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Medicare Part D's Hopeful Lessons for Obamacare
The rocky rollouts of the two laws were strikingly similar. The big difference this time around is an opposition party with its mind set on sabotage.
Congress is back—and the House has an ambitious plan for the year ahead. OK, an ambitious plan to cement its place in history as the Do-Nothingest Congress of all time.
The House has scheduled all of 97 days in session before the November elections, with many of them being half days or pro forma ones. And Majority Leader Eric Cantor's memo to his troops outlining the plan for the year ahead made it clear that there is at most a bare-bones agenda, focused like a laser, yet again, on repealing or further sullying and delegitimizing Obamacare. The only possible good news coming out of that is that the obsessive focus on killing Obamacare may provide the excuse for House leaders to extend the debt ceiling without blackmail this time, by convincing their rank and file that it is the best way to avoid distractions and keep the focus on the health-insurance law.
The obsession with Obamacare, and the near-universal belief among Republican lawmakers and conservative spinmeisters that the law will collapse spectacularly of its own weight, is fascinating.
Remember that when Senator Ted Cruz incited the shutdown last year over the demand to defund Obamacare, his argument was that this was the last chance before the law was implemented in January—after which it would be impossible to stop it, because so many Americans would be delighted with its benefits. Cruz told Sean Hannity last July, "If we don't do it [defund Obamacare] now, in all likelihood, Obamacare will never, ever be repealed. Why is that? Because on January 1, the exchanges kick in, the subsidies kick in; ... their plan is to get the American people addicted to the sugar, addicted to the subsidies, and once that happens, in all likelihood, it never gets …"
At which point Hannity agreed, saying, "It's over—it never gets repealed."
The awful and bumpy rollout of the plan changed all that; now, for Cruz, Hannity, and everyone else in the right-wing echo chamber, there won't be any highs ahead, or at least the highs and sugar addictions will be overwhelmed by bad drugs and overdoses.
Which view is right? We don't know for sure, but there is some interesting evidence in the rollout of the Medicare Part D plan in 2005, via an excellent analysis by Georgetown University's Center on Health Insurance Reform. The report makes clear that there are many parallels between Part D and Obamacare.
First, both plans passed with substantial partisan tension, which tarnished the initial public views of them. Second, both plans created much confusion in the public, with small proportions of Americans having even a basic understanding of what was in the plans and how they would work. Third, both plans had a lot of time after passage and before they actually took effect to prepare for a massive rollout. Fourth, neither had its website ready to roll when the deadline hit, and both had crashes and long delays to gain access. Fifth, even after the websites became more reliable, other problems persisted, including inadequate call centers and inexperienced navigators at the local level who were unprepared with full or sophisticated answers to questions posed by those trying to sign up. Sixth, supporters of the laws issued cautions when they were first unveiled, warning of glitches ahead and asking the public for understanding and help at ameliorating the problems.
Now for the differences. While Medicare Part D was the subject of serious partisan chicanery—the infamous three-hour vote in the House; the conference committee that barred key Senate Democrats from participating, including Senate Democratic Leader Tom Daschle; the "bait and switch" that in the end took out all the parts of the bill that had made Ted Kennedy an initial partner of the Bush Administration—once it was law, most Democrats worked hard to make the plan accessible and workable for seniors, as did Democratic governors and state legislatures.
Of course, the opposite is true of Obamacare. Despite yeoman efforts to make the bill bipartisan—months and months of negotiation by Senate Finance Chairman Max Baucus with Chuck Grassley and other Senate Republicans, starting from a framework devised and endorsed by Grassley—it got not a single GOP vote. But after passage, it has received nothing but yeoman efforts to sabotage it, including from a slew of Republican governors denying insurance to the most needy of their constituents simply to stymie the law's implementation. And whenever a Republican talks about how to make the law work better, instead of blowing it up (Jack Kingston of Georgia comes to mind), he or she is vilified by partisans and their media acolytes.
Second, the mainstream media reported on the glitches in the Medicare Part D plan but did not jump all over them with front-page or highlighted stories, or repeated and lengthy inquests on Sunday talk shows. The opposite has been true of Obamacare, with an added twist that reflects the new economic and political realities for media, as reported in a piece by Maggie Mahar at healthinsurance.org. Mahar investigated a ballyhooed article in the Fort Worth Star-Telegram titled "Obamacare Stirs Anxiety for Thousands." The cases of those who were purportedly shafted by Obamacare proved to be false or exaggerated, and three of the four cases cited were Tea Party adherents who strongly opposed the law, two of whom had never even checked for prices on the exchanges. After a lengthy stonewall by the paper's editors, it became clear that no one had fact-checked the piece, which was written by a reporter with no expertise in health policy, under a tight timeframe, assigned by an editor who only wanted bad news, not any stories of those who had been helped by the new law. This is more a case of underresourced news outlets eager to report bad news than bias, but it reflects the tougher climate for a law that affects far more people in far more ways than Part D did.
Eight years after its rocky rollout and deep public skepticism, the Medicare Part D plan is widely popular. I have no idea if that will be the case with Obamacare—and if achieving popularity takes any length of time, the political damage, in this November election and maybe even in 2016, will already have been done. What I do know is that there are going to be a whole lot of winners under the Affordable Care Act, and a smaller number, but still a significant one, of losers or those caught up in the inevitable upheaval to the healthcare system.
And I know if your only legislative or policy plan for 2014, in the face of a sluggish economy, a crisis of long-term unemployment, and a host of other short and long-term problems facing the country, is to bet on the spectacular failure of the healthcare plan, you deserve the public contempt your Congress is receiving.


