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A blog that's not only one of a kind, but one of a kind and fucking funny. You may not laugh at everything, but I know for goddamn certain you'll laugh at something. People love watching train wrecks—and I'm happy to oblige. Because sharing these stories has taught me not to take life so seriously. And through my experiences with the blog I've found that honestly sharing my most humiliating stories not only makes people laugh, but helps them with their own problems.
Wednesday, December 15, 2010
An Email from Santa Claus to J-Wunder
Cookies and milk. Mother fucking cookies and goddamn milk.
Is that all you cocksuckers can think to give me?! I bring you vcr's, video games, all kinds of shit...and you give me cookies and goddamn milk?! Yeah, that's a fucking fair trade.
Did you ever think about a shooter, a few lines of blow, maybe a blow job? I ride around all fucking night with deer shit hitting me in the face...I'm overweight, I'm constipated and you shitheads give me cookies and mother fucking milk?!
Then I have to go back to the goddamn North Pole and stumble over fucking elves and, hey, you want to know why we have elves? Because we don't have kids. Why? My wife won't fuck.
I'm 300 years old, I've never been laid, and oh yeah, pardon me, there's something else you cocksuckers give me...it's letters...3 billion mother fucking letters!!!
Merry goddamn Christmas, FUCK YOU, I quit!
Go fuck yourself
5 comments:
- J-Wunder said...
I wish I was joking about this email too.
- December 15, 2010 at 7:34 PM
My dad left us a similar letter...not funny.
- December 15, 2010 at 9:02 PM
- J-Wunder said...
Where's the love when you need it right? LOL!
- December 16, 2010 at 5:39 AM
- Paige Tucker said...
This blog is about a letter written by Santa Claus to a person this is almost prank done by a person to another. Found this article very funny I like to read top essay writing service that kind of articles this is just amazing.
- July 26, 2018 at 1:38 AM
- Kai Barraclough said...
This is very funny blog people share the frustration and they make laugh after reading this. We don't use a vulgar language by boom essay review this is very ridiculous thing to abuse anyone just for lay down the frustration.
- February 2, 2019 at 12:43 AM


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Stella Café
Seriously good coffee. A wide variety of food for all dietary needs prepared daily on our premises. Packed lunches on request. NZ craft wine, beer and ciders. A dedicated cheese room with boutique New Zealand cheeses and gourmet foods.
Stone Oven Bakery & Cafe
All food is baked in a traditional big stone oven. Enjoy breakfast, lunch and afternoon tea, great coffee, tea, milkshakes and a large variety of chilled drinks including beer and wine. Order a packed lunch to take on your ride.
Stonecroft Wines
Stonecroft is a small, family owned winery producing organic wines in Hawke's Bay. Best known for Syrah, it has the oldest Syrah vines in New Zealand. The rustic cellar door is open from October to June, welcoming cyclists.
Stopforths Premium Accommodation
Brand new accommodation, 100m from the cycle trail, 400 metres from the Hokitika town centre. We offer unrivalled quality and are the best rated accommodation our size or larger on the West Coast. Explore the Southern sky with keen astronomy...
Strath Taieri Hotel
Built in the 1890s the Strath Taieri Hotel is the last remaining pub in Middlemarch. A must-stay to mix and mingle with locals. Affordable accommodation in two double, two twin and one single room. Great meals and cold beers.
Stumpers Bar, Cafe & Accommodation
Quality hotel accommodation; onsite bar; periodic light entertainment; cafe offering homemade breakfast, lunch and dinner dining; sunny outside seating in summer or a fireside couch in winter. Everything you need under one roof for a hassle free stay during your...
Sublime Lodge
Relax in luxury after a hard day on the bike. Sublime lodge and vineyard offer a unique romantic getaway, amongst the beautiful surrounds of mountains, river and vineyards. We have double and twin rooms with ensuite bathrooms.
Our team is ready to serve hungry cyclists on the Alps 2 Ocean Cycle Trail. Call ahead and order Subway for your group - it's a healthy and tasty way to keep those legs pumping on the trail.
Sunset Cottage
A new three-bedroom home with modern furnishings, air conditioning and log fire. Sleeps up to six in two queen beds and two single beds. We are situated on the Alps to Ocean, close by are Lakes Aviemore and Benmore.
Tahuna Beach Holiday Park and Motel
The ideal location for your kiwi holiday. Situated on the link track to Tasman's Great Taste Trail with access to local cycle trails within minutes. A comprehensive range of accommodation for everyone, camping sites, basic-cabins, studios and motel units.
Taieri Bank Cottage
Situated on a Sheep and Beef farm 2km from Middlemarch our boutique property offers excellent location to the Central Otago Rail Trail. The Cottage is beautifully renovated with all the self-contained amenities you will need. Breakfast included in tariff.
Tailor made Tekapo Backpackers
We are only 300 metres from the bus-stop, shops and restaurants. We offer a range of accommodation from ensuite-double and twin rooms to 6-bed dormitory. No fear - no bunk beds. All beds are made-up.
Tākaro Trails Cycle Tours Hawke's Bay
With over 200kms of leisurely, off-road trail, cycling is the best way to enjoy beautiful Hawke's Bay. For ten years Tākaro Trails has been making cycling easy for visitors with a range of tours covering the whole trail network.
Tamaki Maori Village
Tamaki Maori Village provides an interactive Maori Village experience, cultural show and a Maori Hangi Buffet. A visit to Tamaki Maori Village is a glimpse into New Zealand's rich history of culture and entertainment.
Tapawera Promotion Association
Situated in the beautiful Motueka valley with a stunning mountain backdrop, Tapawera is the gateway to the Kahurangi National Park including Mt Arthur ranges & Mt Owen as featured in Lord of the Rings
Tasman Bay Backpackers
The atmosphere's relaxed, it's warm, spacious, clean & homely. Owned & run by friendly, helpful people. FREE bikes for exploring . FREE bike storage. Free Wi-Fi. FREE hot chocolate pudding/ice cream - every night. FREE breakfast - May to October.
Tasman View Accommodation
Tasman View Accommodation is a unique property offering stylish boutique accommodation, situated on a private farmland setting, directly on the Tasman Great Taste Cycle Trail. We offer 3 self-contained attached double units, each with a separate external entrance.
Tasman Village Cottage
Beautiful self catering or catered cottage situated in a half acre garden filled with roses, peonies, lavenders, fruit trees, large vegetable garden and abundant bird life. The cottage has its own entrance and drive well separated from the house for...
TCB Ski Board & Bike
Bike retail, rental & workshop! Personal service, full bike service department. Open 7 days a week. Winter: 7am-6pm, late night Friday. Summer: 9am-5pm
Te Akatarawa Station
On a family run merino sheep and cattle farm, the four-bedroom cottage offers comfortable and private accommodation for up to 7 guests. Linen is available on request. Full facilities to self-cater, including an outdoor area and BBQ.
Te Aroha Holiday Park
Accommodation at Te Aroha Holiday Park is a unique country camping experience in one of New Zealand's few remaining traditional holiday parks in the Waikato. Enjoy soaking in our mineral hot pool (open during the evening).
Te Aroha Mineral Spa
This is a must-do when visiting Te Aroha. Whether you need to soak your body after a day cycling, or just want to escape, soak in the natural, silky mineral-water that has made Te Aroha famous for over 100 years.
Te Aroha Motel
Te Aroha Motel is located in the midst of this picturesque town, with the Hauraki Rail Trail at our doorstep and other cycle and walking trails in our backyard.. Secure Bike Storage available
Te Aroha Swim Zone
Take a break and make a splash at Swim Zone Te Aroha. Set in a natural bush setting and centrally located in the Te Aroha Domain. The heated pools and outdoor spa provide the perfect place to relax.
Te Awa Winery Restaurant
Located on the Wineries Ride, Te Awa and Vidal Cellar Door and Te Awa Restaurant are the perfect destination - a relaxed, memorable Hawkes Bay dining experience based on the taste sensation of local produce. Restaurant 11am-3pm Cellar Door 10am-4pm.
Te Awanga Cottages
Te Awanga Cottages feature two architecturally designed cottages situated in a picturesque coastal setting. Located on the "Landscapes Trail", within a 10 minute ride to four local wineries, Hygge Café, or a walk through the village to the ocean.
Te Kohurau Restaurant & Cafe
A warm and welcoming dining experience in Kurow! Freshly made food, full of home cooked flavour. Opening hours Monday and Tuesday: 9am-7pm. Wed: Closed. Thursday to Sunday: 9am - 7pm Winter hours may change.
Te Rakau Accommodation and Birding Tours
Unique converted train carriage accommodation provides access to bush walks and eel feeding. Fully guided half & full-day bird watching tours to see wetland & fresh water estuary birds around Lake Onoke and coastal & marine birds along Onoke Spit.
Te Rito Marae
An authentic Maori marae experience located right on the trail in a beautiful rural setting. Welcome onto the marae with a Powhiri, group accommodations and homecooked meals provided.
Te Waiariki Ngawha Springs
A taonga (treasure) of the North. 16 Geothermal mineral hot pools each with unique nutrient and temperature characteristics. Used for centuries for relaxation, therapeutic qualities and healing. Perfect after a day cycling. Open 9am to 9pm.

subset: commoncrawl


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Newport-based creative design agency, Icon Creative Design has appointed a new designer.
Holly Tyler graduated with a first class honours degree in graphic communication from the University of South Wales this summer.
Holly has a particular interest in branding and typography. Her creative talent was recognised when she was awarded a 'New Now' Award in London by YCN, the leading network in recognising and developing emerging creatives in the UK.
Holly said: "Working in Icon's design studio has been an incredible learning curve. Finding intelligent and creative design solutions to live briefs has been hugely rewarding.
"University of South Wales was a great place to study; to progress to a commercial studio shortly after graduating has been the perfect start to my professional design career."


