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Business Herald: Planning battle over Auckland
A new group, Auckland 2040, has risen up to oppose Auckland Council's draft unitary plan, the city's blueprint for the next few decades. Richard Burton, a spokesman, spells out who the organisation is and what it hopes to achieve. If the video does not display or play corrrectly, view it on the New Zealand Herald.. read more →
Business groups lay into plan
By Bernard Orsman Published: The New Zealand Herald – nzherald.co.nz Business groups have joined the chorus of complaints over a new planning rulebook for the city – although the Property Council has declared the first draft a pretty good effort. The Auckland Chamber of Commerce and the Employers and Manufacturers Association are highly critical of.. read more →
Council fights to deny Govt housing control
By Bernard Orsman Published: The New Zealand Herald – 12 June 2013 Minister says such action is a last resort if accords with councils to fast-track plans cannot be reached. The Auckland Council will today ask the Government to scrap provisions in new legislation allowing Wellington to take control of housing developments in Auckland. The.. read more →
Huge response to growth plan
Photo: Richard Robinson Published: The New Zealand Herald.co.nz – 12 June 2013 Auckland Council is sifting through 22,700 comments on its first regional rule book for growth. Deputy Mayor Penny Hulse said feedback came in forms, emails and letters as well as 6540 comments and posts on social media and the Shape Auckland website. Mrs.. read more →
Report: How young are shut out of owning home
Written by: Anne Gibson Photo: Richard Robinson Published: The New Zealand Herald – 11 June 2013 Restrictions on development are blamed for 'absurdly high prices' as land values in Auckland make up more than 60 per cent of the cost of a house, pushing young buyers out and ownership rates down to 1916 levels. Housing.. read more →
Len Brown: Auckland's Unitary Plan
Published: The New Zealand Herald – 10 June 2013 If the video does not play or display properly view on the New Zealand Herald web site. Lower building heights, tighter controls on developers and giving the public the right to object to apartment buildings are among changes being considered for suburbs in Auckland's Unitary Plan… read more →
Easing public fears on city blueprint
By Bernard Orsman Published: The New Zealand Herald – 10 June 2013 Mayor Len Brown has signalled a backdown on heights in some coastal settlements[/caption]Council rethinking Unitary Plan to answer residents' worries on building heights and new apartments in suburbs. Lower building heights, tighter controls on developers and giving the public the right to object.. read more →
Self interest cramps our style
Written by: Paul Little Photo: Sylvie Whinray Published: The New Zealand Herald – 09 June 2013 I'm sure that when the first nomads were being persuaded to embrace agriculture, they were faced with the sort of opposition the Auckland unitary plan is encountering: "I like going around in circles." "Why should I wait for.. read more →
TV houses excite locals
Written by: Kirsty Wynn Photo: Michael Craig Published: The New Zealand Herald – 09 June 2013 The Block's plan for four character homes on double site labelled 'absolutely marvellous' Plans for houses at the centre of the next series of TV3 renovation show The Block NZ are being hailed as a welcome answer to our.. read more →
Waterfront growth goals on track
Published: The New Zealand Herald – 06 June 2013 Report says region's construction and tourism activity will produce 40,000 jobs and $4b for the region by 2040. Homes will play a part in the growth of the Auckland waterfront, says a study on the economic benefits coming to the harbour edge. An updated report by.. read more →
Minister gives Brown a hurry up on plan
Written by: Isaac Davison Photo: Natalie Slade Published: The New Zealand Herald – 06 June 2013 Housing Minister Nick Smith has told Auckland Mayor Len Brown to get a move on with the Unitary Plan so more houses can be built in Auckland. His message comes as the Government and councils appear to be on.. read more →
Mayor's Claim of Support for Compact City Questioned
Press release: Dick Quax Published: Scoop Independent News – 05 June 2013 Mayor Len Brown's claim that the overarching view is that Aucklanders support his compact city is highly questionable according to Councillor Dick Quax. "I don't see how the mayor can come to this conclusion based on the fact that the submissions to the.. read more →
Money talks in race for mayoralty
Written by: Brian Rudman Published: The New Zealand Herald – 03 June 2013 Second term likely for Brown as cost of campaign makes removing the incumbent a rich person's sport Maurice Williamson's brief flirtation with fame is officially over. Dithering cost him his chance to become an international gay icon and common sense has persuaded.. read more →
Kohi apartment plan riles residents
Written by: Wayne Thompson Photo: Dean Purcell Published: The New Zealand Herald – 03 June 2013 Kohimarama residents say the draft Unitary Plan's proposals for five "walls" of apartment blocks reaching back from the popular Auckland beach on Tamaki Drive will blot out the reason they chose to live there: a connection to the sea… read more →
Keep heritage real, says old Shore suburb
Written by: Wayne Thompson Photo: Chris Gorman Published: The New Zealand Herald – 03 June 2013 Devonport group fears Unitary Plan will turn its waterfront area into a fake tourist precinct Devonport Heritage is fighting against the seaside suburb becoming a fake heritage tourist precinct and has called for a special conservation area for commercial.. read more →


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Case Study
In 2010, we were awarded a Total Waste Management contract for all 900 operational and maintenance sites across the UK.Find out more
We have an unrivalled track record of deploying pioneering waste management solutions to the Transport sector that combine efficient, reliable and cost-effective services. The transport industry is complex and demanding, however we have developed expertise that equals the challenges you face, often exceeding our client's expectations!
We work with a diverse range of transport and distribution businesses: road hauliers, bus and coach companies, rail, tram and metro, aviation, ferry and water transport, parcel and courier, food distribution, fuel, importers and exporters and warehousing and distribution.
The brokerage model has many advantages especially where clients have a national spread of depots. By deploying the best supplier in each region we are able to achieve a standardised approach across the whole piece.
One of the most commonly faced issues in the transport sector is staff
We understand the need to be able to offer a rapid response for the diverse waste streams that arise from this sector and have carefully built a service that matches your needs. Reporting is also a very important part of the process. In order to meet the exacting standards that are expected in this sector we have developed our own bespoke online portal "The Hub" which makes critical reporting available 24/7. Click here to find out more.

subset: commoncrawl


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I've got a large .tif that I am trying to break up to match our city grid layer. I want individual rasters that match with the individual grids. I thought the "Split Raster" tool in Pro would be what I needed to use so that I do not have to do each one individually, which would be a pain because there are 200+ individual grid blocks.
But when I run this tool it "Succeeds" after only 2 seconds, and gives me absolutely nothing in the Output Folder that I set. What am I dong wrong?


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|Per Serving
|Fat 10.9g
|Sat Fat 3g
|Salt 2g
|Sugar 1.4g
(Makes 10 dumplings)
Boil the potatoes until soft, drain and leave to cool.
Heat the oil in a sauté pan and fry the mince, ginger and garlic for about six minutes until cooked.
Season with soy sauce and add sesame seeds, spring onions and chilli flakes and gently mix in the cooled cubed potatoes.
Moisten the rice paper a sheet at a time in cold water and fold around a tablespoon of the mixture, sealing at the top by pinching it together. Repeat until you've used all the mixture.
Set aside while you make the kimchi.
Shred the cabbage and salt well. Leave in a colander for 20 minutes then rinse and dry well.
Stir through the chilli paste, add the water and vinegar to taste.
Steam the dumplings in the microwave for 3 minutes and serve with sesame oil and soy sauce to dip and a scattering of sesame seeds, sliced red chillies and spring onions.
100g maris piper potatoes, peeled and cubed
250g lean porkmince
1 thumb of ginger, grated
1 clove of garlic, crushed
4 spring onions, finely sliced
1.5tbsp soy sauce
1tbsp sesame oil
A pinch of sesame seeds
Rice paper dumpling sheets
1tbsp chilli flakes, to taste
Splash of white wine vinegar
Salt to season
For the kimchi
130g Chinese cabbage, shredded
2tbsp chilli paste
Sea salt to salt the cabbage
A splash of water
A splash of rice vinegar or white wine vinegar to taste
Atlantic Coast Seafood Chowder
This warming, golden chowder is filled with delicious potatoes, prawns, mussels and squid. It's super quick to make and sure to warm your cockles!
For a taste of the Emirates in your own home, try this modified version of a classic Tabbouleh dish, with a bit more bite.
Charred potato, grilled peach and sliced lamb with parsley dressing
Get your griddle on with this delicious charred potato, grilled peach and sliced lamb dish. Paired with a homemade parsley dressing, this is the perfect mid-week meal to enjoy yourself or share with friends.
Blue Cheese Mini Sliders With Potato Buns
The perfect recipe to impress your friends - try these small yet delicious burgers with buns made from potato. Enjoy!
This campaign was originally produced in the framework of a programme co-financed by the European Union


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Trustees are the individuals you appoint in your Will to look after your property until, for example, a child is old enough to inherit or where a life interest has been created. The Trustees are usually also the Executors, although in some circumstances we may recommend that the two roles be kept separate.
If your Will is to contain Trusts then we will take you through various choices regarding:
- how the Trust is set up and run
- at what age the beneficiaries (usually children) will be entitled to receive the Trust Fund
- when, and under what circumstances, money being held in the Trust Fund can be used for the children's benefit
- whether money can be made available for guardians
- any additional powers the Trustees should, or should not, be given to assist them in running the Trust Fund
- any duties the Trustees should owe to the estate and to the beneficiaries
Selecting Trustees
In choosing Trustees, as with Executors, you should consider:
- age – will the Trustees be able to cope with the work involved in realising your estate? Are they likely to survive to the end of the Trust?
