Meeting on Sustainable Development Healthcare Delivery: Nutraceuticals & Natural Products

 

On June 1, 2015, the Institute for Life Sciences Collaboration is having a conference – Sustainable Development Healthcare Delivery: Nutraceuticals & Natural Products – as part of the “United Nations at 70” NGO Series. The event will take place at the Church Center for the United Nations, 777 United Nations Plaza (44th St at 1st Avenue), Plaza Room (second floor), New York, NY 10017. The conference will cover global challenges, traditional medicine, regulatory issues, natural products and complementary medicine, and oncology therapy and prevention. In particular, Dr. Jules T. Mitchel, PhD, MBA, President of Target Health Inc., will be leading a panel on regulatory issues. Please note that admission is free and open to the public with advance registration. For detailed information and to register, please visit: http://ilscollaboration.org/news/. Please let us know if you will be attending.

 

Springtime in Central Park (NYC)

 

Winter was cold this year so Springtime is welcome.

 

20150525-12

Springtime in Central Park©Target Health Inc. 2015

 

ON TARGET is the newsletter of Target Health Inc., a NYC-based, full-service, contract research organization (eCRO), providing strategic planning, regulatory affairs, clinical research, data management, biostatistics, medical writing and software services to the pharmaceutical and device industries, including the paperless clinical trial.

 

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.

 

Joyce Hays, Founder and Editor in Chief of On Target

Jules Mitchel, Editor

 

QUIZ

Filed Under News | Leave a Comment

Red Blood Cells

20150525-11

Red blood cells are also known as RBCs, red cells, red blood corpuscles (an archaic term), haematids, erythroid cells or erythrocytes (from Greek erythros for “red“ and kytos for “hollow vessel“, with -cyte translated as “cell“ in modern usage). RBCs are the most common type of blood cell and the vertebrate organism’s principal means of delivering oxygen (O2) to the body tissues – via blood flow through the circulatory system. RBCs take up oxygen in the lungs or gills and release it into tissues while squeezing through the body’s 1) ___. The cytoplasm of erythrocytes is rich in hemoglobin, which is an iron-containing biomolecule that can bind oxygen and is responsible for the 2) ___ color of the cells. The cell membrane is composed of proteins and lipids, and this structure provides properties essential for physiological cell function such as deformability and stability while traversing the circulatory system and specifically the capillary network. In humans, mature red blood cells are flexible and oval biconcave disks. They lack a cell 3) ___ and most organelles, in order to accommodate maximum space for hemoglobin.

 

Approximately 2.4 million new erythrocytes are produced per second in human adults. The cells develop in the bone 4) ___ and circulate for about 100-120 days in the body before their components are recycled by macrophages. Each circulation takes about 20 seconds. Approximately a quarter of the cells in the human body are red blood cells. Packed red blood cells (pRBC) are red blood cells that have been donated, processed, and stored in a blood bank for blood5) ___.

 

As a result of not containing mitochondria, these RBCs use none of the oxygen they transport; instead they produce the energy carrier ATP by the glycolysis of glucose and lactic acid fermentation on the resulting pyruvate. Because of the lack of nuclei and organelles, mature red blood cells do not contain DNA and cannot synthesize any RNA, and consequently cannot divide. They have limited repair capabilities. This also ensures that no virus can evolve to target mammalian red blood 6) ___. When erythrocytes undergo shear stress in constricted vessels, they release ATP, which causes the vessel walls to relax and dilate so as to promote normal blood 7) ___. When their hemoglobin molecules are deoxygenated, erythrocytes release S-nitrosothiols, which also act to dilate blood vessels, thus directing more blood to areas of the body depleted of 8) ___. Erythrocytes can also synthesize nitric oxide enzymatically, using L-arginine as substrate, as do endothelial cells. Exposure of erythrocytes to physiological levels of shear stress activates nitric 9) ___ synthase and export of nitric oxide, which may contribute to the regulation of vascular tonus. Erythrocytes can also produce hydrogen sulfide, a signaling gas that acts to relax vessel walls. It is believed that the cardioprotective effects of garlic are due to erythrocytes converting its sulfur compounds into hydrogen sulfide. Erythrocytes also play a part in the body’s immune response: when lysed by pathogens such as bacteria, their hemoglobin releases free 10) ___, which break down the pathogen’s cell wall and membrane, killing it. Sources: WebMD; Wikipedia; ScienceDaily

