ON TARGET is Going on Vacation Until After labor Day – See You in September
As Summer is here to stay for a while, even a newsletter needs some R&R. So as in year’s past, ON TARGET will take a month off for a breather. Of course, Target Health Inc. continues full-speed ahead as August is always one of our business months.
Target Health’s Business Development Guru Warren Pearlson Visits the Galapagos
Warren Pearlson, Director of Business Development, took the trip of a lifetime to the Galapagos Islands, the birthplace of Charles Darwin’s Theory of Evolution. Without this transformational theory, there would be no modern medicine,
The photo of the Giant Tortoise below was taken on Santa Cruz Island, Galapagos, Ecuador using a Nikon Coolpix s7000.
Giant Tortoise ©Warren Pearlson
For more information about Target Health contact Warren Pearlson (212-681-2100 ext. 165). 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
Biometeorology: Weather Impacts Biological Processes Which Affect Human Health
Biometeorology is the interdisciplinary field of science that studies the interactions between the biosphere and the Earth’s atmosphere on time scales of the order of seasons or shorter. Studies also include the relationship between living organisms and weather. Weather events influence biological processes on short time scales. For instance, as the Sun rises above the horizon in the morning, light levels become sufficient for the process of photosynthesis to take place in plant 1) ___. Later on, during the day, air temperature and humidity may induce the partial or total closure of the stomata, a typical response of many plants to limit the loss of water through transpiration. More generally, the daily evolution of meteorological variables controls the circadian rhythm of plants and animals alike.
Climate processes largely control the distribution, size, shape and properties of living organisms on Earth. For instance, the general circulation of the atmosphere on a planetary scale broadly determines the location of large deserts or the regions subject to frequent precipitation, which, in turn, greatly determine which organisms can naturally survive in these environments. Furthermore, changes in climates, whether due to natural processes or to 2) ___ interferences, may progressively modify these habitats and cause overpopulation or extinction of indigenous species. The biosphere, for its part, and in particular continental vegetation, which constitutes over 99% of the total biomass, has played a critical role in establishing and maintaining the chemical composition of the Earth’s atmosphere, especially during the early evolution of the planet. Currently, the terrestrial vegetation exchanges some 60 billion tons of carbon with the atmosphere on an annual basis (through processes of carbon fixation and carbon respiration), thereby playing a critical role in the carbon cycle. On a global and annual basis, small imbalances between these two major fluxes, as do occur through changes in land cover and land use, contribute to the current increase in atmospheric carbon 3) ___.
Living organisms, for their part, can collectively affect weather patterns. The rate of evapotranspiration of forests, or of any large vegetated area for that matter, contributes to the release of water vapor in the atmosphere. This local, relatively fast and continuous process may contribute significantly to the persistence of precipitations in a given area. As another example, the wilting of 4) ___ results in definite changes in leaf angle distribution and therefore modifies the rates of reflection, transmission and absorption of solar light in these plants. That, in turn, changes the albedo of the ecosystem as well as the relative importance of the sensible and latent heat fluxes from the surface to the atmosphere. For an example in oceanography, consider the release of dimethyl sulfide by biological activity in sea water and its impact on atmospheric aerosols. The methods and measurements traditionally used in biometeorology are not different when applied to study the interactions between human bodies and the atmosphere, but some aspects or applications may have been explored more extensively. For instance, wind chill has been investigated to determine the time period an individual can sustain exposure to given 5) ___and wind conditions. Another important example concerns the study of airborne allergens (such as pollens and aerosols) and their impact on individuals: weather conditions can favor or hinder the release as well as the transport and deposition of these allergens, sometimes severely affecting the well-being of sensitive populations.
Weather pains or weather-related pain, is a phenomenon that occurs when people feel pain, particularly joint pain or migraine headaches correlating with changes in barometric pressure and other weather phenomena. The majority of people who have conditions such as arthritis report feeling pain when a weather front is approaching. Other conditions reported in relation to this are bone injuries, osteoporosis, fibromyalgia, and 6) ___ tunnel syndrome. Changes in barometric pressure and temperature may increase stiffness in the joints and trigger subtle movements that heighten a nociceptive response. Such alteration of structure may be particularly problematic in inflammatory joints whose sensitized nociceptors are affected by movement. Change in barometric pressure may also cause a transient disequilibrium in body pressure that may sensitize nerve endings and account for increased pain preceding changes in temperature or humidity.
