Beaubier: Great! Sophomore year, I realise I'm gay, and now you're telling me I'm a mutie?
- Angel: Um, you may want to live the life for a bit before you start slinging derogatory terms like that, even if you're trying to reappropriate them or whatever.
- Nightcrawler: [Disapprovingly] Gay?
- Angel: Jean-Paul, we've been sent to invite you to the Xavier Institute for Gifted Children, a school in Westchester created by and for our kind.
- Jean-Paul Beaubier: "Our kind?" God, you people are worse than my mom. As soon as I came out of the closet, she tried to make me enroll at Harvey Milk.
- Angel: I'm sorry?
- Jean-Paul Beaubier: It's this "special" high school just for gay kids, where we can supposedly get an education without being harassed by idiots. But you know what? I'd rather get called homo ten times a day than.. than segregate myself from the rest of society.
- Nightcrawler: This is different, mein freund. It may not be safe for you here.
- Jean-Paul Beaubier: And your school will be? Didn't one of your classmates just get murdered?
Issue 47 Edit
- Jean Grey: I am an X-Man... and save the sex-change jokes.
- [Jean Grey and Colossus witness Jean-Paul Beaubier awake. Beaubier is openly gay.]
- Jean Grey: Jean-Paul, this is Piotr.
- Jean-Paul Beaubier: Is... he... single?
- [Colossus is so shocked that he turns into his metal form.]
Issue 48 Edit
- [On being called "Marvel Girl"]
- Jean Grey: I outgrew that handle two bra-sizes ago.
- [A drunk Dazzler enters the Danger Room]
- Iceman: Oh yeah, I forgot we started accepting losers on the team.
- Rogue: She smells like my grandfather.
- Angel: Is your grandfather dead?
- Jean Grey: Take it from a telepath and Cosmo subscriber, men are never what they seem. I mean, who'd guess that a guy like you is constantly daydreaming about Pirates of the Caribbean?
- Nightcrawler: Ah, Miss Kiera Knightley. I'd happily sink a thousand ships just to stare into her... vait, you spy on my fantasies?
Issue 49 Edit
- [Sinister is rolling the wheelchair of Professor X away.]
- Professor X: Where are you taking me?
- Sinister: To the one enemy of the great Charles Xavier.
- [Sinister pushes the wheelchair down the stairs.]
- Sinister: Stairs.
- [In a confrontation against Mister Sinister, whom is holding Dazzler hostage and Rogue has at gunpoint]
- Rogue: He killed Bobby, War. He... he killed the only boy who ever treated me halfway decent, and for that, he gets to--
- Shadowcat: Whoa, rewind! Bobby's alive! I just checked on him. His ice absorbed most of the impact. I think he mighta broke a rib or two, but--
- Dazzler: Hey, morons! Hostage situation here, remember?
Cry Wolf Edit
Issue 50 Edit
- [Heavily-pierced Dazzler is flirting with Colossus]
- Dazzler: Seriously, what's up with you? I'm smoking hot, and I have a thing for strange accents. Why don't you make out with me?
- Colossus: You have more metal in your skin than I have. We would scrape.
- [Seeing a board advertising the sideshow "Wolfsbane, half-wolf, half-woman!"]
- Storm: I am going in there. She is being exploited!
- Wolverine: Maybe she is exploiting them?
- [They peek around the corner. Wolfsbane is sharing a happy dinner with her obviously mutated friends.]
- Wolverine: Everybody's a freak to somebody. You just gotta find your tribe and try to do right by them. But if it makes you feel better, we could storm the ticket booth and eviscerate a few carnies for her.
- Storm: [kisses Logan] You are sweet.
Issue 52 Edit
- [Angel is talking about Fenris, aka Andrea and Andreas von Strucker]
- Angel: Nobody knows whether they are married... or siblings.
- Shadowcat: Ewww.
- Dazzler: That was old since the White Stripes started it.
- Andrea von Strucker: We always funnel the profits generated from Gambit's...acquisitions right back into the Homo superior community.
- Rogue: Steal from the rich to give to the peculiar, huh?
Issue 53 Edit
The Most Dangerous Game Edit
Issue 56 Edit
- [Spiral is theatening the X-Men, holding weapons in each of her six arms]
- Iceman: Gee... how much does a skeez like you spend on deodorant?
A Hard Lesson Edit
Shock and Awe Edit
Magnetic North Edit
Issue 61 Edit
- Professor X: [to his cat] Mystique, that's enough.
- Wolverine: The hell kinda handle is that for a cat?
- Prof. X: I once dated a young woman who went by that name.
- Wolverine: What was she, a stripper?
Issue 62 Edit
- [Lorna Dane awakes in the same cell as Magneto]
- Lorna Dane: [scared to death] I'm in hell.
- Magneto: For Xavier, the world is nothing but shades of grey. For me, the world is black and white.
Issue 63 Edit
- Jean Grey: [in Cyclops mind] Come home soon. I love you so much it hurts, okay?
- Cyclops: [Already out off merged mind state] Yeah, I love you too.
- Wolverine: Please tell me you ain't talking to me. You're sitting on an ejector seat, you know.
- Shadowcat: After this mission, I am so totally changing my nickname. "Shadowcat" sounds so Neopets.
- Sunspot: I always knew you X-narcs were just tools of the man.
- Iceman: Did you hear, the Prof said that speedster kid you visited in the hospital a few months back is part of Alex's little raiding party.
- Colossus: Jean-Paul? He's... he's coming here?
- Jean Grey: This isn't prom, Peter.
Issue 64 Edit
- Havok: You sure you can get us across the pond to the Triskelion, Northstar?
- Northstar: Well, "sure" is a strong word, Alex.
- [Polaris has just refused to join Magneto's Brotherhood]
- Magneto: You overweight harlot.
- [Magneto grabs a chair and smashes it over Polaris' head]
- Mystique: Hello, my love.
- Magneto: Mystique? Is that really you?
- Mystique: "The eyes may be fooled by a woman's disguise, but the heart never fails to recognize."
- Forge: Do you have to go through this routine every time you two see each other?
Issue 65 Edit
- [Deathstrike has just impaled Dazzler. A horrified Angel stares at them.]
- Deathstrike: What's up, mutie? I thought your girlfriend liked getting pierced.
