James Farley Photographs Supermoon Over Winston-Salem, NC.

 

There will be no ON TARGET next week as we are taking off for the Thanksgiving holiday. Our best to all of our readers.  We now have over 6,000 current subscribers to ON TARGET. From time to time we receive newsworthy events and/or photos from our loyal readers.

 

A Supermoon happens when a Full Moon or New Moon coincides with the Moon’s closest approach to Earth; also called perigee. A Super Full Moon looks around 12% to 14% bigger than its counterpart, the Micromoon. The Supermoon on November 14, 2016, was the closest a Full Moon has been to Earth since January 26, 1948. The next time a Full Moon is even closer to Earth will be on November 25, 2034.

 

Our friend and colleague James Farley, photographer extraordinaire, took Supermoon photos in Winston-Salem, NC, which were featured by Lanie Pope on WXII 12 Winston-Salem!

 

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Supemoon over the R J Reynolds building, Winston, NC. ©jfarley Photography.

 

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

 

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Copper: The Bacteria-Fighting Super Element is Making a Comeback In Hospitals

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This is human coronavirus 229E being inactivated on copper. Credit: University of Southampton, England

 

 

Copper is being embraced by some hospitals because of its ability to kill 1) ___ and other microbes on contact, which can help reduce deadly infections.  Copper can kill or inactivate a variety of pathogens by interacting with oxygen and modifying oxygen molecules. In bacteria, this disrupts the outer layer, damaging the genetic material and cell machinery, which can lead to cell death. A recent study found that copper also destroys norovirus. There has been only one published clinical trial showing how copper reduces infections in hospitals. The results, however, were striking. The study, which took place between July 2010 and June 2011, showed that copper surfaces reduced infection rates by 58%. The antimicrobial effect of copper-alloy surfaces is a result of the metal stealing electrons from the bacteria when they come into contact with each other. Once the bacteria donate the electrons to the copper metal, this places the organism into a state of electrical-charge deficit. As a consequence, free radicals are generated inside the cell, which ultimately leads to the cell’s death.

 

Checking into a hospital can boost your chances of infection. That’s a disturbing paradox of modern medical care. And it doesn’t matter where in the world you’re hospitalized. From the finest to the most rudimentary medical facilities, patients are vulnerable to new 2) ___ that have nothing to do with their original medical problem. These are referred to as healthcare-acquired infections, healthcare-associated infections or hospital-acquired infections. These are infections like pneumonia and urinary tract infections. Many of them, like methicillin-resistant Staphylococcus aureus (MRSA), can be deadly. The World Health Organization estimates that “each year, hundreds of millions of patients around the world are affected“ by healthcare-acquired infections. In the United States, the Office of Disease Prevention and Health Promotion in the Health and Human Services Department estimates that 1 in 25 inpatients has a 3) ___-related infection. In developing countries, estimates run higher.

 

Hospital bed safety railings are a major source of these infections. That’s what Constanza Correa, 33, and her colleagues have found in their research in Santiago, Chile. They’ve taken on the problem by replacing them, since 2013, with railings made of copper, an anti-microbial element. Copper definitely wipes out 4) ___. “Bacteria, yeasts and viruses are rapidly killed on metallic copper surfaces, and the term “contact killing“ has been coined for this process,“ wrote the authors of an article on copper in Applied and Environmental Microbiology. That knowledge has been around a very long time. The journal article cites an Egyptian medical text, written around 2600-2000 BCE, that cites the use of copper to sterilize chest wounds and drinking water. Correa’s startup, Copper BioHealth, has not yet assessed the railings’ impact in Chilean hospitals. But a study of the effects of copper-alloy surfaces in U.S. hospitals’ intensive care units, published last year in Infection Control and Hospital Epidemiology, showed promising results: Their presence reduced the number of healthcare-acquired infections from 8.1% in regular rooms to 3.4% in the copper rooms.