- location – will they be able to deal with the logistics of selling and/or clearing a house, for example?
- finances – do they have the skills to look after and invest a potentially large sum of money? Trustees will be able to take expert advice but will still need to make decisions based on that advice
- moral issues – do the Trustees have the same outlook on life that will mean that they agree to spend money on your children in the same way that you would have done?
Next steps
Contact us today on 07887 946 557 or online to discuss how Alex Truesdale Wills Limited can help you with a Will or associated service.


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Already I feel the tension (very slowly) seeping out of my body – it's really been a crazy couple of months!
I'm very much looking forward to this break.
Holiday goals: reading | feasting | sleeping | gym at least once every two days | avoiding alcohol – anything else is a bonus!


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We are committed to collaborating to secure the future of sustainable salmon farming
Skretting is a proud Associate Member of the Global Salmon Initiative (GSI)
Salmon farming is one of the most significant food production success stories of modern times. The establishment of commercial salmon aquaculture didn't begin until the 1970s, but just some 40 years later the global harvest now exceeds 2 million tonnes. Despite its considerable achievements, the industry is not without its challenges, not least meeting the unprecedented demand for the product from a global population expected to quickly reach 9.5 billion people. To ensure it can continue to expand sustainably, it has become increasingly apparent that greater collaborative relationships must be established across the value chain, making full use of its inherent knowledge and expertise to develop tangible industry-wide solutions.
An important way in which Skretting is helping advance the salmon sector is through its membership of the Global Salmon Initiative (GSI). In partnership, GSI salmon farmers and feed companies have committed to working precompetitively together to accelerate progress towards ever increasing standards of sustainability for the farmed salmon industry, and to driving progressive innovation in the feed sector.
GSI Associate Members
Skretting is a proud Associate Member of GSI. GSI Associate Members are organisations that have a shared interest in the continued growth and prosperity of the farmed salmon industry as well as a shared commitment to improving the sustainability of the sector. Associate members work closely with the GSI members on specific projects where shared knowledge and collaborative working will support accelerated progress.
For more information about GSI, visit their website


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City of Nordic
City of Nordic seen here inbound to the Port of Tyne (North East England) on 7th March 2008. Photographed from North Shields Ferry Landing.
Originally Launched as: Arroyofrio Dos
Type of ship : Ro-Ro Cargo Ship
Year of build : 1985-10 Astilleros de Murueta S.A. - Gernika-Lumo Yard/hull No.: 149
Hull Material:Steel; Hull Connections:Welded; Decks:2 dks; Bulbous bow
Registered Owner: BEIRUT SHIPPING CO LTD - Malta
Ship Manager: ABOU MERHI LINES SAL - Lebanon
Length Overall 107.910
Length (BP) 96.530
Breadth Extreme 18.550
Breadth Moulded 18.410
Draught 6.463
Depth 12.100
Gross 8,126
Net 3,058
Deadweight 5,080
Formula Deadweight 9,493
2 oil engines with flexible couplings & single reduction geared to screw shafts driving 2 CP propellers at 165 rpm
Total Power: Mcr 4,796kW (6,520hp)


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Contest URL: Win a Free Subscription to Nat Geo Traveler Magazine!
Prize: Magazine subscription
Deadline: 28th July 2010
Maitravelsite's Blog and Travelogue is giving away a 1 year subscription to National Geographic Traveler Magazine (8 issues)to celebrate its first birthday!
It's very easy to enter: simply guess two very famous places in the world using the clues he's giving in the next days trough the newsletter and via the blog. Check out the original post to know when he will publish the clues.


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Since Pokémon Sun & Moon's announcement back in February, we've seen trailers and new Pokémon but no actual gameplay – until now.
Pokémon Sun & Moon gameplay footage was finally shown off for the first time during Nintendo's E3 Treehouse presentation today, showcasing the new Alola region, fresh mechanics such as detailed trainer and battle animations and innovative menu design.
There was also a trailer showing off four never-before-seen Pokémon: Pikipek, a Normal-Flying type bird Pokémon; Yungoos, a Normal-type mongoose Pokémon; Grubbin, a Bug-type grub Pokémon and Magearna, a Steel-Fairy type legendary Pokémon.
A free-for-all multiplayer battle mode named Battle Royale was also unveiled in the trailer, which sees four players fight against each other at once whilst predicting who will attack who and trying to survive.
Pokémon Sun & Moon is due to release in the UK on November 23rd for Nintendo 3DS.


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!! History Commons Alert, Exciting News
This is a scalable context timeline. It contains events related to the event April 2, 2008: ACLU Learns of Justice Department's 2001 Dismissal of Fourth Amendment. You can narrow or broaden the context of this timeline by adjusting the zoom level. The lower the scale, the more relevant the items on average will be, while the higher the scale, the less relevant the items, on average, will be.
The National Security Agency seeks the assistance of global telecommunications corporation AT&T to help it set up a domestic call monitoring site to eavesdrop on US citizens' phone communications, according to court papers filed in June 2006 as part of a lawsuit against AT&T (see October 2001). The NSA is expressly forbidden from spying on US citizens within US borders unless authorized by the Foreign Surveillance Intelligence Court (FISC) (see 1978). When the NSA program, which wiretaps phone and email communications often without court warrants, becomes public knowledge well over four years later (see December 15, 2005), President Bush, NSA Director Michael Hayden, and other White House and government officials will assert that the program was set up in response to the September 11, 2001 terrorist attacks. If the claims made in the lawsuit are accurate, these assertions are provably false. "The Bush administration asserted this became necessary after 9/11," lawyer Carl Mayer will claim in 2006. "This undermines that assertion." Unbeknownst to most Americans, the NSA is operating a secret "data mining" operation that, by 2006, will have compiled phone records and contact information on millions of domestic phone and email communications. The NSA project is code-named "Project Groundbreaker," and is ostensibly an above-board attempt announced in June 2000 to have AT&T and other firms help modernize its technological capabilities. The project originally seeks to have AT&T build a network operations center that duplicates AT&T's facility in Bedminster, New Jersey; this plan will be altered when the NSA decides it will be better served by acquiring the monitoring technology itself. The agency is seeking bids for a project to "modernize and improve its information technology infrastructure," including the privatization of its "non-mission related" systems support. [TechWeb, 6/13/2000; Bloomberg, 6/30/2006] Groundbreaker's privatization project is expected to provide up to $5 billion in government contracts to various private firms such as AT&T, Computer Sciences Corporation, and OAO Corporation, [Computerworld, 12/4/2000; Government Executive, 9/1/2001] and up to 750 NSA employees will become private contractors. Hayden, who has aggressively instituted a corporate management protocol to enhance productivity and has brought in numerous senior managers and agency executives from private defense firms, is a strong proponent of privatizing and outsourcing much of the NSA's technological operations, and in 2001 will say that he wants the agency to focus on its primary task of breaking codes and conducting surveillance. Hayden does not admit that Groundbreaker is part of a larger NSA domestic surveillance program, [Government Executive, 9/1/2001] and publicly, NSA officials say that the project is limited to administrative and logistics functions. [Computerworld, 12/4/2000] The covert data mining portion of the project is code-named "Pioneer." A former, unnamed employee of the NSA, [Bloomberg, 6/30/2006] and a former AT&T technician, Mark Klein, will provide the key information about Groundbreaker (see Late 2002, July 7, 2009 and December 15-31, 2005). Klein will say in 2006 that he saw the NSA construct a clandestine area within its switching center in San Francisco, and saw NSA technicians shunt fiber optic cable carrying Internet traffic into that area, which contains a large data bank and secret data mining hardware (see April 6, 2006). Klein will say he knew that the NSA built other such facilities in other switching locations. He will go on to say that the NSA did not work with just AT&T traffic; when AT&T's network connected with other networks, the agency acquired access to that traffic as well. [Democracy Now!, 5/12/2006] The information about AT&T and the NSA will become public knowledge after the 2006 filing of a lawsuit against AT&T and other telecommunications firms (see May 12, 2006 and June 26, 2006).