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Out of stock
Infused with pine and frankincense essential oils, and complemented by warm undertones of black pepper and mulled spice; Dubai Sunrise is not only unique in scent, but also provides a variety of benefits for your beard and skin.
Soil Association Certified, Unrefined Organic.
Shea Butter: ( Butyrosperium parkii)For conditioning and adding thickness to your beard, while moisturising the skin beneath.
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Vegan Option replaces the bees wax with Carnauba wax.
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Packed with Vitamin E and Zinc which helps promote hair growth, for a long and healthy beard.
Vitamin E (Tocopherol)
Promotes the circulation of blood to the hair follicles,
Grape-seed oil.(Vitis vinifera), Grapeseed has been found to have a higher concentration of Linoleic acid than many other carrier oils - which research has found to have anti-inflammatory, acne reductive, and moisture retentive properties on skin. Grapeseed oil is very mellow for your skin, and won't clog pores or lead to breakouts. It is also great for for the hair of the beard, and is noted for having healing effects for dry, damaged hair. Since it is so "light", it is also a really great option if you are looking to avoid the greasy feeling that can come from other heavier oils.
All of our products are handmade in small batches to ensure you get the best quality every time. Despite ensuring the highest quality on rare occasions a natural cracking my occur,


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Sacred Moon Festival
The end of July saw Bec and colleague Nat head to Cardwell in Far North Queensland for the Cardwell Sacred Moon Festival. They created a large crescent moon, a 'star tree' and a large-scale winged angel as well as a number of smaller lanterns with the local community.
The Sacred Moon Festival is a spiritual healing and natural therapies festival. The project culminated with the stunning August super moon rising over Hinchinbrook Island as the lantern parade wound it's way gently through the festival site.


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Important Note: These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, cure, or prevent any disease.


