Target Health Will Be at BIOMED Israel Again this Year
Dr. Jules T. Mitchel will again be attending BioMed in Tel Aviv, Israel between June 10-12, 2013. The meeting will be held at the David Intercontinental Hotel along the Mediterranean.
Last year was a highlight for 2 Israeli companies with whom we assisted in their development program. We started working with Protalix Biotherapeutics in 2004 with their NDA approval in 2012 and we started working with MediWound in 2001 with their EMA approval in 2012. We all know drug and device development is not easy and always takes longer than we would like, but when there is an approval, it is always well worth it.
On a personal note, we would like to thank our dear friends Ronit Koren and Marian Gorecki who were instrumental in laying the ground work for our expansion into the Israeli market. We now have more than 10 Israeli clients and growing all the time.
Please let us know if you will be at BioMed and we can plan for a coffee or a tea.
For more information about Target Health contact Warren Pearlson (212-681-2100 ext. 104). For additional information about software tools for paperless clinical trials, please also feel free to contact Dr. Jules T. Mitchel or Ms. Joyce Hays. The Target Health software tools are designed to partner with both CROs and Sponsors. Please visit the Target Health Website at www.targethealth.com
Neuroscience and Music
The Virchow Campus in Berlin
Together with his team, Professor Christoph Ploner, director of the Department of Neurology at the Virchow campus in Berlin, examined a professional cellist who suffered from encephalitis caused by a herpes virus. As a result of the inflammation, the patient developed serious disturbances in 1) ___. Both his memory for the past (retrograde amnesia), as well as the acquisition of new information (anterograde amnesia) were affected. Whereas the patient was unable to recount any events from his private or professional life, or remember any of his friends or relatives, he retained a completely intact musical memory. Furthermore, he was still able to sight-read and play the cello. For the systematic examination of his 2) ___ memory, Dr. Carsten Finke, Nazli Esfahani and Prof. Christoph Ploner developed various tests that take the beginning of his amnesia into account. In comparison to amateur musicians and professional musicians from the Berlin Philharmonic, the patient showed a normal musical memory in all tests. He not only remembered music pieces from the past, but was also able to retain music he had never heard before. The findings show that musical memory is organized at least partially independent of the hippocampus, a 3) ___ structure that is central to memory formation and that it is possible that the enormous significance of music throughout all times and in all cultures contributed to the development of an independent memory for music. Carsten Finke and his colleagues hope that the intact musical memory in patients with amnesia can be used to stimulate other memory content. In this way, perhaps a particular melody can be connected to a person or an everyday task, for example taking medicine.
Other research shows that if you started piano lessons in grade one, or played the recorder in kindergarten, thank your parents and teachers. Those lessons you dreaded — or loved — helped develop your brain. The younger you started music lessons, the stronger the 4) ___ in your brain.
A study published in the Journal of Neuroscience (2013;33:1282–1290) suggests that musical training before the age of seven has a significant effect on the development of the brain, showing that those who began early had stronger connections between motor regions — the parts of the brain that help you plan and carry out movements. This research was carried out by students in the laboratory of Concordia University psychology professor Virginia Penhune, and in collaboration with Robert J. Zatorre, a researcher at the Montreal Neurological Institute and Hospital at McGill University. The study provides strong evidence that the years between ages six and eight are a “sensitive period” when musical training interacts with normal brain 5) ___ to produce long-lasting changes in motor abilities and brain structure. “Learning to play an instrument requires coordination between hands and with visual or auditory stimuli,” says Penhune. “Practicing an instrument before age seven likely boosts the normal maturation of connections between motor and sensory regions of the brain, creating a framework upon which ongoing training can build.”
For the study, 36 adult musicians were tested on a movement task, followed by brain scans. Half of these musicians began musical training before age seven, while the other half began at a later age, but the two groups had the same number of years of musical training and experience. These two groups were also compared with individuals who had received little or no formal musical training. When comparing a motor skill between the two groups, musicians who began before age seven showed more accurate timing, even after two days of practice. When comparing brain structure, musicians who started early showed enhanced white matter in the corpus callosum, a bundle of nerve fibers that connects the left and right motor regions of the brain. Importantly, the study found that the younger a musician started, the 6) ___ the connectivity. Interestingly, the brain scans showed no difference between the non-musicians and the musicians who began their training later in life. This suggests that the brain developments under consideration happen early or not at all. Because the study tested musicians on a non-musical motor skill task, it also suggests that the benefits of early music training extend beyond the ability to play an instrument.