Climate change will affect all of the health issues above, plus will enable new patterns of pests and diseases. 7) ___ virus has already reached us in the U.S. Also, affecting human health currently is malnutrition and water wars, due to crop failure and drought. For people already living on the edge, even the slightest rise in food prices, pushes these families into poor health, despair, panic, rage, human emotions filled with stress and negative consequences. Climate change poses a colossal economic risk to the world tens to hundreds of trillions of dollars in damage, by some estimates. Spending now to avoid it is truly an excellent investment. Cereal harvests, alone, have decreased due to both droughts and extreme heat, and production levels in North America, Europe and Australasia dropping by an average of 19.9% from droughts alone – roughly double the global average. Not only does lowering crop yield increase malnutrition and poverty, it raises food prices. As if these statistics are not warning enough, more alarming is that these areas of the planet are predicted to be the least harmed. Researchers’ work builds on an accumulating body of research and reports that consistently warn of the devastating effects extreme weather is having on agriculture. And the effects will continue, with consequences including drastic food shortages, experts say. Studies from Bangladesh, Ethiopia and Niger have shown that children have increased wasting and stunting rates after a flood or drought, according to the United Nations World Food Programme. For example, children in Niger born during a drought are more than twice as likely to be malnourished between the ages of 1 and 2. Moreover, the U.N. food program estimates that hunger and child malnutrition could increase by as much as 20% before 2050 as a result of climate change. Other researchers predict more dire consequences ten years from now, 2026. Without inclusive and climate-smart development, alongside efforts to rein in greenhouse 8) ___ emissions, agricultural shocks, natural disasters and the spread of diseases could push more than 100 million additional people into poverty by 2026. The poorest people are more exposed than the average population to climate- related shocks such as floods, droughts, heatwaves and disease. The strongest rise in temperature in the Middle East and North Africa is during summer, when it is already very hot. Last summer, in a region of Iran, temperatures were recorded at 164 degrees. This is primarily attributed to a desert warming amplification in regions such as the Sahara. Deserts do not buffer heat well, which means that the hot and dry surface cannot cool by the evaporation of ground water. Since the surface energy balance is controlled by heat radiation, the greenhouse effect by gases such as carbon dioxide and water vapor will increase disproportionately.
Climate change can result in a significant deterioration of living conditions for people living in North Africa and the Middle East, and consequently, many people may have to leave the region. As if heat waves weren’t enough in these regions, ClimateCentral.org reports that water supplies across the Middle East will deteriorate over 25 years, threatening economic growth and national security and forcing more people to move to already overcrowded cities, a new analysis suggests. Satellite reports show that the main aquifer in the Middle East is nearly depleted. The World Resources Institute (WRI) claims water shortages were a key factor in the 2011 Syria civil war. Drought and water shortages in 9) ___ likely contributed to the unrest that stoked the country’s 2011 civil war. Dwindling water resources and chronic mismanagement forced 1.5 million people, primarily farmers and herders, to lose their livelihoods and leave their land, move to urban areas, and magnify Syria’s general destabilization, says the report. More than 500 million people live in the Middle East and North Africa – a region where the numbers of extremely hot days have doubled since 1970. The very existence of these inhabitants is in jeopardy; conjuring the real possibility of 500 million refugees.
Our planet is in trouble now. Some scientists are saying that it may already be too late to do much of anything. Many advise that we have no more than a decade to take action. Others claim that if we go off fossil fuels right now, all over the world, we might have a chance of turning things around. The major contributors to sea-level rise of the largest magnitude would be 10) ___ and Antarctica, which are melting now faster than expected. If both were to melt completely, they contain enough ice to raise sea levels by more than 250 feet combined. If part of the Antarctic, West Antarctica alone melted, it would raise the ocean by 10 feet. Everyone does agree that the world needs good leadership in the area of climate change, and that we must act now and quickly. The recent Paris Summit last April 2016, achieved less than is needed to solve this planetary emergency.