- [Talking on the phone.]
- Colossus: Sorry, the what? Really? Uh, when is it? Yeah. You know what, sure. Email me the details. Okay, tell Warren we miss him. Talk to you soon, Jean-Paul.
- Nightcrawler: Northstar? What was that all about, Peter?
- Colossus: He asked me to go to Homecoming with him.
- Magneto: Cyclops, you are the least threatening boy in the world. You can't hit me without harming your brother.
- Havok: Y'know, for a guy who claims to know about brotherhood...
- Cyclops: You don't know much about brothers
- Cyclops blasts Magneto to the ground without harming Havoc, who was in the line of fire
- Havok: Nice shooting, four eyes.
- Cyclopes: You make a easy target, idiot.
- [Havok & Polaris have just been reunited]
- Jean Grey: Is that a little jealously I sense?
- Cyclops: A little sadness about losing my plane, maybe.
Ultimate X-Men Annual #1 Edit
- [Danger Room simulation]
- Holo-Green Goblin: Congratulations, X-Men. You have the honor of being escorted into oblivion by none other than... the Green Goblin.
- Wolverine: Who the hell writes this crap?
Date Night Edit
Issue 66 Edit
- Cyclops: You've got a date?
- Professor X: I'm handicapped, Scott. Not dead. I'm meeting a woman. It's mostly business, but still a date.
- Cyclops: I get it. It's a business dinner but she's attractive enough for you to wish it were a date.
- Professor X: I think Jean is finally rubbing off on you. This is not a bad thing.
- Cyclops: Actually, Jean is in the other room getting ready, she's been listening in. I think she made me say that.
Issue 67 Edit
- Colossus: This is why you don't want to be around me now, yes? You think I like you -- that way. I promise that is not so.
- Nightcrawler: Uh... well.
- Colossus: It is okay, friend. You need not lie to me. I know you've been avoiding me since you think you found out what I am. Have you never met a girl you are not attracted to? Do you think that I am attracted to every man? Why would you think that? I will admit, your skin is cute, but you are not my type. So do not worry, I promise to keep my hands to myself. Can we just go back to the way things were?
- Nightcrawler: I do not know, mein freund.
- Colossus: I am the same friend you knew, Kurt.
- Nightcrawler: I am thinking now... that I did not know that friend very well...
Issue 69 Edit
- Polaris: Here comes the happy couple.
- Northstar: Please, Lorna -- I believe this is our first date.
- Polaris: I don't think it counts when you've talked on the phone as much as you two already have!
- Colossus: I see you are not one to keep things quiet. No?
- Northstar: I thought you liked that.
- Colossus: I like that you are free with your speech. I see now maybe a little too free?
External links Edit


text:
The pain of the Boston Marathon bombings has led to a beautiful new beginning for one survivor. Last Saturday, James Costello married Krista D'Agostino, one of the nurses at Spaulding Rehabilitation Hospital where he rehabbed after multiple surgeries for burns and shrapnel.
The bride and groom were treated to a top-notch affair at the Hyatt Regency in Boston Saturday. Wedding planner Rachael Gross, owner of Lolagrace Events, helped the couple plan a "nautical wedding, but without the literal nautical elements." (Instead of ropes and anchors, there were white and blue hydrangeas, and silver-rimmed tableware.)
"It was such a true representation of their character, their style, and their love," said Gross. "Everyone was soaring, soaring."
Gross and the Hyatt donated their services as did all of the other vendors affiliated with the wedding including Bella Sera Bridal boutique in Danvers, Blooms of Hope in Belmont, Prudente Photography, Goosefish Press, and Italian crooner Antonio Cassisi. I Do Films flew from Chicago on their own dime to videotape the wedding day.
The couple, now en route to their honeymoon in Hawaii, danced to John Legend's "All of Me" — first as a dance mix with the crowd of 160, then alone as a couple to the slow ballad version.
In lieu of favors, Costello and D'Agostino announced they would make a donation to the Semper Fi Foundation to help provide a military couple with the means to have a wedding.
"They just want to give someone a special moment like we've given them," said Gross.


text:
ST. LOUIS — Loui Eriksson can't seem to win.
The forward already has suffered two concussions this season, coming in 45 days and costing him 21 games, and on Thursday against the Blues, he absorbed a high stick to the mouth that might have cost him some teeth and certainly earned him some stitches.
The injury came on a play that seemed — to the Bruins — to have negated a Blues goal.
Instead, the goal counted and there was no penalty.
"The linesman saw it," coach Claude Julien said after the 3-2 overtime loss. "The rule is the linesman can call it if it's a high stick and there's blood. We thought it was going to get called because he had told us he'd seen it, but that whistle had to be blown right away and it wasn't. Obviously, they can't take it back.
"We've got a player that lost some teeth, got some teeth bashed in, and had quite a few stitches in his mouth. The guy's already been through a lot. Poor Loui for us this year. Nothing is getting called against him and he's just taking his lumps. It was a little disappointing."
It was also a sequence that left Julien yelling (and swearing) at the officials.
The high stick came from Maxim Lapierre just before the Blues brought the puck up the ice, a play that ended with Alexander Steen putting the puck past Tuukka Rask at 15:48 of the first period to open the scoring.
Eriksson was dripping blood, but there was no call.
"We thought, technically we thought [the goal] wouldn't count, they could take it back," Julien said. "But they said no, it had to be blown right away. So anyway, I don't even know if it's mistakes or they weren't 100 percent sure so they didn't really blow the whistle right away.
"Like I said, you move on, whether you're happy or not with it you just move on and you accept that there's mistakes from everybody in this game. You can't let those things drag you down, and we didn't."
Eriksson went down the tunnel to get repairs, and remained there for the rest of the first period. He was back out early in the second period, and played the rest of the game, but did not speak to reporters. He had 15:41 of ice time with one shot on goal.
Young on D
Without Zdeno Chara, who already has left for the Olympics, in the lineup, the Bruins were tasked with taking on the Blues, and the Senators on Saturday, with one veteran on their blue line. That, of course, was Johnny Boychuk, who has played 298 regular-season games.
His teammates on defense? Well, Dougie Hamilton (82), Matt Bartkowski (61), Torey Krug (59), Kevan Miller (23), and David Warsofsky (5) have combined for just 230 games.