“This study is significant in showing that training is more effective at early ages because certain aspects of brain anatomy are more sensitive to changes at those time points,” says co-author, Dr. Zatorre, who is also the co-director of the International Laboratory for Brain Music and Sound Research. But, says Penhune, who is also a member of the Center for Research in Human Development, “it’s important to remember that what we are showing is that early starters have some specific skills and differences in the brain that go along with that. But, these things don’t necessarily make them better musicians. Musical performance is about skill, but it is also about communication, enthusiasm, style, and many other things that we don’t measure. So, while starting early may help you express your genius, it probably won’t make you a 7) ___.”
Oliver Wolf Sacks MD
Music also has a profound impact on emotional problems and learning 8) ___, as shown by the work of Dr. Alfred A. Tomatis in France. It is quite interesting how Dr. Tomatis got involved in his work with Sound Therapy. Somewhat early in his studies, he was called to a Benedictine monastery outside of Paris. The monks were depressed and were having trouble eating and sleeping. Dr. Tomatis was asked to find the cause of their ailments. In the course of his explorations, he discovered that the abbey had recently acquired a new abbot. The new father prided himself on being a modern man, and considering the Gregorian chants too medieval, he had ordered the monks to stop chanting. Without knowing it, the abbot had taken away a primary form of brain stimulation for the monks. When Dr. Tomatis had the abbot reinstate the chanting, the depression lifted, and the monks 9) ___. This incident led Dr. Tomatis to study the effects of sound on the brain. In the course of his work, he discovered the effects of high frequencies on brain processing, emotional problems and blocks to learning.
At the Beckman Research Institute in Duarte, California, noted geneticist Dr. Susumu Ohno ascribed musical notes to each of the 6 amino acids that make up the DNA code. Dr. Ohno was able to transcribe the “music” made by the DNA helixes in living things. He discovered that these sound patterns were not random, but actually made 10) ___. In one of his experiments, he transcribed the melody of a particular type of cancer. The melody had an uncanny similarity to a piece of music written in the 17th century – Chopin’s Funeral March. Had Chopin “intuited” this melody from nature itself?
The importance of sound and music on brain processing is significant to the field of Psychoacoustics. By looking at the changes in brain states and behaviors elicited through sound, language and music, we can more fully understand these phenomena
Part of the genius of Oliver Wolf Sacks MD, a great pioneer of neuroscience, has been his curiosity to explore the mysteries of the human brain and the equally profound mysteries of music: an art that is completely abstract and profoundly emotional, devoid of the power to “represent anything particular or external, but endowed with the capacity to express powerful, inchoate moods and feelings. Using his patients as examples, Dr. Sacks writes about the power of rhythm to help coordinate and energize basic locomotive movement, a power that explains why music can help push athletes to new levels and why the right sort of music (generally, legato with a well-defined rhythm) can help liberate some parkinsonian patients from “their frozenness.” He makes a powerful case for the benefits of music 11) ___. In Dr. Sacks’ view, music can aid aphasics and patients with parkinsonism, and it can help orient and anchor patients with advanced dementia because “musical perception, musical sensibility, musical emotion and musical memory can survive long after other forms of memory have disappeared.” Music, he says, can act as a “Proustian mnemonic, eliciting emotions and associations that had been long forgotten, giving the patient access once again to mood and memories, thoughts and worlds that had seemingly been completely lost.” Dr. Sacks underscores the resilience of the human 12) ___, the capacity of some people to find art in affliction, and to adapt to loss and deprivation.
ANSWERS: 1) memory; 2) musical; 3) brain; 4) connections; 5) development; 6) greater; 7) genius; 8) difficulties; 9) recovered; 10) melodies; 11) therapy; 12) mind
Oliver Wolf Sacks MD
(1933 to Present)
Credit: © Luigi Novi / Wikimedia Commons
Oliver Wolf Sacks, MD (born 9 July 1933), is a distinguished British-American physician, neurologist, writer, and amateur chemist, musician, and fern gardener, who currently holds a position as professor of neurology at NYU School of Medicine. Between 2007 and 2012, Sacks was professor of neurology and psychiatry at Columbia University, where he also held the position of “Columbia Artist”. Before that, he spent many years on the clinical faculty of Yeshiva University’s Albert Einstein College of Medicine. He also holds the position of visiting professor at the UK’s University of Warwick.