Sources: Scientific American; The New York Times; United Nations Reports on Climate Change; National Geographic; Phys.org/2016-climate exodus; Wikipedia; Max Planck Society; World Resources Institute; The Earth Institute at Columbia University
ANSWERS: 1) leaves; 2) human; 3) dioxide; 4) plants; 5) temperature; 6) carpal; 7) Zika; 8) gas; 9) Syria; 10) Greenland
Enormous Cooperation Needed for Planetary Health
By NASA/Apollo 17 crew; taken by either Harrison Schmitt or Ron Evans – nasa.gov/images/content/115334main_image_feature_329_ys_full.jpg
Earthrise taken on December 24, 1968
NASA / Bill Anders – http://www.hq.nasa.gov/office/pao/History/alsj/a410/AS8-14-2383HR.jpg; Public Domain Wikipedia Commons
The idea of the Earth as an integrated whole, a living being, has a long tradition. The mythical Gaia was the primal Greek goddess personifying the Earth, the Greek version of Mother Nature (from Ge = Earth, and Aia = PIE grandmother), or the Earth Mother. James Lovelock gave this name to his hypothesis after a suggestion from the novelist William Golding, who was living in the same village as Lovelock at the time (Bowerchalke, Wiltshire, UK). Golding’s advice was based on Gea, an alternative spelling for the name of the Greek goddess, which is used as prefix in geology, geophysics and geochemistry. Golding later made reference to Gaia in his Nobel Prize acceptance speech.
The perceived relationship between changes in weather and pain has been recorded since the classical Roman age. Hippocrates was the first to note, in about 400 BCE, that many illnesses were related to changes in season. The large body of folklore about how weather affects pain is reflected by traditional sayings and expressions, such as aches and pain, coming rains, feeling under the weather, and ill health due to evil winds. The first publication of documented changes in pain perception associated with the weather was in the American Journal of the Medical Sciences in 1887. This case report described a person with phantom limb pain who concluded that approaching storms, dropping barometric pressure and rain were associated with increased pain complaint. Most investigations examining the relationship between weather and pain have studied people diagnosed with arthritis. After reviewing many case reports, Rentshler reported in the Journal of the American Medical Association in 1929 that there was strong evidence that warm weather is beneficial and barometric pressure changes are detrimental to patients with arthritis.
In the eighteenth century, as geology consolidated as a modern science, James Hutton maintained that geological and biological processes are interlinked. Later, the naturalist and explorer Alexander von Humboldt recognized the coevolution of living organisms, climate, and Earth’s crust. In the 20th century, Vladimir Vernadsky formulated a theory of Earth’s development that is now one of the foundations of ecology. The Ukrainian geochemist was one of the first scientists to recognize that the oxygen, nitrogen, and carbon dioxide in the Earth’s atmosphere result from biological processes. During the 1920s he published works arguing that living organisms could reshape the planet as surely as any physical force. Vernadsky was a pioneer of the scientific bases for the environmental sciences. His visionary pronouncements were not widely accepted in the West, and some decades later the Gaia hypothesis received the same type of initial resistance from the scientific community. Also in the turn to the 20th century Aldo Leopold, pioneer in the development of modern environmental ethics and in the movement for wilderness conservation, suggested a living Earth in his biocentric or holistic ethics regarding land. It is at least not impossible to regard the earth’s parts – soil, mountains, rivers, atmosphere etc.,- as organs or parts of organs of a coordinated whole, each part with its definite function. And if we could see this whole, as a whole, through a great period of time, we might perceive not only organs with coordinated functions, but possibly also that process of consumption as replacement which in biology we call metabolism, or growth. In such case we would have all the visible attributes of a living thing, which we do not realize to be such because it is too big, and its life processes too slow.
Stephan Harding, Animate Earth.
Another influence for the Gaia hypothesis and the environmental movement in general came as a side effect of the Space Race between the Soviet Union and the United States of America. During the 1960s, the first humans in space could see how the Earth looked as a whole. The photograph Earthrise taken by astronaut William Anders in 1968 during the Apollo 8 mission (orbiting the Earth) became, through the Overview Effect an early symbol for the global ecology movement. James Lovelock started defining the idea of a self-regulating Earth controlled by the community of living organisms in September 1965, while working at the Jet Propulsion Laboratory in California on methods of detecting life on Mars. The first paper to mention it was Planetary Atmospheres: Compositional and other Changes Associated with the Presence of Life, co-authored with C.E. Giffin. A main concept was that life could be detected in a planetary scale by the chemical composition of the atmosphere. According to the data gathered by the Pic du Midi observatory, planets like Mars or Venus had atmospheres in chemical equilibrium. This difference with the Earth atmosphere was considered to be a proof that there was no life in these planets. Lovelock formulated the Gaia Hypothesis in journal articles in 1972 and 1974, followed by a popularizing 1979 book Gaia: A new look at life on Earth. An article in the New Scientist of February 6, 1975, and a popular book length version of the hypothesis, published in 1979 as The Quest for Gaia, began to attract scientific and critical attention. Lovelock called it first the Earth feedback hypothesis, and it was a way to explain the fact that combinations of chemicals including oxygen and methane persist in stable concentrations in the atmosphere of the Earth. Lovelock suggested detecting such combinations in other planets’ atmospheres as a relatively reliable and cheap way to detect life.