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At will and sometimes against his will, Sam Brown can return in his mind to that hour in the Kandahar desert when he knelt at the edge of a blast crater and raised his flaming arms to the Afghanistan sky. He'd already run through the macabre slapstick routine of a man on fire, trying to put himself out by rolling on the ground. He'd resorted to pelting his face with fistfuls of sand. That failing, he'd run in helpless circles. Finally he'd dropped to his knees, lifted his arms, and screamed Jesus, save me. Each scream drew fire deeper into his lungs. Behind him his Humvee was a twisted inferno. Bullets whizzed around him. His men were scattering, taking cover, moving dreamily in clouds of so-called moondust, that weird powdery talc, which hung in the air and gave the soldiers the appearance of snowmen. It was going on dusk, and in the fading light the enemy gunfire blazed behind the walls of the village.
Only the day before, Brown's brother, Daniel, had told him, in a phone call, You're invincible, they can't kill you. Best he could remember, he'd always felt invincible. Pretty much right up to the instant they rolled over the IED, he had remained the same man he'd been at West Point. That is, he was a man whose life still had meaning. Every action had been meant to hone him for the glory of battle. Even as varsity stroke, in command of a shell on the rowing team, out on the water every morning at dawn, the sun dripping off his oars, his arms burning as he counted off the strokes, welcoming the pain into his body, bronzed, sculpted, almost too good-looking, he sought hard perfection in himself and those around him.
A diligent cadet who would spend the whole of an afternoon in the library reading about ancient Greek wars in Herodotus, immersed in the virtual reality of history, yearning for his own chance to test his mettle—but that was before eight brain-dead weeks of providing security for the construction of a new FOB in the middle of nowhere, watching bulldozers push sand, anxious for anything to break up the tedium, anything. When he was told his platoon would have to help provide security for a convoy coming through his sector on its way to a hydroelectric dam out in Helmand—delivering turbines, on a hearts-and-minds mission—he was all for the diversion, almost ecstatic when the call came from First Platoon reporting they'd been ambushed and needed backup. Brown had responded immediately. He was on the radio to his lead vehicle when he saw the bright flash. His body went inert as the Humvee lifted into the air. How he escaped from the wreck he couldn't recall.
Kneeling there, on fire, he'd resigned himself to death. All he'd wanted to know was how long? How long would he have to burn? How many more torturous fractions of a second would he have to remain alive?
His gunner, Jensen, had come to his rescue, extinguishing the fire with sand, helping him to his feet. Running for cover, Brown had kept his arms held out in front of him, as if he were carrying an infant that he did not know what to do with. The sleeves of his uniform were burned off, with patches of the desert camo fused to his skin, and the visible bits of his own flesh either meat-raw or charred black. It felt as though his gloves—made of thick leather and fire-retardant Nomex—were somehow cooking his hands.
Crouching behind a wall, he turned to the private beside him and said, "Take my gloves off."
The private hesitated, but then took hold of the glove and started pulling. "Sir," he said, "it's not coming off."
"Take the glove off," First Lieutenant Brown said.
The soldier grimaced but put his strength into it, and the glove came off, and with it, Brown's flesh. They all looked at the glove on the ground and then at his hand. Or tried not to look.
Brown extended the other hand. "This one."
It was dark before vehicles from the other platoon managed to reach them. In the back of a Humvee, Brown watched the hot .50-cal brass shells raining down from the turret. After a few moments, he could hear the battle fading behind, and then they were out bumping across the poppy fields. At one point, Brown caught a glimpse of himself in the side mirror. His hair was ash. His nostrils were black. His face was unrecognizable.
Before the Humvee reached the appointed helicopter landing zone, whatever Brown had been running on was gone. After helping him out of the Humvee and onto a stretcher, Brown's men had wrapped gauze around his eyes to protect them from the flying dust the helicopter would kick up, and when they saw that he was having difficulty breathing, they began to sedate him in preparation to intubate. His arms were too badly burned, so they had to run the IV through his sternum. By the time they heard the Black Hawk and saw its search beam twitching over the poppy fields, the giant blades shredding the dark, the morphine had begun to find its way.
Hunter Hoffman hadn't set out to help burn patients. As a cognitive psychologist—who had gotten his start back in the '80s conducting experiments at Princeton to test the mind's ability to discern between real and false memories—he had begun experimenting with virtual reality as a treatment for arachnophobes. Using a VR game he'd designed called SpiderWorld (see box), he had helped a number of individuals so crippled by fear that they had to seal up their windows to sleep. Outfitted with virtual-reality goggles, the patient began at the far end of a virtual kitchen, opposite the counter, upon which was a small, barely visible spider. Once the fight-or-flight response had subsided, the patient could inch closer until he could stand being close enough to see the spider's reflection in the toaster's chrome finish. Hoffman had created a world that people could enter, reemerging with their nightmares erased. It was an artificial world with the power to transform meaning itself in the so-often-insufferable sphere known as the real.
One day in 1994, a colleague of Hoffman's told him he'd been observing patients at a burn center using hypnosis to control pain. His colleague wasn't exactly sure how the treatment worked, but he thought it had something to do with distraction.
"Distraction?" Hoffman said. "I'll show you distraction," and he showed his friend SpiderWorld.
Not long after, Hoffman went to meet the hypnotist himself, who agreed VR sounded like a pretty good idea. On the very first
burn patient they tried, SpiderWorld worked. He simply forgot to think about his pain. Still, stoves and toasters didn't seem right, considering—kind of cruel, really. So Hoffman hired a world builder to make something else, something colder, fireproof.
Later, after Hoffman became director of the Virtual Reality Analgesia Research Center at the University of Washington Human Interface Technology Laboratory, or HITLab, he had some remarkable success. Using $35,000 goggles—the sort of hardware ordinarily used for training fighter pilots—researchers obtained drops in pain ratings by 30 to 50 percent.
If distraction was the key, why not just use over-the-counter video games for a fraction of the cost? To answer that question, Hoffman had run a control experiment. In his first case study, he had a teenager with a severe flash burn play Nintendo Mario Kart while having five staples removed from a skin graft. The data showed that in terms of reducing pain, anxiety about pain, and time spent thinking about pain, playing Nintendo Mario Kart compared poorly to SpiderWorld. The reason VR was so much more effective than a regular video game came down to a quality called "presence"—that sense of being immersed inside an artificial world.
In 2006, Hoffman presented his findings at a DoD conference on combat-casualty care. The most prominent image Hoffman had played on the screen had been a giant digital snowman, somewhat menacing in mien. Yet it was hard for all the high brass in the room to ignore the two 3-D brain scans comparing activity in the region of the mind known as the pain matrix. In the scan of a patient who had received only conventional opioids during wound care, the matrix was lit up like a cortical pool of lava. The other brain—the brain on VR—was a cooling star. "According to our results," Hoffman said, "VR not only reduces pain perception; it changes the way the brain processes pain signals." A day or so after the conference, he got a call from Colonel John Holcomb, commander of the army's Institute of Surgical Research, or ISR, at Brooke Army Medical Center in San Antonio.
ISR was a unit born during World War II, in part out of the need to find better ways to treat thermal injuries, in anticipation of the waves of atomic-burn casualties that many reasonable, if gloomy, individuals regarded as inevitable. Ironically, sixty years later, those new techniques were being used more than ever, in response not to the most sophisticated weapons on earth but to the most crudely effective. An approximate 70 percent of injuries and deaths of U.S. troops this decade have involved an IED.
"Hoffman, we need VR," Colonel Holcomb said when he called. "Make it happen. Get it over here."
When a man's body explodes in flame, the most visible devastation—the charring, the suppuration, the phantasmagoric melting—takes place on the surface, but the worst damage, the most dangerous and permanent damage, takes place invisibly, under the skin. In the crucible of fire, the body undergoes such a rapid metamorphosis that Major Christopher Maani, chief of anesthesiology at ISR's burn center, likes to compare the physical changes to a kind of satanic fast-forward pregnancy.
"With pregnancy, you have nine months to see how that change is going to happen. You've got swelling, you've got stretching, you've got hormonal changes. With a burn victim, that evolution is so quick. You go from being perfectly where you were five minutes ago, to five minutes after the injury you've got leaking capillary membranes, you've got burn shock, your heart is acting differently, your kidneys are acting differently, your airways are starting to swell. Your mucosae are taking on fluid, so sometimes you get even total body swelling, or anasarca." In anasarca, the body balloons until it looks as if it's going to explode.
A burn trauma is among the most significant stresses that the human body can survive. It's far more complex and devastating than a gunshot
wound or a stab or a blunt-force injury. "All of them are bad," Maani said, "all of them carry their own risks and complications, and each can be a nightmare to deal with, but with burn injuries you often have all those things rolled into one." And that was the condition in which Lieutenant Sam Brown arrived—less than a week after hitting the IED in Afghanistan, with a brief layover in Germany—in San Antonio in the early evening of September 9, 2008.
Fortunately for Sam Brown, in the previous decade or so, with a steady stream of wounded veterans returning from the battlefields of Afghanistan and Iraq, doctors had come up with much better techniques for saving the lives of severe-burn victims. There had been huge leaps in antibiotic therapy, and specific resuscitation formulas tailored to the unique physiology of each patient. Now, rather than waiting, doctors rushed patients into the OR to begin the excision of dead and burned flesh and to begin performing the first skin harvests and grafts. Together, such changes had significantly improved final outcomes.
What had hardly improved at all, however, was the management of pain. Modern science had mapped the brain well enough that neurologists could now trace pain to its source in the pain matrix, and they knew that pain had been an evolutionary friend, a physiological adaptation. But pain experts were gradually starting to understand that it was just as often a pathological adaptation. Not a symptom of something else, but a disease in and of itself. Pain had a tendency to go berserk and send a lot of maladaptive signals, like telling an amputee that his nonexistent foot itched. Yet for all they'd learned, when it came to treating pain, little had changed since the invention of morphine in 1804.
Opiates usually helped, but they had plenty of bad side effects: nausea; acute constipation; they threw off your sleep cycle; some patients didn't respond to them at all for whatever reason; addiction was pretty much par for the course, and as a practical matter for the military, rehab was costly, not to mention possibly fatal: Administer too big a dose and a patient could stop breathing or choke to death on his own vomit. Also, it wasn't very easy to debrief somebody who was stoned out of his mind.
When Brown first came to in San Antonio, he began babbling about Mexico, and terrorists, and an exploding school bus, and an orgy on a battleship. For the previous two weeks, he'd received a continuous infusion of a powerful analgesic called ketamine—as in Special K, the same drug kids use at raves. As a sympathomimetic, ketamine was kind of a wonder drug for trauma and burn victims, Maani explained. The military loved it. Of course, there had been some concerns that it might contribute to post-traumatic stress disorder, since it did sometimes induce psychotic reactions: It was, after all, molecular kissing cousins with PCP.
While Brown's body lay unconscious in Germany and then in San Antonio, his mind had romped and roamed. He'd awakened aboard a naval warship in an empty cabin painted battleship gray. Visitors had entered, not doctors and nurses but a gang of sailor boys and their girls. They'd held a drunken orgy, and one of the sailors had decided to torch Brown with a lighter and a canister of aerosol for fun. The ship had delivered him to a weird hospital in Mexico resembling a mosque. He'd been the only patient. Lurking around the grounds were mysterious Middle Eastern men armed with rifles. One day, while Brown was out walking the mazelike halls, these terrorists snuck into his room and handcuffed dead American soldiers to his hospital bed. To sleep, Brown had lain down among them.