 

ANSWERS: 1) capillaries; 2) red; 3) nucleus; 4) marrow; 5) transfusions; 6) cells; 7) flow; 8) oxygen; 9) oxide; 10) radicals

 

Elizabeth Holmes, Youngest to Make History in Medicine

20150525-8

Elizabeth Holmes (1984-Present)

 

American Founder and CEO of Theranos, Elizabeth Holmes, is interested in the importance of enabling early detection of disease through new diagnostic tools and empowering individuals to make educated decisions about their healthcare.

 

“I don’t want to make an incremental change in some technology in my life. I want to create a whole new technology, and one that is aimed at helping humanity at all levels regardless of geography or ethnicity or age or gender.“ – Elizabeth Holmes

 

Theranos, is a health technology and medical laboratory services company, which Holmes founded in 2003 at age 19 while she was at Stanford University as a chemical engineering major. The company was based on her invention and patent for a way to run 30 lab tests on one drop of blood. By 2014, the company offered 200 tests and was licensed to run in every state of the US. As of 2014, Holmes had 18 US patents and 66 non-US patents in her name and is listed as a co-inventor on over a hundred patent applications. She is the youngest self-made female billionaire on the Forbes 400 list, with an estimated net worth of $4.6 billion.

 

Holmes was born in February 1984 in Washington, D.C. Her father, Christian Holmes IV, worked in the United States, Africa and China as part of government agencies such as USAID. Her mother, Noel Anne (Daoust), worked as a Congressional committee staffer. She has a brother, Christian Holmes V, who is the director of product management at Theranos. One of her ancestors was a founder of the Fleischmann’s Yeast company. She is related to actress Katherine MacDonald who was married to Christian Rasmus Holmes II (1898-1944).

 

As a child, she read the biography of her great-great-grandfather Christian R. Holmes, who was a surgeon, engineer, inventor, and a decorated World War I veteran. He was born in Denmark in 1857 and was the dean of the University of Cincinnati College of Medicine, where a hospital is named after him. The career of her ancestor inspired Elizabeth to take up medicine, but she soon found that she had a fear of needles. She later described this fear as one of her motivations to launch Theranos. Intrigued by their father’s work in China, Elizabeth and her brother learned Mandarin Chinese at a young age. She spent her teenage years in China, and while still in school, started a business selling C++ compilers to Chinese universities. After graduating from St. John’s School in 2002, Holmes enrolled at Stanford University to study chemistry. As a freshman, she was named one of the “President’s Scholars“ and given a stipend of $3,000 to pursue a research project. She persuaded her chemical engineering professor, Channing Robertson, to use the money for a project in his lab. Holmes supplemented her childhood knowledge of Mandarin with summer language programs at Stanford. This helped her obtain an internship at the Genome Institute of Singapore. The Institute was working on developing new methods to detect the SARS coronavirus in blood or nasal swabs. After her return to the US, she wrote a patent application on a wearable patch that would administer a drug, monitor variables in the patient’s blood, and adjust the dosage to achieve the desired effect. She showed her application to Professor Robertson, and told him they could put a cellphone chip on this patch for telemedicine. She filed the patent application in September 2003, as “Medical device for analyte monitoring and drug delivery“. Holmes proposed establishing a company to Professor Robertson in the fall of 2003, while she was a 19-year old sophomore at Stanford. She used money that her parents had saved for her education, to establish Real-Time Cures in Palo Alto. Later, she changed the company’s name to Theranos (an amalgam of “therapy“ and “diagnosis“), because she believed that many people had a cynical reaction to the word “cure“. Initially, she worked out of a basement of a group college house. A semester later, she dropped out to pursue her business career full-time. Professor Robertson served as a director of the company.