Entity Tags: Mark Klein, Michael Hayden, George W. Bush, Foreign Intelligence Surveillance Court, Bush administration (43), Carl Mayer, Computer Sciences Corporation, AT&T, National Security Agency, OAO Corporation
Timeline Tags: Civil Liberties
Shortly after the 9/11 attacks, the NSA expands surveillance operations, relying on its own authorities; some sources indicate this includes a massive domestic data mining and call tracking program, and some contend that it is illegal. In a 2006 public briefing, NSA Director Michael Hayden will say, "In the days after 9/11, NSA was using its authorities and its judgment to appropriately respond to the most catastrophic attack on the homeland in the history of the nation." Following an October 1 briefing by Hayden to the House Intelligence Committee, Representative Nancy Pelosi (D-CA) will write to Hayden on October 11, saying, "[Y]ou indicated that you had been operating since the September 11 attacks with an expansive view of your authorities with respect to the conduct of electronic surveillance" (see October 11, 2001). Some evidence indicates NSA domestic surveillance began even before 9/11 (see Late 1999, February 27, 2000, December 2000, February 2001, February 2001, Spring 2001, and July 2001). [Nancy Pelosi, 1/6/2006; Michael Hayden, 1/23/2006] No Connection to Bush-Authorized Warrantless Domestic Call Monitoring - In his 2006 remarks, Hayden will clearly distinguish between the expansion he initiates under his own authorities, and the warrantless monitoring of calls with one end outside the US authorized later by President Bush (see October 4, 2001), saying, "[E]xcept that they involved NSA, these [Hayden-authorized] programs were not related… to the authorization that the president has recently spoken about." [Michael Hayden, 1/23/2006] 'Stellar Wind' Is Name of Hayden-Authorized Program - In 2012 interviews, former NSA official William Binney will indicate that "Stellar Wind" is the name of the surveillance program initiated by Hayden. [Wired News, 2/15/2012; Democracy Now!, 4/20/2012] Some sources will refer to the Bush-authorized eavesdropping as being part of the Stellar Wind program. [Newsweek, 12/22/2008] Differing Views on Authority for Surveillance - In his 2006 briefing, Hayden will say the Fourth Amendment only protects Americans against "unreasonable search and seizure," and that 9/11 changed what was to be considered "reasonable." Specifically, if communications are believed to have "[i]nherent foreign intelligence value," interception of these communications is reasonable. In addition to referring to Hayden's "view of [his] authorities" as "expansive," Pelosi's letter will give another indication that the NSA's new standard is significantly broader than it was previously, stating, "You indicated that you were treating as a matter of first impression, [redacted] being of foreign intelligence interest." Hayden will publicly clarify in 2006 that the authority for the NSA's operational expansion exists under an Executive Order issued by President Reagan, saying, "These decisions were easily within my authorities as the director of NSA under and [sic] executive order; known as Executive Order 12333." And, he will say, "I briefed the entire House Intelligence Committee on the 1st of October on what we had done under our previously existing authorities" (see October 1, 2001). In her October 11 letter, Pelosi will also write of having concerns about the program that haven't been resolved due to restrictions on information-sharing with Congress imposed by Bush (see October 11, 2001). Binney, who pioneered the development of certain NSA data mining and surveillance technologies, will come to believe that what the NSA is doing is unconstitutional; he will first take his concerns to Congress (see Before October 31, 2001) and then resign on October 31 (see October 31, 2001). [Nancy Pelosi, 1/6/2006; Michael Hayden, 1/23/2006] Surveillance Involves Domestic Communications - In his 2006 remarks, Hayden will not say the NSA is only targeting foreign communications under his post-9/11 authorization. Rather, the context of his remarks will indicate he is referring to domestic communications. More specifically, Hayden will state: "If the US person information isn't relevant, the data is suppressed. It's a technical term we use; we call it 'minimized.' The individual is not even mentioned. Or if he or she is, he or she is referred to as 'US Person Number One' or 'US Person Number Two.' Now, inherent intelligence value. If the US person is actually the named terrorist, well, that could be a different matter." Hayden will also reveal that information is being passed to the FBI, an investigative agency with a primarily domestic jurisdiction, saying, "[A]s another part of our adjustment, we also turned on the spigot of NSA reporting to FBI in, frankly, an unprecedented way." [Michael Hayden, 1/23/2006] One of Pelosi's statements in her letter to Hayden may indicate an aspect of the domestic component: "You indicated that you were treating as a matter of first impression, [redacted] being of foreign intelligence interest," she will write. [Nancy Pelosi, 1/6/2006] In a 2011 interview with Jane Mayer published in the New Yorker, Binney will say the NSA was obtaining "billing records on US citizens" and "putting pen registers [call logs] on everyone in the country." [New Yorker, 5/23/2011] And in a 2012 Wired article, NSA expert James Bamford will write that Binney "explains that the agency could have installed its tapping gear at the nation's cable landing stations—the more than two dozen sites on the periphery of the US where fiber-optic cables come ashore. If it had taken that route, the NSA would have been able to limit its eavesdropping to just international communications, which at the time was all that was allowed under US law. Instead it chose to put the wiretapping rooms at key junction points throughout the country—large, windowless buildings known as switches—thus gaining access to not just international communications but also to most of the domestic traffic flowing through the US." Binney's account is supported by other sources (see October 2001). [Wired News, 2/15/2012] Surveillance Program Is Massive - Bamford, citing Binney, will write: "Stellar Wind… included not just eavesdropping on domestic phone calls but the inspection of domestic email. At the outset the program recorded 320 million calls a day, he says, which represented about 73 to 80 percent of the total volume of the agency's worldwide intercepts." It is unclear exactly when this level of surveillance began. According to whistleblower AT&T employee Mark Klein, construction of secret rooms splitting communications traffic does not begin until Fall 2002 (see Fall 2002). Bamford will write that Binney says, "[T]he taps in the secret rooms dotting the country are actually powered by highly sophisticated software programs that conduct 'deep packet inspection,' examining Internet traffic as it passes through the 10-gigabit-per-second cables at the speed of light." [Wired News, 2/15/2012] Also, Binney's remark to Jane Mayer that the NSA was "putting pen registers on everyone in the country" indicates the broad scope of the program. [New Yorker, 5/23/2011]
Entity Tags: Religious Society of Friends (Quakers), US Department of Justice, National Security Agency, George W. Bush, Michael Hayden, Al-Qaeda, Foreign Intelligence Surveillance Court, House Intelligence Committee, Nancy Pelosi, Ronald Reagan
John Yoo, a deputy assistant attorney general in the Justice Department's Office of Legal Counsel, and OLC special counsel Robert Delahunty issue a joint memo to White House counsel Alberto Gonzales. The memo claims that President Bush has sweeping extraconstitutional powers to order military strikes inside the US if he says the strikes are against suspected terrorist targets. In the days following the 9/11 attacks, Gonzales asked if Bush could legally order the military to combat potential terrorist activity within the US. The memo is first revealed to exist seven years later (see April 2, 2008) after future OLC head Steven Bradbury acknowledges its existence to the American Civil Liberties Union; it will be released two months after the Bush administration leaves the White House (see March 2, 2009). [US Department of Justice, 10/23/2001 ; American Civil Liberties Union [PDF], 1/28/2009 ; New York Times, 3/2/2009] Granting Extraordinary, Extraconstitutional Authority to Order Military Actions inside US - Yoo and Delahunty's memo goes far past the stationing of troops to keep watch at airports and around sensitive locations. Instead, the memo says that Bush can order the military to conduct "raids on terrorist cells" inside the US, and even to seize property. "The law has recognized that force (including deadly force) may be legitimately used in self-defense," they write. In 2009, Reuters will write, "The US military could have kicked in doors to raid a suspected terrorist cell in the United States without a warrant" under the findings of the OLC memo. "We do not think that a military commander carrying out a raid on a terrorist cell would be required to demonstrate probable cause or to obtain a warrant," Yoo and Delahunty write. [US Department of Justice, 10/23/2001 ; New York Times, 3/2/2009; Reuters, 3/2/2009] The memo reasons that since 9/11, US soil can be legally construed as being a battlefield, and Congress has no power to restrict the president's authority to confront enemy tactics on a battlefield. [Savage, 2007, pp. 131] No Constitutional or Other Legal Protections - "[H]owever well suited the warrant and probable cause requirements may be as applied to criminal investigations or to other law enforcement activities, they are unsuited to the demands of wartime and the military necessity to successfully prosecute a war against an enemy. [Rather,] the Fourth Amendment does not apply to domestic military operations designed to deter and prevent foreign terrorist attacks." Any objections based on the Fourth Amendment's ban on unreasonable search and seizures would be invalid since whatever possible infringement on privacy would be trumped by the need to protect the nation from injury by deadly force. The president is "free from the constraints of the Fourth Amendment." The Posse Comitatus Act, which bars the military from operating inside the US for law enforcement purposes, is also moot, the memo says, because the troops would be acting in a national security function, not as law enforcement. [US Department of Justice, 10/23/2001 ; American Civil Liberties Union [PDF], 1/28/2009 ; New York Times, 3/2/2009; Reuters, 3/2/2009; Ars Technica, 3/2/2009] There are virtually no restrictions on the president's ability to use the military because, Yoo and Delahunty write, the nation is in a "state of armed conflict." The scale of violence, they argue, is unprecedented and "legal and constitutional rules" governing law enforcement, even Constitutional restrictions, no longer apply. The US military can be used for "targeting and destroying" hijacked airplanes, they write, or "attacking civilian targets, such as apartment buildings, offices, or ships where suspected terrorists were thought to be." The memo says, "Military action might encompass making arrests, seizing documents or other property, searching persons or places or keeping them under surveillance, intercepting electronic or wireless communications, setting up roadblocks, interviewing witnesses, or