Did that mean possible added responsibility for Boychuk, who had one of his best games of the season in Tuesday's win over the Canucks, leading the Bruins with 24:04 of ice time?
"I don't think it does," Julien said. "I don't expect him to give me more because that means he hasn't given enough. I think I need him to be at the top of his game just to play well and do his job."
It adds up
When Warsofsky was asked about replacing Chara's minutes, he joked, "I don't think I can count that high, how many minutes he usually plays." . . . Blues defenseman Kevin Shattenkirk is a former teammate of Warsofsky's at BU. The 25-year-old Shattenkirk is headed to the Olympics with Team USA . . . The Bruins are on a 4-1-1 stretch on the road, not having lost in regulation since a 4-2 defeat to the Kings Jan. 9 . . . The Bruins had an optional morning skate at the Scottrade Center. Players not on the ice were Milan Lucic, David Krejci, Jarome Iginla, Gregory Campbell, Shawn Thornton, and Rask . . . Jordan Caron was the healthy scratch. Adam McQuaid (leg) also didn't play . . . The Bruins will hold their annual "PJ Drive" during Saturday's game against Ottawa at TD Garden. The team will collect new, unused pajamas for Cradles to Crayons, which will give them to needy children across Massachusetts.
Amalie Benjamin can be reached at email@example.com. Follow her on Twitter @amaliebenjamin.


text:
ALEXANDRIA, VA—With her parents leaving town to celebrate their 98th wedding anniversary, Justice Ruth Bader Ginsburg made plans Friday for a major house party, inviting all her Supreme Court colleagues to what she promised would be "a classic Ginsburg throwdown."
Ginsburg, a Clinton appointee who traditionally votes with the court's liberal wing and whose 120-year-old parents explicitly told her not to have any friends over, confirmed that she waited until her mother and father had pulled out of the driveway before texting "it's on" to her fellow justices and telling them to "get ready to drink [their] asses off."
"My dad is seriously crazy if he thinks I'm not going to throw an epic rager when I have the house to myself all weekend," said Ginsburg, whose father, a furrier and haberdasher by trade, reportedly wrote down the mileage on his 1928 Ford Model A so he would know if his daughter took it out for a spin. "As far as I'm concerned, when the cats are away, the mice will play."
"Besides, I'm 79," she continued as she prepared a tray of Jell-O shots using the mix favored by her supercentenarian mother for its softness on her toothless gums. "They can't tell me what to do anymore."
According to sources, Justices Antonin Scalia, Anthony Kennedy, Samuel Alito, Stephen Breyer, and Clarence Thomas arrived first, catching a ride to the party in the open-backed Jeep Wrangler of Chief Justice John Roberts, who had earlier persuaded his older sister Kathy to buy beer. Justices Sotomayor and Kagan showed up shortly thereafter, having taken longer than expected to dupe their parents into thinking they were sleeping over at each other's houses.
Though David Souter had hoped to drive down from New Hampshire and party with the court "like old times," the retired justice told reporters he had to cancel when his plan to "squeeze some gas money out of the old man" fell through.
Originally intended as a "justices-only thing," the partygoers said the gathering grew much larger when Scalia posted the address of the house on the Justice Department's Facebook page, inviting "everyone who views the writ of certiorari as essential to a robust judiciary" to "come get shwasted at RBG's place."
"Party's off the fucking hook!" exclaimed Breyer, taking a body shot from a 58-year-old court stenographer who had come with friends from the U.S. Court of Appeals for the Fourth Circuit. "Don't get me wrong, [Elena] Kag[an]'s confirmation bash was the shit, but this one's in a totally different league. I'd forgotten how cute first-year federal clerkship girls are. Damn!"
"I'm definitely getting ass tonight," he added, excusing himself to "get blazed" with a group of special assistant U.S. attorneys in the family's carriage shed.
Meanwhile, "reigning flip-cup champions" Kennedy and Alito reportedly set up shop on an oak bagatelle table in the parlor, with games getting so out of hand they nearly broke a porcelain vase recently given to Ginsburg by her 156-year-old grandmother.
Witnesses reported that at approximately 1 a.m., the revelry came to a grinding halt when a police car was spotted in the driveway, prompting the nine members of the highest court in the land to scatter into the woods behind the house.
After an initial scramble by the justices to hide the weed and reach a consensus on whether law enforcement in this instance had probable cause to search persons for possession of a controlled substance, Ginsburg, who was the most sober and once served as general counsel for the American Civil Liberties Union, was nominated to the do the talking.
"The cops were pretty cool and let me off with a warning to keep the noise down and make sure everyone got home safe," Ginsburg said. "It's a good thing, too, because my dad would have really let me have some 19th-century discipline if he found out I had people over."
"He's such an old fogy, and it sucks, because I'm much more responsible now than I was in my 60s," she continued, adding that her father has never fully trusted her since smelling vodka on her breath one night in 1998. "He still thinks of me as being this much younger woman who just qualified for Medicare."
Ginsburg confirmed she would clean the house meticulously Saturday to avoid what happened after her last party, when her father discovered an empty can of beer on his wind-up Victrola gramophone and grounded her for the remainder of the court's term.


text:
Twin sisters – both teachers – have been arrested in Southern California in connection with alleged lewd acts with an underage female student.
Franca and Antonia Munoz-Juvera, 26, were taken into custody at their apartment Thursday evening in Rancho Cucamonga by Riverside County sheriff's detectives. An 18-year-old woman living with the sisters, Eileen Valerio, was arrested as well, the North County Times reported.
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Both Munoz-Juvera sisters are first-year teachers at Lakeside High School in the Lake Elsinore Unified School District.
Franca teaches math and Antonia teaches science.
Detectives initially went to the apartment intending to arrest only Franca Munoz-Juvera after being told there had been "unlawful contact" between her and a female student.
TRENDING: A contrarian Trump scenario for 2024
Details of the alleged crime or the age of the victim have not yet been given.
Police arrested her sister, Antonia, after they became aware that she allegedly knew what had occurred and hadn't reported it.
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Under California law, school teachers are mandatory reporters, required to notify authorities whenever they have knowledge of sexual molestation of minors.