 

Over the next decade, the company grew gradually, raising $400 million from Draper Fisher Jurvetson and Larry Ellison, among others. During this time, Theranos operated in “stealth mode“, remaining highly secretive to avoid potential competitors and investors who could fund a competitor. In 2007, it took three former employees to court, accusing them of misappropriating trade secrets. By 2014, the company offered 200 tests and was licensed to run in every state of the US. It had 500 employees and was valued at more than $9 billion. Holmes retained control of more than 50% of the company’s equity. As of 2014, Holmes has 18 US patents and 66 non-US patents in her name and is listed as a co-inventor on over a hundred patent applications. Holmes is the youngest self-made female billionaire on the Forbes 400 list, where she is #111 with an estimated net worth of $4.6 billion.

 

Elizabeth Holmes at TEDMED

Click to read what the New Yorker magazine, has to say about Elizabeth Holmes

 

More About Theranos

 

 

20150525-9

A number of startups are selling portable diagnostic laboratories that require just a drop of the patient’s blood, made possible by advances in the field of microfluidics. But perhaps lab tests can be made faster, easier and more accurate with a turn-of-the-last-century technology: automation. That’s the bet the Silicon Valley company Theranos is making, and the company recently sealed a deal with Walgreen’s Pharmacy to deliver on-site laboratory services to many of its stores. Henry Ford would recognize the principle that allows Theranos to complete accurate lab tests within four hours: Consistency and automation increase speed and bring price down. Even so, Theranos’s selling point is much smaller than a Model T: a capsule-sized lab vial, and just one needs to be filled for the company to run nearly any standard lab test.

 

20150525-10

Courtesy Theranos

 

Here’s how it works: Blood is drawn with a finger stick, rather than a needle in the arm. (It can also run urine tests with just a drop of that.) There are no botched sticks ? of course, there are no phlebotomists, only machines, in Therenos labs. The bad news for workers may be good news for accuracy because human handling of samples accounts for the lion’s share of variation among results. Automation eliminates spills, tests done in error and other mishandling of the sample. In a few cases, Theranos has designed new diagnostic methods to shave time from the process. The machines mete out bits of the “micro-sample“ for each test a doctor has ordered. In conventional testing, each test requires a dedicated vial, which adds dramatically to the amount of blood required. Theranos is even able to save some of the tiny sample in case the doctor requests further tests after seeing the initial results. All of the diagnostic technology is integrated, which increases precision. Each machine in a conventional lab may calibrate differently, and the mix of brands and ages means results come with an implied “or so“ at the end. Plotting results over time is therefore mostly useless. Theranos offers a full range of laboratory tests for a consistently lower cost than most labs do now, and its prices are readily available through a mobile app and on the company’s website. While a deal with Walgreen’s may not be a Silicon Valley dream, laboratory tests are a big lever in the health care system. In the U.S., they are the industry’s single highest volume activity, with over 5 billion tests performed every year according to a new Beth Israel Deaconess Medical Center study. Access to Walgreen’s will help Theranos get quick-and-painless testing close to most Americans. Singularity Hub, a cutting edge website for innovative technology, is betting that the military will use the instant lab tests. The reason? The list of the company’s board of directors reads like a who’s who guide to recent American military history.

 

Microchip Captures Clusters of Circulating Tumor Cells

 

Circulating tumor cells (CTCs) are cells that break away from a tumor and move through a cancer patient’s bloodstream. Single CTCs are extremely rare, typically fewer than 1 in 1 billion cells. These cells can take up residence in distant organs, and it is believed that this is one mode by which cancer spreads. Even less common than single CTCs are small groups of CTCs, or clusters. While the existence of CTC clusters has been known for more than 50 years, their prevalence in the blood as well as their role in metastasis has not been thoroughly investigated, mostly because they are so elusive. However, recent advances in biomedical technologies that enable the capture of single CTCs have renewed interest in CTC clusters, which are occasionally captured along with single CTCs.

