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Cauliflower Cake with Roasted Figs & Wild Mushroom Sauce

January 19, 2021

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Target Healthy Eating

This is a delicious recipe, if I do say so myself. It could be served as a light meal by itself or presented as a beautiful veggie side dish served with fish, seafood, poultry and lamb. You can make this recipe with or without a wild mushroom sauce. It's shown above without the sauce. ©Joyce Hays, Target Health LLC
As you can see, I experimented quite a lot, until I felt it was ready for readers to try. ©Joyce Hays, Target Health LLC
Once I served the Cauliflower Cake with Wild Mushroom Sauce as the entree with a crisp garden salad. It was gone by the end of the meal. ©Joyce Hays, Target Health LLC
Here you can see how moist this cake is. ©Joyce Hays, Target Health LLC
Luscious as an appetizer. ©Joyce Hays, Target Health LLC
BTW, once when there were 2 servings left-over, we warmed up the pieces and served with eggs, bagels and coffee. Mmmmm ©Joyce Hays, Target Health LLC
Warm and wonderful, just out of the oven. ©Joyce Hays, Target Health LLC

Ingredients

1 onion, well-chopped

2 Tablespoons fresh parsley, well-chopped

1/2 cup freshly grated parmesan

2 cups almond flour

2 Tablespoons extra virgin olive oil

3 cloves garlic, ground with 3 anchovy fillets = paste

10 more fresh garlic cloves, sliced very thin

1 teaspoon turmeric

1 teaspoon curry

2 pinches chili flakes

1 pinch pepper

1 or 2 large cauliflower heads, cleaned, then broken into florets

4 eggs

1/2 teaspoon baking power

1/2 teaspoon baking soda

2 Tablespoons ricotta

6 or 7 fresh figs, run under cold water, dry with paper towel. Cut in half. Bake in a tin, next to the cauliflower cake

Bunch green grapes, wash, pat dry, drain. Pick off the stems and bake with the figs.

Easy to find ingredients. ©Joyce Hays, Target Health LLC

Directions

1.     Preheat oven to 350-370 degrees, depending on your oven.

2.     Do all chopping, slicing, grating etc. now.

3.     Boil or steam the cauliflower for 20 minutes, or until soft. Drain well, dry with paper towel and set aside.

4.     In a skillet, add extra virgin olive oil and cook the garlic/anchovy paste, onions and extra garlic. Let it cool down and set aside.

5.     Get out a medium mixing bowl and add the eggs. Beat the eggs and add the spices. Then, beat in the ricotta.

6.     Using a medium or large sieve, held over the mixing bowl, add the flour, baking powder and baking soda. Slowly sift, into the egg mixture, stirring all the time.

7.     Add the parmesan into the dough and combine well.

8.     Add contents of the skillet, into the dough and combine well.

9.     Add the cooked cauliflower into the dough and combine well.

10.  Add the chopped parsley into the dough and combine well.

11.  Butter a spring-form baking pan.

12.  With a spatula, scrape out all the dough from the mixing bowl, into the baking pan.

13.  Place pan into a 350 degree oven and bake for 45 minutes.

14.  Put the figs and green grapes into a buttered tin and bake along with the cauliflower cake. Serve as garnish with the cake.

Wash the cauliflower, then break into florets. ©Joyce Hays, Target Health LLC
Boil or steam the cauliflower florets, drain, pat dry with paper towel, set aside. ©Joyce Hays, Target Health LLC
Chop onion and extra garlic at the same time. ©Joyce Hays, Target Health LLC.
Sometimes, if I do not feel like getting out the mortar & pestle, I simply use a fork to mash the anchovy fillets with the chopped or sliced garlic, right in a skillet with olive oil. ©Joyce Hays, Target Health LLC
Grating the parmesan. ©Joyce Hays, Target Health LLC
In a large bowl, add the eggs. ©Joyce Hays, Target Health LLC
Whisk the eggs. ©Joyce Hays, Target Health LLC
Add all the spices to the beaten egg mixture, then the sour cream. ©Joyce Hays, Target Health LLC
Get out a sieve. Add the flour, the baking powder and the baking soda, to the sieve and sift into the egg mixture. Mix the flour into the egg mixture with a large fork. ©Joyce Hays, Target Health LLC
Add the parmesan to the dough and mix it together with a large fork. ©Joyce Hays, Target Health LLC
Add the contents from the skillet and stir well. ©Joyce Hays, Target Health LLC
Add the cooked cauliflower to the dough and stir to combine. ©Joyce Hays, Target Health LLC
Add the chopped parsley to the cauliflower dough and combine very well. ©Joyce Hays, Target Health LLC
Use a spring-form baking pan and butter it generously. ©Joyce Hays, Target Health LLC
Use a spatula to get all the dough out of the mixing bowl and into the baking pan. ©Joyce Hays, Target Health LLC
Spring-form pan goes into a 350 degree oven for 45 minutes. ©Joyce Hays, Target Health LLC
After baking 45 minutes, the cauliflower cake comes out looking like this. Let it cool down for 10 minutes, then run a knife around the edges, remove the sides of the pan and serve on a platter, with or without a wild mushroom sauce. The cake is soft, moist and delicious. ©Joyce Hays, Target Health LLC
Here is a piece of cauliflower cake with wild mushroom sauce and a baked fig. ©Joyce Hays, Target Health LLC