 

Healthcare-acquired infections are a huge problem. People come to the hospital with a sickness, and they get another one in the hospital. Then they have to stay longer and spend more money on treatment. Sometimes it can cause 5) ___. Eighty percent of these infections come from touching hospital surfaces. In the hospital room, the most contaminated surface is the bed rail. It’s the most manipulated by medical staff and patients. It’s in direct contact with the patient. That’s the most critical surface in the room. A hospital’s objective is to decrease the chance of infection due to surface contact. So if we can replace current bed rails with copper bed rails, there is the potential to kill viruses, fungi and bacteria continuously. The magnitude of the problem is that in industrialized countries, 5% of patients develop these infections and the number is three times more in developing countries. In the United States, the annual direct cost to treat these infections is $40 billion a year. At least 15 hospitals across the country have installed, or are considering installing, copper components on “high-touch“ surfaces easily contaminated with microbes – faucet handles on sinks, cabinet pulls, toilet levers, call buttons and IV poles. “We’ve known for a long time that copper and other metals are effective in killing microbes, so it wasn’t a great leap to incorporate copper surfaces into hospitals,“ said John Lynch, medical director of infection control at Seattle’s Harborview Medical Center, which is redesigning a waste-disposal room to incorporate copper on light switches and door handles. For many hospitals, the death of Ebola patient Thomas Eric Duncan last year at a Dallas hospital heightened concerns – two nurses caring for him caught the 6) ___ because of poor infection control. And even before that, public health officials had identified nearly two dozen dangerous pathogens – many of them resistant to virtually all antibiotics – whose spread in health facilities and elsewhere could result in potentially catastrophic consequences. They include MRSA, a potentially deadly infection that is increasing in community settings; VRE, which can cause a variety of infections; and C. diff, which causes life-threatening diarrhea and sends 250,000 people to the hospital every year.

 

On any given day, about 1 in 25 patients in acute-care hospitals has at least one health-care-associated infection, according to the CDC or 7) ___ for ___ ___ and ___. Pneumonia and surgical-site infections are among the most common. In 2011, about 75,000 patients with health-care-associated infections died in the hospital. Hospital officials aren’t the only ones interested in copper. Hartsfield-Jackson Atlanta International Airport installed drinking fountains retrofitted with antimicrobial copper surfaces. In Colorado Springs, the U.S. Olympic Committee’s flagship training center uses custom dumbbells with antimicrobial copper grips. So do two professional hockey teams, the Los Angeles Kings and St. Louis Blues. Even a Chick-fil-A in Morganton, N.C., installed antimicrobial copper on restroom door handles.

 

Now, the CDC is pressing for more research. Recently, it held a roundtable on environmental infection control in preventing Ebola and other health-care-associated infections. Officials, who are exploring copper and other technologies, are working with hospitals, academics and the copper industry. The Defense Department, which funded the first clinical trial on copper and hospital-acquired infections, is researching copper’s effectiveness against one type of bacteria, acinetobacter, which can cause pneumonia or bloodstream infections among critically ill patients, including wounded 8) ___ returning from the battlefield. Many experts have concluded that traditional methods for reducing hospital-acquired infections, such as hand washing, aren’t enough, because people don’t always do what they are supposed to do and many pathogens can survive for long periods on surfaces. That’s why hospitals are experimenting with other ways to destroy them, including using ultraviolet light and hydrogen peroxide vapor to target germs in nooks and crannies not easily reached by cleaning crews. But those measures require actions by human beings – which is not the case with copper. “It’s always working, it requires no human intervention, no supervision, and it’s acting continuously,“ said Michael Schmidt, a microbiology professor at the Medical University of South Carolina and one of the researchers who conducted the first and largest study of copper surfaces in hospitals. Besides the South Carolina hospital, the study involved Memorial Sloan Kettering Cancer Center in New York and the Veterans Affairs hospital in Charleston, S.C. About 600 patients who were admitted to the intensive-care units at the facilities were randomly assigned to receive care in traditional patient rooms or ones in which six frequently touched objects – such as bed rails, tables, IV poles and nurse call buttons – were made from copper alloys. While welcoming the findings, researchers said additional studies are needed to answer many questions. “Is there a minimal risk number out there – how many bacteria on a surface to really put people at risk?“ said L. Clifford McDonald, a medical epidemiologist at the CDC. “Right now, there’s not enough data on copper or other technologies to make firm recommendations on what hospitals should do,“ he said. In the meantime, facilities should continue to thoroughly clean patients’ rooms and supplement that with disinfectants. And everyone, especially health-care workers, should wash their hands with soap and water.