The Gaia hypothesis, also known as Gaia theory or Gaia principle, proposes that organisms interact with their inorganic surroundings on Earth to form a synergistic self-regulating, complex system that helps to maintain and perpetuate the conditions for life on the planet. Topics of interest include how the biosphere and the evolution of life forms affect the stability of global temperature, ocean salinity, oxygen in the atmosphere, the maintenance of a hydrosphere of liquid water and other environmental variables that affect the habitability of Earth. The hypothesis was formulated by the chemist James Lovelock and co-developed by the microbiologist Lynn Margulis in the 1970s. The hypothesis was initially criticized for being teleological and contradicting principles of natural selection, but later refinements resulted in ideas framed by the Gaia hypothesis being used in fields such as science, biogeochemistry, systems ecology, and the emerging subject of geophysiology. Nevertheless, the Gaia hypothesis continues to attract criticism, and today some scientists consider it to be only weakly supported by, or at odds with, the available evidence. In 2006, the Geological Society of London awarded Lovelock the Wollaston Medal in part for his work on the Gaia hypothesis. Co-evolutionary Gaia and Influential Gaia, which assert that there are close links between the evolution of life and the environment and that biology affects the physical and chemical environment – are both credible. In the 21st Century, but scientists claim that it is not useful to use the term Gaia in this sense. Time will tell.
Fire and Ice – Robert Frost (1920)
Some say the world will end in fire,
Some say in ice.
From what I’ve tasted of desire
I hold with those who favor fire.
But if it had to perish twice,
I think I know enough of hate
To say that for destruction ice
Is also great
And would suffice.
In an anecdote he recounted in 1960 in a Science and the Arts presentation, prominent astronomer Harlow Shapley claims to have inspired Fire and Ice. Shapley describes an encounter he had with Robert Frost a year before the poem was published in which Frost, noting that Shapley was the astronomer of his day, asks him how the world will end. Shapley responded that either the sun will explode and incinerate the Earth, or the Earth will somehow escape this fate only to end up slowly freezing in deep space. Shapley was surprised at seeing Fire and Ice in print a year later, and referred to it as an example of how science can influence the creation of art, or clarify its meaning.
Editor’s note: Of course, the reverse is also true. Writers like Jules Verne imagined a submarine long before it was invented. We all know about the prescient musings and drawings of the greatest Renaissance man, Leonardo da Vinci. Good imaginations conjure up creative dreams. Then, depending upon the talents and abilities of the dreamer, some sort of creation follows, either artistic or scientific.
NIH Launches Early-Stage Yellow Fever Vaccine Trial
Aedes aegypti – NIH Website
As of July 21, 2016, the WHO has reported a total of 3,682 suspected yellow fever cases with 361 deaths in the African country of Angola. Meanwhile, another 1,798 suspected cases have been reported in the Democratic Republic of The Congo (DRC), including 85 deaths. Cases with links to Angola have also been reported in Kenya and China.
Yellow fever virus is found in tropical and subtropical areas in South America and Africa. According to the World Health Organization (WHO), It caused an estimated 84,000 to 170,000 severe cases of disease and 29,000 to 60,000 deaths in 2013. The virus is transmitted to people primarily through the bite of infected female Aedes aegypti mosquitoes. Mild cases of infection can cause fever, back pain, headache, nausea, vomiting, fatigue and weakness. Most people recover, but approximately 15% of those infected develop severe disease manifested as yellow eyes and skin (jaundice), hemorrhage and shock, resulting in potentially fatal kidney, liver or heart conditions.
More than 105 million people in Africa have been vaccinated against yellow fever in mass campaigns since 2006, according to the WHO. Despite this success, vaccine supplies are limited. In addition, in very rare cases, the current yellow fever vaccine can produce severe adverse complications, such as neurologic side effects, multiple organ system dysfunction and death. For this reason, the vaccine should not be given to infants, the elderly, pregnant women and those with compromised immune systems.