These hallucinations hadn't been like ordinary dreams. Dream time accelerated, skipped, blurred. Brown's hallucinations had played out in real time. He remembered the tedium of his days at sea, counting off the minutes and hours. He recalled trying and failing to get comfortable beside those corpses handcuffed to his hospital bed. "It was," he said, "nothing short of reality." If he'd known it, the word he might have used to describe what his hallucinations had that a dream lacked was presence.
His doctors were surprised that he was able to recall it all with such horrible precision. Perhaps, despite the massive amounts of analgesia, the whole trip was some kind of unconscious interpretation of the surgical grafts they'd performed on him while he'd been sedated. As if the pain had somehow snuck in and managed to build an entire virtual world in his mind, complete with invented cities, mosques, and torturers. Wide-awake now to his new dawning reality—once conscious, the first surgical consent he gave was to have his left index finger amputated—Brown had to wonder if this world was preferable to the psychedelic one he had just escaped.
Morphine barely touched the worst levels of pain, such as the excruciating daily cleaning and debridement of open wounds. The first morning after Brown had regained consciousness, two nurses came to change his bandages. As gentle as they tried to be, the scabs still ripped, and the open air on his bared nerve endings made him writhe in agony. After an hour, which was how long it took just to take the bandages off, one of the nurses put two more milligrams of Dilaudid into his IV before wheeling him into the shower room. The nurses lathered him with soap and began to scrub and scour his skin. Even with the Dilaudid, they may as well have strapped him to a metal gurney, doused him with gasoline, and set him back on fire.
Every day he had to undergo the showers. He begged them not to do it, and his whole day was built around dreading it. Pain was ultimately a subjective experience, and the anxiety that built up to the daily torture of wound care, the anticipation, the fear of knowing what was coming, of being set on fire by your memory over and over again every day, often triggered a cycle of escalating pain that led inexorably toward PTSD.
After a few months, when the scar tissue from his grafts began to grow out of control, Brown discovered a new kind of torture even more agonizing even than the showers.
Scar tissue, of course, was meant to knit things back together. But his had gone into overdrive. It was a hypertrophic, aggressive scarring pattern, and it had something to do with his collagen tendrils not being properly "organized." The worst was how it had thickened on his back and shoulders, where his own skin had been harvested and the first grafts had been made while he was off in his ketamine dreams. His scars looked like some kind of mutant armor. In physical therapy, in hopes of restoring his range of motion, they had to stretch those contractures out. It was like stretching—and ripping—a plastic milk jug. On a scale of 1 to 10 the pain was easily a 9. His pain was always being quantified, appointed a numerical grade. On many days it was a 10. Why had nobody yet realized that—just to be fair—they really needed a new scale that went from 1 to 50? At least.
First Lieutenant Amy Larsen and Sam Brown: He was a burn patient, she was his dietician. "How about some lieutenant time?" he asked.
It was once he was off the ICU, in the step-down unit, that Maani came in one day and asked if Sam would be interested in taking part in a research trial. He consented, along with eleven other soldiers in the burn unit. He probably would have consented to just about anything now if it promised relief. Soon thereafter, doctors wheeled an apparatus into his room, a robotic-arm-type thing with what looked like a welder's mask affid to one end. This was the delivery system for a state-of-the-art virtual-reality game, they explained. It was called SnowWorld.
When they first lowered the goggles over his eyes, Brown was not all that impressed. He found himself floating through a kind of glacial canyon, but the overall vibe was pretty kiddie. Snowflakes wheeled gently from a digital sky. Snowmen and penguins lined up on ledges along the fjord. The soundtrack was kind of lame, too. Kind of an upbeat chirpy world music, a catchy-against-your-will kind of thing that he'd never heard before. If you'll be my bodyguard, I can be your loo-ong lost pal, the lyrics went.
But there was no question Sam felt very much inside this Disneyesque world on ice, and it was a hell of a lot better than being present while they yanked and pulled at his petrified shoulders. So he tried to get into the game. A few milligrams of Dilaudid didn't hurt.
The action of the mouse allowed him to fire off snowballs as fast as he could click. He had, more or less, a snowball M16. When one of the snowmen lobbed a big misshapen snowball at him, magically unholstering it from its hip with its stick arm, he took it out with three controlled head shots. The first shot turned the snowman to ice, freezing it with its arm served back, mid-lob. A third sent an explosion of ice shrapnel raining down into the canyon. Eerily, its disembodied face, the charcoal eyes and carrot nose and button teeth, lingered in the air for a few seconds afterward.
I can call you Betty, and Betty when you call me...
He passed under a low overhang, a kind of narrow passage in the bluish opalescent icy wall, strafed a couple of igloos, and then turned his attention to a squad of penguins flapping their wings further up the escarpment.
After a few circuits, he realized that each time he went through the cavern by the waterfall and then came back out, all the snowmen and penguins he'd killed were resurrected. It was a game that could not be won. So to make it more interesting, he began to test how to ricochet snowballs off the canyon wall and make carom shots. He started thinking trajectory. He thought ballistics, correcting his maximum ordinates before laying down wave after wave of penguin annihilation.
When he stopped shooting, he could hear the trickle of the river moving underneath him, and he took a moment to notice that he was suspended in air, floating along, out of his body. Everything moved in slow motion, just a few frames slower than reality, which was relaxing. As he passed beside the waterfall, he felt a tug of pain from the outside world but then directed his attention to the flying fish leaping below. He fired off a few shots, and his snowballs splashed up with blue steam.
Don't wanna end up a cartoon in a cartoon graveyard, bone digger, bone digger.
Sam found out quickly that the woolly mammoths wading below were indestructible. Shoot them and they only trumpeted angrily, so he didn't bother wasting any more rounds. Sometimes the snowfall waned, the sky turned blue, and then the snow started again. Between Paul Simon, the indoor waterfall, and the sedated peripatetic tempo, the whole place kind of had the feel of a suburban mall. Except, of course, here you could machine-gun everything in sight guilt-free.
The truth was, he was rather enjoying it. It wasn't like he could feel a cold breeze blowing through his hair or any bullshit like that, but being down in that digital wintry realm, it did have a certain effect, enough that he found himself drifting back to the last time he'd gone skiing with Daniel, his brother, at the same resort in Colorado where his family had always gone on Christmas break, this last trip being during his final year at West Point. He and Daniel had gone skiing backcountry, off the trails, well beyond where the tourists went, so they had it all to themselves. They had found a bowl that was pure and untouched, the powder so deep they'd just floated down the whole way, the best skiing of his life. He also remembered the crazy stunt his brother had pulled that Christmas, cracking everyone up, when he'd gone on a black-diamond run almost naked, busting down the mountain in nothing but a pair of bor shorts and red-and-white-striped elf tights, the pom-pom on his red Santa hat flipping back and forth. It was only as he got closer, almost to the bottom, that you could see the rubber skull mask, and when he skidded to a stop, his laughter was muted by the mask, the steam of his breath huffing out the rubber eyeholes.
Before Sam knew it, the game was over. His therapists were taking off the goggles. "We're already done?" He still had a whole village of igloos left to liquidate.
When they went through the list of questions, Sam was surprised to hear himself say that his observed pain had only been a 6. The therapists were pleased, and maybe a bit surprised as well, to tell him that they had gotten more range of motion than previously.
"Really?" But it was true, Sam had only been vaguely aware of the pain, mostly when it had caused him to muff a shot. The game play was like a white noise that canceled out the pain—as great a relief as he'd gotten so far during therapy, better even than morphine.
Later on, Hunter Hoffman came in to explain how it worked. Sam immediately liked Hoffman, who must have been about 50 but had the wispy blond hair and boyish energetic demeanor of a surfer on some kind of mission impossible. He liked hearing Hoffman break apart the mechanics of how his mind and his pain operated. How giving pain attention meant giving pain meaning, and how meaning amplified the experience of pain. How his conscious attention was like a spotlight. "Usually," Hoffman said, "it is focused on the pain during your wound care, but we're luring that spotlight into the virtual world."
Virtual Iraq
M4 rifle in hand, vets suffering from PTSD patrol a generic Middle Eastern street. The unseen therapist introduces sensory triggers—the shock wave of an IED, the Muslim call to prayer, spices pumped in by a scent machine.
Arachnophobes endure increasingly intimate encounters with digital spiders until theyre brave enough to touch both a virtual spider and, with their actual fingers, a lifelike replica of a Goliath bird-eating tarantula.
Dirty Bathroom
Germaphobes explore a series of increasingly befouled bathroom stalls, touching every nasty surface. The final test: flush a clogged toilet and resist the urge to flee as feces and urine flood the floor.
Chez Fortune
Gambling addicts enter a dim bar equipped with blinking slot machines. Music blares, and cigarette smoke clouds the room. Ask the bartender which machine to play and hell tell you, They all pay eventually.
Sam thought about one of the questions they had asked when he'd finished: "While experiencing the virtual world, to what extent did you feel like you WENT INSIDE the computer-generated world?"
0 = I did not feel like I went inside at all
1–4 = mild sense of going inside
5–6 = moderate sense of going inside
7–9 = strong sense of going inside
10 = I went completely inside the virtual world
He had answered "moderate" for that one. But everything was relative. When it came to being inside virtual worlds, he was a veteran. He knew a thing or two about immersion. SnowWorld did not even compare to KetamineWorld. KetamineWorld was a solid 10 for presence. Still, he fid Hoffman with his brown eyes and said, "I think you guys are onto something."
In the following weeks, he was surprised how often he found himself wanting the balm of that snowy fireproof wonderland. The fact of the matter was, his doctors had let him visit it only the one time—not as a patient but as a research subject. They would need to test the game on a larger sample of patients before prescribing it as therapy. For now, Brown would have to depend on drugs alone. After two more months, he was stable enough to arrange a visit home to Virginia at Christmas. If he wanted snow, he stood a better chance of seeing it there than he would in Texas.
Since he had microstomia—meaning his mouth was frizzled down to the size of a nickel—he couldn't eat real food yet and had to drink this geriatric stuff called Boost Plus. He was going to need five pints a day just to get him through Christmas. So his case adviser paged a dietician to make the arrangements, and when she came into the room, Sam could see she was nervous as hell. Cute, but nervous as hell. She tried to cover it up by being extra perky, the way nurses sometimes did. She was new—her name was Amy—and probably wasn't used to being around burn victims yet. Sam could only imagine what he must have looked like to her, sitting there in jeans and sneakers and an antimicrobial T-shirt spotted with blood from his seepy wounds.
A week later, at his parents', he was watching some lousy Christmas special on TV, having a beer (with a straw), when the phone rang. To his surprise, it was the dietician. She sounded less chirpy, more stuffy and uptight: "Hi, it's Lieutenant Larsen. How are you doing, Lieutenant Brown?"
"Hey Amy," he said, "how's it going?" He tried to chat her up, but she was all business. As soon as she knew the Boost Plus had arrived safely, she hung up.
When he returned to Texas, he was living in an apartment near BAMC, existing in a state of limbo, no longer a full-time patient but not yet repatriated into the world of the healed. The pain he experienced during daily physical-therapy sessions had not so much diminished as become familiar, habitual. So had the drugs, which worried him. There was this quote he'd scratched on a Post-it that he carried around with him: "He who makes a beast of himself gets rid of the pain of being a man." He'd heard it in a song by Avenged Sevenfold, then later Googled it. The quote was Samuel Johnson's. He didn't know what metalcore sentiment Johnson had had in mind, but for him, it described every burn victim's fear: that he will wander the earth as a monster, alone, unloved, unplugged from his soul in a haze of drugs.
Then, in February, he had to go back in for an eye-release surgery (his left cheek was contracting and pulling the eyelid down), and on his way to getting discharged, he ran into Amy Larsen. Just for the heck of it—maybe just to be testy—he asked if she wanted to go to the rodeo with him.