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In Case You Missed It
Alabama Not Affected By Court Ruling in Proof of Citizenship
By Brandon Moseley and Bill Britt
Alabama Political Reporter
You have to be a US citizen in order to participate in the election process (either by birth or by completing the naturalization process). Everyone knows and understands this; but no one has been required to provide proof that they are actual citizens in order to participate.
That was about to change after the Executive Director Brian Newby of the Election Assistance Commission (EAC) had granted the requests of Alabama, Georgia, and Kansas to include documentary proof of citizenship requirements in the state-specific instructions to the federal voter registration form, used for mail-in registration. On Friday, September 9, the United States Court of Appeals for the District of Columbia Circuit narrowly reversed (2-1) a lower court ruling and issued an injunction against imposing the requirement.
In a written reply to questioning by Alabama Political Reporter editor Bill Britt, Alabama Secretary of State Deputy Chief of Staff John Bennett answered: "Currently, the Alabama form requires that each applicant certify under penalty of perjury that they are a US citizen, however, they have not been required to provide specific proof of citizenship unless evidence existed which would have called into question that applicants citizenship. At this time we have not yet implemented systems which would require the proof to be presented upfront."
Bennett said, "We will continue to closely watch and monitor the situation to ensure that Alabama continues to comply with the law, both state and federal, in every situation.
Secretary Merrill has made it clear and continues to confirm that he wants every eligible US citizen, that is a resident of Alabama, to be registered to vote and to have a photo I.D.
On Monday, September 12, The President of the Lawyers Committee for Civil Rights Under Law Kristen Clarke said in a statement, "Proof of citizenship requirements are yet another tactic used by those seeking to make it more difficult for people to register and vote across our country, we hope that the DC District Court ultimately grants relief that will help ensure that tens of thousands of eligible citizens in Kansas, Georgia, and Alabama are not denied the right vote by an unnecessary and burdensome restriction."
The plaintiffs, which included the Georgia State Conference of NAACP Branches, the Peoples' Coalition for the Peoples' Agenda, and the League of Women Voters of the United States, Alabama, Georgia and Kansas, argued that the executive director's decision was outside the scope of his authority because the EAC could act only with the approval of three Commissioners, and no such action had been taken by the Commissioners to approve the states' requests.
Alabama State Auditor Jim Zeigler (R) said on Saturday in response to the ruling: "This is an absurd ruling. We must fight this. Only US citizens should vote in US elections."
In Case You Missed It
House passes General Fund Budget
By Brandon Moseley
Alabama Political Reporter
The Alabama House of Representatives passed the state General Fund Budget on Tuesday.
The General Fund Budget for the 2019 fiscal year is Senate Bill 178. It is sponsored by Sen. Trip Pittman, R-Montrose. State Rep. Steve Clouse, R-Ozark, carried the budget on the House floor. Clouse chairs the House Ways and Means General Fund Committee.
Clouse said, "Last year we monetized the BP settlement money and held over $97 million to this year."
Clouse said that the state is still trying to come up with a solution to the federal lawsuit over the state prisons. The Governor's Office has made some progress after she took over from Gov. Robert Bentley. The supplemental we just passed added $30 million to prisons.
The budget adds $50 million to the Department of Corrections.
Clouse said that the budget increased the money for prisons by $55,680,000 and includes $4.8 million to buy the privately-owned prison facility in Perry County.
Clouse said that the budget raises funding for the judicial system and raises the appropriation for the Forensic Sciences to $11.7 million.
The House passed a committee substitute so the Senate is either going to have to concur with the changes made by the House or a conference committee will have to be appointed. Clouse told reporters that he hoped that it did not have to go to conference.
Clouse said that the budget had added $860,000 to hire more Juvenile Probation Officers. After talking to officials with the court system that was cut in half in the amendment. The amendment also includes some wording the arbiters in the court lawsuit think we need.
The state General Fund Budget, SB178, passed 98-1.
Both budgets have now passed the Alabama House of Representatives.
The 2019 fiscal year begins on Oct. 1, 2018.
In addition to the SGF, the House also passed a supplemental appropriation for the current 2018 budget year. SB175 is also sponsored by Pittman and was carried by Clouse on the floor of the House.
SB175 includes $30 million in additional 2018 money for the Department of Corrections. The Departmental Emergency Fund, the Examiners of Public Accounts, the Insurance Department and Forensic Sciences received additional money.
Clouse said, "We knew dealing with the federal lawsuit was going to be expensive. We are adding $80 million to the Department of Corrections."
State Representative Johnny Mack Morrow, R-Red Bay, said that state Department of Forensics was cut from $14 million to $9 million. "Why are we adding money for DA and courts if we don't have money for forensics to provide evidence? if there is any agency in law enforcement or the court system that should be funded it is Forensics."
The supplemental 2018 appropriation passed 80 to 1.
The House also passed SB203. It was sponsored by Pittman and was carried in the House by State Rep. Ken Johnson, R-Moulton. It raises securities and registration fees for agents and investment advisors. It increases the filing fees for certain management investment companies. Johnson said that those fees had not been adjusted since 2009.
The House also passed SB176, which is an annual appropriation for the Coalition Against Domestic Violence. The bill requires that the agency have an operations plan, audited financial statement, and quarterly and end of year reports. SB176 is sponsored by Pittman and was carried on the House floor by State Rep. Elaine Beech, D-Chatham.
The House passed Senate Bill 185 which gives state employees a cost of living increase in the 2019 budget beginning on October 1. It was sponsored by Sen. Clyde Chambliss, R-Prattville and was being carried on the House floor by state Rep. Dimitri Polizos, R-Montgomery.
Polizos said that this was the first raise for non-education state employees in nine years. It is a 3 percent raise.
SB185 passed 101-0.
Senate Bill 215 gives retired state employees a one time bonus check. SB215 is sponsored by Senator Gerald Dial, R-Lineville, and was carried on the House floor by state Rep. Kerry Rich, R-Guntersville.
Rich said that retired employees will get a bonus $1 for every month that they worked for the state. For employees who retired with 25 years of service that will be a $300 one time bonus. A 20-year retiree would get $240 and a 35-year employee would get $420.
SB215 passed the House 87-0.
The House passed Senate Bill 231, which is the appropriation bill increase amount to the Emergency Forest Fire and Insect and Disease Fund. SB231 is sponsored by Sen. Steve Livingston, R-Scottsboro, and was carried on the House floor by state Rep. Kyle South, R-Fayette.
State Rep. Elaine Beech, D-Chathom, said, "Thank you for bringing this bill my district is full of trees and you never know when a forest fire will hit.
SB231 passed 87-2.
The state of Alabama is unique among the states in that most of the money is earmarked for specific purposes allowing the Legislature little year-to-year flexibility in moving funds around.
The SGF includes appropriations for the Alabama Medicaid Agency, the courts, the Alabama Law Enforcement Agency, the Alabama Department of Corrections, mental health, and most state agencies that are no education related. The Alabama Department of Transportation gets their funding mostly from state fuel taxes.
The Legislature also gives ALEA a portion of the gas taxes. K-12 education, the two year college system, and all the universities get their state support from the education trust fund (ETF) budget. There are also billions of dollars in revenue that are earmarked for a variety of purposes that does not show up in the SGF or ETF budgets.
Examples of that include the Public Service Commission, which collects utility taxes from the industries that it regulates. The PSC is supported entirely by its own revenue streams and contributes $13 million to the SGF. The Secretary of State's Office is entirely funded by its corporate filing and other fees and gets no SGF appropriation.
Clouse warned reporters that part of the reason this budget had so much money was due to the BP oil spill settlement that provided money for the 2018 budget and $97 million for the 2019 budget. Clouse said they elected to make a $13 million repayment to the Alabama Trust fund that was not due until 2020 but that is all that was held over for 2020.
Clouse predicted that the Legislature will have to make some hard decisions about revenue in next year's session.
In Case You Missed It
Day Care bill delayed for second time on Senate floor, may be back Thursday
By Samuel Mattison
Alabama Political Reporter
The day care bill, which would license certain day care centers in Alabama, was once again delayed on the state Senate floor after one lawmaker requested more information.
Its brief appearance Tuesday ended with state Sen. Gerald Dial, R-Lineville, saying a compromise had not yet been worked out with the bill's detractors.
Alabama's Senate has been hesitant to act on the legislation because of complaints of state Sen. Shay Shelnutt, R-Trussville, who has been an opponent of the bill since its introduction last year. The bill's delay on Tuesday marks the second time its been taken off the Senate's agenda.
The bill has had a rocky time in this year's session, but the bill's sponsor state Rep. Pebblin Warren, D-Tuskegee, said she is still confident about its passage out of the Legislature.
Warren, D-Tuskegee, filed the bill this session with the support of influential lawmakers including Gov. Kay Ivey, who told reporters last year that she though all day cares should be licensed.
Mainly sparked by the death of 5-year-old boy in the care of a unlicensed day care worker, the bill had great momentum coming into this year' session.
Despite the growing support from lawmakers, Religious groups had concerns that the bill would increase state-sponsored reach into religious day cares in churches and non-profit groups.
Spearheading the dissenters was Alabama Citizens Action Program, a conservative religious-based PAC.
Warren, proponents, and ALCAP announced a compromise to the bill while it was still in the Alabama House.
Announced by ALCAP originally, the new bill was a weaker version in that it did not require that all day cares in the state be regulated. Instead, religious-based day cares would only need to be registered if they received federal funds. At a Senate committee meeting in February, Warren said a similar requirement was about to come from federal law in Congress.
The bill moved through the House in a overwhelming vote in favor of the proposal and passed unanimously out of a Senate committee a few weeks ago.
Warren, speaking to reporters after its passage from the House, said she was unsure if the bill would encounter resistance in the upper chamber.
It was the Senate that killed the daycare bill last year amid a cramped last day where senators took the bill off the floor. The bill may face similar complications this year, as lawmakers seem to be preparing to adjourn within a few weeks.
In Case You Missed It
Fantasy sports bill fails on Senate floor
By Samuel Mattison
Alabama Political Reporter
Would-be Fantasy Sports players in Alabama will have to wait to legally play in the state following a Senate vote on Tuesday.
The Alabama Senate decisively killed a bill to exempt fantasy sports from the state's prohibition on gambling.
Not even entertaining a debate on the Senate floor, the proposal was killed during a vote for the Budget Isolation Resolution, which is usually a formality vote preluding a debate.
Fantasy sports are contests where participants select players from real teams to compete on fantasy teams using the real-world players' stats.
Since 2016, the practice has been illegal in Alabama following a legal decision by the Attorney General's Office that categorized it as gambling.
The bill's sponsor, state Sen. Paul Sanford, R-Huntsville, predicted the bill's failure during a committee meeting two weeks ago, where the bill passed unanimously.
- Sen. Paul Sanford speaks to reporters after a Senate Committee meeting on Feb. 28, 2018. (Samuel Mattison/APR)
Speaking to reporter's after the committee meeting, Sanford said the decision to file the bill was mainly a philosophical belief that the practice shouldn't be illegal.
Sanford, a fantasy sports player before its ban, said that fantasy sports are a way to bring people closer together and not a means to win money. The Huntsville senator is not seeking re-election.
The bill's failure in the Senate follows its trajectory last year too. A similar version of the bill, also sponsored by Sanford, failed in the Senate during the final days of the 2017 Legislative Session.
Since Sanford is retiring, it is unclear if the bill will even come back next session, or if it will even have a Senate sponsor.
In Case You Missed It
House OKs bill to clarify consulting contracts by state legislators
By Brandon Moseley
Alabama Political Reporter
Tuesday, the Alabama House of Representatives passed a bill to try to clarify how legislators accept consulting contracts under Alabama's 2010 ethics law. Some pundits have suggested that House Bill 387 is actually designed to weaken the existing ethics law.
Sponsor state Rep. Rich Wingo, R-Tuscaloosa, argues that the legislation is merely a clarification and is intended to prevent legislators from inadvertently crossing the line into illegality.
Wingo said that his bill would require legislators to notify the Alabama Ethics Commission that they have entered into a consulting agreement in an area outside of their normal scope of work.
State Rep. Paul Beckman, R-Prattville, said, "I have never understood why members of this body were allowed to take contracts as consultants or counselors."
Wingo said, "Never do I use the word counselor in my bill; it is consulting."
Beckman asked, "Are we going to be getting into an area where every time we turn around we create a bureaucratic nightmare where we have to go get an opinion. These opinions whether it is orally or written don't hold up in a court of law." Beckman said, "We are serving the people here but we get this admonition that we can still be a consultant if we get an opinion."
Wingo said, "This does not apply to professions where a member is currently licensed."
Beckman said, "I would like to see more opinions coming out of the Ethics Commission. Right now we have the Ethics Commission competing with the Attorney General's office over who has more authority."
State Rep. John Rogers, D-Birmingham, said,"This happened to a friend of mine. He just got out of prison. He was a state senator and had a written letter from the Ethics Commission which his lawyer read at trial and the jury convicted him anyway."
Rogers never named his friend, but reporters think he was talking about former state Sen. Edward Browning 'E. B.' McClain who spent over 22 years in the legislature until he was convicted on 47 counts of conspiracy, mail fraud, bribery, and money laundry in 2009.
A federal jury found that McClain and the Rev. Samuel Pettagrue were guilty in a scheme where McClain would secure public funds for Pettagrue's community programs and then receive a kickback once the funds were in hand. McClain was sentenced to five years and ten months in prison. McClain was not prosecuted under the Alabama ethics law as the state has a much weaker ethics statute then. The current ethics law was passed in 2010.
Rogers said, "If they offer me a consulting contract for a field like aerospace engineering that I know nothing about they are trying to pay me off. If you can already be a consultant for something you know about why would you seek a consulting contract for something you don't know about.
Rogers this is how they can pay you off for your vote."
State Rep. Artis "A.J." McCampbell said, "I don't like making changes to things like this because we get into things called unintended consequences."
McCampbell was reading from the bill and Wingo said, "You are reading from the original version it has completely changed." "We worked tirelessly on this bill with the Ethics Commission this is not a fly by night bill."
"If a member of the legislature enters into a contract to do a consulting contract outside of their normal field of work this bill requires that they consult with the Ethics Commission first," Wingo said. "It is up to the member to notify the Ethics Commission not to the company or person offering them the money."
State Representative Pebblin Warren, D-Tuskegee, said, "Everybody but legislators are allowed to do contract work up to $30,000."
Rep. Wingo said, "This is not intended to be a roadblock."
State Representative Arnold Mooney, R-Indian Springs, said, "The whole purpose of this is not to prevent members from doing work in your field." "What you are doing is offering to protect me."
State Representative John Knight, D-Montgomery, asked Wingo what the Alabama Attorney General said about this legislation.
Wingo replied, "I have not contacted the Attorney General."
Knight responded, "Something from the Ethics Commission does not carry a lot of protection from the Attorney General. We have seen that in the past. I think the Attorney General and the Ethics Commission should be in agreement in the working on this."
Wingo answered, "Maybe this is a first step."
Rep. Laura Hall, D-Huntsville, asked, "Do we have anybody doing work outside of their regular scope of work?"
Wingo answered, "Yes I think so."
Wingo said, "If we had had this bill four or five years ago maybe we could have been spared the embarrassment that this body experienced with the former Speaker."
Wingo was referring to former Speaker of the House Mike Hubbard who was convicted of 12 counts of felony ethics violations in June 2016. Ironically, Hubbard is largely responsible for creating the ethics law that he was found guilty of violating 11 times in his relentless pursuit of outside contracts and personal wealth.
Unlike McClain, however, Hubbard has not yet served any of this sentence.
House Bill 387 passed 67-0 with 26 legislators abstaining.
The bill now moves to the Senate for its consideration.
(Original reporting by the Alabama Media Group's Lisa Osborn in 2009 was consulted in this report.)