To address this issue, the National Institute of Allergy and Infectious Diseases (NIAID), has begun an early-stage clinical trial of an investigational vaccine designed to protect against yellow fever virus. The Phase 1 study is evaluating whether an experimental vaccine developed by the Danish biopharmaceutical company Bavarian Nordic is safe, tolerable and has the potential to prevent yellow fever virus infection. Bavarian Nordic’s experimental yellow fever vaccine, dubbed MVA-BN-YF, is based on the company’s proprietary MVA-BN platform, which uses an attenuated (weakened) version of the Modified Vaccinia Ankara (MVA) virus as a vaccine vector to carry yellow fever virus genes into the body. According to Bavarian Nordic, more than 7,600 people, including 1,000 individuals who are immunocompromised, have been safely vaccinated with MVA-BN-based vaccines.
The placebo-controlled, double-blinded clinical trial will enroll 90 healthy men and women ages 18 to 45 who have never been infected with a flavivirus, which is the family of viruses that includes yellow fever virus, West Nile virus, dengue and Zika virus, among others. Participants will be divided into six groups: One will receive the currently licensed yellow fever vaccine (15 participants) and five groups (15 participants each) will receive the investigational Bavarian Nordic vaccine, either with or without an adjuvant, a substance that is added to a vaccine to increase the body’s immune response to the vaccine. The investigational vaccine will be administered intramuscularly while the licensed yellow fever vaccine will be administered subcutaneously. Trial participants will receive one or two doses of vaccine or placebo, separated by a month.
Previous laboratory and animal studies have suggested that combining MVA-BN with ISA 720, an experimental immune-boosting adjuvant that has been used in prior clinical trials, induces a strong immune response after a single dose of vaccine. One goal of the study will be to assess whether two doses of unadjuvanted vaccine or a single dose of ISA 720 adjuvanted vaccine could provide protection against yellow fever.
The multi-site clinical trial will be conducted by NIAID-funded Vaccine and Treatment Evaluation Units (VTEUs) at the University of Iowa in Iowa City and Saint Louis University in Missouri. Emory Vaccine Center in Decatur, Georgia will assist in evaluating data.
Additional details about the trial can be found at ClinicalTrials.gov using the identifier NCT02743455.
Chronic Disease Outcomes After Severe Acute Malnutrition in Malawian Children (ChroSAM)
Heightened risk of non-communicable diseases (NCD) in children exposed to severe acute malnutrition (SAM) at around 2 years of age is plausible in view of previously described consequences of other early nutritional insults. As a result, tackling severe SAM is a global health priority. As a result, in order to explore the long-term effects of SAM, a study published online in The Lancet Global Health (25 July 2016), used developmental origins of health and disease (DOHaD) theory to evaluate this group of malnourished children in Malawi.
The study followed up 352 Malawian children (median age 9.3 years) who were still alive following SAM inpatient treatment between July 12, 2006, and March 7, 2007, (median age 24 months) and compared them with 217 sibling controls and 184 age-and-gender matched community controls. The outcomes of interest were anthropometry, body composition, lung function, physical capacity (hand grip, step test, and physical activity), and blood markers of NCD risk. For comparisons of all outcomes, the study used multivariable linear regression, adjusted for age, gender, HIV status, and socioeconomic status; puberty was adjusted for in the body composition regression model.
Results showed that compared with controls, children who had survived SAM had lower height-for-age values; shorter leg length; smaller mid-upper arm, hip and calf circumference, hip circumference, and less lean mass. Survivors of SAM had functional deficits consisting of weaker hand grip and fewer minutes completed of an exercise test. The study did not detect significant differences between cases and controls in terms of lung function, lipid profile, glucose tolerance, glycated hemoglobin A1c, salivary cortisol, sitting height, and head circumference.
According to the authors, the results suggest that SAM has long-term adverse effects and that survivors show patterns of so-called thrifty growth, which is known to be associated with future cardiovascular and metabolic disease. However, the evidence of catch-up growth and largely preserved cardiometabolic and pulmonary functions suggest the potential for near-full rehabilitation. The authors added that future follow-up should try to establish the effects of puberty and later dietary or social transitions on these parameters, as well as explore how best to optimize recovery and quality of life for survivors.
FDA and the Zika Virus
Recently, the Office of the Florida Department of Health State Surgeon General announced that it is conducting an epidemiological investigation into a number of non-travel related cases of Zika virus in Miami-Dade and Broward Counties. These may be the first cases of local Zika virus transmission by mosquitoes in the continental United States. Miami-Dade County and Broward Counties are adjacent counties in South Florida.