"We found out Antonia knew of the relationship and did nothing," Cpl. Dennis Gutierrez said.
Without providing details, Gutierrez said that Valerio, the roommate, was also arrested because she had "facilitated the crime."
Franca Munoz-Juvera was booked on suspicion of committing lewd acts with a minor – a felony. Antonia Munoz-Juvera and Valerio were booked on suspicion of conspiracy to commit criminal acts and contributing to the delinquency of a minor.
Both teachers have been placed on administrative leave while the district investigates.
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Teacher 'sexpidemic'
The phenomenon of teachers accused or convicted of having sex with their students has come to the forefront of national and international news in recent years.
Some of the cases involving women have been chronicled by WND, including:
Adrianne Hockett: Accused of having sex with a 16-year-old special-needs student in a Houston apartment she rented for the get-togethers. The boy has testified the pair would "have sex, drink beer and smoke weed."
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Amber Jennings, 31: Though Jennings was initially charged with having sex with a 16-year-old, the counts against the Sturbridge, Mass., woman were reduced to a single charge of disseminating harmful materials to a minor. She reportedly admitted e-mailing naked photos of herself to a former student. She received no jail time, only two years of probation after pleading guilty.
Amber Marshall, 23: Northwest Indiana woman allegedly had sexual contact, including intercourse, with several students at Hebron High School, and turned herself into authorities, telling police she knew what she did was illegal.
Amira Sa'Di, 30: Clayton County, Ga., woman remarked she didn't think her relationship was inappropriate based on her Internet research, learning the Peach State's age of consent is 16.
Amy Gail Lilley, 36: Inverness, Fla., woman and softball coach at Lecanto High School charged with a lesbian relationship with a 15-year-old girl. She received no prison time, being sentenced to two years of house arrest and eight more years of probation.
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Amy McElhenny
Amy McElhenney, 25: Charged with having a sexual relationship with an 18-year-old male student, the 25-year-old Hebron High School Spanish teacher and former Miss Texas contestant will not be serving any jail time after a Denton County, Texas, grand jury refused to issue an indictment. While the age of consent in Texas is 17 years, a state law bans sexual relationships between educators and students even if the student is of legal age and the relationship is consensual. She could have faced 20 years in prison if indicted and convicted.
Angela Comer
Angela Comer, 26: Middle-school teacher from Tompkinsville, Ky., fled with her alleged lover, her 14-year-old male student, before being tracked down in Mexico where she reportedly planned to marry the boy. She was indicted for illegal sex acts with a minor and returned to Kentucky. Charges include felony custodial interference, two counts of third-degree sodomy and four counts of unlawful transaction with a minor relating to sexual acts.
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Angela Stellwag, 24: Delran, N.J., woman accused of having sex in her apartment with a 14-year-old boy she met in school. She was charged with sexual assault for activity that allegedly took place in August 2004. She pleaded not guilty in August 2006.
Beth Raymond, 31: Private-school employee from Pownal, Maine, charged with risk of injury to a minor and second-degree sexual assault of a juvenile male at Eagle Hill School in Greenwich, Conn. In July 2006, she was sentenced to 18 months prison.
Bethany Sherrill, 24: Daughter-in-law of school-board president charged with molesting a 15-year-old middle-school student. Reports state Sherill allegedly had oral sex with the boy and sent him coded text messages. She resigned her position at Jefferson Elementary School in Farmington, Mo., and eventually received 90 days in jail and two years probation, and was forced to register as a sex offender.
Brandy Lynn Gonzales
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Brandy Lynn Gonzales, 27:The Houston-area teacher and her husband were arrested in December 2006 for sexually assaulting students at an elementary school two years earlier. Prosecutors allege that Gonzales met a student at a local movie theater, where she performed oral sex on the boy as well as another student at the theater. Husband Johnny Gonzales is also charged with having performed sex acts with one teen. Prosecutors told the judge they have sufficient evidence to file further charges.
Cameo Patch
Cameo Patch, 29: Substitute teacher at Tooele High School in Tooele, Utah, arrested for allegedly performing oral sex on a 17-year-old male student. The sexual activity was allegedly consensual, and reportedly took place off school grounds after the pair had exchanged phone numbers in a restaurant. She was sentenced to no jail time, despite comments from the judge that a man would have likely gone to prison.
Carol Flannigan
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Carol Flannigan, 50: Boca Raton, Fla., music teacher reportedly slept with 11-year-old former student, and also had a simultaneous sexual relationship with the boy's father. In a deposition, the boy's father said he had the same sort of sexual relationship with Flannigan that ex-President Bill Clinton had with Monica Lewinsky. In February 2006, Flannigan was sentenced to five years prison as part of a plea deal.
Carrie McCandless
Carrie McCandless, 29: The former Colorado social-studies teacher, who also happens to be married to the principal, was charged in November 2006 with having had sexual contact with a 17-year-old male student during an overnight school camping trip. The instructor, who also coaches cheerleading, could be sentenced to up to 12 years in prison for sexual assault on a child by a person in a position of trust and contributing to the delinquency of a minor.
Cathy Heminghaus
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Cathy Heminghaus, 46: Special-education teacher from Ferguson, Mo., charged with statutory sodomy involving at least three of her students at Ferguson Middle School. She reportedly told friends she had performed oral sex on the children on several occasions.
Celeste Emerick, 32: Police in Huber Heights, Ohio, say the Wayne High School teacher hosted a party where students were shown pornography. Prosecutors charged her with one count of sexual battery, a felony in Ohio.
Christina Gallagher, 26: Jersey City, N.J., woman received no jail time, but was ordered to pay more than $1,000 in fines, sentenced to a lifetime registration as a convicted sex offender and ordered to attend therapy for having sex with a 17-year-old student in late 2004. The former Rahway High School instructor was banned from teaching and seeing the student with whom she had sex.
Christine Duda, 39: Teacher at the Normandy Alternative School in St. Louis County, Mo., allegedly took a 16-year-old hearing-impaired male student to her home for sex in December 2005. She was charged with two counts of felony statutory rape and fired by the school district.
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Christine Scarlett, 36: English teacher at Strongsville High School in Ohio began a sexual relationship with the 17-year-old captain of the football team, Steven Bradigan, in November 2002 and eventually gave birth to Bradigan's son. Scarlett was fired from her teaching job, but insists nothing improper happened during the time she was Bradigan's teacher. She was never charged with any criminal wrongdoing.