Sacks is the author of numerous best-selling books, including several collections of case studies of people with neurological disorders. His 1973 book Awakenings was adapted into an Academy Award-nominated film of the same name in 1990 starring Robin Williams and Robert De Niro. He, and his book Musicophilia: Tales of Music and the Brain, were the subject of “Musical Minds”, an episode of the PBS series Nova.
Sacks was the youngest of four children born to a North London Jewish couple: Samuel Sacks, a physician (died June 1990), and Muriel Elsie Landau, one of the first female surgeons in England. Sacks had a large extended family, and among his first cousins are Israeli statesman Abba Eban, writer and director Jonathan Lynn, and economist Robert Aumann. When Sacks was six years old he and his brother Michael were evacuated from London to escape the Blitz, retreating to a boarding school in the Midlands where he remained until 1943. During his youth he was a keen amateur chemist, as recalled in his memoir Uncle Tungsten. He also learned to share his parents’ enthusiasm for medicine and entered The Queen’s College, Oxford University, in 1951, from which he received a Bachelor of Arts (BA) in physiology and biology in 1954. At the same institution, in 1958 he went on to undertake a Master of Arts and earn a BM BCh, thereby qualifying to practice medicine. He undertook residencies and fellowship work at Mt. Zion Hospital in San Francisco and at UCLA.
After converting his British qualifications to American recognition (i.e., an MD as opposed to BM BCh), Sacks moved to New York, where he has lived and practiced neurology since 1965. Sacks began consulting at chronic care facility Beth Abraham Hospital (now Beth Abraham Health Services, a member of CenterLight Health System) in Bronx, NY, in 1966. At Beth Abraham, Sacks worked with a group of survivors of the 1920s sleeping sickness, encephalitis lethargica, who had been unable to move on their own for decades. These patients and his treatment of them were the basis of Sacks’ book, Awakenings.
Sacks served as an instructor and later clinical professor of neurology at the Albert Einstein College of Medicine from 1966 to 2007, and also held an appointment at the New York University School of Medicine from 1992 to 2007. In July 2007 he joined the faculty of Columbia University Medical Center as a professor of neurology and psychiatry. At the same time, he was appointed Columbia University’s first “Columbia University Artist” at the University’s Morningside Heights campus, recognizing the role of his work in bridging the arts and sciences.
Since 1966 Sacks has served as a neurological consultant to various New York City nursing homes that are run by the Little Sisters of the Poor, and from 1966 to 1991 was a consulting neurologist at Bronx Psychiatric Center. Sacks returned to New York University School of Medicine in 2012, serving as both a professor of neurology and consulting neurologist in the center’s epilepsy center.
Sacks’ work at Beth Abraham helped provide the foundation on which the Institute for Music and Neurologic Function (IMNF) is built; Sacks is currently an honorary medical advisor. The Institute honored Sacks in 2000 with its first Music Has Power Award. The IMNF again bestowed a Music Has Power Award on Sacks in 2006 to commemorate “his 40 years at Beth Abraham and honor his outstanding contributions in support of music therapy and the effect of music on the human brain and mind”. The IMNF is a US nonprofit organization conducting research into and applying music therapy. It is located in The Bronx, New York City.
The institute a member of the CenterLight Health System (formerly Beth Abraham Family of Health Services) has for 35 years conducted clinical research studies on the effects of music on the human condition. It is directed by music therapist Dr. Concetta M. Tomaino with scientific guidance from the neurologist Oliver Sacks. Its aim is to restore, maintain and improve the physical, emotional and neurologic functioning in people who have been debilitated through stroke, trauma, dementia, Alzheimer’s disease, Parkinson’s and other processes through the systematic use of music. The director of the institute Dr. Concetta M. Tomaino states that “If you’re stimulating almost every key component of our brain at one time, you have a way of reaching areas of the brain that are still functioning.” The mission of the institute is to develop and apply music-based therapies emanating from new discoveries and educational collaborations within the international research and treatment communities. The institute claims results of their treatment such as regaining memory loss, rebuilding motor skills, calming and counteracting apprehension or fear, promoting movement for physical rehabilitation, and recovering language skills.