 

According to an article published online in Nature Methods Researchers (18 May 2015) a microfluidic chip has been developed that can capture rare clusters of circulating tumor cells from unprocessed blood, which could yield important new insights into how cancer spreads. The work was funded by the National Institute of Biomedical Imaging and Bioengineering (NIBIB), part of the National Institutes of Health. The new technology — called Cluster-Chip — was developed with support from a Quantum Grant from NIBIB, which funds transformative technological innovation designed to solve major medical problems with a substantial disease burden, such as preventing cancer metastasis or precisely tailoring therapeutics to an individual’s cancer cell biology. When the authors recently used Cluster-Chip to capture and analyze CTC clusters in a group of 60 patients with metastatic breast, prostate, and melanoma cancers, CTC clusters-ranging from two to 19 cells were found in 30-40% of the patients. According to the authors, the presence of these clusters is far more common than was thought in the past and the fact that clusters were seen in this many patients is remarkable.

 

The chip is designed to slowly push blood through many rows of microscopic triangle-shaped posts. The posts are arranged in such a way that every two posts funnels cells towards the tip of a third post. At the tip, single cells — including blood cells and single CTCs — easily slide to either side of the post and continue through the chip until reaching the next tip; however CTC clusters are left at the tip, hanging in the balance due to forces pulling them down the post in opposite directions. To determine the efficiency of Cluster-Chip, the authors introduced fluorescently tagged cell clusters (ranging from 2-30 cells) into the chip and counted the number of clusters that were captured and the number that flowed through undetected. At a blood flow rate of 2.5ml/hr, the chip captured 99% of clusters containing four or more cells, 70% of three-cell clusters, and 41% of two-cell clusters. Comparison of the clusters under a microscope before and after capture found that the chip had no negative effects on the integrity of the clusters as a whole. The authors next compared the efficiency of their novel chip to two currently-used methods that have had some success capturing CTC clusters. They found that at similar blood flow rates, the Cluster-Chip was significantly more efficient than a filter-based method, which pushes blood through a membrane with pores only large enough to let single cells pass through. The chip was also more efficient than a different microfluidic chip  that isolates CTCs and occasionally clusters using antibodies that stick to special proteins found on the surface of some tumor cells. The results highlight the importance of the unique Cluster-Chip capture technique, which is based on the structural properties of CTC clusters rather than their size or the presence of surface proteins. This latter property makes the Cluster-Chip well-suited for capturing CTC clusters from a range of cancer types, including those that lose surface proteins during metastasis and those that never express them, such as melanoma.

 

The authors tested the Cluster-Chip in a small trial of 60 patients with metastatic cancer. In this study, the chip captured CTC clusters in 11 of 27 (40.7%) breast cancer patients, 6 of 20 (30%) melanoma patients, and 4 of 13 (31%) prostate patients. The large number of clusters found in the patient samples suggests a possibly greater role for clusters in the metastatic cascade. To characterize the biology of the clusters, the authors measured a marker of tumor cell proliferation — an indicator of increased invasiveness and poor outcomes — in one breast cancer patient with high numbers of both single CTCs and clusters. Approximately half of the cells in the patient’s clusters were positive for the proliferative marker, demonstrating that clusters can contain both actively proliferating and quiescent cells. The authors also noted the rare presence of non-tumor cells within clusters in less than 5% of patients.

 

About the National Institute of Biomedical Imaging and Bioengineering: NIBIB’s mission is to improve health by leading the development and accelerating the application of biomedical technologies. The Institute is committed to integrating the physical and engineering sciences with the life sciences to advance basic research and medical care. NIBIB supports emerging technology research and development within its internal laboratories and through grants, collaborations, and training. More information is available at the NIBIB website.