Deanna Bobo
Deanna Bobo, 37: Special-education teacher at Raymond E. Wells Junior High School in Greenwood, Ark., allegedly had sex twice in 2005 with a 14-year-old boy in his own bed while his parents were not home. She denied the charge, but was convicted in September 2006 of two counts of first-degree sexual assault and sentenced to 12 years in prison.
Debra LaFave
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Debra LaFave, 25: Tampa, Fla., area teacher received no jail time despite having sex with her 14-year-old male student in a classroom and her Hillsborough County home. In another county, Marion, she was accused of having sex with the boy in an SUV. LaFave claimed at a March 2006 news conference she had a bipolar disorder. The boy's father said LaFave should have received prison time in her plea deal, noting, "It's a horrible, ugly thing that she's done."
Diane DeMartini-Scully, 45: Mattituck, N.Y., woman was the school psychologist at East Hampton Middle School on Long Island when she was accused of having sex with the 16-year-old boyfriend of her own 13-year-old daughter. She allegedly had intercourse and oral sex with the boy on a number of occasions in May 2005 in her home and car. She was arrested after allegedly secretly visiting her young paramour at his new home in North Carolina.
Donna Carr Galloway, 33: Married mother of two found naked in a car with a 17-year-old student.
Elisa Kawasaki, 25: Biology teacher from Fresno, Calif., area, pleaded no contest to sex with a teen boy, and prosecutors dropped four other counts.
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Elizabeth Miklosovic, 36: Grand Rapids, Mich., teacher at South Haven's Baseline Middle School pleaded no contest to sexually assaulting a 14-year-old female student she "married" in a pagan ritual in June 2004. Miklosovic is also accused of touching the girl's genitals while camping in public parks. She told the judge before sentencing, "The entire ordeal has been blown totally out of proportion for something that was innocent, kind and nurturing in nature." She was sentenced to five to 25 years.
Elizabeth Stow, 26: Tulare Western High School teacher from Fresno, Calif., area convicted of having sex with three of her students was sentenced to nine years, but the judge suspended that sentence and gave her one year, followed by five years of probation. She was also ordered to register as a sex offender.
Ellen Garfield, 43: Former student at Solomon Schecter School in Newton, Mass., said his music teacher took him into an empty classroom where she worked, partially disrobed, and coaxed him into having sex with her in 1998. Garfield was acquitted of all charges in September 2005.
Emily Morris, 28: Teacher at Leeds High School in St. Clair County, Ala., faced a possible 20-year sentence, but received one year in jail for having consensual sex with a 15-year-old student.
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Erica Rutters, 29: Teacher at Oxford Christian Academy in New Oxford, Pa., allegedly wrote erotic messages to a 16-year-old student and had sexual intercourse with him four times in her apartment. She pleaded guilty to corruption of a minor, and received no jail time, just three years of probation in March 2006.
Georgianne Harrell, 24: Teacher at Holley Elementary School in Sylvester, Ga., charged with performing oral sex on a 9-year-old boy in April 2005, allowing students to gaze down her blouse and slashing her wrists with glass in front of her students. Though she originally pleaded not guilty, she changed her plea to guilty just before trial, and was sentenced to 25 years in prison for aggravated child molestation.
Gwen Cardozo, 33: Teacher at Wasson High School in Colorado Springs, Colo., accused of having sex with a 17-year-old male student. Police charged her with sexual assault on a child by one in a position of trust, and Cardozo resigned her position in March 2005. She pleaded guilty in July 2005 and received a deferred sentence, meaning no jail time if she remains trouble-free for four years.
Heather Ingram, 30: Mathematics, science and business teacher at Chatelech Secondary School in Sechelt, British Columbia, had sex with a 17-year-old student. The relationship cost Ingram her job and reportedly led to the breakup of her 12-year common-law marriage to a man four years her senior.
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Jacquelyn Faith Garrison, 19: Substitute teacher at South Central High School in Winterville, N.C., was indicted in January 2006 on charges she was having an improper relationship with a 15-year-old student. The case involves some 50 phone calls and text messages exchanged between Garrison and the boy, who reportedly became uncomfortable when things of a sexual nature came up.
Janelle Bird
Janelle Marie Bird, 24: Accused of having a two-year affair with a 15-year-old student from East Hill Christian School, in Pensacola, Fla. Declaring her love for the boy, she was charged with two counts of lewd and lascivious battery and two counts of unlawful sexual activity with a minor. Though Bird could have received 30 years upon conviction, she was sentenced in 2006 to two years in state prison.
Jaymee Wallace
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Jaymee Wallace, 28: Basketball coach in Tampa, Fla., charged with having an 18-month lesbian relationship with a student. Authorities say the student, who was 15 when she met Wallace, voluntarily had sex with the coach more than 50 times, in a parking lot at Busch Gardens and often at Wallace's own apartment while a fellow classmate was in an adjacent room. According to the police report, the sexual relationship reportedly began in early 2003, after the student received a note from Wallace saying she "found her attractive and wanted to know if she felt the same way."
Joan Marie Sladky, 28: Redwood City, Calif., woman sentenced to six months in county jail for having sex with a 16-year-old student after pleading no contest to four counts of unlawful sexual intercourse, oral copulation and penetration with a foreign object. The Spanish teacher's relationship with the boy spanned six months, as she reportedly had sex with him once at his home and three times at her residence, which was on the property of the private Baptist church and school where she taught.
Katherine Tew, 30: Married English teacher from Greenville, N.C., arrested for having sex with a 17-year-old boy. She taught at South Central High School in Winterville, N.C., and was convicted of taking indecent liberties with a child, but found not guilty of the more serious sex charge. She was not given prison time, and lost her teaching license for at least two years.
Kathy White, 39: Teacher at Lumberton High School in Lumberton, Texas, charged with having sex with a 17-year-old student. The victim, Michael Ferguson, alleges: "She just started grabbing me and hormones were on and it just happened." Ferguson provided KBTV-TV with an e-mail allegedly sent by White, in which the teacher told him, "I get these cravings for YOU and that's not NORMAL! If I had it my way, I'd do you once a week just because it's good."