"You know," he said in his softest drawl. "How about some lieutenant time?" He was surprised when she said yes.
It turned out the rodeo was on Valentine's Day. She'd never gone to one, but Sam's old man had actually done rodeo, so he talked her through it a bit, though the point was fairly obvious: Hold on to the bull until it gored you or threw you to the ground. People stared at them, but he didn't care. Just being around Amy, having her touch his arm, where the skin was seamed, meshlike and web-textured, gave him a sense of comfort—a reassuring presence—that he had not felt in a long time.
The following weekend, a family friend was getting married in Houston, and she agreed to be his date. Somewhere in the midst of all those hours alone in her car to Houston and back, Amy told Sam about the first time she had seen him in the hospital, before he'd even been conscious. He had been bandaged from head to toe, hooked up to a ventilator and feeding tubes, in deep sedation, off floating across a sea of ketamine. But when she heard that he was awake and extubated, she just felt this bizarre need to go talk to him. It was kind of crazy. She didn't even know him. She didn't know what he looked like under all the bandages. But when she got to his room, there was already a crowd, a circle of doctors and family members wearing the yellow isolation gowns, blue caps, and blue masks, and a chaplain leading everyone in prayer. Right away she turned and walked out.
It was not until the end of November—two months later—that she got the page from Sam's case adviser about the Boost Plus. She confessed how nervous she had been, but not on account of his appearance. His face was rippled, like wax that had been blown by a gust of wind just before cooling, and the sides of his nostrils were fused to his face; but the brown eyes that looked out from underneath the hardened mask of melted flesh weren't the eyes of any monster. She'd seen photographs of him from before: rock climbing, in a tank top with his crew team, looking gorgeous and smug as hell. If they'd met a year earlier, she's not sure she'd have fallen for him. In this respect, the fire had changed him for the better. By the time she met Sam Brown, he'd had the ego burned off.
By March, Sam was able to go jogging again. So he and Amy started running together, talking, and finally one day, while they were stretching, Sam stopped and said, Look, if we're going to keep hanging out like this, does that mean we're dating? And Amy said yes, she thought it did, and then he said that he was of the opinion, given how short life was, even if they were both still in their twenties, that if he was going to date somebody, he felt it ought to be with marriage as an ultimate goal. Did she think she agreed with that? Amy said that yes, she thought she did. And so they continued jogging and dating until the end of April, when Sam proposed.
A month later, they ordered a cheesecake and flowers and got married in a friend's backyard. Sam's brother, Daniel, was best man. A few weeks later, they had another reason to celebrate: Sam received word he'd been promoted to captain. He and Amy didn't go on a honeymoon right away, because Sam was scheduled for surgery to cut the scar tissue away from around his mouth. The result was he got back the semblance of an upper lip. That was followed by another surgery where microscopic holes were poked all over the skin on his face and neck to try and break down the scar tissue that was threatening to swallow up his features. But the scar tissue just continued to grow thicker. While he was suffering through his post-op recovery, Maani contacted him to say that if he was still interested, he could come back in for another dose of SnowWorld. He needed to demonstrate it for a few visiting officials. Sam leapt at the chance. He didn't care if he had an audience.
But once he donned the goggles, the experience fell short of what he remembered. It still did an okay job, but now, somehow, the distractions—the music, the demonically happy snowmen, the exploding penguins—felt more like sensory overload. That, but also, he wasn't a patient in this hospital anymore, nor was he caught in that lonely gray limbo of an apartment. He had a real home now, where Amy and a little peace and quiet were waiting.
The next Easter, in 2010, Sam and Amy finally managed to take a proper honeymoon, to Hawaii. One afternoon, swimming in the hotel pool, Sam was in one of those rare moments where, without medication, he felt no pain, felt like his old self, and he didn't harbor a doubt in his mind as to why the most beautiful girl at the hotel was sunning herself on a towel, waiting for him and only him. She made the world around them bloom into something that not even the best VR architect could ever have conceived. There was no beating this actual water, this actual sun, this actual wife. Then this actual kid, this 4-year-old shit who'd been porpoising around, came up for air right in front of Sam, and you could see the kid thought he'd come face to face with the Creature from the Black Lagoon. Maybe if it had been another time, Sam would have let it go, but this time, jerked so abruptly out of his bliss, he snapped: "You know, if you don't wear sunscreen like your mother tells you, you'll end up looking like me!"
Soon after they got home, Sam had to go back into the hospital to have tissue expanders surgically implanted. That was in May. A tissue expander was basically an inflatable silicone balloon that went just under the skin and was gradually pumped full of saline over several months. The tension caused the cells to grow more skin, which the surgeon could then harvest and graft onto his face. It was somewhat like getting a breast implant, except the bags were rectangular shaped, and Sam was getting four: two under the soft skin on both hips and two on his upper chest, below each shoulder. It was slow torture, every bit as excruciating as it looked, and lasted right up until the final procedure—the first step of which was to remove most of his face.
A week after surgery, the graft was going south. There were dark areas, gray patches. They waited another week just to see, but when they took off the bandages, the graft had turned black. The scarring from that surgery too now began to grow with a vengeance, thick and red, hard as exoskeleton. Soon he could not move his face at all. This made it easier for him to conceal his emotions and harder for Amy to see, in the following weeks, that he was slipping away.
He no longer accepted that this was his reality. He couldn't. He even wondered sometimes, fleetingly, whether Amy was a dream, perhaps generated from the same place in his mind that, under the influence of ketamine, had built those minarets and mazes and phantom ships. The last time, ironically, that he could have known, really known, without a trace of doubt, where he was, was in Afghanistan, after his gunner, Jensen, had rescued him but before the morphine, when he was curled in the back of a Humvee, headed to the helicopter landing zone. In dust kicked up by other vehicles, the driver had gotten lost, and Sam had still somehow mustered enough clarity of mind and enough strength, or at least enough adrenaline, to rouse himself from the backseat, radio for coordinates, and tell the driver where to go: due south three and a half kilometers. He leaned forward to jab at the GPS with his finger. "Look, we are right here." He was just as stunned as the driver to see his own flesh smeared on the glowing screen. Outside, through the armored windshield, the last gray specks of daylight glimmered in the dust rising from the poppy fields. That was the last time Sam could have said for sure that any map in his life could correlate to one and only one world, virtual or otherwise.
He became a recluse, hardly ever leaving the house. What was interesting was that he no longer really feared pain. Not physical pain. He had chosen to be strict with himself about getting by now on lower doses of drugs. He had learned to escape into his own mind, where there was a quiet chamber awaiting him, a peaceful void without a soundtrack or flying snowballs, but also without Amy or anyone, where the pain only came through like a distant muted voice that he could choose to ignore.
Then, one evening, he and Amy sat down and watched a movie together called, of all things, Fireproof. The movie was about this firefighter and a nurse whose marriage is about to dissolve. The firefighter, played by Kirk Cameron, gets injured while saving a girl from a house fire. He's brought to the hospital where his wife works and where she's been flirting with a doctor who doesn't know that she is married to the firefighter (since things had already gotten really bad, bad enough that she no longer wore her wedding band). By the time the credits rolled, Amy was sobbing.
Sam found himself suddenly panicked at the thought of losing her, the one person who had made his life bearable. If he was going to win out over self-pity, if he was going to save his marriage, he'd have to recommit to the only world that mattered. The others were all cheap phantoms. Mazes of smoke and ash. Because this world, the one with meaning, the one where he was a lucky bastard just to be alive, this world that had the deepest and most unforgiving kinds of pain that you could not even fucking believe—well, he, for one, would not have rid himself of it for anything.
Last July, Maani and Hoffman published the results of the study in which Sam Brown had participated. Echoing the civilian studies, soldiers reported significant drops in pain while immersed in SnowWorld. Time spent thinking about pain, which is an inextricable contributor to actual pain, dropped from 76 percent without SnowWorld to 22 percent with SnowWorld. Amazingly, some of the biggest drops were for the most severe levels of pain, which went against every previous expectation. Since then, SnowWorld has received a good deal of enthusiasm from several well-lit corners of the Pentagon. At least one four-star general, after seeing the results from the ISR study, has gone so far as to say that he foresees a day coming soon when VR pain distraction might become standard care. There is nearly equal excitement about Hoffman's other applications, including one called IraqWorld, a virtual-reality exposure therapy he built to treat soldiers with PTSD.
Hoffman knows that more studies need to be done before VR becomes a regular part of a medic's field kit. To that end, he and his colleagues at HITLab are now using $7.5 million in NIH grants to further investigate how VR affects the mind and how better to apply it in clinical situations. One part of the study is looking at using small doses of ketamine to enhance the sense of presence. But he is confident that eventually, as the technology becomes more sophisticated, VR will be exponentially more effective. Soon, he predicts, VR worlds will be customized, personally tailored, and as in social networks or Second Life, they'll allow patients to bring along other people—a vet's mother, girlfriend, buddies. Hoffman imagines programs that will tap into a patient's happy memories—of a ski vacation or a honeymoon or a morning rowing on a river, sunlight dripping from the oars.
Hoffman can also see battlefield applications. Customized VR worlds will be pre-programmed right into the soldier's eye gear. He's already experimenting with piezoelectric crystals to that end. It doesn't seem like much of a stretch to imagine a near future in which combat patients could simultaneously distract themselves from their own pain while inflicting it on a virtual and remote enemy. A soldier could put his mind inside a drone instead of watching as a medic changed his bandages. In such a future of techno-utopian warfare, at least for those combatants equipped to fight outside the pain matrix, victory will indeed belong to those who have rid themselves of the inconvenience of being men and who, for all we know, may as well bleed snow.
By last winter, Sam had started jogging with Amy again, and the cold air felt wonderful in his lungs. He had already begun having laser therapy on his face and was seeing some results. The scar tissue was starting to settle, to calm, and he felt reasonably optimistic that before long it would soften and become more pliable as it gradually had on his arms. A few days after Christmas, Amy told him she was pregnant. They went into their bedroom and lay down together and called his brother, Daniel, a navy corpsman serving as a medic with the Marines at Camp Pendleton. Daniel had just returned from Afghanistan. He wasn't sure when he was headed back, probably soon. Sam told him that his son's name was going to be Roman Alexander.
"Really? I'm going to be an uncle?" Sam could almost hear in his brother's voice an innocence that he remembered from before either of them had seen war.
On that last ski trip in Colorado, when the two of them had gone off the trails, they had taken the chairlift to the very end and then hiked through the woods, carrying their skis, coming out above the treeline, out of breath, above that pristine untouched bowl. It curved out below them, empty and unblemished. They had it all to themselves.
It was Sam's last semester at West Point, and he knew he might be deployed the following year. But there was a chance Daniel, already on active duty, could beat him over there.
In a moment, they would hammer it to the bottom, racing each other all the way. Just before he lowered his goggles and pushed off, Sam took one last look down. The sky was blue and white, and his shoulders felt loose and ready to fly. The bowl held the promise of everything and nothing. When he raised his face to the snow falling softly across the treeless ridge, he felt the cold against his skin, and it felt like nothing so much as glory.
Jay Kirk is the author of 'Kingdom Under Glass', just out in paperback.