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March 2, 2016
One of China's top legal voices has spoken out against televised confessions, an increasingly common tool used by Chinese authorities to humiliate human rights advocates, lawyers, book publishers and journalists.
China should not drag people in front of the cameras to plead guilty, Zhu Zhengfu, deputy chairman of the All China Lawyers Association, said this week in a rare internal reproach to the broad clampdown that has enveloped the country under President Xi Jinping.
Such confessions, he said, are of little legal value and may rely on coercion.
"Legally speaking, if there is no evidence to support the case, a guilty plea on television should be inadmissible," he said in an interview with Beijing News that was widely disseminated in China on Wednesday. "Because there are too many possibilities for a suspect to be led into pleading guilty against their will and contrary to the facts."
'I Can't Stay Out of This' — Two Statements on the Zhang Kai Case


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Feast of Tentacles is a DIY record label and distro based in Nottingham, UK, that has already put out a plethora of great releases by bands like Thou, Cough, Rot in Hell, Army of Flying Robots, Kowloon Walled City and many more. Whenever he gets a break from lacerating his vocal chords with local sludge behemoths Moloch, Chris Braddock runs the label on his own, so M3 decided to ask Chris about the label's history, the unfortunate death of the record store and the resurgence of vinyl…
M3 – First of all, could you tell us a bit about Feast of Tentacles, and what it is that you do?
Chris Braddock – FOT was set up in 2006 and is a DIY record label and distro that focuses on HC, punk, metal releases. My first release was a split 7″ between Army of Flying Robots and Kamikazee.
FOT is a one man operation so I do everything from mailorder to paying for releases.
What inspired you to start the label? What is your own musical background?
I had been knocking around the local HC / punk scene for a while and wanted to get involved. I wasn't in any bands at the time. I had been on tour with friends bands and went to a lot of gigs. So I started the label to release something by my close friends in Army of Flying Robots. I went on to be in some local bands and am currently in Moloch.
What would be your preferred medium to listen to music (eg. Vinyl, CD, tape, MP3 etc.), and why?
Definitely vinyl. The whole package of an LP or 7″ is much more special and impressive that CD or tape. MP3s serve a purpose in that it is an easy way for people to access music but they are pretty disposable.
Do you feel the idea of an album, as a piece of art that people will listen to from start to finish, has been undermined or forgotten about in the digital age?
Yes in certain circles. Many bands still aspire to write and record an albums worth of material, but some punk/HC bands concentrate on smaller releases like 7″s and splits. Which is understandable as there is more cost involved in recording/releasing an LP and people can be hesitant to shell out more money on a full length of a band that is less established. Although many people in the HC/punk scene that I know spend more money on vinyl than downloads.
Much has been made of the supposed death of the record store in recent years. Do you believe the digital age has killed the record store, and if so, do you think that this is a necessary part of progression, or a tragic loss?
It's a tragic loss. I used to love trawling record shops and spending hours in Selectadisc (RIP) in Nottingham. Online stores and downloads have definitely played their part.
Do you think the widespread adoption of MP3 has in some devalued the musical experience? Is the popularity of small pressings, differently coloured vinyl, limited edition versions etc in some way a reaction to the vast availability of digital files?
Small record labels (like FOT) need any help they can get to shift units. Hence small runs, limited colours, pre-order versions etc. I don't think it's necessarily a reaction to digital files. People will make digital copies, post tracks on blogs, share with friends and hopefully people will go on to purchase the vinyl on the back of that. These limited editions just make it more desirable.
Recently, there seem to be a large number of bands offering their releases for free via sites like Bandcamp. What do you think of this distribution method, do you think it is an effective solution to the problem of illegal downloading?
I think it is pretty effective – at least it's the band's choice to give their music away. The amount of blogs I found offering FOT releases for download without any label / band info / links is crazy. I don't mind blogs putting my stuff up for download as long as the label/band is credited.
Do you think traditional copyright laws are still enforceable in the digital age, or do you think we will have to rethink the concept of copyright itself?
Copyright has gone out of the window especially in underground music. It needs a rethink – closing file sharing sites helps. But once the music is out there it's OUT THERE.
Finally, what does the future have in store for Feast of Tentacles?
I have 6 or 7 releases pencilled in for the next 12 months or so from Moloch, Thou, Lich, Seven Sisters of Sleep, Column of Heaven, Pinebarrens and more.
For more information about Feast of Tentacles, you can visit their website and find the label on Facebook, Twitter, Bigcartel & Tumblr.


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The Corn Belt is a band of Earths that spans from Earth West 100,000 to around Earth West 460,000.[1][2]
The Corn Belt is known as such because these Earths offer good conditions for farming: regular rainfall, herds of healthy-looking animals, and grassland and prairies littered with familiar looking trees and scrub.[3]
The Long Earth
Lobsang and Joshua passed through the Corn Belt during the Journey in 2030. On the nineteenth day, around Earth West 460,000, Lobsang declared that they had reached the limit of the Corn Belt, the worlds beyond being too warm and the forests too thick to make farming worthwhile.[2]
Community content is available under CC-BY-SA unless otherwise noted.


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* New Price * Remarkable Mapleton Estate with a Gentleman's Ranch! Gorgeous storybook setting on a stunning and private, fully fenced and gated 6.27 acres zoned for horse property with 11.9 shares of underground pressurized irrigation (the most shares in the area). Completely updated main home with 9,639k sq ft. The home boasts an impressive brand new Chef's kitchen with marble counters and premier appliances, incredible main floor living with a luxurious master suite and 3 additional large bedrooms. Upper floor sq footage is guest quarters above the detached 4 car garage. State of the art, brand new incredible barn/bath/office with 4 heated and rubber padded stalls with custom stall fronts…all designed to compliment and enhance the estate. Luxury dog facility/office which can be easily converted to add 3 additional bedrooms and baths. Two brand new hay barns and 3 additional bathrooms in the outbuildings. Tons of land to ride horses and relax by the pool (with pool house) while enjoying the mountain views. This estate truly has it all!
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Watch Revolution Season 2 Episode 14 online via TV Fanatic with over 6 options to watch the Revolution S2E14 full episode. Affiliates with free and paid streaming include Amazon, iTunes, Vudu, YouTube Purchase, Google Play, and Verizon On Demand.
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Miles questions Neville and Jason's intentions while Aaron clashes with Priscilla over the nano code on Revolution.
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Many Midwestern states have been inundated with flooding since the middle of March. Warm temperatures brought rain and melted heavy snow pack. All of the water just couldn't be absorbed into frozen ground, and it was more than the infrastructure could handle. Levies breached, waterways bulged, and flooding was widespread.
Over the years, changes in climate have led to seasonal weather extremes. This intense flooding will continue to happen, and lawmakers need to determine what can be done about it. Only now are states acknowledging the problem. The governors of Iowa, Missouri and Nebraska have committed to working together to address regional solutions to levee repairs and improve flood management.
Heavy Flood Damage
The Missouri river has tributaries that wind throughout the Midwest Plains. March flooding was especially devastating there. Iowa's losses are estimated to be $2 billion, Nebraska's losses are over $1 billion. Heavy losses to livestock, crops, infrastructure, buildings, homes, and farm machinery will lead to significant cleanup and recovery costs. And the water hasn't even fully subsided yet.
As rural residents watched their lands wash out, lawmakers came together to figure out what to do. They've begun to address the funding and policies in place to deal with this disaster.
Field Hearing April 17
Ken Anderson of Brownfield Ag News reported on the Senate Environment and Public Works Committee field hearing in Glenwood, Iowa on April 17. Iowa Senator Joni Ernst presided over the hearing. Additional committee members included Iowa Senator Chuck Grassley, Kansas Senator Jerry Moran and New York Senator Kirsten Gillibrand, who is seeking the Democratic nomination for president.
The hearing was an opportunity for Senators and stakeholders to express their concerns on the Corps' management of the Missouri River basin flooding.
Joseph L. Murphy, Senior Communications Manager of the Iowa Soybean Association also reported on the field hearing. Parts of Southwest Iowa experienced extreme flooding this spring. Ernst, who hosted the meeting, made several comments.
"I want to emphasize that the Missouri [flooding] is not just in the past tense," Ernst said. "This is an ongoing disaster. People are hurting, flood waters are still in homes and neighborhoods and lives have yet to be rebuilt."
"Having your farmland, homes and businesses flooded out every few years cannot become a fact of life," Ernst said. "This trend of flood and rebuild, flood and rebuild must end."
Corps on Defense
Corps officials admit that there wasn't much that could have been done about the flash floods that breached many Iowa levees. Major General Scott Spellmon, the Deputy Commanding General for Civil and Emergency Operations said their main focus was on public safety.
"The number one priority of the Corps in all of our operations and all our projects remains life and public safety," he said. "The damage to the levees in the region is extensive. Many levees across the entire region from Council Bluffs to Kansas City overtopped during this flood."
At least 32 levee systems were completely under water during the spring floods. As of last Wednesday there were 114 breaches on those levees. The Corps is now working to repair them.
Grassley Critical
Many have been questioning the Corps' priorities for managing the Missouri River flow, even though the Corps claims that endangered species don't currently influence reservoir operation. Iowa Senator Charles Grassley is one.
"For years I have worked with my downstream Missouri River colleagues to make flood control the number one priority of the Corps in its management of the river," Iowa Republican Charles Grassley said during his opening statement. "Protection of life and personal property should take precedence over recreation and experiments that may or may not help endangered species and the other six functions identified in the Master Manual."
Recent changes to the Corps' management of the Missouri River has led to some of the worst flooding ever recorded.
"It seems to me that misguided decisions and misplaced priorities have eclipsed common sense," Grassley said. "A little more Midwestern common sense might have protected local communities, millions of bushels of grain, and tens of thousands of acres of farmland."
In 2004 the Corps changed river management protocols. Some contend that those changes have led to more frequent and severe floods along the Missouri River. The program, called the Missouri River Recovery Program (MRRP) changed the volume and timing of the flow releases. Some say this benefits the Missouri River basin ecosystem, but doesn't do much for flood control.
Grassley published his opening statement for the meeting on his website. He laid out a series of points. First, he shared disappointment in the Corps' level of communication with the public. He went as far as saying they were "unresponsive" and believes that additional measures of communication are necessary. Second, he believes that flood control should be the first priority of the Corps. Protection of life and personal property should take prescience over experimental endangered species management.
He went on to point out the unfavorable ruling against the Corps in the mass action lawsuit of 372 plaintiffs from Iowa, Nebraska, Missouri, and Kansas that the Corps' changes to the river "had the effect of raising the Missouri River surface elevations in periods of high flows."
The number one priority of the Corps should be flood control. Period.
Read more at grassley.senate.gov
Funding Issues
DTN Ag Policy Editor Chris Clayton says that even if Congress appropriated funds for levee repairs in the Midwest, it doesn't necessarily mean that's where those funds will go. Clayton's article was published on AgFax. The Corps and the White House use cost-benefit analysis to decide which levees to rebuild first- and that might mean they repair levees where property values are higher.
The Corps maintained at the hearing that there was little that could have been done to prevent the extreme flooding. The sheer volume of water in the rivers just overwhelmed the levee system. Six upstream dams on the Missouri River couldn't have prevented the downstream flooding on the Platte River.
Major General Scott Spellmon said,
"Even if flood control were the only authorized purpose for these six projects (dams) and they were all empty, this event still would have occurred."
He cited the meteorological event, dubbed a "bomb cyclone," that put water on top of snow — on top of frozen ground — which quickly went into tributaries, "and frankly just overwhelmed the design capacity of the levee system below the federal projects (dams)."
Spellmon said it's time to revisit the 97 recommendations made after the 1993 flooding on the Missouri and Mississippi rivers. However, most of those recommendations required changes in the law that were ignored because they reduced development in flood plains. The Senators say they want higher levees, but Spellmon pointed out that the Corps' has a $98 billion backlog of unfunded projects- a third of which are flood control measures.
Mistakes Have Been Made
But a lot of flood management going on right now just doesn't make sense. Take the town of Hamburg, Iowa for example. Right now, 30% of homes and 90% of businesses there are under water. A 13-foot emergency levee from 2011 that used to be there had to be taken down because it didn't meet Corps' standards. But in order to build one up to Corps' standards, the town needed to come up with $5.6 million. That didn't happen, and now there's little of Hamburg, Iowa left.
Senator Kirsten Gillibrand (D-NY), and also a 2020 presidential candidate was also challenging to the Corps flood prevention measures.
"They are too slow, too bureaucratic and they don't have enough money."
The four Senators were in agreement that an emergency appropriations bill needed to be passed that could increase the aid for several recent natural disasters. Different House and Senate versions of that bill remain tied up in the Senate.
Farmers recognize that climate changes over the years have brought seasonal changes and extreme weather. Intense flooding will continue to happen, and states need to figure out what can be done about it. The problem is only now truly being acknowledged.