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Kelly Lynn Dalecki, 28: Elementary-school teacher from St. Augustine, Fla., pleaded no contest to charges she had sex with a 13-year-old boy in 2003. The boy's parents reportedly found more than 50 sexually explicit e-mails and pornographic pictures allegedly sent by Dalecki on his computer. Dalecki was sentenced to nearly a year in prison.
Kristen Margrif
Kristen Margrif, 27: Mayville, Mich., teacher accused of having sex with a 16-year-old male student in her car or at his summer workplace in June and July 2005. She was given a one-year delayed sentence in June 2006 on three felony counts of second-degree criminal sexual conduct with a student, meaning she'll only have to serve probation if she remains trouble-free for a year.
Kristi Oakes
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Kristi Dance Oakes, 32: Teacher allegedly had sex with a 16-year-old boy who was in her biology class the previous year. Oakes resigned from her post at Seymour High School in Sevierville, Tenn., and reportedly lost her home and even the job she took at a grocery store after resigning from the school system because of the charges. In July 2006, she pleaded guilty and was sentenced to six months in jail.
Lakina Stutts, 40: School-bus driver admitted to cops she had sex with a 14-year-old student in her home and in a car outside the boy's home.
Laura-Anne Brownlee, 26: Former music mistress at a top private school in Belfast, N. Ireland, was given a six-month suspended sentence on charges of indecently assaulting a 15-year-old boy.
Laura Lynn Findlay, 30: Band teacher at Ricker Middle School in Buena Vista Township, Mich., charged with having sex with at least 5 students, one as young as 14. She was sentenced in August 2006 to at least seven and as much as 25 years in prison.
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Lynn Saunders, 38: A former basketball star at the College of Staten Island, the gym teacher at St. Paul's School in New Brighton, N.Y., was arrested in March 2005 for allegedly molesting a 12-year-old girl whose family she had befriended. Saunders admitted to touching the girl's breasts and genital area on several dates in February 2005. She received no jail time, only probation and registration as a sex offender. The family is now suing Saunders and the Archdiocese of New York, claiming the girl became suicidal and still suffers from "severe emotional shock, trauma, embarrassment, anxiety and other psychological injuries."
Margaret De Barraicua
Margaret De Barraicua, 30: Sacramento, Calif., area woman arrested after police found her having sex with a 16-year-old male student in her car while the woman's toddler was strapped into a seat in the back. She pleaded guilty to four felony counts of statutory rape and was sentenced to a year in jail and five years formal probation.
Maria Saco, 28: Math teacher at Lincoln Middle School in Passaic, N.J., sentenced in 2005 to a year in jail for an intimate relationship with a teen student who was 14 when they first met. Saco reportedly gave the boy a key to her apartment.
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Mary Kay Letourneau, 34: Des Moines, Wash., teacher did prison time after having sex with a sixth-grade student, Vili Fualaau, in 1996 and eventually had two children by him. She originally had Fualaau in her second-grade class at Shorewood Elementary School in Burien, Wash. The couple has since married.
Melissa Michelle Deel, 32: Bristol, Tenn., teacher at Virginia Middle School pleaded guilty to crossing the state line into Virginia to have oral sex with a 13-year-old male student. As part of her plea agreement, Deel agreed never to profit from the crime, as well as have no contact with the boy and his family without court permission. She was sentenced to a year and two months prison.
Michelle Kush, 29: Substitute teacher at Boone County High School in Florence, Ky., allegedly had sex with a 15-year-old boy several times during summer break. She was charged with two counts of rape and one sodomy count. In August 2006, Kush was sentenced to 60 days in jail, 30 days on house arrest and five years probation.
Nicola Prentice, 22: British woman from Sheffield, England, given a 12-month suspended jail sentence after she seduced a 16-year-old student and began a 19-month affair.
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Nicole Barnhart
Nicole Andrea Barnhart, 35: Highlands Ranch, Colo., woman reportedly told police she loves the 16-year-old boy with whom she was having sex. A teacher at Ponderosa High School, she pleaded guilty to felony sexual assault on a child, resulting in a two-year prison sentence and a minimum of 10 years in a sex-offender probation program.
Nicole Long
Nicole Long, 29: English teacher at Ayersville High School in Ohio resigned her teaching post after being accused of raping a 17-year-old boy. She pleaded guilty in January 2005 to a charge of sexual battery, and was sentenced in March to three months in jail.
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Nicole Pomerleau, 31: English teacher at Olympic High School in Charlotte, N.C., arrested in March 2004 for allegedly having a sexual relationship with her 16-year-old student. The age of consent in North Carolina is 16, but teachers having sex with students is an exception to the law. Though Pomerleau admitted the affair, she got no prison time and did not have to register as a sex offender.
Pamela Balogh
Pamela Balogh, 39: Gym teacher and coach at a Somerset, N.J. Catholic high school was charged in December 2006 with sexually assaulting a 15-year-old female student over a period of 10 months. Authorities say the assaults happened mainly in Balogh's office.
Pamela Smart, 22: Media-services director at Winnacunnet High School in Hampton, N.H., had convinced her 15-year-old lover to murder her husband. She was arrested in 1993 and is now serving a life sentence. The Nicole Kidman film "To Die For" is based on her story.
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Pamela Rogers Turner, 27: Former model and beauty-pageant contestant also taught at Centertown Elementary School in McMinnville, Tenn. She was arrested in February 2005 for allegedly having a three-month sexual relationship with a 13-year-old boy. She resigned her teaching position and was charged with 15 counts of sexual battery and 13 counts of statutory rape. Originally sentenced to 270 days in August 2005, she got in additional trouble in April 2006 for sending text messages, nude photos, and sex videos of herself to the same boy while using her father's cellphone. In July 2006, she was sentenced to seven years for violating her probation.
Rachelle Vantucci, 32: Ex-substitute teacher from Geneseo, N.Y., admitted having sex with a 16-year-old boy she met at a local riding stable. After pleading guilty, Vantucci agreed to surrender her teaching license and register as a sex offender.
Rebecca Boicelli, 33: Redwood City, Calif., woman gave birth to a baby last year and DNA test results gave prosecutors enough evidence to prove the father is Boicelli's former student, who was 16 at the time of conception. She was sentenced to two years in prison.