Sacks remains a consultant neurologist to the Little Sisters of the Poor, and maintains a practice in New York City. He serves on the boards of The Neurosciences Institute and the New York Botanical Garden. For his entire life Sacks has had a condition known as prosopagnosia or face blindness. In a December 2010 interview Sacks discussed how he had also lost his stereoscopic vision the previous year due to a malignant tumor in his right eye. He now has no vision in his right eye. His loss of stereo vision was recounted in his book The Mind’s Eye, published in October 2010. Sacks discussed his struggles with prosopagnosia in an interview with Leslie Stahl on 18 March 2012 episode of 60 Minutes.
Sacks has never married or lived with anyone and says that he is celibate. In a December 2001 interview he stated that he had not had a relationship in many years and has described his own shyness as “a disease”. Sacks swims almost every day and has done so for decades. He discussed his work and his personal health issues in the 28 June 2011 BBC documentary Imagine.
During his time at UCLA, Sacks experimented heavily with various drugs. He described his various experiences in an article published in 2012 by The New Yorker and his 2012 book Hallucinations. Sacks describes a transformative experience he had while reading a book by the 19th century migraine physician Edward Liveing (father of George Downing Liveing) after taking a massive dose of amphetamine. Sacks claimed that the experience convinced him to chronicle and publish his observations of neurological diseases and oddities, becoming the “Liveing of our Time”.
Women’s, Men’s Brains Respond Differently to Hungry Infant’s Cries – NIH study Documents Gender Variations in Brain Activity
Previous studies have shown differences in patterns of brain activity between when an individual’s attention is focused and when the mind wanders. The pattern of unfocused activity is referred to as default mode. When individuals focus on something in particular, their brains disengage from the default mode and activate other brain networks.
Infant cries are a critical survival mechanism that draw the attention of adult caregivers, who can then satisfy the basic needs of otherwise helpless infants. A study published in NeuroReport (2013;24:142-146) asked men and women to let their minds wander, then played a recording of white noise interspersed with the sounds of an infant crying. For about 15 minutes, participants listened to white noise interspersed with short periods of silence and with the sounds of a hungry infant crying. The patterns of their brain activity were recorded by a technique known as functional magnetic resonance imaging. The study analyzed brain images from 18 adults, parents and nonparents. Results showed that when participants listened to the typical infant cries, the brain activity of men and women differed. When hearing a hungry infant cry, women’s brains were more likely to disengage from the default mode, indicating that they focused their attention on the crying. In contrast, the men’s brains tended to remain in default mode during the infant crying sounds. The brain patterns did not vary between parents and nonparents.
According to the authors, studies documenting the brain activity patterns of adults represent first stages of research in neuroscience understanding how adults relate to and care for infants.
Brain Patterns May Help Predict Relapse Risk For Alcoholism
The prefrontal brain plays a role in regulating emotion, the ability to suppress urges, and decision-making. Chronic drinking may damage regions involved in self-control, affecting the ability to regulate cravings and resist relapse. Relapse is common among those trying to overcome alcohol dependence and is often triggered by stress and exposure to events or places that the individual associates with alcohol. Studies suggest that most people in recovery from alcoholism relapse at least once before they successfully quit drinking.
According to an article published online at the JAMA Psychiatry (1 May 2013), distinct patterns of brain activity are linked to greater rates of relapse among alcohol dependent patients in early recovery. The research, supported by the National Institutes of Health, may give clues about which people in recovery from alcoholism are most likely to return to drinking. Using brain scans, the study found that people in recovery from alcoholism who showed hyperactivity in areas of the prefrontal cortex during a relaxing scenario were eight times as likely to relapse as those showing normal brain patterns or healthy controls. Using functional magnetic resonance imaging, the authors compared the brain activity patterns of 45 patients who were about to successfully complete an inpatient treatment program for alcoholism to those of 30 people with no history of alcoholism. While undergoing brain scans, participants were asked to imagine relaxing situations such as sunning on a beach, as well as recent stressful situations. The patients in recovery were then followed for 90 days after leaving treatment to determine how many had returned to drinking.
The study found that individuals in recovery who showed patterns of heightened activity in the prefrontal region during the relaxing situation were much more likely to experience cravings for alcohol and subsequent relapse. These patterns of craving-related activity increased the likelihood of early relapse by 8.5 times and relapse to heavy drinking by 8.7 times. Abnormally low activity during the stressful scenario was also linked to greater number of days drinking after relapse.
Among the alcohol-dependent patients in this study, 30 percent had relapsed two weeks after leaving treatment, 46 percent had relapsed at the end of one month, and 71 percent had returned to drinking at the final three-month follow-up.