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On June 1 a criminal trespass complaint was filed at a West Washington Street residence. According to reports, a complainant at EZ Bottle Shop reported that someone in a blue Cadillac Escalade had struck a vehicle in the parking lot and then left. An officer noted he observed a indention on the rear driver's side bumper of the the vehicle.
On May 30 a discharging firearms within city limits report was filed at a Morgan Circle residence. According to reports, a woman told officers that on May 28 someone had discharged two shots on the street in front of her residence and, she said, persons were implicating her in the incident. An employee at the complex reported finding two expended shell casings in front of the woman's residence. Reports allege that a pickup truck with Greene County tags came into the area with people in the back of the truck and someone threw water balloons at the truck. The truck left but returned and when it came back, a second vehicle blocked the truck and then, reports state, people started throwing lawn chairs at the truck. The vehicle blocking the truck moved and the truck left.
On May 30 Rayshawndria Gardner, 25, Columbus, was arrested and charged with theft by receiving stolen property, failure to maintain lane, no insurance, no tag and failure to report striking a fixed object. According to reports, an officer responded to a wreck complaint on Interstate 20 and when he arrived he observed Gardner walking alone up the Exit 113 ramp. The officer said Gardner someone in the wreck needed help. The officer detained Gardner and placed her in his patrol vehicle. The officer then drove to the wreck and witnesses alleged that Gardner was the sole occupant of the vehicle involved in the crash. Gardner allegedly told the officer that she and another person had taken the vehicle on a test drive from a dealer in DeKalb County auto dealership and had not returned. The officer checked on the vehicle and learned that it had been reported stolen out of DeKalb County.
On May 26 Tanja Deanna Trippe, 17, Madison was arrested and charged with shoplifting. According to reports, an employee at Wal Mart, Eatonton Road, alleged that Trippe and a 16-year-old had taken price tags off items and replaced them with lower price tags in order to pay a lower price. Total value of the items is $302.12, reports state. Trippe was arrested and detained and the juvenile was turned over to relatives.
On May 27 an information report was filed at Ingles, Eatonton Road. According to reports, an officer arrived after a woman stated that her 4-year-old grandchild had locked grandson had accidentally locked himself in the vehicle and had been in the vehicle for approximately four minutes. The officer attempted to open the vehicle using an unlock kit but failed. The officer then forced entry by breaking the driver's side front window and released the child. Reports state that the child was sweating but appeared unharmed and did not require medical attention.


text: 2oh1 1 Report post Posted May 6, 2019 I'd love it if the Flirc UI software remembered which controller I used last, or if it would let me choose which controller to see when the app opens. I use Flirc extensively, and I always use the full keyboard controller, so I'd like the Flirc UI app to open with that controller instead of the minimalist one I never use. P.S. I LOVE FLIRC! I've been using the v1 dongle for five years and just bought a v2 in order to upgrade my setup a bit. Flirc is fantastic! Quote Share this post Link to post Share on other sites


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Be quiet! is aiming for the budget and mainstream builders with their Pure Base 600 case. It is their first…Read More »
Several of Thermaltake's popular mid-tower cases have been updated with tempered glass editions. The move comes following demand from fans…Read More »
When it comes to system building, size equals convenience with large full-tower cases offering plenty of room to work with.…Read More »
Despite the higher number in the name, the MasterCase Pro 6 sits behind the MasterCase Maker 5t since the Maker…Read More »
Reeven whose current product line mostly consist of CPU coolers have begun branching out with case offerings, showcasing their Rheia…Read More »
Cooler Master has been a staple in the computer and modding industry since 1992, and since that time they have…Read More »
One of the more interesting trends I've observed at CES and Computex this year are manufacturers pushing the boundaries of…Read More »
The Canadian model for the MasterBox 5 was released initially several weeks ago (and was previously reviewed here at Modders-Inc)…Read More »
Cooler Master's current chassis line prioritize function and its design aim is to provide users with the flexibility to make…Read More »
Supermicro's main target is primarily the server market but they have been carefully integrating a gaming line accessible for regular…Read More »
In addition to having a case modding invitational with some of the world's top modders at Computex, In Win was…Read More »
For those who love watercooling, ID-cooling has taken the hobby one-step further by integrating the loop into the actual chassis…Read More »


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25 NYC Restaurants Serving Family Thanksgiving Dinner
Submitted by Diana Kim on
Thanksgiving is a time to count your blessings—and to spend hours in the kitchen, right? Eh, we New Yorkers of small-space kitchens and rapid-fire takeout options often prefer to let someone else handle our annual turkey fest. Of course, in New York City we can choose from many award-winning restaurants for that amazing dinner. With that in mind, we've rounded up a number of options in Manhattan, Brooklyn, and Queens to make this November 28, 2019 as easy and delicious as possible. Be sure to make reservations early.
Now, instead of deep-cleaning your apartment to host those far-flung relatives (and their expectations), you can spend the night before Thanksgiving in a more festive way—say, watching the inflation of the Macy's Thanksgiving Day Parade balloons, sightseeing, or even volunteering. After all, what could be more of a New York City Thanksgiving experience than that?
Find even more family-friendly NYC eateries in our local restaurant guide. Visiting and still looking for a place to stay? Check out these top family-friendly NYC hotels, or these Midtown gems offering views of the Macy's parade.