subset: commoncrawl


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Living Without Food
The question of how long you can go without food depends on a lot of factors. Will and determination definitely play a part. Political prisoners on hunger strikes and fasting religious leaders have been known to go for weeks at a time without any food. Gandhi fasted for 21 days while in his 70s. People lost in the wild have also survived for long periods of time without eating.
Medically speaking, most doctors agree that healthy humans can go up to eight weeks without food as long as they have water. People have gone longer and been fine, and people have starved to death in less time. Being strong and in good physical shape can help you survive longer, but so does having extra body fat. The body stores energy needed to live in the form of fat, carbohydrates and proteins. The carbs are the first thing to be used up without more food coming in. The fat goes next, which explains why people with more of it can survive longer. Then the proteins go. If you get to the point that your body is using up proteins, basically the body itself, then you're in bad shape.
Your metabolism also plays a role. Metabolism is what converts food into energy. If you have a slow metabolism, you'll burn your food intake slower and be able to go longer without replacing the food energy. If you go without food, your metabolism will adjust accordingly and slow down on its own -- basically doing what it can to pitch in for survival's sake.
Climate is a major factor too. The bad news is that both cold and hot weather are no good if you have no food. The good news is that extreme heat and cold will kill you in other ways before you have a chance at starvation. But in terms of living without food, heat means faster dehydration -- cold means more energy is burned to keep the body's temperature at a cozy 98.6 degrees Fahrenheit (37 degrees Celsius). If you're lucky enough to be in mild temperatures, you'll be able to live a little longer without food.
Some symptoms you may see if you go more than a couple of days without food are:
- Weakness
- Confusion
- Chronic diarrhea
- Irritability
- Bad decision making
- Decreased sex drive
- Immune deficiency
Advanced starvation will cause your organs to shut down one by one. People in the throes of severe starvation might experience the following:
- Hallucinations
- Convulsions
- Muscle spasms
- Irregular heartbeat
In the next section, we'll look at how important water is and what happens to your body without it.


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The Bradley Revit Thermostatic Mixing Valve Library consists of more than 30 Revit valve family components in Bradley's five valve product groups:
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Bitcoin ATM Aliquippa – Coinhub
Coinhub Bitcoin ATM in Aliquippa PA
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Bitcoin ATM Aliquippa – Coinhub
2061 Brodhead RdAliquippa Pennsylvania 15001USA
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About Aliquippa
Aliquippa is the largest city in Beaver County, Pennsylvania, United States, located on the Ohio River about 18 miles (29 km) northwest of Pittsburgh. The population was 9,238 at the 2020 census. It is part of the Pittsburgh metropolitan area. Formerly the location of a large Native American trading center, Aliquippa grew to become a center for steel manufacturing by the early 20th century, similar to other towns in the area. With the closure of most large employers by the 1980s, Aliquippa has since become an economically distressed community.
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Naruto. What is there to say about Naruto? What is there to truly say about one of the most ballin' animes currently running? Well there's a lot more to say than that it's just balling. This show fulfills every young boys' dream of becoming a ninja. And not just any ordinary ninja, but a true Shinobi with Ninjutsu and Thaijustsu for days. You got the Kunai and Shuriken, and the classic substitution technique. These young children Shinobi put legitimate ninjas to shame. They are unstoppable. And this show is infectious.
But there's just one debate we have to deal with before we move on to the plot of Naruto. And that is: Naruto Dubbed vs
Naruto Subbed? There are those younger kids who would argue dubbed, due to an ability to watch a show (not read, though not a valid argument) and a lot of younger kids watched this on Cartoon Network. There are a handful of good voice actors in the show that make it worth watching it. But there's the flipside of the coin. The subbed version, when it comes down to it, is better done. There's swearing, and Rock Lee's secret technique isn't called Loopy Fist. That was a bit of a disappointment. For a more serious tone for the older fans of Naruto should watch the subbed version. But it all comes down to a preference of English vs Japanese. It's the same show, just a different feel. It's all up to you.
So, Naruto is a show about Naruto Uzumaki (Maile Flanagan). He is a ninja in training and hoping to become the leader of the village he lives in one day, known as The Village Hidden in the Leaves. The Third Hokage, leader of the village, sees much promise in Naruto and hopes that his sensei's, Iruka Umino (Quinton Flynn) and Kakashi Hatake (Dave Wittenberg). With his teammates Sasuke Uchiha (Yuri Lowenthal), the cool calm-headed prodigy out to prove himself, and Sakura Haruno (Kate Higgins), the hot-headed and pretty much useless book smart girl, Naruto can't fail in his mission to become the best. Believe it!
There's a lot of arcs and sections in this show. There's the introduction of all the characters, the Chunin exams (the test that sees if you're ready to become the next level ninja), and the battles between Orochimaru (Steven Blum) and his henchmen. With each trial for Naruto comes more responsibility and more powers. The show culminates in a huge twist and leaves more than 60 episodes of fillers that have nothing to do with the main plot. That's not to say that there aren't fillers throughout that aren't cool and entertaining, I personally found a lot of the fillers to be funny and not so much a detraction from the show as an enhancer of the lesser characters. And how many cool characters there are.
There's the 12 Ganin, 3 of which I've already mentioned. There's Kiba Inuzuka (Kyle Hebert), the dog master of Akamaru and a master of, well, I'll let you check everyone's powers out. Shino Aburame (Derek Stephen Prince) is the master of bugs, and one of my favorite Shinobi in the show. Filling out Team 8 is Hinata Hyuga (Stephanie Sheh), the master of soft palm. She has a huge crush on Naruto but never
reveals it in the original Naruto, an unfortunate thing.
Team 10 is made up of some real destructive masters as well. Choji Akimichi (Robbie Rist), the expanding fat kid with a penchant for lots and lots of niblets and chips. Shikamaru Nara (Tom Gibis) one of my favorite characters in the show and one of the only truly gifted in the series. His ability with shadows will leave you… breathless. And then there's Ino Yamanaka (Colleen O'Shaughnessey), the useless girl who is more useless than Professor X. (You'll see why.)
And then there's Team Guy, the most masterful of all the masters. Led by Might Guy (Skip Stellrecht), his mastering of the physical Thaijustsu is just too legit to quit. Under Guy's tutelage is Rock Lee (Brian Donovan), the only kid who will never quit and always fights to the end with his Flying Leaf Hurricane. Tenten (Danielle Judovits) is a weapons master and is always twirling and releasing weapons on everyone's asses. And the semi-leader of the team is Neji Hyuga (Steve Staley) master of his cousin's soft fist and intelligent as Hell.
All of these awesome characters flesh out a show about honor and friendship, being the best and doing everything in your power to prove your self worth. There's self discipline, training montages, and
everything you wanna see in a shounen of this magnitude that needs to be seen by all young men out there that need a great role model in their lives, or just a great action cartoon/anime. Oh, and don't forget the villains! I already mentioned Orochimaru, but there's the best character and best voice actor that needs to be mentioned, nay, worshipped. Gaara (Liam O'Brien) is a disciple of the Village Hidden in the Sand, and a true beast of a fighter. With a gourd full of sand that does his every bidding, there's more than meets the eye to this character. And he will completely slaughter you. Two words: SAND COFFIN.
So watch this show for sure. The production value gets better as the show goes along, and for those that like dubbed anime, it's not the worst in the world. And that brings up an issue. Maile Flanagan ruins this show. She may have a similar voice that can mirror the tone that Naruto Japanese version can do, but that's just a bit of a stretch. Maile Flanagan's whiney voice and childish lines leave a lot to be desired from a leading role. Oh, and, well, it's just gross. Sorry there, Flannie old pal, but it's probably for the best the dubbed version was cut off in the middle of Naruto Shippuden. But, for overall story and deliverance, Naruto as a whole, for all it's worth, deserves a 8.8 out of 10. Definitely top 10 anime of all time to watch before you die. (You can skip the fillers.)