According to the authors, the patterns of observed brain activity may one day serve as a neural marker that could help clinicians identify alcohol-dependent patients in recovery who are most at risk of relapse, and that the findings may also have implications for the use of medications and behavioral treatments that restore prefrontal function, as they could potentially benefit people at high risk of relapse.
Your Brain on Music
Researchers want to better understand what happens in your brain when you listen to music.
Whether you are rocking out to Macklemore & Ryan Lewis in your car or reading with Bach in your bedroom, music has a special ability to pump us up or calm us down. The scientific world is still trying to figure out what’s going on in our brains when we listen to music and how it produces such potent effects on the psyche. We’re using music to better understand brain function in general,” said Daniel Levitin, a prominent psychologist who studies the neuroscience of music at McGill University in Montreal.
Three studies published in April 2013, explore how the brain responds to music. The quest to dissect exactly what chemical processes occur when we put our headphones on is far from over, but there are some clues.
Music and Health
Listening to music feels good, but can that translate into physiological benefit? Levitin and colleagues published a meta-analysis of 400 studies in the journal Trends in Cognitive Sciences (2013; 17:179-193), suggesting that the answer is yes. In one study reviewed, patients who were about to undergo surgery were randomly assigned to either listen to music or take anti-anxiety drugs. During the study, patient’s ratings of their own anxiety, as well as the levels of the stress hormone cortisol were measured Results showed that patients who listened to music had less anxiety and lower cortisol than people who took drugs. Levitin cautioned that this is only one study, and more research needs to be done to confirm the results, but it points toward a powerful medicinal use for music. The nice part about music is that arguably it is less expensive than drugs, easier on the body and it doesn’t have side effects. The authors also highlighted evidence that music is associated with immunoglobin A, an antibody linked to immunity, as well as higher counts of cells that fight germs and bacteria.
How Music Changes the Brain
So music is good for us, but how do we judge what music is pleasurable? A report published in the journal Science Now (11 April 2013) suggests that patterns of brain activity can indicate whether a person likes what he or she is hearing. Valorie Salimpoor, a researcher at the Rotman Research Institute in Toronto and former Levitin student, led a study in which participants listened to 60 excerpts of music they had never heard before while in a functional magnetic resonance imaging (fMRI) device. The 19 participants were asked to indicate how much money they would spend on a given song when listening to the excerpts, while also allowing researchers to analyze patterns of brain activity through the fMRI. The study authors highlight in their results a brain area called the nucleus accumbens, which is involved in forming expectations. According to the authors, there is actually a network of activity that predicts whether or not you’re going to buy this music as you’re listening to the music. The more activity in the nucleus accumbens, the more money people said they were willing to spend on any particular song in the “auction” set-up that the authors designed.
Another brain area called the superior temporal gyrus is intimately involved in the experience of music, and its connection to the nucleus accumbens is important. The genres of music that a person listens to over a lifetime impact how the superior temporal gyrus is formed. The superior temporal gyrus alone doesn’t predict whether a person likes a given piece of music, but it’s involved in storing templates from what you’ve heard before. For instance, a person who has heard a lot of jazz before is more likely to appreciate a given piece of jazz music than someone with a lot less experience. “The brain kind of works like a music recommendation system,” Salimpoor said.
Beholding Beauty: How It’s Been Studied
Are we all hearing the same thing? It seems intuitive that different people, based on their personalities, preferences and personal histories of listening to particular music, will have different experiences when exposed to a particular piece of music. Their attention to various details will vary and they might like different things about it. But Levitin and his collaborators showed in a study published in the European Journal of Neuroscience (2013; 37:1458–1469), that from the perspective of the brain, there may be more similarities among music listeners than one thinks. Seventeen participants who had little or no music training took part in the study which, like Salimpoor’s, is small, but typical for an fMRI study. Participants listened to four symphonies by composer William Boyce of the late Baroque period, which the authors chose because they reflect Western music but were likely to be unfamiliar to subjects. Among participants, the authors found synchronization in several key brain areas, and similar brain activity patterns in different people who listen to the same music. This suggests that the participants not only perceive the music the same way, but, despite whatever personal differences they brought to the table, there’s a level on which they share a common experience. Brain regions involved in movement, attention, planning and memory consistently showed activation when participants listened to music — these are structures that don’t have to do with auditory processing itself. This means that when we experience music, a lot of other things are going on beyond merely processing sound. One resulting theory is that these brain areas are involved in holding particular parts of a song, such as the melody, in the mind while the rest of the piece of music plays on.