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I am also entering in the Simon Says - Anything Goes.
Thank you for visiting and have a great day!
How totally cool, both of these cards, Kristie! Love those flowers and how you interpreted both the sketch and color challenge with the female card. How in the heck did you color the petals? It's probably right there in front of me but my mind's drawing a blank. Is it a 2-part stamp? And the masculine card is dynamite. I think if it were me, I'd put a couple of grommets or brads at the upper right corner, but that's just me. You could snip off the tails of the brads so you don't have them showing on the inside since it's a single layer. Grommets would be ok showing on the inside since their "backsides" are still neat and tidy. But even without, this card is so cool! Mwah!
Both of the cards look great, my idea for the masculine card would be buttons red white & blue to tie in the stars and the paper. I also think that if you left it plain it looks just as nice!ReplyDelete
Ever so sweet card for Dynamic Duos, Kristie. Great layout and I love your flowers.ReplyDelete
"Step Away From The Card!" Don't change a single thing Kristie! The male card looks amazing as is. Clean & simple and perfectly balanced! I love the white space!
The gal card however, seems to 'need' the ribbon - could be that a nice feminie touch balances this design or the lighter colors need just a bit of something more!
Both amazing cards! A+ on your homework assignment :)
Two amazing cards!
They are both gorgeous. I think I would lay three tiny buttons on the top right side above the stars to see what they look like. If they look good then glue them down, if not....bag it because the card is awesome just like it is.ReplyDelete
I might try buttons, brads or see how a mixture of red, white and blue twine would look.ReplyDelete
Fabulous cards! Great design elements to showcase both feminine and masculine cards! Thanks for joining us for the Simon Says Stamp Challenge!ReplyDelete
I love your his & hers cards, Kristie! Great idea... I think I need to try it! Thanks for joining us at Dynamic Duos this week :o)ReplyDelete
Kristie great homework cards! That white satin ribbon is beautiful.ReplyDelete
Such beautiful homework. It is interesting to see the same sketch used for both genders.ReplyDelete
They're both fab as they are, Kristie ... cool and CAS ... if in doubt, add nothing! Anita :)ReplyDelete
Wonderful job on your homework...A+ on both!ReplyDelete