searching for suspects." [Newsweek, 3/2/2009] Yoo writes that the Justice Department's criminal division "concurs in our conclusion" that federal criminal laws do not apply to the military during wartime. The criminal division is headed by Michael Chertoff, who will become head of the Department of Homeland Security. [Washington Post, 4/4/2008] Sweeping Away Constitutional Rights - Civil litigator Glenn Greenwald will later note that the memo gives legal authorization for President Bush to deploy the US military within US borders, to turn it against foreign nationals and US citizens alike, and to render the Constitution's limits on power irrelevant and non-functional. Greenwald will write, "It was nothing less than an explicit decree that, when it comes to presidential power, the Bill of Rights was suspended, even on US soil and as applied to US citizens." Justifying Military Surveillance - Greenwald will note that the memo also justifies the administration's program of military surveillance against US citizens: "[I]t wasn't only a decree that existed in theory; this secret proclamation that the Fourth Amendment was inapplicable to what the document calls 'domestic military operations' was, among other things, the basis on which Bush ordered the NSA, an arm of the US military, to turn inwards and begin spying—in secret and with no oversight—on the electronic communications (telephone calls and emails) of US citizens on US soil" (see December 15, 2005 and Spring 2004). "If this isn't the unadorned face of warped authoritarian extremism," Greenwald will ask, "what is?" [Salon, 3/3/2009] If the president decides to use the military's spy agency to collect "battlefield intelligence" on US soil, no law enacted by Congress can regulate how he goes about collecting that information, including requiring him to get judicial warrants under the Foreign Intelligence Surveillance Act (FISA). In 2007, Yoo will say in an interview: "I think there's a law greater than FISA, which is the Constitution, and part of the Constitution is the president's commander in chief power. Congress can't take away the president's powers in running war." [Savage, 2007, pp. 131; PBS Frontline, 5/15/2007] Cheney and Addington will push the NSA to monitor all calls and e-mails, including those beginning and ending on US soil, but the NSA will balk. Domestic eavesdropping without warrants "could be done and should be done," Cheney and Addington argue, but the NSA's lawyers are fearful of the legal repercussions that might follow once their illegal eavesdropping is exposed, with or without the Justice Department's authorization. The NSA and the White House eventually reach a compromise where the agency will monitor communications going in and out of the US, but will continue to seek warrants for purely domestic communications (see Spring 2001, After September 11, 2001, and October 2001). [Savage, 2007, pp. 131] Military Use Considered - In 2009, a former Bush administration lawyer will tell a reporter that the memo "gave rise to the Justice Department discussing with the Defense Department whether the military could be used to arrest people and detain people inside the United States. That was considered but rejected on at least one occasion." The lawyer will not give any indication of when this will happen, or to whom. Under the proposal, the suspects would be held by the military as "enemy combatants." The proposal will be opposed by the Justice Department's criminal division and other government lawyers and will ultimately be rejected; instead, the suspects will be arrested under criminal statutes. [Los Angeles Times, 3/3/2009]
Entity Tags: Steven Bradbury, US Department of Homeland Security, US Department of Defense, Robert J. Delahunty, Office of Legal Counsel (DOJ), Bush administration (43), Michael Chertoff, Alberto R. Gonzales, National Security Agency, American Civil Liberties Union, Glenn Greenwald, George W. Bush, US Department of Justice, John C. Yoo
New York Times headline from article revealing NSA surveillance. [Source: CBS News]The New York Times reveals that after the 9/11 attacks, President Bush granted the National Security Agency (NSA) secret authorization to eavesdrop on Americans and others inside the US without going through the Foreign Intelligence Surveillance Act (FISA) court to obtain legal warrants (see Early 2002. The administration justifies its actions by claiming such eavesdropping, which includes wiretapping phones and reading e-mails, is necessary to find evidence of terrorist activities, and says the nation needs the program after the 9/11 attacks exposed deficiencies in the US intelligence community's information gathering process, and because of what they characterize as the "handcuffing" of US intelligence agencies by restrictive laws. The Times has had the article for over a year; the White House prevailed on the Times not to publish its findings for that time, arguing that publication would jeopardize continuing investigations and warn potential terrorists that they were under scrutiny. Many believe that the White House wanted to delay the publication of the article until well after the 2004 presidential elections. The Times delayed publication for over a year, and agreed to suppress some information that administration officials say could be useful to terrorists. (Less than two weeks before the article is published, Bush tries to convince the Times not to print the article at all: see December 6, 2005.) Two days after the Times publishes its article, Bush will acknowledge the order, and accuse the Times of jeopardizing national security (see December 17, 2005). The NSA program eavesdrops without warrants on up to 500 people in the US at any given time, officials say; the overall numbers have likely reached into the thousands. Overseas, up to 7,000 people suspected of terrorist ties are being monitored. Officials point to the discovery of a plot by Ohio trucker and naturalized US citizen and alleged al-Qaeda supporter Iyman Faris to bring down the Brooklyn Bridge with blowtorches as evidence of the program's efficacy. They also cite the disruption of an al-Qaeda plot to detonate fertilizer bombs outside of British pubs and train stations by the program. But, officials say, most people targeted by the NSA for warrantless wiretapping have never been charged with a crime, and many are targeted because of questionable evidence and groundless suspicion. Many raise an outcry against the program, including members of Congress, civil liberties groups, immigrant rights groups, and others who insist that the program undermines fundamental Constitutional protections of US citizens' civil liberties and rights to privacy. Several other government programs to spy on Americans have been challenged, including the Federal Bureau of Investigation (FBI)'s surveillance of US citizens' library and Internet usage, the monitoring of peaceful antiwar protests, and the proposed use of public and private databases to hunt for terrorist links. In 2004, the Supreme Court overturned the administration's claim that so-called "enemy detainees" were not entitled to judicial review of their indefinite detentions. Several senior officials say that when the warrantless wiretapping program began, it operated with few controls and almost no oversight outside of the NSA itself. The agency is not required to seek the approval of the Justice Department or anyone else outside the FISA court for its surveillance operations. Some NSA officials wanted nothing to do with a program they felt was patently illegal, according to a former senior Bush administration official. Internal concerns about the program prompted the Bush administration to briefly suspend the program while Justice Department officials audited it and eventually provided some guidelines for its operations. A complaint from Judge Colleen Kollar-Kotelly, the federal judge who oversees the FISA Court, helped spur the suspension, according to officials. Kollar-Kotelly questioned whether information obtained under the program was being improperly used as the basis for FISA wiretap warrant requests from the Justice Department. Some government lawyers say that the Justice Department may have deliberately misled Kollar-Kotelly and the FISA court about the program in order to keep the program under wraps. The judge insisted to Justice Department officials that any material gathered under the program not be used in seeking wiretap warrants from her court. The question also arose in the Faris case, when senior Justice Department officials worried that evidence obtained by warrantless wiretapping by the NSA of Faris could be used in court without having to lie to the court about its origins. [New York Times, 12/15/2005]
Entity Tags: US Supreme Court, George W. Bush, US Department of Justice, Iyman Faris, National Security Agency, New York Times, Al-Qaeda, Foreign Intelligence Surveillance Court, Colleen Kollar-Kotelly
Bush administration officials tell Senate Intelligence Committee members that they will not promise to continue seeking warrants for surveillance on US citizens, as the administration agreed to do in January 2007. They insist that President Bush has the Constitutional authority to decide whether or not to order the NSA to conduct surveillance without warrants if he desires. The secret wiretapping program was revealed to the public just weeks before the agreement (see December 15, 2005), and immediately drew tremendous outcries of criticism from civil libertarians, from lawmakers from all across the political spectrum, and from much of the public. Since the January agreement, the Foreign Intelligence Surveillance Act (FISA) court has issued warrants for domestic wiretaps after being given evidence showing some kind of probable cause to justify the proposed surveillance. Previously, the wiretapping program had ignored the FISA restrictions. Now Bush officials, most notably the new director of national intelligence, Mike McConnell, are saying that Bush has the authority under Article II of the Constitution to order warrantless wiretaps on US citizens. Invoking Presidential Authority - In Senate testimony on this day, Russ Feingold (D-WI) asks McConnell if he is willing to promise that the administration will no longer ignore the law and the court when monitoring citizens. McConnell replies, "Sir, the president's authority under Article II is in the Constitution. So if the president chose to exercise Article II authority, that would be the president's call." McConnell is echoing previous arguments made by Bush and other officials, who have said that Bush has the power to order wiretaps without court review, both under the Constitution and under the September 2001 Congressional authorization to use military force against al-Qaeda. McConnell says that the administration is conducting surveillance against Americans only with court warrants, and has no plans "that we are formulating or thinking about currently" to resume domestic wiretapping without warrants. "But I'd just highlight," he adds, "Article II is Article II, so in a different circumstance, I can't speak for the president what he might decide." [New York Times, 5/2/2007] Article II is the section of the Constitution that delineates the powers of the executive branch, and establishes the fundamental "separation of powers" doctrine that governs American democracy. Constitutional expert Steve Mount notes that the "Constitution is deliberately inefficient; the "Separation of Powers devised by the framers of the Constitution was designed to do one primary thing: to prevent the majority from ruling with an iron fist." [Mount, 1995] White House Seeking Congressional Authorization - While the administration continues to argue that it has the power to eavesdrop on US citizens without warrants, it also continues to seek Congressional legislation affirming and perhaps expanding that power. The White House justifies that hoped-for legislation by pointing to national security and the war on terrorism, as well as the challenges posed by new communications technologies such as e-mail and wireless communications. White House officials have consistently refused to go into specifics as to what communications gaps they feel need plugging. And they have consistently ignored Congressional requests for information and documents related to the NSA's domestic spy program, now being called the "Terrorist Surveillance Program" by White House officials and their Republican colleagues. Many Congressional Democrats say they would be reluctant to support any such legislation until they receive the information they have requested. "To this day, we have never been provided the presidential authorization that cleared that program to go or the attorney general-Department of Justice opinions that declared it to be lawful," says Senator Sheldon Whitehouse (D-RI). "Where's the transparency as to the presidential authorizations for this closed program? That's a pretty big 'we're not going to tell you' in this new atmosphere of trust we're trying to build." [New York Times, 5/2/2007]