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3D printing empowers the lab
Stunning advances in 3D printing technology herald a new era of design creativity in the lab, write Stephen Beirne and Gordon Wallace.
Creativity in materials science research has been tempered, some may even say thwarted, by big manufacturing for years. After a number of decades where advances in materials science have often been limited by our inability to fabricate effectively, we have now entered a new era.
The explosion in 3D printing technology is now empowering those engaged in materials science research, education and commercialisation to do things not previously possible. These advances will have a staggering impact — they will accelerate the thought-to-thing process, delivering practical solutions sooner, but they'll also empower scientists to make unprecedented fundamental advances in science.
For example, the ability to arrange living cells in 3D within naturally occurring or synthetic biomaterial structures will give insights into environmental effects on cell behaviour never seen before.
The technology also empowers scientists with the ability to fabricate customised structures from the ground up using hardware and software that can be accommodated in most research laboratories at reasonable cost.
This enables us to challenge traditional commercialisation models involving materials and device manufacture that are based on mass production, cost reduction, sales targets.
So what is '3D printing'?
3D printing — or additive fabrication — involves depositing and fusing materials layer-by-layer to create complex 3D custom-designed structures. These structures are conceptualised, manipulated and defined within a growing array of computer aided modelling environments. A set of digitised instructions then drives the printer to create the required structure layer-by-layer.
There are several types of printing methods: from extruding a molten polymer which solidifies as it cools, to a fluid that is ink-jetted onto a surface and turned into a solid structure through a chemical reaction. We can build metal objects by laying metal in powder form then welding or melting selected areas with a laser to build the structure layer by layer.
Empowering researchers
The ability to create customised 3D plastic or metal structures in the laboratory in a matter of hours rather than days or even weeks, accelerates experimental design.
At ACES (ARC Centre of Excellence for Electromaterials Science) we discover, design, and develop nanostructured electromaterials that integrate with other material and biological components, for use in the fields of energy conversion, energy storage and medical bionics.
In bionics in particular, 3D printing enables us to create structures that support delicate biological entities, such as nerve and muscle cells, that cannot be assembled using conventional approaches.
For example, we recently developed a "bio-ink" formulation that allows us to print living cells; delivering both nerve and muscle cells to potentially build tissue and organs layer by layer. The cells are maintained using a biopolymer suspension, preventing them from settling in the ink and clogging the print head, and delivering them through the printer to the surface in a way that maintains the cells in a healthy state.
Pushing the boundaries: printing printers
In an interesting twist, 3D printing has also enabled us to create next generation fabrication equipment.
There are limits to what can be accomplished with off-the-shelf equipment. To get around these barriers we recently custom built a printer — using a 3D printer.
We needed a print head that could deliver living cells in a biopolymer sheath. New printer components capable of this, including a dual reservoir system and co-axial print-head, were designed and fabricated in-house. The era of printing printers is upon us!
Empowering education and entrepreneurs
Just as our capacity for research is empowered by 3D printing so also is our ability to deliver effective education and training.
Imagine the ability to explain and demonstrate the principles of additive fabrication in a class room. Low-cost fused deposition modelling systems allow a demonstrator to setup a fully functioning 3D printer in a classroom environment in a matter of moments with nothing more than a laptop and a mains power supply.
Educators now have access to basic software and fabrication tools to integrate elements of concept development, design for manufacture, and actual physical realisation of a component into an afternoon undergraduate class.
The simultaneous production of a finished component as its design is being conceptualised, discussed and refined by a student group is a powerful education concept that will certainly stimulate thought around the fabrication technique and invariably spark design and application creativity.
Now we can be bold, even audacious. We can develop materials not amenable to current processing and fabrication approaches with the knowledge that we can print printers; creating the fabrication machinery of the future in tandem with breakthroughs in materials science!
We can develop new approaches to education and training and develop new business models and ventures.
All will feed into the innovation pipeline delivering exciting opportunities and challenges for us all.
About the authors:Professor Gordon Wallace is currently the Executive Research Director at the ARC Centre of Excellence for Electromaterials Science and Director of the Intelligent Polymer Research Institute. He previously held an ARC Federation Fellowship and currently holds an ARC Laureate Fellowship.
Dr Stephen Beirne is a Research Fellow at the Intelligent Polymer Research Centre at the University Of Wollongong. There he is directly responsible for the implementation of a suite of commercial and custom additive fabrication tools.
Published 16 April 2013


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Microsoft's Surface tablet is a measured gamble to enter the cutthroat tablet business, but the company could be alienating longtime hardware partners that are also expected to announce Windows 8 devices starting later this year.
The Surface tablet models come with a 10.6-inch display and will be distributed directly to customers, via Microsoft stores and the company's online store. Microsoft's goal is to offer a package of hardware and software built around Windows so the company can effectively compete with Apple, which offers the iPad and iPhone devices running on the iOS platform, analysts said.
Microsoft is offering two tablets, the Surface with Windows RT for ARM processors, and the Surface Pro with Windows 8 Pro for x86 Intel processors. The Surface tablet with Windows RT is lighter and comes with Office 15, which includes widely used productivity applications such as Word and Excel. Microsoft's new tablets will come with a kickstand and a thin cover that doubles as a keyboard and trackpad.
The creation of its own tablet is a sign that Microsoft has lost faith in PC manufacturers to develop devices that can take advantage of the Windows OS, analysts said. Apple has dominated the tablet market, and Microsoft had to take hardware development into its own hands as PC makers were not generating enough excitement to drive interest in Windows 8. Companies like Dell, Hewlett-Packard, Acer, Asus and Lenovo are expected to come out with tablets running the upcoming Windows 8 and RT operating systems.
If the Surface tablets become successful, Microsoft could potentially be stealing future revenues from its partners who view the tablet segment as profitable, said Roger Kay, principal analyst at Endpoint Technologies Associates.
"I have to believe that [the partners] are fairly discontent about it," Kay said. "The tablet is the heart and soul of Windows 8, and it looks like Microsoft has reserved it."
Microsoft has licensed Windows to hardware makers for PCs since the 1980s, but that business model may be getting antiquated, Kay said. Microsoft may be seeking a new business model around tablets, but at the same time the PC market is not going anywhere and Microsoft wants to retain its Windows licensing business, Kay said. Microsoft may be experimenting with a new tablet business model, but the software company will have to strike the right balance in maintaining a relationship with the PC makers on tablets and PCs.
Shaw Wu, a financial analyst at Sterne Agee, agreed, saying Microsoft's tablets could eat into the sales of devices from Windows partners. The full impact of Microsoft's tablets on PC makers has yet to be determined, Wu said in a research note sent on Tuesday.
The Surface is crucial for Microsoft to establish a presence in the tablet market and to compete with Apple, said David Daoud, research director for personal computing at IDC. Microsoft's move to tablets came likely because PC makers failed to take the lead in making tablets good enough to compete with Apple, Daoud said.
"[Device makers] have been lagging in terms of creativity," Daoud said.
Apple's iPad dominates the market while competitors have stopped making certain tablet models or are trying to catch up. Hewlett-Packard last year discontinued the TouchPad, while Dell has discontinued Streak consumer tablets, and both companies are now planning to re-enter the consumer tablet market with devices based on Windows 8. Tablets with the Android OS offered by companies like Samsung, Asus, Acer and Lenovo have not sold as well as the iPad.
Microsoft had to take the lead in development as device makers were not willing to spend on research and development, Daoud said. Device makers are making razor-thin margins on consumer PCs and tablets, and have limited spending on innovation in tablets. Ultimately Microsoft's lead with the Surface tablets could inspire device makers to release the next-generation Windows hardware and get a better understanding of the software and hardware ecosystem, Daoud said.
"The move is somewhat predictable. What is unpredictable is Microsoft taking the lead on the hardware side," Daoud said.
At the start, Surface tablets will only be available through Microsoft Stores and online, which limits adoption potential, said Sarah Rotman Epps, an analyst at Forrester Research, in a blog entry. But a larger struggle for buyers revolves around distinguishing the Windows 8 and Windows RT tablets, she added.
"Selling x86-based tablets in the same retail channels as Windows RT tablets will confuse consumers and sow discontent if consumers buy x86 and think they're getting something like the iPad. Microsoft and its partners need to articulate a compelling strategy for how they will manage consumer expectations in the channel," Rotman Epps wrote.
But with or without the help of device makers, Microsoft is now gearing up to battle Apple.
"They have to do something, they can't just sit there and let Apple take over the world," IDC's Daoud said.
Agam Shah covers PCs, tablets, servers, chips and semiconductors for IDG News Service. Follow Agam on Twitter at @agamsh. Agam's e-mail address is email@example.com