 

At an American Hospital Association conference in July, Todd Linden, chief executive of Grinnell Regional Medical Center in Iowa, gave a 70-minute presentation on copper items installed in 13 of the hospital’s patient rooms. The 49-bed facility also plans to use copper in renovating its emergency room. Grinnell College biology professor Shannon Hinsa-Leasure is conducting a clinical trial on the hospital’s use of copper. The hospital’s fitness center also has copper components, including on its free weights. Olin Brass and its manufacturing partners donated products for the hospital; community donations paid for the fitness center. A typical U.S. hospital room contains about $100,000 of goods and equipment, experts say. The average cost to outfit a hospital room with antimicrobial copper items is about $5,000, Linden said. But one infection adds $43,000 in patient costs, according to federal data. And under the Affordable Care Act, hospitals with higher infection rates and other patient injuries face decreases in their Medicare reimbursements.

 

The copper industry, meanwhile, provided financial help to several facilities interested in experimenting with 9) ___surfaces. The Copper Development Association gave $50,000 in grants to four hospitals in 2013 and 2014, said Adam Estelle, a project engineer with the trade group. The association began promoting copper’s antimicrobial properties in 2008, when several groups of copper products met standards of the Environmental Protection Agency to be registered as antimicrobial and effective in killing six types of bacteria, including MRSA, VRE and the deadly E. coli 0157 strain, the culprit in numerous food recalls, illnesses and deaths. Pullman Regional Hospital in Washington State received a $10,000 grant from the copper industry group two years ago. The 26-bed hospital bought more than 1,200 cabinet drawer pulls and 22 handicapped-access buttons on doors. Ed Harrich, chief of surgical services, and his staff have been methodically installing the hardware. He persuaded hospital administrators to approve another $10,000 for more items. More than 150 health-care and other facilities have installed antimicrobial copper alloy surfaces manufactured in the U.S. since 2011, according to the Copper Development Association. Cost is an issue. Adding copper surfaces is about 15 to 20% more expensive than using traditional stainless steel. But the long-term 10) ___are worth it. Sources: The Washington Post, Wall Street Journal, NPR; Medscape; ScienceDaily

 

ANSWERS: 1) bacteria; 2) infections; 3) hospital; 4) microbes; 5) death; 6) virus; 7) Centers for Disease Control and Prevention; 8) soldiers; 9) copper; 10) benefits

 

Francis Schlatter (1856-1896), Healer with Copper Rod

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Francis Schlatter Credit: Unknown – This image is available from the United States Library of Congress’s Prints and Photographs Division; Public Domain, Wikipedia Commons

 

Francis Schlatter (1856-1896) was an Alsatian cobbler who, because of miraculous cures attributed to him, became known as the Healer. Schlatter was born in the village of Ebersheim, Bas-Rhin, near Selestat, in Alsace on April 29, 1856. In 1884 he emigrated to the United States, where he worked at his trade in various cities, arriving in Denver, Colorado, in 1892. There, a few months later, he experienced a vision at his cobbler’s bench in which he heard the voice of the Father commanding him to sell his business, give the money to the poor, and devote his life to healing the sick. He then undertook a two-year, 3,000-mile walking pilgrimage around the American West which took him across eastern Colorado, Kansas, and Oklahoma, and then to Hot Springs, Arkansas, where he was arrested and jailed for vagrancy. In early 1894 he escaped and headed west, walking across Texas, New Mexico, and Arizona and into southern California, where he began his first efforts at healing with the Indians of the San Jacinto Valley. After two months, he again took up his pilgrimage and traveled east across the Mohave Desert, living on nothing but flour and water.

 

In July 1895 he emerged as a Christ-like healer in the Rio Grande villages south of Albuquerque. There, while treating hundreds of sick, suffering, and disabled people who flocked to Albuquerque’s Old Town, he became famous. Crowds gathered about him daily, hoping to be cured of their diseases simply by clasping his hands. The following month he returned to Denver, but did not resume his healings until mid-September. During the next few weeks, his ministry drew tens of thousands of pilgrims to a small home in North Denver. Schlatter is said to have refused all rewards for his services. His manner of living was of the simplest, and he taught no new doctrine. He said only that he obeyed a power which he called Father, and from this power he received his healing virtue.