 

Animals’ Presence May Ease Social Anxiety in Kids with Autism

 

Autism spectrum disorders (ASDs) affect the structure and function of the brain and nervous system. People with these conditions have difficulty communicating and interacting with other people. They also have restricted and repetitive interests and behaviors. According to a study published online in Developmental Psychobiology (27 April 2015), companion animals — like dogs, cats or the guinea pigs in the study — may prove to be a helpful addition to treatment programs designed to help children with ASDs improve their social skills and interactions with other people. While previous studies suggest that in the presence of companion animals, children with autism spectrum disorders function better socially, the current study provides physiological evidence that the proximity of animals eases the stress that children with autism may experience in social situations. This study is among several funded under a public-private partnership established in 2008 between NICHD and the WALTHAM Centre for Pet Nutrition, a division of Mars Inc., to establish a human-animal interaction research program to support studies relevant to child development, health, and the therapeutic use of animals.

 

For the current study, the authors measured skin conductance, the ease at which an unnoticeable electric charge passes through a patch of skin, in children with ASDs and in typically developing children. The study design divided the 114 children, ages 5 to 12 years old, into 38 groups of three. Each group included one child with ASD and two of their typically developing peers. Each child wore a wrist band fitted with a device that measures skin conductance. When people are feeling excited, fearful, or anxious, the electric charge travels faster through the skin, providing an objective way for researchers to gauge social anxiety and other forms of psychological arousal. For the first few minutes, the children read a book silently, giving researchers a baseline measure of skin conductance while carrying out a non-stressful, familiar task. Next, each child was asked to read aloud from the book in the presence of the two peers in their group, a task designed to measure their level of apprehension during social situations. The study staff then brought toys in the room and allowed the children 10 minutes of free play time. These situations may be stressful for children with ASDs, who may have difficulty relating socially to their typically developing peers. Finally, the study team brought two guinea pigs into the room and allowed the children to have 10 minutes of supervised play with the animals. The researchers chose guinea pigs because of their small size and docile nature — much easier to manage in a classroom than larger animals.

 

Results showed that, compared to the typically developing children, the children with autism had higher skin conductance levels when reading silently, reading aloud, and in the group toy session. These higher levels are consistent with reports from parents and teachers, and from other studies, that children with ASDs are more likely to be anxious in social situations than typically developing children. However, when the session with the guinea pigs began, skin conductance levels among the children with ASDs dropped significantly. The authors speculated that where human counterparts inherently pass social judgment, animals are often perceived as sources of unconditional, positive support, and offer unqualified acceptance and their presence makes the children feel more secure. For reasons the authors cannot explain, skin conductance levels in the typically developing children rose during the session with the guinea pigs. The researchers believe that these higher readings may indicate excitement at seeing the animals, rather than any nervousness or apprehension. The authors added that earlier studies have shown that children with ASDs were less likely to withdraw from social situations when companion animals are present. These studies, along with the current findings, indicate that animals might play a part in interventions seeking to help children with autism develop their social skills. However, the authors cautioned, however, that the findings do not mean that parents of children with ASDs should rush to buy an animal for their children, but that further research is needed to determine how animals might be used in programs aimed at developing social skills. The authors added that the study was conducted in a supervised setting, by researchers experienced in working with kids with ASDs who understand the needs and requirements of the animals, and that careful supervision was provided during the study, to ensure the welfare of the children as well as the animals.