Rhianna Ellis, 24: Social-studies teacher at the High School for Health Professions and Human Services in Manhattan, N.Y., allegedly began a 10-month sexual relationship with an 17-year-old player on the school's basketball team, and reportedly gave birth to his baby. The teen boy even introduced Ellis to his parents, never indicating she was his teacher.
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Robin Gialanella, 26: Teacher at Silver Bay Elementary School in Toms River, N.J., engaged in kissing, and inappropriate conduct and conversations with two sixth-grade boys, ages 11 and 12, in 2003 and 2004. She was sentenced to 364 days in jail with psychotherapy, must register as a sex offender, will be under lifetime supervision and must surrender her New Jersey teaching certificate.
Robin Winkis, 29: English teacher at Central York High School in York, Pa., allegedly had sex with a 17-year-old boy after giving him alcohol. Authorties accused her of five alleged sex acts during October and November 2005. She pleaded guilty as part of a deal, and was sentenced to two to 23 months in jail.
Samantha Solomon, 29: Guidance counselor at the High School for Health Professions and Human Services in Manhattan, N.Y. was fired after school bosses learned she was having sex with a teenage boy. She denies the allegations, attributing them to rumors gone wild.
Sandra "Beth" Geisel, 42: English teacher at Christian Brothers Academy, an all-boys school in Albany, N.Y., allegedly had sex three times with a 16-year-old male student in May 2005, including once on school grounds in the football stadium's press box. Originally indicted in September for three counts of third degree rape, she pleaded guilty to a single count of rape and was sentenced to six months in jail, and ranked as a Level 1 sex offender, the lowest risk.
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Shelley Allen, 35: Teacher's aide from Cherokee County, Texas, was arrested in June 2005. Allen was charged with sexual assault of a child and faces a possible 20 years behind bars.
Shelley White, 24: Geography teacher in Britain had been engaged to be married before she kissed a 15-year-old student on at least three occasions. She avoided jail, but received 12 months community service.
Sherry Brians
Sherry Brians, 41: Middle-school language-arts instructor in Buttonwillow, Calif., originally arrested in January 2006 on suspicion of engaging in lewd acts with a 12-year-old male student, a felony that involves sexual contact. She pleaded not guilty to two counts of annoying or molesting a child under 18.
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Stephanie Burleson: Volleyball coach and teacher at Floresville High School in Texas six years ago, pleaded guilty to all charges for molesting a 16-year-old female student. She was sentenced to 10 years probation, and required to register as a sex offender.
Susan Clickner, 47: The eighth-grade science teacher at Blanchard Middle School in Lowell, Mass., was sentenced to serve 18 months for having sex with one of her students in the back seat of her car. Clickner had been accused of luring the 14-year-old during the summer of 2005 into the back seat of her car and molesting him. He later told his parents, who notified police. She also was ordered to register as a sex offender.
Susan Eble, 35: Former teacher's aide is accused of having a sexual relationship with a 14-year-old boy.
Tara Lynn Crisp, 29: Police allege she had sex with a student at least three times beginning when he was 14.
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Toni Lynn Woods, 37: Middle-school teacher in Braxton County, W.Va., confessed in 2005 to having sexual intercourse with three juveniles a total of four times and oral sex with one of those juveniles and another juvenile a total of four times. She reportedly described herself as a "monster" when she pleaded guilty. She resigned, surrendered her teaching certificate, and was given consecutive sentences of one-to-five years on four counts of third-degree sexual assault.
Traci Tapp
Traci Tapp, 28: Gym teacher at Hammonton High School in New Jersey accused of sexual contact with three male students, including having sex in her home multiple times in one night with a 16-year-old. In January 2006, she avoided any jail or probation time by admitting inappropriate touching, but she lost her teaching license.
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Afghan puppy rescued by soldier finds new home in Highland Village
Afghan puppy rescued by soldier finds new home in Highland Village
By LINDSEY BEVER Morning News
July 26, 2010, 7:04AM
Family photo
It cost $4,000 to fly Wylie to Texas.
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HIGHLAND VILLAGE Seven months ago, the wild puppy roughing it in a small guard shack on a mountain in eastern Afghanistan knew only of unforgiving weather and the promise of combat.
But Wylie's three-month journey to America has opened her eyes to a brand-new life.
"When I took her outside for the first time, she laid her chin on the grass and looked around," said Steve Rodems, stepfather of Army Reserves Staff Sgt. Hannah Schlegel, who rescued Wylie from eastern Afghanistan. "She had never seen or walked on grass. She had never smelled flowers or looked at trees. It was a very sweet moment."
Now, the recently domesticated adolescent pup is fitting in nicely in Highland Village.
Schlegel rescued Wylie, the 10-month-old Afghan hound-shepherd mix, in December 2009. She found Wylie in a small guard shack on a mountain in eastern Afghanistan and smuggled her back to her base in Khost to protect the puppy from danger.
A month later, Schlegel began raising money to ship Wylie from Kabul, Afghanistan, through PayPal, an online money transfer service. Through the financial support of her family, friends and perfect strangers, she raised every cent needed for the more than 7,000-mile trip - a $4,000 plane ticket.
"It says a lot about people that even with everything going on at home, a simple story about a girl and her dog can still melt everyone's heart," Schlegel said via e-mail. "But it's not just my story anymore; it's the story of everyone who has donated to help bring her home."
The funds that were raised helped Schlegel arrange transport through the Afghan Stray Animal League. An Afghan drove Wylie to Kabul where she stayed in a kennel until her flight to Pakistan could be arranged. She flew to Islamabad and in May finally made it to the United States where she was met by Schlegel's parents, Steve and Nancie Rodems of Highland Village.
But spending three months of her young life in transport made for a rough transition, Rodems said.
"I called Hannah. I said, 'Forget trained; she's not even domesticated,' " he said, laughing. "She just didn't have time to be a puppy. But she's been diametrically getting better.
"Compared to what Hannah has to do on any given day, taking care of Wylie is such a small sacrifice to make."
Wylie is now a long, lanky and clumsy adolescent dog, wrestling with the other family dog, Lily, and transporting Rodems' shoes from his closet to the couch.