The results also reflect the power of music to unite people, Levitin said. “It’s not our natural tendency to thrust ourselves into a crowd of 20,000 people, but for a Muse concert or a Radiohead concert we’ll do it,” Levitin said. “There’s this unifying force that comes from the music, and we don’t get that from other things.” Further research might compare how individuals with healthy brains differ in their musical listening compared to people with autism or other brain disorders and the methods that we use can be applied to understand how the brain tracks auditory information over time.
What the Brain Draws From: Art and Neuroscience
The next frontier in the neuroscience of music is to look more carefully at which chemicals in the brain are involved in music listening and performing, and in which parts of the brain are they active. Any given neurochemical can have different function depending on its area of the brain. For instance, dopamine helps increase attention in the frontal lobes, but in the limbic system it is associated with pleasure. By using music as a window into the function of a healthy brain, scientists may gain insights into a slew of neurological and psychiatric problems. “Knowing better how the brain is organized, how it functions, what chemical messengers are working and how they’re working — that will allow us to formulate treatments for people with brain injury, or to combat diseases or disorders or even psychiatric problems,” Levitin said. Source: Elizabeth Landau , CNN
TARGET HEALTH excels in Regulatory Affairs. Each week we highlight new information in this challenging area
FDA Issues Proposal to Increase Consumer Awareness of Tanning Bed Risks
According to the American Academy of Dermatology, there is a 75% increase in the risk of melanoma, the deadliest type of skin cancer, in those who have been exposed to ultraviolet radiation from indoor tanning, and the risk increases with each use. The proposed order does not prohibit the use of sunlamp products by those under the age of 18, but it provides a warning on the consequences.
The FDA has issued a proposed order that, if finalized, would reclassify sunlamp products and require labeling to include a recommendation designed to warn young people not to use these devices. The order would reclassify sunlamp products from a low risk device (class I) to a moderate risk device (class II). If the order is finalized, manufacturers would have to submit a pre-market notification (510(k)) to the FDA for these devices, which are currently exempt from any pre-market review. Manufacturers would have to show that their products have met certain performance testing requirements, address certain product design characteristics and provide comprehensive labeling that presents consumers with clear information on the risks of use. The order proposes to include a contraindication against use on people under 18 years old, and the labeling would have to include a warning that frequent users of sunlamp products should be regularly screened for skin cancer.
The FDA will take comments on the proposed order for 90 days.
Asparagus Cauliflower Cheese Tart
Here is another wonderful asparagus recipe, because this delicious crunchy little veggie is now in season and growing locally. I am making it a second time this week, just to see how the egg substitute works instead of the eggs I originally used. Originally, mashed potatoes were used instead of cauliflower. I find that not only does the cauliflower make this dish lighter in texture (and lower in calories), but the flavors seem more heightened with the cauliflower; whereas the potato makes everything more dense. If I make this recipe next week ( third time in 10 days) I may add 1 Tablespoon of crème sherry . . . just as an experiment.
PS: After trying out the egg substitute, we conclude that it’s not as good as regular eggs. Now, I need to try 1 whole egg and 4 egg whites, or simply 1 pint of egg whites instead of the 4 whole eggs. My guess is that the 1 pint of egg whites will end up being the best solution because, not only will it hold the custard aspect of the recipe together, but taste will not suffer, calories will be even lower, and there will be zero cholesterol………..with plenty of healthy protein.
- 1 head cauliflower, steamed ahead of time
- Pinch black pepper, (grind to your own taste)
- 1 pound locally grown, thick asparagus spears, woody ends removed
- 8 ounces filo pastry (be sure to thaw completely) (buy it ready-made)
- 1/2 cup extra virgin olive oil
- 1 container tofutti (tofu cream cheese)
- 1 cup freshly grated soy Cheddar
- 4 large organic or free-range eggs (or use egg beater substitute)
- 1 (8-ounce) container no-fat sour cream
- 1 teaspoon turmeric
- 2 garlic cloves, juiced
- 1 onion
- 2/3 cup cilantro, chopped
- Prepare a bowl of water with ice cubes in it.
- After washing and snapping off the tough ends of the asparagus, steam them for about 1 minute, just to turn the color to a bright green. Then stop the cooking process, immediately, by plunging them into the ice water. Let them cool down for 1 minute. Then drain in a colander.