 

Innovation at FDA – Accelerated Approval for Drugs and Biologics

 

In May 2014, FDA issued a Guidance for Industry – Expedited Programs for Serious Conditions – Drugs and Biologics. This Guidance codifies processes that FDA uses to get drugs and biologics to market sooner, when there is an unmet need to address serious conditions. Programs include:

 

Accelerated Approval Program: The FDA allows for earlier approval of drugs that treat serious conditions, and that fill an unmet medical need based on a surrogate endpoint. A surrogate endpoint is a marker, such as a laboratory measurement, radiographic image, physical sign or other measure that is thought to predict clinical benefit, but is not itself a measure of clinical benefit. The use of a surrogate endpoint can considerably shorten the time required prior to receiving FDA approval. Drug companies are still required to conduct studies to confirm the anticipated clinical benefit. These studies are known as phase 4 confirmatory trials. If the confirmatory trial shows that the drug actually provides a clinical benefit, then the FDA grants traditional approval for the drug. If the confirmatory trial does not show that the drug provides clinical benefit, FDA has regulatory procedures in place that could lead to removing the drug from the market.

 

Breakthrough Therapy: Breakthrough designation is for a product that is intended alone or in combination with one or more other drugs to treat a serious or life threatening disease or condition and preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. Breakthrough therapy designation will usually mean that the effect of the drug will be large compared with available therapies. In such cases, the development program for the breakthrough therapy could be considerably shorter than for other drugs intended to treat the disease being studied. However, FDA notes that a compressed drug development program still must generate adequate data to demonstrate that the drug is safe and effective to meet the statutory standard for approval. Omitting components of the drug development program that are necessary for such a determination can significantly delay, or even preclude, marketing approval. Sponsors can design efficient clinical trials in a number of ways. FDA will seek to ensure that a sponsor of a product designated as a breakthrough therapy receives timely advice and interactive communications to help the sponsor design and conduct a drug development program as efficiently as possible. During these interactions, the Agency may suggest, or a sponsor may propose, alternative clinical trial designs (e.g., adaptive designs, an enrichment strategy, crossover or N-of-1 design, use of historical controls) or use of an interim analysis by a data monitoring committee. These trial designs may result in smaller trials or more efficient trials that require less time to complete and may help minimize the number of patients exposed to a potentially less efficacious treatment (i.e., the control group treated with available therapy). Such approaches may be especially useful in studies in rare diseases. For example, single-arm trials may be an important option in rare diseases with well-understood pathophysiology and a well-defined disease course

 

Fast Track: Fast Track emphasizes the critical nature of close early communication between the FDA and sponsors and adds to existing programs, such as accelerated approval, the possibility of a “rolling review“ for an application.

 

Priority Review: A Priority Review designation means FDA’s goal is to take action on an application within 6 months (compared to 10 months) if the drug could provide significant advantages such as:

1. evidence of increased effectiveness in treatment, prevention, or diagnosis of condition;

2. elimination or substantial reduction of a treatment-limiting drug reaction

3. documented enhancement of patient compliance

4. evidence of safety and effectiveness in a new subpopulation

 

Edamame/Pepper/Corn/Bean Salad with Honey/Lemon/Soy Dressing, Cashews & More

20150525-1

This salad is a tasty meal in itself. The white strips are jicama, which could be grated instead if you want smaller pieces. ©Joyce Hays, Target Health Inc.

 

Ingredients

 

2 cups shelled edamame beans

1 cup raw fresh yellow corn

1 or 2 diced avocados

1 cup toasted and salted (optional) cashews

1/2 cup sliced or diced roasted and peeled red bell peppers

1 1/2 cups fresh French green beans, blanched, shocked (ice water) and chopped

2 cups diced jicama

1/2 cup salad dressing, more as desired

1 cup daikon sprouts or substitute your favorite sprouts

1/4 cup plus 2 Tablespoons hemp seeds (or black sesame seeds)

 

 

20150525-2

The variety of ingredients make this salad special. Take a deep breath of the fresh rosemary. The grated fresh ginger really adds a mysterious touch; you hardly know it’s there, but without it, you’d miss it. The jicama is healthy and gives a nice crunchy texture, not to mention the delicious cashews. Go with low sodium soy in the awesome dressing. ©Joyce Hays, Target Health Inc.