Entity Tags: Steve Mount, Sheldon Whitehouse, Senate Intelligence Committee, National Security Agency, Al-Qaeda, Bush administration (43), Foreign Intelligence Surveillance Court, Russell D. Feingold, Mike McConnell, George W. Bush
The American Civil Liberties Union (ACLU) secures an 81-page memo from March 14, 2003 that gave Pentagon officials legal justification to ignore laws banning torture (see March 14, 2003). The Justice Department memo was written by John Yoo, then a top official at the Office of Legal Counsel, on behalf of then-Pentagon General Counsel William J. Haynes. It guides Pentagon lawyers on how to handle the legal issues surrounding "military interrogations of alien unlawful combatants held outside the United States." According to Yoo's rationale, if a US interrogator injured "an enemy combatant" in a way that might be illegal, "he would be doing so in order to prevent further attacks on the United States by the al-Qaeda terrorist network." That motive, Yoo opines, justifies extreme actions as national self-defense. While the existence of the memo has been known for some time, this is the first time the public has actually seen the document. This memo is similar to other Justice Department memos that define torture as treatment that "shock[s] the conscience" and risks organ failure or death for the victim. Legal scholars call the memo evidence of "the imperial presidency," but Yoo, now a law professor at the University of California at Berkeley, says the memo is unremarkable, and is "far from inventing some novel interpretation of the Constitution." The ACLU receives the document as the result of a Freedom of Information Act (FOIA) request from itself, the New York Civil Liberties Union, and other organizations filed in June 2004 to obtain documents concerning the treatment of prisoners kept abroad. The Yoo memo is one of the documents requested. [John C. Yoo, 3/14/2003 ; United Press International, 4/2/2008; American Civil Liberties Union, 4/2/2008] According to the ACLU, the memo not only allows military officials to ignore torture prohibitions, but allows the president, as commander in chief, to bypass both the Fourth and Fifth Amendments (see April 2, 2008). [American Civil Liberties Union, 4/2/2008] The Fourth Amendment grants the right for citizens "to be secure in their persons" and to have "probable cause" shown before they are subjected to "searches and seizures." The Fifth Amendment mandates that citizens cannot be "deprived of life, liberty, or property, without due process of law." [Cornell University Law School, 8/19/2007] Amrit Singh, an ACLU attorney, says: "This memo makes a mockery of the Constitution and the rule of law. That it was issued by the Justice Department, whose job it is to uphold the law, makes it even more unconscionable." [American Civil Liberties Union, 4/2/2008]
Entity Tags: William J. Haynes, Office of Legal Counsel (DOJ), New York Civil Liberties Union, Al-Qaeda, US Department of Justice, American Civil Liberties Union, John C. Yoo, Amrit Singh, US Department of Defense
Timeline Tags: Torture of US Captives, Civil Liberties
The American Civil Liberties Union learns of another Justice Department memo in a Freedom of Information Act (FOIA) response that produces a 2003 memo supporting the use of torture against terror suspects (see April 1, 2008). This 2001 memo (see October 23, 2001), says that the Constitution's protections against unreasonable searches and seizures—fundamental Fourth Amendment rights—do not apply in the administration's efforts to combat terrorism. The Bush administration now says it disavows that view. Background - The memo was written by John Yoo, then the deputy assistant attorney general, and the same lawyer who wrote the 2003 torture memo. It was written at the request of the White House and addressed to then-Attorney General Alberto Gonzales. The administration wanted a legal opinion on its potential responses to terrorist activity. The 37-page memo itself has not yet been released, but was mentioned in a footnote of the March 2003 terror memo. "Our office recently concluded that the Fourth Amendment had no application to domestic military operations," the footnote states, referring to a document titled "Authority for Use of Military Force to Combat Terrorist Activities Within the United States." Relationship to NSA Wiretapping Unclear - It is not clear exactly what domestic military operations the October memo covers, but federal documents indicate that the memo relates to the National Security Agency's Terrorist Surveillance Program (TSP). The TSP began after the 9/11 attacks, allowing for warrantless wiretaps of phone calls and e-mails, until it stopped on January 17, 2007, when the administration once again began seeking surveillance warrants from the Foreign Intelligence Surveillance Court (see May 1, 2007). White House spokesman Tony Fratto says that the October 2001 memo is not the legal underpinning for the TSP. Fratto says, "TSP relied on a separate set of legal memoranda" outlined by the Justice Department in January 2006, a month after the program was revealed by the New York Times (see February 2001, After September 11, 2001, and December 15, 2005). Justice Department spokesman Brian Roehrkasse says department officials do not believe the October 2001 memo was about the TSP, but refuses to explain why it was included on FOIA requests for documents linked to the TSP. No Longer Applicable - Roehrkasse says the administration no longer holds the views expressed in the October 2001 memo. "We disagree with the proposition that the Fourth Amendment has no application to domestic military operations," he says. "Whether a particular search or seizure is reasonable under the Fourth Amendment requires consideration of the particular context and circumstances of the search." The ACLU's Jameel Jaffer is not mollified. "The recent disclosures underscore the Bush administration's extraordinarily sweeping conception of executive power," he says. "The administration's lawyers believe the president should be permitted to violate statutory law, to violate international treaties and even to violate the Fourth Amendment inside the US. They believe that the president should be above the law." He continues, "Each time one of these memos comes out you have to come up with a more extreme way to characterize it." The ACLU has filed a court suit to challenge the government's withholding of the memo. [Associated Press, 4/3/2008] Another civil rights group, the Electronic Frontier Foundation, joins the ACLU in challenging the memo (see April 2, 2008).
Entity Tags: Jameel Jaffer, Brian Roehrkasse, American Civil Liberties Union, Alberto R. Gonzales, Bush administration (43), Foreign Intelligence Surveillance Court, Terrorist Surveillance Program, US Department of Justice, John C. Yoo, Electronic Frontier Foundation, Tony Fratto
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text: CLINICAL SCIENCERelationship of immunologic response to antiretroviral therapy with non-AIDS defining cancer incidenceYanik, Elizabeth L.a; Napravnik, Soniaa; Cole, Stephen R.a; Achenbach, Chad J.b; Gopal, Satisha; Dittmer, Dirk P.a; Olshan, Andrew F.a; Kitahata, Mari M.c; Mugavero, Michael J.d; Saag, Michaeld; Moore, Richard D.e; Mathews, W. Christopherf; Hunt, Peterg; Eron, Joseph J.aAuthor Information aUniversity of North Carolina, Chapel Hill, North Carolina bNorthwestern University, Chicago, Illinois cUniversity of Washington, Seattle, Washington dUniversity of Alabama, Birmingham, Alabama eJohns Hopkins University, Baltimore, Maryland fUniversity of California, San Diego gUniversity of California, San Francisco, California, USA. Correspondence to Elizabeth L. Yanik, 9609 Medical Center Dr Rm. 6E-216, Rockville, MD 20850, USA. Tel: +1 240 276 7186; e-mail: email@example.com Received 5 October, 2013 Revised 27 November, 2013 Accepted 27 November, 2013 AIDS: April 24th, 2014 - Volume 28 - Issue 7 - p 979-987 doi: 10.1097/QAD.0000000000000167 Free Metrics Abstract Objective: To estimate the association between immunologic response to antiretroviral therapy (ART) and non-AIDS defining cancer (NADC) incidence in HIV-infected patients. Design: A prospective cohort including patients with at least 1 cell/μl CD4+ cell count and HIV-1 RNA measure after ART initiation between 1996 and 2011 in the Centers for AIDS Research Network of Integrated Clinical Systems, a collaboration of eight HIV clinics at major academic medical centres in the United States. Methods: Measures of immunologic response were 6-month CD4+ post-ART, latest CD4+ and CD4+ count-years, a cumulative measure of CD4+ lymphopenia. Cox regression with inverse probability-of-exposure weights was used to calculate adjusted hazard ratios of virus-related and virus-unrelated NADC incidence. Results: Among 9389 patients at ART initiation, median CD4+ cell count was 200 cells/μl [interquartile range (IQR) 60–332)], and median HIV-1 RNA was 4.8 log10copies/ml (IQR 4.3–5.4). Median follow-up was 3.3 years (IQR 1.5–6.5). After 6 months of ART, median CD4+ cell count was 304 cells/μl (IQR 163–469). One hundred and sixty-four NADCs were diagnosed during study follow-up, 65 (40%) considered virus-related. Virus-related NADCs were inversely associated with 6-month CD4+ cell count (hazard ratio per 100 cells/μl increase = 0.71), latest CD4+ cell count (hazard ratio per 100 cells/μl increase = 0.70) and CD4+ cell count-years (hazard ratio per 200 cell-years/μl increase = 0.91) independent of CD4+ cell count at ART initiation, age and HIV-1 RNA response. No associations were found with virus-unrelated NADCs. Conclusion: Poor CD4+ cell count response was strongly associated with virus-related NADC incidence, suggesting an important role for T-cell mediated immunity in pathogenesis. Lower CD4+ cell count proximal to cancer diagnosis may be a result of subclinical cancer. Intensified cancer