 

On the night of November 13, 1895, he suddenly disappeared, leaving behind him a note in which he said that his mission was ended. Then, in 1897 news came out of Mexico that the healer’s bones and possessions had been found on a mountainside in the Sierra Madre. At the same time, a New Mexico woman named Ada Morley published a book called The Life of the Harp in the Hand of the Harper which told of the healer’s three-month retreat on her ranch in Datil, New Mexico, after his disappearance from Denver. The book, which carried the title the healer gave it, also contained a first-person description of his two-year pilgrimage, which he believed held the same significance for mankind as Christ’s forty days in the wilderness. On departing the Morley ranch, Schlatter told Morley that God intended to establish New Jerusalem in the Datil Mountains, and the healer promised to return at that time. In the wake of the healer’s death, several men claiming to be Francis Schlatter made headlines around the country in 1909, 1916, and 1922.

 

In August Strindberg?s autobiographical novel Inferno, Francis Schlatter is mentioned as a doppelganger of another man Strindberg met in Paris in 1896, the year after Schlatter disappeared. He was afraid of Schlatter. The “double“ turned out to be Paul Herrmann, a German-American painter.

 

The Healer’s Copper Rod

 

In 1906 Edgar Lee Hewett, who became a noted archaeologist and museum director, was conducting research near Casas Grandes, Chihuahua, Mexico, when his Mexican guide pointed out an unmarked grave. Ten years before, the guide said, he had come across the body of a dead man following a blizzard. From the guide’s description, Hewett surmised that the dead man the guide had come across was Francis Schlatter, whom Hewett had met and whose healing sessions he observed in 1895. Hewett asked if any of the man’s possessions had survived. The guide led him to the home of the jefe of Casas Grandes, and there Hewett saw Schlatter’s Bible, saddle, and copper rod – which had become a mysterious hallmark of the healer from the time of his disappearance. Years later, in 1922, Hewett returned to Mexico and examined the copper rod again. By now, Edgar Lee Hewett had become the director of the School of American Research (now the School for Advanced Research) and the Museum of New Mexico Hewett showed interest in the rod and made a donation to the village of Casas Grandes to hire a teacher. Back in Santa Fe, a few weeks later, he received a heavy, burlap-wrapped package, and inside was Francis Schlatter’s copper rod. He placed the rod in the collections of the two institutions he directed, which shared space in the Palace of the Governors in Santa Fe, N.M. Today the rod lies in the collections of the New Mexico History Museum in the Palace of the Governors. Almost immediately after reports came out of Mexico announcing the healer’s death, skepticism arose. Ada Morley, who had visited at length with Schlatter during his three-month stay at her ranch in New Mexico in early 1896, had her doubts. “The men who found the skeleton declared to have been [Schlatter’s],“ she said, “say it was resting as though it had never been disturbed. I know the coyotes would never have left it, if it had ever lain there bearing flesh.“ The New York Times expressed doubts as well. “It does not appear that the human remains were actually identified as Schlatter’s,“ the newspaper stated on June 19, 1897, “or that any identification was possible.“ However, the presence of the healer’s possessions at the scene, especially his copper rod, convinced most people otherwise. Over the next twenty-five years, several men arose claiming to be Francis Schlatter. One, a Presbyterian minister named Charles McLean, died in Hastings, Nebraska, in 1909, creating a controversy between skeptics and believers. Two others, August Schrader and Jacob Kunze, who formed a healing team that operated between 1908 and 1917, were arrested and jailed in 1916 for mail fraud. A final so-called imposter died in St. Louis, Missouri, in October 1922.

 

During the second half of the twentieth century, a renewed interest in Schlatter brought with it speculation about the claim of the healer who had died in St. Louis. Most recently, The Vanishing Messiah: The Life and Resurrections of Francis Schlatter (2016), argues that the healer conspired to stage his death in the mountains of Mexico and returned to the United States to continue healing in the eastern and southern parts of the country until his death in St. Louis in 1922. The Vanishing Messiah claim rests in part on the discovery of a largely forgotten autobiography in the Library of Congress entitled Modern Miracles of Healing: A True Account of the Life, Works and Wanderings of Francis Schlatter, the Healer, attributed to “Francis Schlatter, The Alsacian,“ and published in 1903.