Easy Wild Mushroom Sauce

Ingredients

1 pound mixture of 4 different mushrooms (i.e.: white button, baby bella, shitake, cremini), cleaned with damp paper towel then, thinly sliced & chopped a little

1 Tablespoon butter

1 Tablespoon extra-virgin olive oil

1 teaspoon, low sodium soy sauce

1 Onion, very well-chopped

2 garlic cloves, ground with 2 anchovy fillets = paste

6 to 10 more garlic cloves, sliced.

1 Tablespoon flour (any flour you have. I used almond flour)

1 cup broth (chicken, beef, veggie - I used chicken broth. For a deeper flavor, use beef broth)

1/4 cup sour cream

1 teaspoon Worcestershire sauce

1/2 teaspoon Dijon mustard

2 pinches black pepper

2 pinches chili flakes

1/2 cup white wine or sherry or brandy (I used sherry)

3/4 cup heavy cream

Garnish: small handful fresh chives, well chopped

Directions

1.     Get all cleaning, chopping, slicing, measuring, done, so that all you need to do next, is the cooking.

2.     In a large skillet, melt the butter and add the soy sauce. Mix the two together. An interesting chemical reaction takes place and a new umami flavor is the result.

3.     Add the anchovy/garlic paste to the skillet and cook for a few minutes. You can also just add the anchovies and the sliced garlic to the skillet and mash them in the skillet. Make the paste right there in the skillet. When possible, I like to use anchovies instead of salt. Stir this paste into the butter.

4.     Add the olive oil, all the onions and garlic to the skillet. Stir and cook for a few minutes.

5.     Add all the chopped and sliced mushrooms. Stir into the mixture and continue cooking.

Chopping the mushrooms. ©Joyce Hays, Target Health LLC
Chopping onions and garlic. ©Joyce Hays, Target Health LLC
About to start mashing (with a fork), anchovy fillets with fresh chopped or sliced garlic cloves. ©Joyce Hays, Target Health LLC
Cooking together, the anchovy/garlic paste, plus chopped onions and more chopped garlic. ©Joyce Hays, Target Health LLC
Paste with onions and extra garlic has turned light brown, is soft and is done. Next, add all the chopped or sliced mushrooms and stir with the onion mixture. Next, add flour and stir in well. ©Joyce Hays, Target Health LLC
Measure out your broth and your white wine, sherry or brandy. Never use cooking wine. Always, use a wine you like to drink. Add to the skillet and stir in. Next, add Worcestershire sauce, mustard, sour cream, 2 pinches black pepper, 2 pinches chili flakes. Stir in well. ©Joyce Hays, Target Health LLC
Add the heavy cream to the mushroom mixture. Simmer for about 3 to 5 minutes, to let some of the liquid cook down. When the sauce reaches the thickness of gravy, the mushroom sauce is done. Serve over the cauliflower cake, nice and hot. ©Joyce Hays, Target Health LLC
One time, I made this recipe and served as an appetizer; it was perfect! ©Joyce Hays, Target Health LLC
Once I baked the cauliflower cake in a rectangle shaped baking pan. It looked as you see, above. ©Joyce Hays, Target Health LLC
When the Cauliflower Cake with Mushroom Sauce was served as the entree with a crisp salad, this was the appetizer - salmon tartare with avocado and a few salmon eggs as garnish. ©Joyce Hays, Target Health LLC
Here is the dessert. Simple fresh fruit and vanilla yogurt. ©Joyce Hays, Target Health LLC
Nicely chilled Pinot Grigio went well with each course. ©Joyce Hays, Target Health LLC

You can carry on, the torch of peace and brotherhood and simply live by the Golden Rule!

Bon Appetit!

From   Our Table to Yours

Have a Great Week Everyone!