When Schlegel comes home from her 400-day deployment in late August or early September, she and her fiance, Staff Sgt. Jeffrey Koegler, will take Wylie to her permanent home in Northern Virginia, where the three will begin their civilian life together.
"My parents have been absolutely wonderful in taking care of her while I've been overseas," Schlegel said. "I cannot wait till I get home in a few months to reunite with her."
But until then, Schlegel's parents are enjoying an affectionate Wylie.
"Wylie, good girl. Good girl!" Rodems said, kissing her on the snout. "That's what she lives for. Now, she's a part of this family."
Cat maid to:
Rose semi feral, a cpietra rescue, female tabby (approx 13 yrs)
Jasper RIP (2001-2018)
Sweet Pea RIP (2004?-2014)
Puddles RIP (1996-2014)
Snowball RIP (1991-2005)
In a cat's eye, all things belong to cats.-English Proverb
While we are free to choose our actions, we are not free to choose the consequences of our actions. Stephen R. Covey
such a nice story brenda and the pins
L4H,it's nice that some good news are coming out of Afghanistan,he is one lucky pup
"The cruelest animal is the Human animal"
3 kitties,Rocky(r.i.p my boy),Chico,Vinnie
This is so wonderful. I've been reading a lot lately about soldiers bringing over dogs and cats. It's hard for strays here, imagine what it must be like for them over there.
There are only two rules at my house: House rule #1. Cats rule. House rule #2. See rule #1.
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When asked her address, the spinster heroine of Rainer Werner Fassbinder's little-seen 1974 gem Martha replies "21 Douglas Sirk Street," a nod to the German émigré whose fever-pitched '50s melodramas (All That Heaven Allows, Written On The Wind, and Imitation Of Life, among others) were a clear inspiration to Fassbinder. In his generous introduction to 1978's In A Year With 13 Moons, the better-known of two superb new Fassbinder DVD reissues, director Richard Linklater cites the Sirk influence on Fassbinder's fertile "second period" in the early to mid-'70s, when the director's fusion of dark comedy, high emotion, and sociopolitical critique reached its apex. To watch these seemingly contradictory films, with their arrhythmic tonal swings and slippery point of view, is to experience a state of thrilling imbalance, of never knowing precisely how to feel.
The insightful liner notes for Martha, penned by Chicago Reader critic Jonathan Rosenbaum, include an exchange between Fassbinder and lead actress Margit Carstensen that epitomizes the wildly varied responses his work tends to inspire. Where Carstensen views the marriage between her submissive, brutalized character and her supremely abusive husband as a form of tragic resignation, Fassbinder sees a happy ending—or, as Rosenbaum puts it, "a match made in heaven between a masochist and a sadist." It's possible to laugh all the way through the film, just as it's possible to rank Carstensen among the suffering matrons of Sirk's oeuvre. Either way, it's a shame the film's baroque audacity never got its due in America until now.
In a casting coup, Karlheinz Böhm, who starred as the voyeuristic filmmaker-turned-killer in Michael Powell's infamous Peeping Tom, plays Carstensen's husband with the same chilling inscrutability, revealing nothing behind his placid features. Swooping in after Carstensen (a virginal 31-year-old librarian) loses her father to a heart attack, Böhm subjects her to constant physical and psychological tortures. On their honeymoon, he allows his pale bride to fall asleep in the sun, then violently ravages her badly burned body. Once home, he terrorizes her into memorizing passages from a civil-engineering textbook, makes her quit a job she loves, and confines her to a form of house arrest. Like Sirk, Fassbinder holds up this marriage as a grim assessment of bourgeois repression, though he doesn't share Sirk's warm regard for his heroine, who contributes to the situation as much as she's victimized by it.
Fassbinder extends a bit more sympathy toward Volker Spengler, the transvestite martyr in the deeply personal 13 Moons, but he doesn't underplay the pathetic nature of Spengler's fractured identity. Another story about the crazy things people do for love, In A Year With 13 Moons details the lonely street life of a Frankfurt drifter who had a sex-change operation in Casablanca years earlier, inspired by the offhand comment ("too bad you're not a girl") of a cruelly remote object of desire. Convincing neither as a man nor as a woman, to others or to herself, Spengler seeks out her well-heeled crush (Gottfried John) atop a towering building, where he rules the business world like a concentration camp. (The password to his office is "Bergen-Belsen.") But with its innovative design, the film is really a journey into Spengler's past, as she revisits old haunts, trying to construct the person she's become.
Shot mere weeks after Fassbinder's lover committed suicide, In A Year With 13 Moons exists as a repository of ideas that had accumulated in his career to that date, which may be why it appeals so much to Linklater, whose philosophical treatises Slacker and Waking Life serve a similar function. Structurally radical and emotionally operatic, the film links several bravura setpieces, including a monologue on self-mutilation set on the killing floor of a slaughterhouse, a long take of a nun recalling Spengler's harrowing childhood at an orphanage, and an absurd boardroom song-and-dance sequence inspired by Dean Martin and Jerry Lewis. At once melodramatic and coolly distant, wrenching and clinical, Fassbinder's character study never telegraphs the "right" way to respond to it, which leaves viewers with plenty to sort out afterwards.


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Here is a quote from Jeffrey Gitomer:
In your business:
Video is the new brochure.
Video is the new testimonial letter.
Video is the new proposal.
Video is the new training manual.
Video is the new instructional manual.
Video is the new letter and email.
Mr. Gitomer is right. Cable television is coming on strong. Businesses are creating their own networks on YouTube. Websites that sell effectively are using video to increase viewership and cement sales. We're becoming more sophisticated viewers and are expecting more. We want to be informed and not sold to in the traditional way.
Video is growing in our business. We used to mainly create 30-second commercials and now we are asked to put video on the web, in emails and create YouTube stations for clients that are using technology to the fullest. Even radio and newspapers are using video. Video is a critical part of your business when you need to show how something works or want to educate a customer.
Because of this schools are using video more frequently in the classroom and as an online learning source.
Right now most of the quality you see isn't that great. As time goes by, you'll see more need for better quality video production.
You might want to start thinking about how your business can use video to help your customers (not necessarily sell them). High definition video cameras have dropped dramatically in price. Folks are even producing decent video from their iPhones. Grab a camera and start producing. You might as well get started now so your video looks great – and you have a leg up on the competition.