 

No Effects of Short-Term vs. Long-Term Blood Storage on Mortality after Transfusion

 

Randomized, controlled trials have suggested that the transfusion of blood after prolonged storage does not increase the risk of adverse outcomes among patients, although most of these trials were restricted to high-risk populations and were not powered to detect small but clinically important differences in mortality. As a result, a study published in the New England Journal of Medicine (2016; 375:1937-1945) was performed to determine whether the duration of blood storage would have an effect on mortality after transfusion in a general population of hospitalized patients.

 

In this pragmatic, randomized, controlled trial conducted at six hospitals in four countries, patients who required a red-cell transfusion were randomly assigned to receive blood that had been stored for the shortest duration (short-term storage group) or the longest duration (long-term storage group) in a 1:2 ratio. Only patients with type A or O blood were included in the primary analysis, since pilot data suggested that the goal of achieving a difference in the mean duration of blood storage of at least 10 days would not be possible with other blood types. Written informed consent was waived because all the patients received treatment consistent with the current standard of care. The primary outcome was in-hospital mortality, which was estimated by means of a logistic-regression model after adjustment for study center and patient blood type.

 

From April 2012 through October 2015, a total of 31,497 patients underwent randomization. Of these patients, 6761 who did not meet all the enrollment criteria were excluded after randomization. The primary analysis included 20,858 patients with type A or O blood. Of these patients, 6,936 were assigned to the short-term storage group and 13,922 to the long-term storage group. The mean storage duration was 13.0 days in the short-term storage group and 23.6 days in the long-term storage group. There were 634 deaths (9.1%) in the short-term storage group and 1213 (8.7%) in the long-term storage group (odds ratio, 1.05 P=0.34). When the analysis was expanded to include the 24,736 patients with any blood type, the results were similar, with rates of death of 9.1% and 8.8%, respectively (odds ratio, 1.04, P=0.38). Additional results were consistent in three prespecified high-risk subgroups (patients undergoing cardiovascular surgery, those admitted to intensive care, and those with cancer).

 

According to the authors, among patients in a general hospital population, there was no significant difference in the rate of death among those who underwent transfusion with the freshest available blood and those who underwent transfusion according to the standard practice of transfusing the oldest available blood.

 

Statin Use and Risk of Rheumatoid Arthritis

 

Statins have antiinflammatory/immunomodulatory effects that may be useful in preventing rheumatoid arthritis (RA), but previous observational studies about the risk of RA with statin use yielded conflicting results. As a result, a study published in Arthritis and Rheumatology (27 October 2016) was performed to determine whether high-intensity statin treatment is associated with reduced risk of RA.

 

The study used data from the UK Clinical Practice Research Datalink. For the analysis, the authors performed a nested case-control analysis in a population-based cohort of patients who began receiving statins between 1997 and 2009 and were followed up until a first diagnosis of RA, death, end of registration with the physician’s practice, or end of January 2011. For each case of RA, age-, gender-, and calendar year-matched controls were randomly selected from risk sets. The hazard ratio (HR) of incident RA was estimated in the highest quintile of duration-weighted average statin intensity compared to the lowest, using conditional logistic regression. Models were adjusted for smoking status, total cholesterol level, obesity, history of cardiovascular disease, coexistent autoimmune disease, hypothyroidism, and persistence with treatment.

 

The research cohort included 528,654 new users of statins, with 1,357 new cases of RA occurring during a mean follow-up of 3.3 years, for an incidence rate of 7.9 per 10,000 person-years. Cases were more likely to be smokers, to have other autoimmune diseases, and to have had lower total cholesterol levels at baseline. Research showed that the incidence of RA was lower in the highest statin intensity quintile (adjusted HR 0.77 [95% confidence interval 0.63-0.95]) in comparison to the lowest quintile.

 

The authors concluded that in this large population-based study, high-intensity statin treatment was associated with a reduced risk of RA in comparison to low-intensity statin treatment.