screening should be considered for patients on ART with low CD4+ cell counts. Introduction Among HIV-infected individuals, the burden of non-AIDS-defining cancers (NADCs) is increasing [1], with malignancies such as lung cancer, anal cancer and Hodgkin lymphoma contributing to substantial morbidity and mortality [1–3]. This is largely due to ageing of the HIV population [4,5] and a high prevalence of risk behaviours such as tobacco use, alcohol use and sexual behaviours [6]. However, HIV infection and the resultant immune suppression may also increase cancer risk [7,8]. More severe immunosuppression, as quantified through nadir CD4+ cell count and current CD4+ cell count, is associated with greater incidence of several NADCs [7,9–11]. Effective antiretroviral therapy (ART) would be expected to reduce NADC risk, but prior studies have not found consistent associations between ART use and lower NADC incidence [4,12–14]. These inconsistencies may partly be due to differences in the effectiveness of ART between patients. Immunologic response to ART, as measured by CD4+ cell counts, is likely a major mediator of ART effects on NADC incidence. Although patterns of cancer incidence differ over time after ART initiation [15,16], the reasons for these patterns are not well understood, including the impact of immunologic ART response. We evaluated the relationship between immunologic ART response and NADC incidence among HIV-infected patients initiating a first ART regimen in the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) between 1996 and 2011. Materials and methods Study population CNICS is a network of eight US HIV clinical cohorts that collects data from HIV-infected patients 18 years of age or older through electronic medical records [17]. CNICS includes detailed information on ART, laboratory measures, demographics and diagnoses, including cancer diagnoses, which have been ascertained and verified through a standardized data collection process [18]. Each CNICS site obtained local institutional review board approval. We included patients who initiated a first ART regimen, defined as at least three different antiretrovirals, at one of the CNICS sites between 1 January 1996 and 30 August 2011. Among these patients, we included those who had a CD4+ cell count and HIV-1 RNA measure within 12 months prior to ART initiation; were alive for more than 6 months post-ART initiation; and had at least 1 cell/μl CD4+ cell count and HIV-1 RNA measure within the first 6 months post-ART initiation. Measures of immunologic antiretroviral therapy response Several measures were used to characterize immunologic ART response on the basis of CD4+ cell counts obtained as a part of routine clinical care. Six-month CD4+ cell count, a measure of early immunologic response, was defined as the latest CD4+ cell count measurement taken within the first 6 months after ART initiation. Latest CD4+ cell count, a time-varying measure of immunologic response, was updated whenever a patient had a new CD4+ cell count result. Finally, CD4+ cell count-years, a time-varying measure of cumulative immunologic response, takes into account both the magnitude and duration of immunologic response using the trapezoidal rule to estimate the area under the curve across multiple CD4+ cell count measurements. Specifically, the accumulation of CD4+ cell count-years is calculated by multiplying the average of two consecutive CD4+ cell counts by the time interval between the two counts and then summing the values across all intervals between counts. Similar methods have been used to calculate cumulative HIV viremia [19,20]. As an example, a patient with a CD4+ cell count of 300 cells/μl for the first year after ART initiation, and a patient with a CD4+ cell count of 200 cells/μl for the first 6 months and a CD4+ cell count of 400 cells/μl for the second 6 months, would both have accumulated 300 cells/μl CD4+ cell count-years 1 year after ART initiation. All immunologic measures were considered continuously and categorically to identify the most accurate parameterization with relation to NADC incidence. Because immunologic measures proximal to cancer diagnoses may be more likely to be affected by subclinical cancer, analyses were done with 6-month (and 12-month) exposure lags in which immunologic measures were used to predict NADC diagnoses that occurred more than 6 (and 12) months after the immunologic ART response measurement. Statistical analysis At-risk time for NADC incidence started after the first 6 months of ART to avoid the inclusion of cancers that developed before ART initiation and to allow time for at least one CD4+ cell count to be obtained after ART initiation. For analyses with 6-month and 12-month exposure lags, at-risk time started at 12 and 18 months, respectively, to allow a minimum of 6 months to assess immunologic measures. Patients remained in follow-up irrespective of ART changes or interruptions until the first of NADC diagnosis, death, loss-to-follow-up (>12 months without a clinic visit), last date of cancer ascertainment for each CNICS site (range: 31 May 2010–31 August 2011) and administrative censoring 10 years after ART initiation. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals (95% CIs) as measures of association and precision, respectively. Immunologic response associations were considered with incidence of all NADCs [21], NADCs known to be related to viral coinfections [human papillomavirus (HPV): anal, squamous cell oral cavity/pharynx, penis, vagina/vulva; Epstein-Barr virus (EBV): Hodgkin lymphoma; hepatitis B virus (HBV) and hepatitis C virus (HCV): liver cancer] [18,22] and virus-unrelated NADCs. Multivariable Cox regression was used to adjust for time-fixed confounders measured at ART initiation, including CD4+ cell count, age, prior antiretroviral use, calendar year, race, sex, transmission risk and CNICS site, with inverse-probability weights used to further adjust for time-varying plasma HIV-1 RNA level. Inverse-probability weights were applied to account for time-varying confounding introduced by the virologic response occurring before the immunologic response [23–25]. These weights were calculated using linear regression models to estimate the probability density of the observed CD4+ cell counts for each patient with covariates for the HIV-1 RNA measurements from the prior two clinical visits. Application of these weights in the multivariable Cox regression models allows estimation of effects of immunologic response independent of the prior virologic response. In addition, inverse-probability-of-censoring weights were applied to account for differential censoring by prior HIV-1 RNA measurements, and inverse-frequency weights were applied to account for differences in the frequency of obtaining CD4+ cell count tests [24–26]. For each observation, all calculated weights were multiplied together to create a single weight that was used in the regression models (mean total weight = 1.02, SD = 0.79). As 6-month CD4+ cell count was a time-fixed measure not subject to time-varying confounding, total weights for this measure did not incorporate inverse-probability weights to account for time-varying virologic response (mean = 1.00, SD = 0.17), but models were adjusted for the HIV RNA measure prior to the 6-month CD4+ cell count. All immunologic measures were assessed separately as predictors in bivariable and weighted, multivariable regression models. Associations were also estimated among patients with a CD4+ cell count at ART initiation of less than 200 cells/μl and at least 200 cells/μl to assess effect measure modification. To determine which immunologic measure was the strongest independent predictor, Akaike's information criterions (AICs) were calculated for each multivariable regression model and compared to assess the relative model fit. The lowest AIC represents the model with the best fit to the data indicating the most predictive CD4+ response measure. Sensitivity analyses were conducted among patients without NADC diagnoses prior to 6 months of ART and among patients with no prior exposure to single or dual ART. All statistical analyses were conducted using SAS version 9.2 (SAS Institute Inc., Cary, North Carolina, USA). Results Patient characteristics Of the 25 337 patients enrolled in CNICS at the time of this study, 11 485 initiated a first ART regimen at a CNICS site between 1996 and 2011 and had CD4+ cell count and HIV RNA measures within 12 months prior to ART initiation. Among these patients, 9389 were alive and had obtained at least one HIV RNA level and CD4+ cell count at 6 months after ART initiation. The 9389 patients included were representative of the entire CNICS population: 20% were women, 43% white and 41% black (Table 1). The median age at ART initiation was 38 years [interquartile range (IQR) 32–45)], and the median calendar year of ART initiation was 2004 (IQR 2000–2007). Most patients initiated a protease inhibitor-based (47%) or nonnucleoside reverse transcriptase inhibitor (NNRTI)-based (43%) ART regimen, whereas a minority initiated a regimen with both a protease inhibitor and an NNRTI (4%), a triple-nucleoside reverse transcriptase inhibitor regimen (5%) or a regimen including an entry or integrase inhibitor (2%). At first combination ART initiation, 27% of patients had evidence of prior antiretroviral exposure, including single or dual ART use. The median HIV-1 RNA level at ART initiation was 4.8 log10 copies/ml. Within 6 months of ART initiation, 64% of patients were virologically suppressed (<400 copies/ml).Table 1: Demographic and clinical characteristics of 9389 patients at combination antiretroviral therapy initiation in the CFAR Network of Integrated Clinical Systems, 1996–2011.After 6 months of ART, patients were followed for a median of 3.3 years (IQR 1.5–6.5) with a total of 41 538 person-years of follow-up. Over the course of follow-up, 692 deaths occurred and 3156 patients were lost-to-follow-up. Follow-up was censored for 46% of patients at the last date of cancer ascertainment, and 1104 patients were censored at 10 years post-ART initiation. Immunologic response The median CD4+ cell count at ART initiation was 200 cells/μl (IQR 60–332). After ART initiation, patients contributed a median of nine CD4+ cell count measurements (IQR 4–17). The median CD4+ cell count was 260 cells/μl (IQR 121–419) during the first 6 months of ART, 324 cells/μl (IQR 182–504) in the second 6 months and 358 cells/μl (IQR 213–539) in months 12–18 of ART. More than 2 years after ART initiation, median CD4+ cell count values only increased slightly (Fig. 1). Patients accumulated a median of 1925 cells*years/μl (IQR 1239–2686) by the 54–60 month time interval after ART initiation equivalent to having an average CD4+ cell count of 385 cells/μl over 5 years (Fig. 1). By 10 years after ART initiation, the median CD4+ cell count-years accumulated was 4572 cells*years/μl (IQR 3144–6152) equivalent to having an average CD4+ cell count of 457 cells/μl over 10 years.Fig. 1: Distribution of latest CD4+ cell counts and CD4+ cell count-years by 6-month time intervals over the first 10 years after combination antiretroviral therapy initiation.Lines, interquartile range; Symbol, median value.Immunologic response and non-AIDS defining cancer incidence In total, 164 NADCs were diagnosed at a median of 3.8 years after ART initiation (IQR 2.0–6.8) for a total incidence rate of 395 per 100 000 person-years. Sixty-five NADCs were categorized as virus-related