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|Advances in Breast Cancer Radiotherapy
Read the article and then use the corresponding link to take the CME test. Members must be logged in to take the test for free.
Duval County Medical Society CME Portal, May 2019
New Advances in Breast Cancer Radiotherapy
Date of Release: May 1, 2019
Date Credit Expires: May 1, 2021
Estimated Completion Time: 1 hour
The Duval County Medical Society (DCMS) is proud to provide its members with free continuing medical education (CME) opportunities in subject areas mandated and suggested by the State of Florida Board of Medicine to obtain and retain medical licensure. The DCMS would like to thank the St. Vincent's Healthcare Committee on CME for reviewing and accrediting this activity in compliance with the Accreditation Council on Continuing Medical Education (ACCME). This month, the DCMS CME Portal includes an article, "New Advances in Breast Cancer Radiotherapy" authored by Julie Bradley, MD, Michael Rutenberg MD, PhD, Raymond Mailhot, MD, MPH, and Nancy Mendenall, MD, which has been approved for 1 AMA PRA Category 1 credit.TM For a full description of CME requirements for Florida physicians, please visit www.dcmsonline.org.
Julie Bradley, MD, Associate Professor of Radiation Oncology, UF Health Jacksonville, Michael Rutenberg MD, PhD, Assistant Professor of Radiation Oncology, UF Health Jacksonville, Raymond Mailhot, MD, MPH, Assistant Professor of Radiation Oncology, UF Health Jacksonville, Nancy Mendenall, MD, Medical Director, UF Health Proton Therapy Institute.
Needs Assessment:
While radiotherapy plays a critical role in the treatment of breast cancer, the nuances in the planning and delivery of radiotherapy may not be well understood. Technological advances have occurred rapidly in radiotherapy, and modern techniques have undergone various degrees of adoption in the United States. Increased familiarity with the details considered in radiation design and delivery may improve understanding between disciplines and improve patient care.
CME Credit Eligibility:
A minimum passing grade of 70% must be achieved. Only one re-take opportunity will be granted. If you take your test online, a certificate of credit/completion will be automatically downloaded to your DCMS member profile. If you submit your test by mail, a certificate of credit/completion will be emailed within 4 weeks of submission. If you have any questions, please contact the DCMS at 904-355-6561 or firstname.lastname@example.com.
Faculty Disclosure:
Michael Rutenberg MD, PhD and Nancy Mendenall, MD report no significant relations to disclose, financial or otherwise with any commercial supporter or product manufacturer associated with this activity. Julie Bradley, MD disclosed travel financial support from Ion Beam Applications. Raymond Mailhot, MD, MPH disclosed travel reimbursements from IBA and Varian.
Disclosure of Conflicts of Interest:
St. Vincent's Healthcare (SVHC) requires speakers, faculty, CME Committee and other individuals who are in a position to control the content of this educational activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly evaluated by SVHC for fair balance, scientific objectivity of studies mentioned in the presentation and educational materials used as basis for content, and appropriateness of patient care recommendations.
Joint Sponsorship Accreditation Statement:
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of St. Vincent's Healthcare and the Duval County Medical Society. St. Vincent's Healthcare designates this educational activity for a maximum of 1 AMA PRA Category 1 credit.TM Physicians should only claim credit commensurate with the extent of their participation in the activity.
Radiation therapy has undergone immense growth in knowledge, technology, and precision. Treatments for breast cancer have evolved from sole reliance on bony anatomy and clinical set-up to detailed dose measurements to organ substructures. Imaging techniques have evolved from 2-dimensional (2D) to 3-dimensional (3D) with the standardized use of computed tomography simulation and target delineation. Advances in technology with intensity-modulated radiotherapy and volumetric modulated arc therapy have increased high-dose conformality and low-dose normal-tissue exposure. Proton therapy is emerging as a modality that can minimize the compromises between target coverage and avoidance of organs at risk. Although not yet in clinical use, a significant step in precision radiotherapy is on the horizon: the use of genomics, which may allow tailored radiation doses based on the genetic make-up of the tumor and patient-specific factors conferring radiosensitivity or radioresistance.
The benefit of radiation therapy in the treatment of breast cancer has been well-established. While a multitude of radiation techniques can be used to treat breast cancer, all are directed by the simultaneous goals of covering the target and avoiding organs at risk (OARs). While various studies have shown improvements in local-regional control, disease-free survival, and overall survival with the use of radiation therapy for breast cancer, toxicity to the nearby normal tissue can detract from the therapeutic ratio. Even with significant improvements in systemic therapy in recent years, modern studies continue to show a benefit to radiotherapy. Reduction in target volume with partial breast irradiation and cardiac-sparing techniques, such as deep-inspiration breath hold and prone positioning, have contributed to show improvement in the therapeutic ratio.
In one study, randomization to irradiation of the whole breast and regional lymphatics compared to whole-breast irradiation alone resulted in improved 10-year disease-free survival (DFS) (82 percent vs. 77 percent, respectively; p=0.01).1 A similar study comprised of 44 percent high-risk node-negative patients and 24 percent mastectomy patients also showed a 3 percent improvement in 10-year DFS with the addition of supraclavicular (SCV) and internal mammary node (IMN) irradiation compared to irradiation to the breast or chest wall alone (72.1 percent vs. 69.1 percent; p=0.04).2
Historically, radiation was delivered based on bony anatomy as seen on x-rays or fluoroscopy. Using computed tomography (CT) to direct the location of the radiation therapy portals was initiated in the 1990s. By the early 2000s, CT-based treatment planning was routinely used, with CT scanners becoming available within most radiation oncology departments in the United States. The transition from 2D to 3D imaging allowed for the ability to define 3D targets. Targets (gross disease or areas at risk for microscopic disease) and adjacent tissues, such as OARs, are delineated on the CT imaging using various treatment planning systems. While contouring has been implemented for different diseases at different rates, contouring has had a slow rate of adoption in breast cancer. In fact, the first Radiation Therapy Oncology Group (RTOG) protocol that required contouring in treatment of the whole breast opened in 2011.3
Delineation on CT allows the dose to a structure (such as a target or OAR) to be determined, including the minimum dose, the maximum dose, and the amount of dose to a certain volume.4 Goals for target coverage and limits for OARs are used to guide treatment planning. In an iterative process, if target coverage is suboptimal or the OAR dose is exceeded, the dosimetrist changes the plan design to find a better solution. Without contours, the dose distribution can be visually assessed, but dose-volume relationships cannot be determined.5,6
With the transition to contour-based planning, it was recognized among experts that variation existed in the definitions of the targets and OARs.7 In an attempt to standardize these structure definitions more than five years ago, the RTOG published an online contouring atlas based primarily on muscle and bony anatomy.8 Since that time, several investigators have assessed the comprehensiveness of this contouring atlas. Brown et al reported that in 39 percent of patients, disease in the supraclavicular region occurred outside of the volume suggested by the RTOG atlas.9 Jethwa et al reported that 22 percent of disease fell outside of the recommended internal mammary node volume.10 A 3- to 4-cm expansion beyond the RTOG axillary nodal volume in the anterior and cranial directions for the level I (low) axilla was recommended by Gentile et al.11 A revised atlas by NRG Oncology (the cooperative group that replaced RTOG) is in development. Other contouring atlases were developed after the seminal RTOG atlas. The Danish atlas was based on expert consensus and the use of vessel location as well as muscle and bone anatomy.12 The PROCAB/ESTRO (PROject on CAncer of the Breast/European Society of Radiation Oncology) guidelines are vessel-based and centered around a 5-mm margin on the veins in the regional lymphatic regions.13
While these atlases provide guidelines, they are not meant to prohibit adjustments to each individual case. Particularly for those who present with node positive disease, fusion of the imaging at diagnosis (including positron emission tomography (PET) and magnetic resonance imaging (MRI) to the CT simulation images) can ensure that the area that previously harbored gross disease is fully covered with sufficient dose to eradicate any microscopic residual disease (Figure 1A).
Figure 1: (A) Tumor involving an inframammary crease warrants a generous inferior border of the radiation field to ensure adequate coverage of tissue at risk for harboring microscopic disease.
Early referral to radiation oncology allows assessment of the disease at presentation, which may alter the radiation fields. Once the disease has regressed with systemic therapy, or been excised with surgery, the opportunity for the radiation oncologist to tailor the radiation fields based on initial disease presentation has passed (Figure 1B).
Figure 1: (B) Supraclavicular nodes extending posteriorly, beyond typical contouring guideline recommendations, highlights the need for adaptation of the guidelines to the individual patient.
Surgical clips to demarcate the lumpectomy bed allow the boost volume to be accurately defined. Surgical clip demarcation is important in all breast-conserving cases, but is absolutely critical in oncoplastic reconstructions and for external-beam partial-breast irradiation.
With 2D or 3D treatment planning, contouring contributes to a high-quality plan, yet it is not a required step in the treatment planning process. A plan can be created in the absence of contours and reviewed based solely on isodose distributions. However, for more advanced treatment planning, such as step-and-shoot intensity-modulated radiation therapy (IMRT), arc therapy, or proton therapy, a treatment plan cannot be generated without contours as dose is prescribed to a delineated volume rather than a point. With these planning techniques, the high dose achieves tighter conformality around the target volume. Therefore, the target delineation is a critical step in the treatment planning process upon which all of the subsequent steps hinge. Prioritization of target coverage and OAR goals may be necessary and may depend on the clinical situation.
Treatment plan evaluation includes a review of the radiation dose distribution achieved by a particular plan, which designates field size and shaping, number and angle of fields, weighting of fields (how much dose is delivered through a given field), and technique. The robustness, or reliability, of the treatment plan must be considered. Factors such as treatment delivery time, respiratory motion, potential change in anatomy, such as variation in seroma size, are assessed. Other variables, like thorax shape, proximity of the heart to the chest wall, breast size and shape, presence of expanders, and implants, can impact radiotherapy dosimetry and contribute to decisions about the optimal radiation modality.14,15 In women with left-sided breast cancers, the proximity of the left anterior descending artery and left ventricle to the chest wall can present a challenge, particularly if the IMNs are treated.16,17
3D conformal photon radiation therapy (3DCRT) remains a common form of treatment for breast cancer. This technique is robust in that modest changes in breast size or shape or changes in seroma are unlikely to affect the dosimetry (Figures 2a and 2b).
Figure 2: (A) An image from a computed tomography verification scan at fraction 10 of radiotherapy shows a new seroma posterior to the expander at the inferior aspect (top image) that was not present on the CT simulation images (bottom image).
Figure 2: (B) The 3-dimensional conformal dose distribution was not affected by the seroma development.
While the high dose may not be as conformal as IMRT or arc techniques, the low dose tends to be more confined compared to these approaches. A common beam arrangement consists of parallel-opposed photon tangent fields to treat the breast or chest wall, IMNs, and low axilla, matched to an anterior photon field that treats the high axilla and SCV nodes. Smaller fields may be inserted within a larger field or dose-absorbing wedges may be placed in the beam path, particularly in tangential fields, to modulate or improve dose homogeneity. Electrons may be used to treat superficial targets, such as a thin chest wall or some lumpectomy cavities. With 3DCRT, a dosimetrist selects the beam angles and evaluates the dose distribution to maximize target coverage and OAR constraint goals in an iterative fashion.
IMRT uses multiple beams (typically 5 to 7) to achieve conformality of the high dose distribution to the target volume. Unlike 3DCRT, with IMRT, the target coverage and OAR constraint goals are entered into the treatment planning system, and the system selects beam angles and shapes. Volumetric modulated arc radiotherapy (VMAT) is a type of IMRT that also achieves high dose conformality with faster delivery time.18 While IMRT uses multiple independent beam angles, VMAT delivers radiation continuously in an arc as the gantry rotates around the patient. Multiple parameters can be adjusted during this dynamic delivery, such as field shape and orientation, dose rate, and rate of gantry rotation.19 These techniques yield high-dose conformality, but often expose larger volumes of normal tissue to low-dose radiation compared to the 3DCRT technique (Figure 3); for example, there may be an increase in the volume of heart receiving 5 Gy,18 a parameter associated with an increasing risk of cardiac disease.