 

FDA Research Helps to Speed Development of Zika Virus Vaccines and Therapeutics

 

The recent spread of the Zika virus and its association with increased rates of neurological disorders and complex congenital syndromes, such as microcephaly in babies and Guillain-Barre Syndrome in adults, has created an urgent need for animal models to examine the virus’ pathology. Better understanding the impact and long-term effects of the Zika virus infection in mice may be useful in efforts to find ways to combat it in a human population. A new mouse model developed by scientists at the U.S. Food and Drug Administration may help in exploring the potential activity of Zika virus vaccines and therapeutics. Published in PLoS Pathogens (17 November 2017), is the description of a neonatal mouse model that provides a platform for potentially improving and expediting studies to understand the causes and effects (pathology) of the Zika virus.

 

The FDA’s scientists found that neonatal mice of the C57BL/6 mouse strain are susceptible to the Zika virus and develop neurological symptoms 12 days post infection. These mice eventually recover from disease and thus the model provides an opportunity to study the virus’ long-term effects as well as an additional means for early exploration of experimental Zika virus vaccines and therapeutics. This advancement is just one of many research projects the FDA has undertaken as part of the agency’s comprehensive effort to fight the Zika virus. For example, the FDA has invested in initiatives to understand the effectiveness of technologies that reduce pathogens (such as viruses or other microorganisms that can cause disease) in blood, evaluate the impact of red blood cell storage on virus infection, expand the agency’s database of virus-infected samples essential to the development of diagnostic devices, and explore how long the Zika virus persists in body tissues, among other projects.

 

In addition to advancing research initiatives, the FDA is also working rapidly in a variety of areas to respond to the emerging Zika virus outbreak. The agency’s activities are focused on protecting the safety of our nation’s supply of blood and human cells, tissues and cellular and tissue-based products, encouraging development of diagnostic tests to help clinicians detect and diagnose Zika virus infection, and evaluating the safety and efficacy of any investigational vaccines and therapeutics that are currently in various stages of early development.

 

Pumpkin/Date Cake with Amaretto & Orange Zest Topping

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This new holiday cake recipe overflows with luscious flavors, not the least of which is the Amaretto liqueur. It’s so-o addictive, we could not stop picking at it after we had dessert, because each crumb is replete with yum! ©Joyce Hays, Target Health Inc.

 

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Delicious with or without whipped cream or vanilla ice cream. Here we’re having dessert with a dollop of cool whip. ©Joyce Hays, Target Health Inc.

 

Ingredients for Cake Layer

 

3/4 cup butter or canola oil

1 and 1/4 cup brown sugar

2 and 2/4 cups almond flour

2 teaspoons baking powder

1/2 teaspoon baking soda

Pinch salt

2 teaspoons cinnamon

1/4 teaspoon allspice

1/2 teaspoon ground nutmeg, grind your own or use store bought

1/3 cup fresh ginger, grated then chopped very fine

2 Tablespoons Amaretto liqueur

1/2 cup pecans, chopped

5 eggs

2 Tablespoons molasses

One 15-ounce can pumpkin puree

 

Date Filling Ingredients

 

4 Tablespoons unsalted butter, melted

3 eggs, beaten

1/4 cup molasses

1/4 cup, golden syrup or organic corn syrup

1/2 teaspoon cardamom

1/4 teaspoon allspice

1/4 teaspoon clove

1/4 teaspoon nutmeg

1/2 teaspoon kosher salt

1 teaspoon orange zest

2 Tablespoons Amaretto liqueur

1/2 teaspoon vanilla extract

1 cup chopped dates (press into the cup)

2 cups pecan halves or pieces (press into the cup)

 

Glaze Ingredients

 

1 and 1/4 cups confectioners sugar

2 Tablespoons Amaretto liqueur

1 Tablespoon orange zest

 

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Directions

 

1. Heat oven to 350 degrees.

2. Grease a round 9“ spring-form cake pan

3. Grate the ginger

 

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Grate the fresh ginger. Use the small or medium holes. ©Joyce Hays, Target Health Inc.

 

 

4. In a large mixing bowl, on low speed, beat together the butter (or canola oil) and brown sugar until well blended.

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Beating together the butter with the brown sugar. ©Joyce Hays, Target Health Inc.

 

 

5. Slowly, while beating, add the flour, baking powder, baking soda, salt, spices, ginger, and nuts. Mix well; the batter will be a little crumbly looking.