As one of the FDA’s key public health responsibilities is to help ensure the safety of the nation’s blood supply. According to Peter Marks, M.D., Ph.D., Director, FDA’s Center for Biologics Evaluation and Research (CBER), the FDA is now being tasked with taking important steps to respond to Zika cases in the United States.
In consideration of the possibility of local transmission of the Zika virus, and as a prudent measure to help assure the safety of blood and blood products, the FDA is requesting that all blood establishments in Miami-Dade County and Broward County cease collecting blood immediately until the blood establishments implement testing of each individual unit of blood collected in the two counties with an available investigational donor screening test for Zika virus RNA or until the blood establishments implement the use of an approved or investigational pathogen inactivation technology. Additionally, the FDA recommends that adjacent and nearby counties implement the precautions above to help maintain the safety of the blood supply as soon as possible.
The FDA is also working closely with companies that are making blood screening tests available under an Investigational New Drug application (IND) to ensure that these companies are ready to expand testing as needed. Blood collection establishments in the rest of the United States may also choose now or in the future to participate in testing under IND, even in the absence of local mosquito-borne transmission of Zika virus. The FDA continues to support those regions of the United States at risk of local mosquito-borne Zika transmission that have already started screening their blood supply for Zika virus and encourages other areas at high risk to begin doing so. According to Dr. Marks, the FDA will continue to monitor this potential outbreak in cooperation with the Centers for Disease Control and Prevention (CDC) and Florida State public health authorities, and will provide updates as additional information becomes available.
The Polar Vortex
Did everyone experience a polar vortex two winters in a row? Icy cold! Now, in the midst of the 2016 hottest summer on record, I was wishing for a quick relief of polar vortex. The wish got translated into a mixed summer drink of the same name. This is the very first time our unique drink is being published, in time for all of our readers to mix one for themselves. Let me tell you, we’ve had the time of our lives, experimenting with amounts of various ingredients. We’ve been making them all week. It was fun being guinea pigs in order to share with you for the first time, The Polar Vortex. ©Joyce Hays, Target Health Inc.
©The Polar Vortex, Joyce Hays, Target Health Inc.
1.5 jiggers vodka, I used Grey Goose
1.5 jiggers Ginger Liqueur, I used Domaine de Canton
1.5 jiggers Blue Curacao, I used Giffard Curacao Bleu
1 jigger Almond syrup, I used Sirop de Morin Almond Orgeat
1/2 to 1 cup Sparkling water or diet Sprite, I used Saratoga water once then diet Sprite
Big fresh blueberries
We calculated that a total of 1.5 drinks each, was the same amount of alcohol as splitting a bottle of wine. ©Joyce Hays, Target Health Inc.
Blueberries to put onto each pick. ©Joyce Hays, Target Health Inc.
Bowl of ice cubes. ©Joyce Hays, Target Health Inc.
1 Martini glass per person
Drink shaker with built-in strainer
1 pick per drink
Inexpensive tools, bought on Amazon. ©Joyce Hays, Target Health Inc.
First, put anywhere from three to five or six blueberries on each pick. ©Joyce Hays, Target Health Inc.
Then, put the berry laden picks into each Martini glass. ©Joyce Hays, Target Health Inc.
Next, add all of the ingredients into the shaker. Add the alcohol beverages first, then the almond syrup, then the sparkling water or diet Sprite. Finally, fill the shaker up to one inch from the top, with ice cubes. Stand near a kitchen sink or bar sink and shake vigorously for about 1 minute. Have a towel handy to catch any drips, and pour into your martini glasses. Fill the glasses to about 1.5 inches from the top of the glass. Be aware that the shaker could drip a little, also the glasses. The blue Curacao could stain – just keep this in mind.
Now, raise your glasses and make a toast. Nibble on the blueberries, they get better as they become infused with the Polar Vortex. Have a good time!
This week, the Mostly Mozart music festival began at Lincoln Center. We went to a beautiful concert at well-designed Alice Tully Hall, which is in the Juilliard building. I was in music heaven with Mozart Piano Concerto #20, one of my favorite pieces of music. Here is a link, to hear what we heard:
The Piano Concerto No. 20 in D minor, K. 466, was written by Wolfgang Amadeus Mozart in 1785. The first performance took place at the Mehlgrube Casino in Vienna on February 11, 1785, with the composer as the soloist. The young Ludwig van Beethoven admired this concerto and kept it in his repertoire.
Enjoying ©The Polar Vortex
From Our Table to Yours !