- Preheat the oven to 350 degrees F.
- Get an ovenproof dish. Layer the sheets of filo pastry in the dish, brushing them with olive oil and let about 1-inch hang over the edge. You want to get the pastry about 5 layers thick (not 5 inches). Put a clean, damp kitchen towel over the top and put aside.
- In a large bowl, mash all of the cauliflower with the grated soy cheddar cheese and the container of tofutti (soy cream cheese).
- In a separate bowl, mix together the eggs (or egg beaters) and no-fat sour cream and stir into your cheesy mashed cauliflower. Add the chopped onion, the garlic, the turmeric the pinch black pepper, and the chopped cilantro and mix together.
- Spread the mashed cauliflower over the filo pastry, then bring up the sides of the filo and scrunch them together to form a rim. Take the asparagus and line them up across the filling, making sure you cover it all. Brush all over with the remaining olive oil and pop into the preheated oven for around 20 minutes or less, or until golden and crisp. Jiggle it to see if the tart has any looseness to it, and if so bake for another 5 minutes, or until it no longer jiggles.
Let it stand for 3 to 8 minutes, just to set.
This asparagus dish is so-o good and not difficult to make. I think it’s delicious enough to serve for dinner on its own on a warm Spring or Summer evening, (it has everything: protein, carbs, healthy fat) with a tossed salad, and some lovely French bread or rolls (that you warm up while baking this dish). Mmmm, getting hungry already. We’re having the egg beaters version tonight with icy Sauvignon blanc. Then, a blueberry dessert.
Sauvignon blanc wine grapes
Sauvignon blanc wine – Enjoy!
TEDMED 2013-Immersion in Optimism
Mark L. Horn, MD, MPH, Chief Medical Officer, Target Health Inc.
For nearly four unusual days last month I had the privilege of representing Target Health as a Delegate at the TEDMED Conference, held this year in Washington, D.C.
As a hardened veteran of more than three decades of medical meetings, I have a lot of historical perspective (perhaps baggage?) when evaluating Conferences. In large measure because of this background and the many profound differences between TEDMED and traditional medical meetings, it’s taken some time to integrate and prepare a summary of the TEDMED event.
TEDMED was simultaneously energizing and aspirational; there was a pervasive optimism sometimes lacking at the traditional medical education meetings I attend. This has been increasingly true at recent events where conversations among attendees have focused upon declining reimbursement, insurance company and government interference with clinical practice, concerns about implementing the Affordable Care Act, and frustrations with increasing requirements to report data.
While the multiple challenges facing health care were ‘front and center’– in fact the TEDMED Great Challenges (in health and medicine) Program, an ongoing effort, received considerable attention–, there was a mood, almost a conviction, that solutions are achievable. The meeting was organized to encourage attendees to view health care challenges as addressable. The format, a series of inspirational talks (more on this later) coupled with a ‘Hive’ of innovator companies devoted to creative applications of technology, generated a continuous ‘buzz’ of interactive activity that grew organically during the meeting as these innovators and Delegates got to know each other.
The bonding and general enthusiasm were facilitated by the format; the main sessions were attended by all participants, generating a shared experience. These sessions and speakers were eclectic, diverse, and profoundly entertaining. The gamut ranged from individuals creatively dealing with serious illnesses and disabilities to a workout session with Richard Simmons who offered an engaging and strangely (given the large setting) intimate approach to weight loss and fitness – a potential tool (effective for some, likely not all) for addressing obesity (among the TEDMED Great Challenges). There were performers and patients, academics and afflicted, but all were positive and engaged—problem solvers and strivers. I left some sessions with a smile, others with a tear, but in virtually all instances was inspired and energized.
What made the experience unique was that each session could be followed-up with a short walk to the Hive where there was a bevy of entrepreneurs, some of whom would inevitably have technologies suitable for addressing the issues raised during the sessions. Uniquely among conferences (and it is really not a small thing), the food was healthy and plentiful, and there were places to sit. Participants had time to stroll leisurely through the area during breaks, stopping to interact with the entrepreneurs, without hurrying to the nearest takeout restaurant to avoid starvation during the subsequent sessions.
I left feeling not so much inspired as reassured that our medical future is in good hands; there are, happily, lots of energetic, idealistic, extraordinarily capable (and increasingly young to this observer) individuals ‘working out our problems’. Should Target ask, I shall happily volunteer to represent the Company at TEDMED 2014.