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Just before adding the eggs, the mixture will start to look crumbly. ©Joyce Hays, Target Health Inc.

 

 

6. Add the eggs one at a time, scraping the bottom and sides of the bowl after each addition.

7. Stir in the Amaretto, molasses and pumpkin, beating together slowly, so all ingredients are combined well.

 

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After adding the eggs, one at a time, with beaters on, add the pumpkin, molasses and Amaretto. ©Joyce Hays, Target Health Inc.

 

 

8. Pour the batter into the greased spring-form cake pan.

 

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With an electric mixer, this recipe is easy. Here, the mixture has been scraped out of the mixing bowl, with a spatula, and poured into the greased spring-form pan. ©Joyce Hays, Target Health Inc.

 

9. Bake for 30 minutes, or until cake is lightly browned on the edges and the middle springs back when touched.

 

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Into the oven. ©Joyce Hays, Target Health Inc.

 

 

10. Remove the bread from the oven and let it cool for 15 minutes before taking it out of the pan(s). Let it cool a bit, then glaze if desired.

 

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Just taken out of the oven. It has risen, but as it cools, it will fall back, making room for the date layer. ©Joyce Hays, Target Health Inc.

 

11. While the pumpkin cake is baking, make the date filling

12. Chop the dates

 

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Chop the dates. ©Joyce Hays, Target Health Inc.

 

 

13. Grate the orange zest

 

14. In a medium saucepan, whisk together melted butter, eggs, molasses, golden syrup, cardamom, allspice, clove, nutmeg, salt, orange zest, Amaretto, vanilla extract. Cook, stirring, over medium heat until mixture thickens slightly, about 5 minutes. Stir in dates.

 

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Melt the butter © Joyce Hays

 

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To the melted butter add all the other ingredients for the date layer of the pumpkin cake. Stir well ©Joyce Hays, Target Health Inc.

 

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Finally, add the chopped dates and stir well. ©Joyce Hays, Target Health Inc.

 

15. Pour the date layer, over the prebaked pumpkin cake, then sprinkle pecans over the soft date mixture. Bake for 20 to 30 minutes, or until filling is no longer jiggly and seems set.

 

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With a spatula, scrape every last bit of the date mixture, out of the frying pan and over the top of the now, cooled pumpkin cake. Then press the pecan halves into the soft date layer. ©Joyce Hays, Target Health Inc.

 

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With date layer and pecans added, cake goes into oven for the second time. ©Joyce Hays, Target Health Inc.

 

 

16    While cake is baking again, make the glaze: Whisk together all the ingredients, in a small bowl or measuring cup, adding extra liquid until the glaze is smooth and the consistency of molasses.

 

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Mix together the sugar and the Amaretto together, needed for the glaze topping. ©Joyce Hays, Target Health Inc.

 

 

17. Remove from oven and cool on a rack for 15 minutes. Run a knife around the edge of pan to loosen cake, then remove the side of the spring-form bake pan.

18. Last, with a spoon, drizzle the sugar/Amaretto topping all over the top of the pumpkin-date cake and let it set. Don’t put cake back into the oven. Let the cake sit with the topping for about 30 minutes, before serving.

 

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After cake has been removed from oven the second time, let it cool for 15 minutes, before you add the glaze. Then with a teaspoon, drizzle the glaze all over the top of the pumpkin-date cake. ©Joyce Hays, Target Health Inc.

 

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Finally, sprinkle the orange zest over the top of the cake and let it sit for another 15 minutes, before you serve it. ©Joyce Hays, Target Health Inc.

 

 

19. Serve with vanilla ice cream, cool whip, whipped cream or without anything added.

 

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We ate versions of this pumpkin/date cake all week, while I tried out different ingredients. We had it without pumpkin and the glaze; with a peanut butter topping; with a shortbread crust. Each time we sampled this recipe, for dessert, we gave the rest of cake away. It wasn’t ready to share with our special readers until this past Friday, when I added the Amaretto to the recipe. Hope you enjoy it, we loved doing it and especially the final version. ©Joyce Hays, Target Health Inc.

 

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Trying out a new Italian red. Very good, similar to a cross between a cabernet and a merlot. ©Joyce Hays, Target Health Inc.

 

 

 

From Our Table to Yours !

 

Bon Appetit!