Figure 3: Comparison treatment plans for a patient with breast cancer, including (A) 3-dimensional conformal radiotherapy, (B) intensity-modulated radiotherapy, (C) volumetric modulated arc therapy, (D) and pencil-beam scanning with protons.
10% of the prescription dose is shown in orange, 50% in green, 90% in light blue, 95% in pink, and 110% in dark blue.
In (A), there is a small amount of high dose to the heart but less low dose compared to (B) and (C). In (B) and (C), there is less high dose to the ipsilateral lung but an increased volume of low dose. In (D), both low and high doses are eliminated from the heart and lung while maintaining 95% coverage of the targets (the breast and internal mammary nodes).
One dosimetric study predicted an increased risk of contralateral breast cancer with the use of IMRT compared to conventional 3D technique, but not with VMAT.20 In a dosimetric study comparing VMAT and conventional 3DCRT, VMAT achieved high dose conformity and lower mean heart doses, but the dose to the contralateral breast and/or lung increased.21 Five randomized trials comparing IMRT to 2D or 3DCRT22,23,24,25,26 have shown a reduction in acute radiation dermatitis with the use of IMRT.27
Protons differ from photons in that they are particles rather than energy, they have mass, and they travel only a finite distance. With proton therapy, the depth of penetration into tissue can be controlled, thus there is no exit radiation dose beyond the tumor target. In addition, less dose is deposited along the entrance path compared to photons. Protons deposit most of the dose at the end of their path in a sharp peak of energy deposition called the Bragg peak (Figure 4).
Figure 4: (A) The path of a single proton as it enters the body and deposits the vast majority of its energy at a single point. This phenomenon is referred to as the Bragg peak. Oncologists can manipulate the deposition depth by controlling the speed of the proton in addition to controlling the target area, thereby reducing radiation to normal tissue. (B) A comparison of the amount of radiation delivered with conventional photon radiation therapy versus proton therapy. Conventional therapy is distinguished by a relatively high entrance dose and exit dose. By contrast, proton therapy has a much lower entrance dose and no exit dose. The goal in radiation therapy is to minimize damage to healthy tissue by minimizing the tissue exposed in the entrance and exit doses. Borrowed with permission from UF Health Proton Therapy Institute.
Therefore, with protons, most of the dose is deposited in the target compared to outside of the target with photons (regardless of photon technique, be it 3DCRT, IMRT, or VMAT).
In the use of proton therapy for breast cancer, anterior en face beams are aimed directly at the target in the direction of respiratory motion, rather than tangentially, minimizing the risk of loss of target coverage during respiration and improving the robustness of the proton plan. The en face beam orientation also allows for a choice of treatment with arms akimbo rather than overhead, which may increase patient comfort during treatment delivery. The abrupt dose fall-off permits coverage of all target areas, including the internal mammary nodes, while simultaneously achieving little or no dose to the heart (Figure 3).
A median mean heart dose of < 1 Gy, even with IMN treatment, has been consistently achieved in multiple studies of proton therapy for breast cancer.28,29,30,31,32 The dose can be modulated to maximize radiation avoidance to cardiac substructures, such as the coronary arteries. Proton therapy for unilateral breast cancer typically eliminates the dose to the contralateral lung. In the setting of regional lymphatic irradiation, the volume of ipsilateral lung receiving 5 Gy and 20 Gy is often decreased by 50 percent compared to 3D conformal photon therapy treatment.30,32 Compared to IMRT, proton therapy also delivers significantly less low-dose radiation (V5, V10) to the lung with reduced or similar moderate-to-high-dose radiation (V20, V40).28,29 Of all currently available techniques, proton therapy yields the lowest overall integral dose (dose to non-targeted tissue).32 With the decreased integral dose and lung dose as well as elimination of contralateral breast/chest wall dose, proton therapy may decrease the rate of second malignancy.33
Proton therapy can be delivered with passive-scattering (double-scattering or uniform scanning) or with scanning (intensity-modulated proton therapy [IMPT]) techniques. The skin dose can be higher with proton therapy compared to photon techniques, increasing the risk of radiation dermatitis. With IMPT, modulation can be used to decrease the dose to skin, but passive-scattering does not allow for this.34
While all aspects of breast cancer radiotherapy operate within guidelines, each step in the process is individualized depending on patient needs, including positioning (supine or prone; with protons, arms up or akimbo), target delineation (adjusted based on review of initial imaging; decision on which nodal volumes are at high enough risk to warrant treatment; partial or whole breast treatment), and modality (photon vs. electron vs. proton; 3DCRT vs. IMRT vs. VMAT with photons; double scattering vs. scanning proton therapy). In addition, the prescription dose is largely empirical, based on historical studies, with minimal variation between patients. These treatment planning decisions are made after evaluating patient and disease characteristics, but rarely on genomics.
The optimal radiation technique to treat breast cancer may vary with the treatment volume, patient anatomy, and laterality of the breast cancer. However, the initial step of accurate target and OAR delineation is essential to high-quality radiotherapy regardless of delivery technique. Current challenges include reducing radiation exposure to normal, non-targeted tissues (especially the heart and lung) while improving the coverage of critical breast cancer targets, such as regional nodes. Compared to conventional 3DCRT, the use of IMRT and VMAT improve conformality of the high dose to the target regions but at the expense of exposing a greater volume of uninvolved adjacent tissue (contralateral breast and lung) to low radiation doses. Proton therapy improves target coverage, achieves conformality of the high-dose volume to the target, and significantly reduces both OAR and integral doses. Advanced radiation techniques may further enhance the therapeutic ratio through increased target coverage and/or reduction of critical organ exposure and allow for dose escalation, intensification, or hypofractionation to further improve outcomes. Genomic analysis for tumor and healthy tissue radiosensitivity appears to be a key step in the forward progress of precision radiotherapy, allowing for tailoring of radiation dose and modality. Significant improvements in patient outcomes are anticipated with these novel techniques, but a minimum of 10 years of follow-up will be necessary to confirm expectations.
1. Whelan TJ, Olivotto IA, Parulekar WR, et al. Regional nodal irradiation in early-stage breast cancer. N Engl J Med. 2015 Jul 23;373(4):307-16.
2. Poortmans PM, Collette S, Kirkove C, et al. Internal mammary and medial supraclavicular irradiation in breast cancer. N Engl J Med. 2015 Jul 23;373(4):317-27.
3. Vicini FA, Radiation Therapy Oncology Group. RTOG 1005: A phase III trial of accelerated whole breast irradiation with hypofractionation plus concurrent boost versus standard whole breast irradiation plus sequential boost for early-stage breast cancer. 2014 Jul 31.
4. Pereira GC, Traughber M, Muzic RF, Jr. The role of imaging in radiation therapy planning: past, present, and future. BioMed Res Int. 2014;2014:231090.
5. Bentel G, Marks LB, Hardenbergh P, et al. Variability of the location of internal mammary vessels and glandular breast tissue in breast cancer patients undergoing routine CT-based treatment planning. Int J Radiat Oncol Biol Phys. 1999 Jul 15;44(5):1017-25.
6. Saito AI, Vargas C, Morris CG, et al. Differences between current and historical breast cancer axillary lymph node irradiation based on arm position: implications for radiation oncologists. Am J Clin Oncol. 2009 Aug;32(4):381-6.
7. Li XA, Tai A, Arthur DW, et al. Variability of target and normal structure delineation for breast cancer radiotherapy: an RTOG Multi-Institutional and Multiobserver Study. Int J Radiat Oncol Biol Phys. 2009 Mar 1;73(3):944-51.
8. White J, Tai A, Arthur D, et al. Breast cancer atlas for radiation therapy planning: consensus definitions [Internet]. 2017 [cited 2017 May 7]. Available from: https://www.rtog.org/LinkClick.aspx?fileticket=vzJFhPaBipE=
9. Brown LC, Diehn FE, Boughey JC, et al. Delineation of supraclavicular target volumes in breast cancer radiation therapy. Int J Radiat Oncol Biol Phys. 2015 Jul 1;92(3):642-9.
10. Jethwa KR, Kahila MM, Hunt KN, et al. Delineation of internal mammary nodal target volumes in breast cancer radiation therapy. Int J Radiat Oncol Biol Phys. 2017 Mar 15;97(4):762-9.
11. Gentile MS, Usman AA, Neuschler EI, et al. Contouring guidelines for the axillary lymph nodes for the delivery of radiation therapy in breast cancer: evaluation of the RTOG breast cancer atlas. Int J Radiat Oncol Biol Phys. 2015 Oct 1;93(2):257-65.
12. Nielsen MH, Berg M, Pedersen AN, et al. Delineation of target volumes and organs at risk in adjuvant radiotherapy of early breast cancer: national guidelines and contouring atlas by the Danish Breast Cancer Cooperative Group. Acta Oncol. 2013 May;52(4):703-10.
13. Verhoeven K, Weltens C, Remouchamps V, et al. Vessel based delineation guidelines for the elective lymph node regions in breast cancer radiation therapy - PROCAB guidelines. Radiother Oncol. 2015 Jan;114(1):11-6.
14. Guan H, Dong YL, Ding LJ, et al. Morphological factors and cardiac doses in whole breast radiation for left-sided breast cancer. Asian Pac J Cancer Prev. 2015;16(7):2889-94.
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16. Sardar P, Kundu A, Chatterjee S, et al. Long-term cardiovascular mortality after radiotherapy for breast cancer: a systematic review and meta-analysis. Clin Cardiol. 2017 Feb;40(2):73-81.
17. Henson KE, McGale P, Taylor C, et al. Radiation-related mortality from heart disease and lung cancer more than 20 years after radiotherapy for breast cancer. Br J Cancer. 2013 Jan 15;108(1):179-82.
18. Popescu CC, Olivotto IA, Beckham WA, et al. Volumetric modulated arc therapy improves dosimetry and reduces treatment time compared to conventional intensity-modulated radiotherapy for locoregional radiotherapy of left-sided breast cancer and internal mammary nodes. Int J Radiat Oncol Biol Phys. 2010 Jan 01;76(1):287-95.
19. Webb S. Volumetric-modulated arc therapy: its role in radiation therapy [Internet]. Medical Physics Web; 2009 Jun 25 [cited 2017 May 7]. Available from: http://medicalphysicsweb.org/cws/article/opinion/39542.
20. Johansen S, Cozzi L, Olsen DR. A planning comparison of dose patterns in organs at risk and predicted risk for radiation induced malignancy in the contralateral breast following radiation therapy of primary breast using conventional, IMRT and volumetric modulated arc treatment techniques. Acta Oncol. 2009;48(4):495-503.
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28. Ares C, Khan S, Macartain AM, et al. Postoperative proton radiotherapy for localized and locoregional breast cancer: potential for clinically relevant improvements? Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3):685-97.
29. Xu N, Ho MW, Li Z, et al. Can proton therapy improve the therapeutic ratio in breast cancer patients at risk for nodal disease? Am J Clin Oncol. 2014 Dec;37(6):568-74.
30. MacDonald SM, Patel SA, Hickey S, et al. Proton therapy for breast cancer after mastectomy: early outcomes of a prospective clinical trial. Int J Radiat Oncol Biol Phys. 2013 Jul 1;86(3):484-90.
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To take the test and earn CME credit, click here.
1. How does the RTOG contouring atlas define target nodal areas in the treatment of breast cancer?
a. 5mm margin around vessels
b. bone and muscle
c. based only on pre-treatment imaging
d. definitions vary based on patient age and body mass index
2. The purpose of clips placed in the tumor bed at the time of surgery is to:
a. decrease the risk of infection
b. minimize post-operative risk of bleeding
c. improve accuracy of post-treatment mammogram surveillance
d. ensure full coverage of the tumor bed with the prescribed dose of radiation
3. Evaluation by radiation oncology early in the work-up and assessment of a patient is important because:
a. radiation should be the initial step in breast cancer treatment.
b. CT simulation is required prior to the start of other therapies.
c. radiation dose and fields may be tailored based on clinical findings at initial diagnosis.
d. the radiation modality should be determined at that time.
4. Which of the following factors does not affect plan robustness?
a. prescription dose
b. respiratory motion
c. treatment delivery time
d. change in seroma
5. Advantages of 3D conformal radiation therapy over IMRT or VMAT include all of the following except:
a. less low dose exposure to normal tissues
b. less sensitive to daily differences in patient set-up
c. increased conformality of high dose
d. increased robustness in the setting of breast edema
6. Which of the following modalities uses a continuous arc to deliver radiation dose?
a. 3D CRT
b. IMRT
c. VMAT
d. Proton therapy
7. Which modality eliminates the exit dose beyond the target volume?
a. 3D CRT
b. IMRT
c. VMAT
d. Proton therapy
8. The sharp fall-off of dose at the end of the proton path is called the:
a. given dose
b. Bragg peak
c. beam angle
d. Compton effect
9. One advantage of proton therapy compared to IMRT or VMAT is:
a. decreased dose to adjacent organs such as heart, lung and contralateral breast
b. increased conformality of high dose
c. decreased skin dose
d. target contouring is not necessary
10. What is the sensitivity of the 51-gene radiosensitivity signature?
a. 17%
b. 51%
c. 77%
d. 84%
Beers with Peers, July 2020
Beers with Peers, October 2020