 

Directions

 

Make the Salad dressing First

1 1/2 teaspoons grated fresh ginger

1 1/2 teaspoons coarsely chopped shallot

1 1/2 teaspoons coarsely chopped fresh rosemary

2 Tablespoons soy sauce

2 Tablespoons honey

3 Tablespoons sweet rice vinegar (or white vinegar)

1 1/2 Tablespoons fresh lemon juice

1/2 cup canola oil

 

In a blender, grind the ginger, shallots and rosemary to a paste.

Add the soy sauce, honey, vinegar and lemon juice to the ginger mixture and blend until fairly smooth.

With the blender running, slowly add the oil. This makes about three-fourths cup dressing, more than is needed for the remainder of the recipe. The dressing will keep, up to 3 days, covered and refrigerated.

 

Complete the Salad

 

In a large bowl, combine the edamame, corn, avocado, cashews, peppers, green beans and jicama.

Add one-half cup of the dressing and toss to coat. Taste, and add additional dressing if needed.

Garnish with the daikon sprouts and hemp seeds. Serve immediately

 

 

20150525-3

 

20150525-4

These 3 fresh fruits are reaching a peak. Now they’re 4 out of 5 stars and luscious together: peaches, strawberries and pixie tangerines. A wonderful dessert by themselves or add a little peach schnapps for added zip. ©Joyce Hays, Target Health Inc.

 

20150525-5

Dekuyper Peachtree Schnapps

 

20150525-6

Feeling adventurous, we tried a New Zealand sauvignon blanc, called Man O’ War. This is the first white wine that gave a real unexpected punch and a finish that doesn’t let go. Much earlier in the year, we recommended an Australian red called, Sexy Beast, that knocked our socks off (so to speak) with its robust nose, palette, finish, and a 93 point rating from Wine Spectator. On the white side, Man O’ War gives a similar knockout punch, if that’s what you like in your whites. Wines from this part of the world are delicious and well worth trying. Man O’ War gets a 91 point rating. Neither of these breaks the bank.

 

So, we began our meal with chilled Man O’ War and the delicious fresh veggie salad, with recipe, above, in this newsletter.  Although, we ate indoors, this salad is wonderful for meals out of doors on summer days & evenings, because with no mayo in it, it won’t spoil.  Next we had rare fillet mignon with a marsala mushroom sauce.  We only eat steak at home, because we have never had such a tender cut at a restaurant, including well known steak houses and premier restaurants.  Along with the delicious steak, so tender you could cut it with a fork, were baked mini red potatoes.  Each one is bite size. Before baking, I soak them in a bowl with olive oil and garlic, then just spread out on a baking sheet and bake for less time than a usual size baked potato.  We had crunchy broccoli saut?ed in the olive oil and garlic, I used for soaking the mini potatoes.  Dessert was the freshly cut up peaches, tangerines and sweet strawberries with peach schnapps which is lighter than most licquers.  This was a lovely meal.

 

Winter is gone in the Big Apple and New York is green and glorious with tree lined blocks and flowers everywhere.  We saw a play at the Lucille Lortel Theater on Christopher Street in the West Village, our old stomping grounds years ago.  Fun to be back in the Village, but the play, a dark comedy called Punishment,was bizarre and without a point, about husbands finding agreed upon reasons to spank their wives, I guess to give their lives more structure or more excitement or who knows?  On top of this odd focus, there was no point of view about masochism or victimhood.  The plot appeared to be an assortment of loosely formed ideas about marriage which never came together with any kind of resolution. One form of idiocy led to another, followed by an intermission and then back to the same old grind of stupid meaningless situations.  The first scene of a spanking bordered on the risque, but the playwright backed away a bit, which could/might have made the time spent in the audience, more interesting, but even the possibility, escaped the writer. Because we love New Yorktheater (and donate to many theater clubs), we give such a play a wide berth.  Off Broadway theaters are important laboratories for ideas and we accept this play in that vein.

 

Hope your Memorial Day (USA) weekend was relaxing and pleasurable.

 

 

From Our Table to Yours!

 

Bon Appetit!