with the most frequent being anal cancer (N = 26). Ninety-nine NADCs were virus-unrelated with the most frequent being lung cancer (N = 22) (Table 2).Table 2: Non-AIDS defining cancer diagnoses occurring more than 6 months after combination antiretroviral therapy initiation in the Center for AIDS Research Network of Integrated Clinical Systems, 1996–2011.Higher values for six-month CD4+ cell count, latest CD4+ cell count and CD4+ cell count-years were all associated with lower NADC incidence (Table 3). When examined by type of NADC, all immunologic measures were strongly and inversely associated with virus-related NADCs, even after adjustment for CD4+ cell count at ART initiation, prior HIV-1 RNA measures, age and other demographic and clinical variables. In weighted multivariable regression, a 100 cells/μl increase in a patient's 6-month CD4+ cell count was associated with a 29% lower hazard of virus-related NADC incidence (95% CI 5–47) (Table 3). Similarly, a 100 cells/μl increase in the latest CD4+ cell count was associated with a 30% lower hazard of virus-related NADC incidence (95% CI 7–48). Finally, a 200 cells*years/μl increase in CD4+ cell count-years was associated with a 9% lower hazard of virus-related NADC incidence (95% CI 3–16). The CD4+ cell count-years association with virus-related NADC incidence appeared stronger among patients with a CD4+ cell count at ART initiation of less than 200 cells/μl (adjusted hazard ratio 0.89, 95% CI 0.82–0.98) than among patients with a CD4+ cell count of at least 200 cells/μl (adjusted hazard ratio 0.94, 95% CI 0.81–1.08). When included in these models, CD4+ cell count at ART initiation was inversely, but weakly associated with virus-related NADC incidence (adjusted hazard ratio in model with latest CD4+ cell count 0.90, 95% CI 0.75–1.08).Table 3: Associations of measures of immunologic response to combination antiretroviral therapy with non-AIDS defining cancer incidence.All measures were assessed with 6-month and 12-month exposure lags. Latest CD4+ cell count was less strongly associated with virus-related NADCs that occurred more than 6 months after the CD4+ cell count measurement (adjusted hazard ratio with 6-month exposure lag 0.85, 95% CI 0.75–0.95; Table 3) while other CD4+ cell response measure associations did not change appreciably. When AICs from separate models for each of the three immunologic response measures were compared, the AIC was lowest for the latest CD4+ cell count model both in bivariable and multivariable analyses (AICs: latest CD4+ cell count = 1070.6, six-month CD4+ cell count = 1075.0, CD4+ cell count-years = 1076.8), indicating that this was the strongest predictor of virus-related NADC incidence. However, after 6-month and 12-month exposure lags were implemented, AICs were lowest for the model using the 6-month post-ART CD4+ cell count (6-month lag AICs: latest CD4+ cell count = 975.8, 6-month CD4+ cell count = 972.6, CD4+ cell count-years = 974.0), indicating that this measure was the strongest predictor of virus-related NADCs occurring at least 6 months after measurement. When immunologic measures were categorized, associations indicated that virus-related NADC incidence decreased further with each increasing category of improved immunologic response. For example, when compared with the reference category of CD4+ cell count-years of less than 600 cells*years/μl, CD4+ cell count-years between 600 and 1600 cells*years/μl had a hazard ratio of 0.83 (95% CI 0.41–1.65) and CD4+ cell count-years of more than 1600 cells*years/μl had a hazard ratio of 0.30 (95% CI 0.10–0.85) for virus-related NADCs (Fig. 2). Similar findings were observed for latest CD4+ cell count and 6-month CD4+ cell count categories.Fig. 2: Time to first virus-related non-AIDS defining cancer diagnosis from 6 months to 5 years after antiretroviral therapy initiation by CD4+ cell count-years category (a) and 6-month CD4+ cell count category (b).Survival probabilities were calculated using the Kaplan–Meier method, with death, loss-to-follow-up and end of cancer ascertainment as censoring events. For CD4+ cell count-years, no patients had accumulated more than 600 CD4+ cell count-years by 6 months post-ART. At the time at which patients accumulated enough CD4+ cell count-years to qualify for a higher CD4+ cell count-years category, they were censored from the lower category and included in the higher CD4+ cell count-year category risk set as late entries. The first patients accumulated more than 600 CD4+ cell count-years at 16 months post-ART (start of solid gray line), and the first patients accumulated more than 1000 CD4+ cell count-years at 33 months (start of dotted gray line).No immunologic measures were associated with virus-unrelated cancer incidence in any analyses despite improved precision due to a larger number of cancer events (Table 3). Similar associations were observed in sensitivity analyses in which only the 6876 antiretroviral-naive patients were included. For instance, among this subgroup, a 100 cells/μl increase in a patient's 6-month CD4+ cell count was associated with a 27% lower hazard of virus-related NADC incidence (95% CI 11–41) in weighted, multivariable analyses. Results were also similar in analyses in which 382 patients were excluded with NADC diagnoses prior to 6 month post-ART initiation. Of these, 382 patients were excluded due to prior NADC diagnoses, 10 had another cancer diagnosis after 6 months of ART. Discussion In this study, a greater CD4+ cell count ART response was associated with lower NADC incidence, specifically for NADCs related to viral coinfections (HPV, EBV, HBV or HCV). This association was independent of CD4+ cell count at ART initiation, HIV-1 RNA response, age and other patient factors, and was consistently observed for measures of early, time-varying and cumulative time-varying immunologic ART response. Inverse associations were specific to virus-related NADCs. No associations were observed for virus-unrelated NADCs. As we did not censor patients with ART interruptions or switches, our measures of immunologic response are influenced by the clinical realities of ART failure or toxicity, consistency of ART drug supply and patient adherence. CD4+ cell count-years were used as a novel measure to capture the degree and duration of immune response. This may be particularly relevant to virus-related NADCs, as longer periods of immunosuppression may provide greater susceptibility to acquisition, reactivation or persistence of oncogenic viruses [27–33]. Cumulative immunologic ART response was most protective among patients with a CD4+ cell count of less than 200 cells/μl at ART initiation highlighting the importance of prompt initiation of effective ART as a cancer prevention strategy for severely immunosuppressed patients. However, in our analysis, CD4+ cell count-years was not a stronger predictor of NADC incidence than latest CD4+ cell count or 6-month CD4+ cell count, indicating that this more complex measure may not be of clinical importance for NADCs. Latest CD4+ cell count was the strongest predictor of virus-related NADC incidence. This may reflect immunosuppression and greater oncogenic potential of viral coinfections facilitating the transition to cancer. Conversely, greater CD4+ cell count declines proximal to cancer diagnosis may be a marker of immune dysregulation caused by subclinical cancer. In particular, Hodgkin lymphoma is known to decrease T-cell populations in HIV-infected and HIV-uninfected populations [32,34–36]. Regardless, declines in a patient's most recent CD4+ cell count could be an important indicator to identify HIV-infected individuals for intensified cancer screening strategies. Although subclinical cancer may alter the latest CD4+ cell count before diagnosis, it is less likely that subclinical cancer is present for CD4+ cell count measurements taken well before cancer diagnosis. When cancer diagnoses were excluded that occurred less than 6 and 12 months after CD4+ cell count measurement, all immunologic measures remained associated, but 6-month post-ART CD4+ cell count became the strongest predictor of virus-related NADC incidence. The strong association of early immunologic response as captured by the 6-month post-ART CD4+ cell count may indicate that the initial early recovery from severe immunosuppression is the most important component of the immunologic ART response for reducing virus-related NADC risk. Potent initial ART regimens and early interventions to maximize ART adherence may be important methods of cancer prevention in the HIV population. Several prior studies have found similar associations with cancer incidence. Our results parallel those previously found in the ATHENA cohort, in which cumulative exposure to CD4+ cell counts less than 200 cells/μl and latest CD4+ cell count were both associated with infection-related NADC risk [37]. Latest CD4+ cell count has been shown to be associated with virus-related NADC incidence in a number of studies including both ART-treated and ART-naive populations, and these associations have been attributed to the increased risk of oncogenic infection [7,10,37]. However, as mentioned previously, separating immunologic effects of subclinical malignancy from effects of CD4+ lymphopenia resulting from HIV may be difficult. The interaction between inadequate immune recovery and HPV-associated dysplasia and malignancy may be of particular interest. Low CD4+ cell counts increase the risk of developing cervical cytologic abnormalities [30,31]. However, effective ART has not been convincingly associated with a decreased risk of cervical [38] or anal dysplasia [39]. Multiple factors including competing risks (i.e. prolonged survival on ART allowing greater opportunities for development of dysplasia and cancer) and immunologic experience before and after ART initiation may need to be accounted for when examining this question. Further work should be conducted examining the relationships between immunologic measures, specific oncogenic viruses and precancerous abnormalities. Our findings are generalizable to other HIV-infected populations in the US given that CNICS is a large multisite clinical cohort from diverse geographic areas. Another strength was our use of comprehensive clinical data on CD4+ cell count and HIV-1 RNA measurements with recently verified cancer diagnoses [18,40]. The use of advanced analytic methods allowed us to accurately estimate cumulative and time-updated immunologic measures and adequately account for confounding due to the close correlation with virologic measures. This study is the first to our knowledge to estimate associations of cumulative immunologic response with NADC incidence and compare them with other immunologic measures in a US HIV-infected population. A number of limitations should be considered. With the exception of hepatitis B and C, we could not confirm the presence of oncogenic viral infection at the time of virus-related NADC diagnosis, and for certain cancers in this category, tumours may not have had oncogenic viruses present in tissue (e.g. oral pharyngeal squamous cell carcinoma associations with HPV [41]). If a poorer immunologic response increases the risk of viral oncogenesis, then associations would likely be stronger for confirmed virus-associated cancers. Second, we also had limited information on behavioural cancer risk factors, such as tobacco and alcohol use. However, in a previous CNICS substudy, tobacco and alcohol use were not significantly associated with ART adherence, and thus may be unlikely to greatly confound immunologic response associations with NADC incidence [42]. Finally, information was only available while patients attended a CNICS site. We could not fully capture a patient's immunologic experience prior to ART, though we adjusted for CD4+ cell count at ART initiation. In addition, one-third of patients were lost-to-follow-up and may have experienced different cancer incidence or immune recovery patterns than those observed. In summary, our findings demonstrate that CD4+ cell count response after ART initiation influences risk for virus-related NADCs. Associations persisted after adjusting for CD4+ cell count at ART initiation, indicating that, beyond the effects of immune status at ART initiation, changes in immune status after ART initiation impact virus-related NADC risk with the influence of early CD4+ cell response being most notable. This highlights the importance of adherence to effective, durable ART to reduce risk of virus-associated cancers in a population at increased risk for repeated episodes of infection with oncogenic viruses. Following ART initiation, if a patient's latest CD4+ cell count is low, this may be an indication to initiate more frequent screening for virus-related NADCs, such as the anal Pap smear for detection of anal dysplasia. This population may also benefit from new screening modalities not currently used in the general U.S. population. Acknowledgements E.L.Y. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. E.L.Y., S.N., S.R.C., C.J.A., S.G., A.F.O., D.P.D. and J.J.E. conceived the study concept and design. E.L.Y. conducted the data analysis and wrote the initial manuscript. All authors were involved in the interpretation of results and revision of the manuscript and approved the final draft of the manuscript. This work was supported by the National Institutes of Health [5T32AI007001-35 to E.L.Y., RO1-DE018304 to D.P.D., funding from the AIDS malignancy consortium (UO1 CA121947) and the Oral HIV/AIDS research alliance (OHARA) to D.P.D, R24-AI067039, P30-AI50410, and a NCI AIDS malignancy supplement grant to P30-CA016086]. The funding sources did not participate in the design and conduct of the study; collection, management, analysis and interpretation of the data; or the preparation, review or approval of the manuscript. We would like to thank the patients, principal investigators, coinvestigators and research staff at participating CFAR Network of Integrated Clinical Systems sites at the following institutions: Case Western Reserve University; University of Alabama at Birmingham; University of California at San Francisco; University of Washington; University of California at San Diego; Fenway Community Health Center of Harvard University; University of North Carolina at Chapel Hill; and Johns Hopkins University. In particular, we thank Kenneth Mayer at Fenway Community Health Center, Peggie Griffith of the Data Management Core at University of Washington and Donna Porter of the Administrative Core at University of Alabama at Birmingham for their assistance. Conflicts of interest S.N. has received grant support from Pfizer, Bristol-Myers Squibb and Merck; J.J.E is a consultant to Bristol Myers Squibb, GlaxoSmithKline, Merck, ViiV and Janssen, and has received research support (to UNC) from GlaxoSmithKline, Bristol Myers Squibb and Merck; M.J.M. is a consultant for Bristol Myers Squibb, Gilead and Merck; M.S. is a consultant for Bristol Myers Squibb, Merck, Gilead and Janssen. All other authors have no conflicts of interest to declare.References 1. Shiels MS, Pfeiffer RM, Gail MH, Hall HI, Li J, Chaturvedi AK, et al. Cancer burden in the HIV-infected population in the United States. J Natl Cancer Inst 2011; 103:753–762. Cited Here 2. Simard EP, Pfeiffer RM, Engels EA. Cumulative incidence of cancer among individuals with acquired immunodeficiency syndrome in the United States. Cancer 2011; 117:1089–1096. Cited Here 3. Simard EP, Engels EA. Cancer as a cause of death among people with AIDS in the United States. 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Patient reported outcomes in routine care: advancing data capture for HIV cohort research. Clin Infect Dis 2012; 54:141–147. Cited Here Keywords:antiretroviral therapy; cancers; CD4+ cell count; HIV infections; immune reconstitution; tumour virus infections © 2014 Lippincott Williams & Wilkins, Inc.View full article text


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DayeTime: What's Maine got that we ain't got?
What does Avoyelles Parish have in common with Maine?
Well, Maine is called the Pine Tree State and Avoyelles has a lot of pine trees.
Maine also has a significant French influence, bordering Canada's majority French Quebec Province and one-third French New Brunswick Province.
Maine is known for its really big crawfish. They call them lobsters. I like our "little lobsters" better than their "big crawfish."
Both states also have a lot of people driving automobiles and buying auto insurance.
It is at this point where there is a marked difference in the two states. It is a difference that is drawing some attention in the Legislature this year.
You see, Maine has the lowest average auto insurance in the nation at $896 a year. Louisiana has the second-highest average insurance cost at $2,339 a year.
I'm no math whiz, but by my calculations that means we are paying over 2.5 times more for auto insurance -- on average -- than those chowder-eaters in Maine.
The national average is $1,470 a year.
Mississippi's average is about $1,800 a year.
Based on these figures, a person looking for a home along the Mississippi River could apparently save over $500 a year in auto insurance by moving to Natchez instead of Vidalia.
Of course, there are other things to consider when deciding where to move.
For example, is being surrounded by New England Yankees really worth saving almost $1,450 a year on your auto insurance?
I have almost come to the conclusion that the only way to afford auto insurance is to have an accident and hire one of those attorneys from the TV and billboard ads to win you a huge settlement.
The only problem with that plan is that it would only make the insurance premiums go higher for everybody. We might even overtake Michigan as the nation's No. 1 highest average insurance rate. Michigan's average is $2,693 a year.
House Bill 372, called the "Omnibus Premium Reduction Act of 2019" has been passed by the House and has been assigned to a Senate committee for consideration.
Among the points made in the bill are that "motor vehicle accident claims comprise a major portion of the lawsuits filed in Louisiana's state courts," which it contends increases auto insurance rates.
The bill calls for reducing auto insurance by creating a legal system that is less inviting to auto accident-related lawsuits.
The bill would also increase the time to file a lawsuit from one year to two -- something I have advocated in this space, based on my decade-plus experience as an auto claims adjustor settling bodily injury claims.
I call the one-year time limit the Personal Injury Lawyer Full Employment Rule (PILFER) because it practically forces anyone who has even a minor injury to hire an attorney to file suit to beat the one-year deadline.
I would recommend extending the time limit to three years because it gives the injured party time to fully heal and gives the insurance company time to obtain and properly evaluate the medical records to reach a fair settlement -- without the need for attorney involvement.
Another proposed reform is to reduce the threshold for a jury trial from $50,000 to $5,000.
That means a case in which the settlement is expected to be over $5,000 could be decided by a jury. At this time, a claim expected to settle at less than $50,000 is decided by a judge. Under the new law, only a minor claim of less than $5,000 could be decided by a judge.
I have read comments from insurance company organizations that point out that in Louisiana, judges are elected. Insurance companies don't vote. Plaintiffs do.
I don't necessarily agree with the not-so-subtle innuendo in those comments, but it is a point to consider.
A jury trial can be iffy for both sides.
Juries can be very sympathetic to someone hurt in an accident that is suing the big, bad insurance company.
They may also stop to realize that awarding an excessively high settlement could result in increased premiums for all those drivers not hurt in that accident.
There are other proposals in the bill of a more technical/legal nature that are no doubt important, but better left for discussion in the Legislature than here.
The Louisiana Association of Business & Industry (LABI) said the bill is the "most important one we have seen for quite some time."
The business organization noted on its website that the law would "implement long-needed and obvious reform to our legal system that will hopefully lead to better auto insurance rates for Louisiana individuals, families and businesses."
Those of you with teenage drivers may want to check with a realtor in Maine.
The average annual cost to insure a 16-year-old in Louisiana is $11,616. That same teen in Maine could be insured for $4,700.
For almost $7,000 a year, I could probably learn to like lobster and clam chowder -- but would still prefer crawfish and seafood gumbo.


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ASHEBORO — According to the American Cancer Society, it is estimated that 13,560 new cases of throat cancer will be diagnosed in 2015. Laryngeal and hypopharyngeal cancers are commonly referred to as throat cancers. Often these cancers develop because of prolonged alcohol or tobacco use, a poor diet, HPV, a weakened immune system, heartburn, genetic syndromes and/or work hazards.
On Tuesday, June 5, a free throat cancer screening will be conducted from 2-5 p.m. at Randolph Health Ear Nose & Throat, 124 N. Park St., Asheboro. This free screening is open to adults who have had not had a screening in the past year, are hoarse and have smoked or currently are smokers or use tobacco products. These screenings will be conducted by Dr. Brandon Ma.
According to the American Cancer Society, common symptoms associated with throat cancer include: hoarseness, sore throat that doesn't go away, constant coughing, pain when swallowing, trouble swallowing, ear pain that doesn't go away, trouble breathing, weight loss and/or lump or mass in the neck.
"The best way to beat throat cancer is by prevention and early detection," said Dr. Ma. The American Cancer Society notes that 80 percent of people who develop throat cancer use tobacco products, and another 70 percent are frequent drinkers.
"In many cases, the primary culprit of throat cancer is smokeless tobacco," added Dr. Ma. "It's very important to see your doctor immediately if you have any abnormal growths or patches in your mouth or throat."
Space is limited and appointments are required. To register, call 336-633-7788.


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I'm sure you must have heard YUNG's 'Shege A Kaduna' if you haven't by now you should.. Well this is the remix and on this one he teams up with Croc's City's very own Terry Tha Rapman. They go hard on this joint in the native Hausa as expected and in English… Dem KD boiz are not smiling.. Enjoy!
DOWNLOAD Yung – S.A.K (Remix) ft. Terry Tha Rapman
"Yung – S.A.K (Remix) ft. Terry Tha Rapman",
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