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High quality and accurate 3d model of Modern Sofa 2x
• Nice topology (only tri and quad polygons)
• Real-world sizes and proportions
• The model is grouped for easy selection and placing in your scene, all objects are named correctly
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I am in desperate need of a some organization… I have not posted anything for the last couple of weeks because I was not organized enough to get the photos up and posted. I have about 5 quilts finished and photographed but I have not been able to get them sorted and corrected so that I can post.
So here comes the admission… I am not quite myself at the moment… and actually have not been for a little while. You see it seems the knock to my head a the end of 2016 did a little more damage than originally thought. I have not been able to read properly for a little while… my eyes and brain are not communicating the way they should be. It means that blogging has been a much more of a task than it used to be… and I have been reluctant to do it.
The quilting though has been surprisingly easier than my Neuro-optometist thought it would be. There is a lot to be said for muscle memory. It seems all those years of mindlessly sewing has helped me continue working during this fun phase… though some of my paper piecing stitches have not followed the lines the way they should…
After keeping this under my belt of the last 6 months I thought I should come clean about the struggle. I am seeing a large number of people with the word "neuro" in front of their title and things are getting better…slowly. So I ask for your patience as I try and find a rhythm as my brain heals.
All that being said I do have a quilt to share this week… and it is one I LOVE…
This quilt is another beauty that came out of a PMQG Charity Sew Day. It took tons of brightly colored solid scraps as well as some cream/white scraps – I spent a lot of time with my Accuquilt cutter cutting 5 inch squares for this one!
The solids worked so nicely and I have become a bit of a solid fan for charity quilts…. though I do miss the novelty fun that comes from using prints…
The quilting on this piece is beyond amazing. One of our talented long armers, Cindy Lund had a field day… each star is quilted with a different pattern and the sashing is free motioned. The quilting really does make this quilt so much more special.
I mean it is beyond anything I had imagined when I handed the quilt over… I am always in awe of the work of our amazing long arm quilters… they do such an amazing job… and it is a job that I am not particularly fond of, which makes me even more grateful for their time and talents.
As this is quite a large quilt I used a nice piece of wideback for the backing. The backing was donated by Elizabeth Hartman and is part of her widleback collection for Robert Kaufman. I have a been so grateful for the wide back donation we got from Elizabeth… it has saved me piecing backs for so many of the larger quilts.
To finish the quilt off I made the unusual decision to bind in white… because the sashing was not added around the outside of the quilt a darker binding would have made the quilt a little imbalanced I think.
This beauty is labeled up and headed to Camp Erin. We have a wonderful collection of quilts going to this cause this year. I was thrilled to run across the documentary "One Last Hug" on HBO last month, which is about Camp Erin… it is always nice to know more about where the quilt are going and who they are helping.
Quilt Details:
Quilt Block: Traditional block known as African star or pinwheel star
Block size: 12 inch
Fabric: Solid scraps with Kona white and Snow background.
Finished Size: 54″ x 68″


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Yep every cat lover knows what this feels like. Cats are their own creatures and do what they want.
T.S. Eliot really knew what he was talking about in his Old Possum's Book of Practical Cats. Yep cats do what they want, and you can't do anything about it.
Just try telling them what to do. All you get is a stare, a meow, and the cat doing exactly what you asked them not to.
And what about when you try to read a book or go on your laptop? Instant rubbing, stepping, and messing with.
But as much as they ignore you, mess with your stuff, and just do what they want..they are utterly adorable and you love them. After all:
And cats are always there for you when you need them:
For more on cats, go to That Darn Cat
For more Garfield, go to What a Fanatic!
For more on Lillian Jackson Braun, go to It's Fantastico!
For more of my favorite quotes, go to Tea Time


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Happy March! How are you guys? Feeling spring-y already I have been centered around art, wedding-stuff (I found a dress, yay!) and some unfortunate drama in a project I was working on so it's good to take some time to sit down and spend some time with the ol' blog. Also, the blog giveaways are coming so don't fret! 2COP is a hefty toddler now and just turned four, which is something we need to celebrate 😉 However, today we are bathing in some scarlet goodness, which is the Ewa Michalak PL Lśniąca Scarlet. This set was generously provided me by Ewa Michalak, but all opinions are my own!
The Design: The PL Lśniąca Scarlet is a classic PL-style from Ewa, which means it's a padded plunge. The design features seams though, which gives the bra its signature well-constructed feel and improves the fit for a padded bra. As someone who doesn't enjoy padded bras as much, I wasn't even surprised that I still liked this particular bra – it's the absolute royal of the padded bra family and I wear it each time I want to feel uplifted and oomphed to the max. The cups feature removable cookies, which is great if you want something extra, have a-symmetry or change a bit in size during your cycle.
The style of the bra is not the most ornate I have seen in the Ewa Michalak collection, but it still manages to appear striking with its colour and satin-y materials. This bra can easily be worn under t-shirts (with a darker colour, of course) but it's still appropriate for boudoir as well. What's not to like!
The Fit: The PL bra is not unfamiliar to me and thus I pretty much knew it would fit me in my regular size of 70GG. I don't find EM sizing to be that different from British D+ brands, maybe just a bit tighter in the band, so I usually go for my looser band size 70 (UK 32). Picking a size is pretty easy for me personally, as the EM team usually does it for me when I provide them with my usual size. Ewa Michalak bras are infamous for varying in fit and size, which is why it pretty much depends on the style whether I go for 70G or 70GG, or even H. This one runs very true-to-size though, which always makes the shopping experience a bit easier.
I have literally no bad things to say about the fit of the PL Lśniąca Scarlet: everything just seems to fall into place perfectly. The cups encase my breast tissue well when I insert just one of the pads into my right cup (my left boob is bigger). The cups are just deep enough for my breast tissue to sit in them without the cup foam collapsing at the bottom (very usual with most padded bras if there's not enough depth at the bottom of the cup) and luckily the wires are not too narrow for me with this particular EM style! I am so happy, as this trait with Ewa bras has always been a bit of a hit-or-miss with me.
Comfort: In addition to being well-fitting, Ewa bras are usually a pleasure to wear all-day, as the materials are well-thought out. The PL bras are always lined with cotton to feel comfortable against the sensitive boob skin (I am sure most women relate to boob itch, don't you?!), which is something I wish every lingerie brand did with their bras. It also makes the bra much more comfortable during the summer months, as sweat does not play well with artificial fibers, in my personal experience. The straps are pretty well placed with this style, I would say and they are fully-adjustable, which is great for tall and petite girls alike.
The Lśniąca Scarlet "high-waisted" panties are not the highest I have seen, but still proper cute and sexy. The lace on the back could a bit stretchier in my opinion and if you have a more rounded butt than me, I would suggest sizing up. For reference, I have 40″ hips and these were a size 38/10. These are perhaps not your everyday panties but are sure to make some hearts flutter, if that is what you wish for!
The Lśniąca Scarlet can be bought at the EM online store, which you find here. It's made-to-order which means it can take 2-3 weeks to make and after that the product will be shipped to you. If you can't find your size in the drop-down menu, the EM team will be happy to make a custom size, however those are non-refundable and cannot be exchanged. The price for a custom sized bra is 20 PLN higher than the regular price of the bra. The bra (in regular sizes 30-44 A-JJ) costs 189 PLN and the high-waisted briefs (36-48, UK 8-20) cost 69 PLN.


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Welcome to Breathe Maids a Cleaning Service focused around amazing customer service.
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About Dallas
Dallas () is the third-largest city in Texas and the largest city in the Dallas–Fort Worth metroplex, the fourth-largest metropolitan area in the United States at 7.5 million people. It is the largest city in and seat of Dallas County with portions extending into Collin, Denton, Kaufman, and Rockwall counties. With a 2020 census population of 1,304,379, it is the ninth-most populous city in the U.S. and the third-largest city in Texas after Houston and San Antonio. Located in the North Texas region, the city of Dallas is the main core of the largest metropolitan area in the Southern United States and the largest inland metropolitan area in the U.S. that lacks any navigable link to the sea.Dallas and nearby Fort Worth were initially developed as a product of the construction of major railroad lines through the area allowing access to cotton, cattle, and later oil in North and East Texas. The construction of the Interstate Highway System reinforced Dallas's prominence as a transportation hub, with four major interstate highways converging in the city and a fifth interstate loop around it. Dallas then developed as a strong industrial and financial center and a major inland port, due to the convergence of major railroad lines, interstate highways and the construction of Dallas/Fort Worth International Airport, one of the largest and busiest airports in the world. In addition, Dallas has DART (Dallas Area Rapid Transit) with different colored train lines that transport throughout the Metroplex.Dominant sectors of its diverse economy include defense, financial services, information technology, telecommunications, and transportation. The Dallas–Fort Worth metroplex hosts 23 Fortune 500 companies, the second-most in Texas and fourth-most in the United States, and 11 of those companies are located within Dallas city limits. Over 41 colleges and universities are located within its metropolitan area, which is the most of any metropolitan area in Texas. The city has a population from a myriad of ethnic and religious backgrounds and one of the largest LGBT communities in the U.S. WalletHub named Dallas the fifth-most diverse city in the United States in 2018.
Neighborhoods around DallasSouth Dallas, Bryan Place, Greenland Hills, Baylor-Meadows, The L Streets, West End, Government District, Cedars, Belmont Park, South Boulevard/Park Row, Hollywood/Santa Monica, Main Street District, Arts District, City Center District, State Thomas, Deep Ellum, Dallas Downtown Historic District, Dallas County, Neighborhood Barber, neighborhood store + gallery,
Things To Do in Dallas
The Dallas World Aquarium
Dallas Zoo
The Dallas Arboretum and Botanical Garden
Perot Museum of Nature and Science
Klyde Warren Park
The Sixth Floor Museum at Dealey Plaza
African American Museum of Dallas
Reunion Tower
Pioneer Plaza
Dallas Museum of Art
Nasher Sculpture Center
Old City Park
Crow Museum of Asian Art of The University of Texas at Dallas
Giant Eyeball
John F. Kennedy Memorial Plaza
Dealey Plaza
Texas Discovery Gardens
George W. Bush Presidential Center
Rainbow Vomit
Dallas Holocaust and Human Rights Museum


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The first non-triple-digit summer day in a long time
It's not hot today. The high is supposed to be 84. There could be thunderstorms, although in Las Vegas that can mean you get a 30-second sprinkle and call it done. This is the first time we've had a day like this in months. It's been a hot, dry summer. This is not terribly unusual for Las Vegas, but it's definitely a significant contrast with Iowa, where we were for three years previous. I don't mind the heat, but I do mind the climatological monotony.
My work at the Mob Museum is going very well, but Las Vegas generally is not as hospitable as one would like. With the endless violence reported on the news, the ubiquitous homeless people approaching us in parking lots and the thoughtless and angry motorists on the streets, not to mention the recent report ranking Nevada 50th in education, we are less than impressed with our new-old home.
But summer is weird. Things might look better before too long. Fortunately, it's that time of year when some things return to normal. In a week, our younger daughter will return to Iowa State University for the fall semester. In two weeks or so, our son-in-law will return to the classroom to teach eighth-graders. At month's end, college and pro football will start their regular seasons. In mid-September, the fall TV season will kick off, bringing back a handful of shows we like. And by late September we might start feeling the first signs of fall.
Since I don't blog that often, I should throw in a few updates:
– The Nevada sesquicentennial book launched in May with a great event at the Clark County Library. The book has been well received and is selling well. In fact, the first printing is nearly sold out. We're not sure yet whether there will be a second printing.
– I wrote a long essay for this year's Las Vegas Writes book. The book's theme is "Lost and Found," and I wrote about lost and found Nevada historical documents and artifacts. The book will debut at the Vegas Valley Book Festival in October.
– Speaking of the book festival, I am scheduled to participate in two panel discussions there, one on the Las Vegas Writes book and one on the Nevada sesquicentennial.
– I've been writing some essays and book reviews for Desert Companion, Nevada Public Radio's monthly magazine. My old friends and colleagues Andrew Kiraly and Scott Dickensheets run that operation, and I enjoy writing for them.
– I recently completed a big project to rescue the Las Vegas CityLife and Las Vegas Mercury hard copy archives from the Las Vegas Review-Journal, which wanted to dispose of them, and donate them to the Nevada State Museum. There were many car trips from the R-J to my house, where the 75 banker's boxes of papers were stored in my garage, and then there were many more car trips from my house to the museum. Thanks to museum director Dennis McBride for taking an interest in preserving these publications.
Upcoming events related to the release of 'Sun, Sin & Suburbia: The History of Modern Las Vegas'
• Friday: Oct. 12, 10 a.m., KNPR: Interview with the author of "Sun, Sin & Suburbia: The History of Modern Las Vegas."
• Friday, Oct. 12, 5-7 p.m., Artifice, 1025 S. First St.: Pre-book release gathering. Friends and colleagues of the author welcome.
• Saturday, Oct. 13, 1-3 p.m., Nevada State Museum: Book talk and release. Public invited to discuss Las Vegas history and perhaps buy a new book about it.
• Sunday, Oct. 14, 10 a.m.-noon, Barnes and Noble, Henderson. Book signing.
• Sunday, Oct. 14, 1 p.m.-3 p.m., Barnes and Noble, Rainbow and Lake Mead. Book signing.


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These are photos taken of we three. Is there any purer joy than children who love the camera and are in awe that what they do is reflected back to them? There is an awe in their innocence that they, themselves, are magically recorded. These are older phone photos but I have been waiting for an opportunity to use them. And besides, getting the pic also means getting a hug.
Related articles
- Say Cheese! March is Phoneography Month (thewordpressghost.wordpress.com)
- Say Cheese! March is Phoneography Month (dailypost.wordpress.com)
- iPhoneography: Being Lost In The Details (thismansjourney.net)
- iPhoneography Monday: Nature (angelinem.wordpress.com)
- iPhoneography Week IV – Challenger's Choice. (whatiseerightnow.wordpress.com)


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In the early morning of September 16th 1810 a church bell in Dolores, Guanajuato rang out, gathering all the towns' people. A priest named Miguel Hidalgo y Costilla wanted to gather the people of Mexico to rise against the Spanish crown. It took another 11 years for Mexico to gain independence but this event, known as the Grito de Dolores, was the spark that began it all.
Today the biggest celebration happens in Mexico City where at 11 p.m. on the night of the 15th the President steps out on to the balcony of the National Palace overlooking a massive crowd in the decorated courtyard. There he rings a similar bell to the one once used by Hidalgo and comments on the historical Heroes of Mexico ending with an enthusiastic "Viva Mexico!"
At Breathless Resorts & Spas, we will be celebrating with an explosion of Mexican culture. Experience real Mariachi music, authentic Mexican cuisine, traditional Mexican-style games and activities and to top it all off the beautiful color and life that only a celebration from the passionate people of Mexico could inspire. Talk to your concierge for all the details.
Head to Facebook & Twitter and send a hearty "Viva Mexico!" to your favorite resort!


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I love black and white photos that other people take but find it… well, abhorrent to take the color out of my photos. This photo of the opening of a spiral train tunnel at Kicking Horse Pass and the Continental Divide in the Canadian Rockies told me to go black and white. And a red, high contrast filter made it perfect.
There is more story to this tunnel so stay tuned.


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Boston Pops to honor Bernstein with season-long appreciation
Centennial celebration: Boston Pops to honor Bernstein with season-long appreciation
Although the Boston Pops won't play happy birthday, it will give a 100th birthday gift to Leonard Bernstein and the audiences at Symphony Hall. The orchestra celebrates the legendary composer and conductor in nearly every performance this season, performing his music for Broadway, film and dance, as well as his classical works.
"Maybe we sometimes pay too much attention to anniversaries, but this one is seminal in terms of his influence on American musicians," said Pops conductor Keith Lockhart. "All of us who grew up in the later part of the 20th century had this vision that there finally was an American conductor we wanted to be like. He was perhaps most celebrated as a conductor, but he also had an amazingly diverse career and extraordinarily broad appeal."
Celebrations are taking place not just in Boston, where Bernstein conducted both the Pops and the Boston Symphony Orchestra, but around the world. Lockhart said he has gone to celebrations in Japan, Norway and Paraguay.
From May 9 – June 16, the Pops will dedicate five of its 27 performances entirely to Bernstein repertoire and will be joined by vocalists. These Bernstein Tribute concerts will have music from "West Side Story," "On the Town," and two other Broadway shows, from the ballet "Fancy Free" and the film "On the Waterfront," excerpts from his Mass, opera Candide and other classical works.
It's fair to speculate that Bernstein would be delighted at this honoring by the Pops, with which he had his professional conducting debut at the Hatch Shell in 1941 at age 22.
"To me in those days the Pops was heaven itself," he told a Pops audience when he conducted the orchestra in Symphony Hall decades later. "I thought it was the supreme achievement of the human race."
Other all-Bernstein programs this season are concert presentations of "West Side Story" with singers and "On the Town" with singers, dancers and full choreography by Tony Award winner Kathleen Marshall.
"We're celebrating the eclecticism of his talent," Lockhart said.
As a conductor, Lockhart particularly admires the ways Bernstein inhabited the mind of each composer and brought his unique interpretation.
"He was full of musical personality, and when you listened you could always tell if he was conducting," Lockhart said. "Even if I didn't agree with his interpretation, I always found it interesting."
Of the four matinees (with half-price for ages 17 and under), Lockhart is particularly excited about the two performances of Disney's Broadway Hits, created by the Disney Company to celebrate the 25th anniversary of the first Disney musical on Broadway. Composers include Alan Menken, Elton John, Phil Collins, Tim Rice and Richard and Robert Sherman.
"I conducted the world premier (of Disney's Broadway Hits) with the Disney folk in Royal Albert Hall in London, and it was spectacular with an incredible cast," he said.
The other matinees are "Dance to the Movies" and "West Side Story in Concert." The dance program stars dancers and singers from "Dancing with the Stars," "So You Think You Can Dance" and "American Idol." As in past years, John Williams Film Night and the Boston Pops Gospel Choir returns.
For the centennial, the Pops also created the website www.celebratebernstein.org for people to learn more about Bernstein.
Reach Jody Feinberg at email@example.com. Follow her on Twitter @JodyF_Ledger
Presented by the Boston Pops, May 9 to June 16, Symphony Hall, 301 Massachusetts Ave., Boston. $30-$150, with half-price matinees ages 17 and under. 888-266-1200 and www.bso.org.