Developing New Drugs in the Age of Individualized Medicine

January 19, 2021

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Regulatory

The following is based on an FDA press release.

Advances in scientific knowledge and drug development technology have provided an opportunity for new approaches to drug development, which have contributed to an increase in development and approval of drugs for the treatment of rare/orphan diseases. In the past eight years, the FDA has approved more than twice as many drugs for rare/orphan diseases as in the previous eight years. For genetic diseases, recent approaches to testing and molecular diagnosis have allowed the pinpointing, in some cases, to the exact cause of a patient's disease. Thus, for a patient with a very rare genetic disease, development of a drug product that is tailored to that patient's specific genetic variant may be possible.

Developing these products - also referred to as “n of 1“ therapies by some because they are designed for a patient population of one person - brings a set of challenges and considerations not seen with the typical drug development process. First, the disease is often rapidly progressing, requiring prompt medical intervention. Therefore, development needs to proceed very quickly to have a chance at helping the individual. Second, drug discovery and development for these drug products may be carried out by academic investigators, rather than by biopharmaceutical or pharmaceutical companies. These investigators may be less familiar with FDA's regulations, policies and practices, and less experienced in interacting with the FDA.

At this time, development of individualized genetic drug products is most advanced for antisense oligonucleotide (ASO) products. Therefore, the FDA has taken the first steps in bringing clarity to this emerging area of individualized drug development by releasing a new draft guidance on investigational new drug (IND) submissions for individualized ASO drug products. The guidance was developed to advise those developing ASO products on an approach to interacting with, and making regulatory submissions to, the FDA. The guidance addresses the following points:

  1. The approach to obtaining feedback from the FDA,
  2. The expectations and process for making regulatory submissions to the FDA,
  3. Recommendations about the requirement for Institutional Review Board (IRB) review of the protocols within, and
  4. How to obtain informed consent.

As also discussed in a New England Journal of Medicine editorial in October 2019, FDA is fully aware that this new drug-discovery paradigm raises many ethical and societal issues that will need to be addressed throughout the process. For example, in these situations, the individuals and their families often function more like drug development collaborators than traditional trial participants. Therefore, it is important to discuss with the individual and family members how effectiveness will be measured. It is also important to ensure that the individual and family members understand the parameters for continuing administration of the investigational drug product before emotions influence decisions, and to recognize that some investigational drug products may fail, or worse, lead to unforeseen side effects.

The FDA understands that it will need to work together with the developers of these drug products to bring them safely to patients, and we are willing to engage as needed to address the challenges. For example, for those developing these drug products, it will be important to further understand the required data and information that must be submitted to the FDA so that clinical testing can begin. The FDA is continuing to consider and further develop policy to address some of these issues.

FDA stated that they are optimistic that development of these individualized drug products may spur gene sequencing that leads to the development of additional individualized drug products for the same disease. For this approach to drug development, all of those involved need to determine, collectively, how to effectively bring these drug products to all who need them. If there is the scientific ability to develop drug products for these rare/orphan diseases, there is a need to find ways to bring them to patients while ensuring there is the right balance of risk to benefit. This draft guidance provides clarity on the early development and IND submission process, is the FDA's first step in working with those who are developing these individualized drug products.

Source: FDA

ALS and FTD Linked to a Mutation Associated with Huntington's Disease

January 19, 2021

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Neurology

Several neurological disorders have been linked to “repeat expansions,“ a type of mutation that results in abnormal repetition of certain DNA building blocks. For example, Huntington's disease occurs when a sequence of three DNA building blocks that make up the gene for a protein called huntingtin repeats many more times than normal. These repeats can be used to predict whether someone will develop the illness and even when their symptoms are likely to appear, because the more repeats in the gene, the earlier the onset of disease. On 4 December 2020, the NIH released results of a study that has made a surprising connection between frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS), which opens a potentially new avenue for diagnosing and treating some individuals with FTD or ALS.

For the study, the authors, taking advantage of technology available at the NIH, screened the entire genomes from large cohorts of FTD/ALS patients and compared them to those of age-matched healthy individuals. While several patients had a well-established genetic marker for FTD/ALS, a small subset surprisingly had the same huntingtin mutation normally associated with Huntington's disease. Remarkably, these individuals did not show the classical symptoms of Huntington's but rather those of ALS or FTD. According to the authors, none of these patients' symptoms would have clued their physicians into thinking that the underlying genetic cause was related to the repeat expansion seen in Huntington's disease. The authors stated that whole genome sequencing is changing how neurological patients can be diagnosed, and that traditionally this has been based on which disease best fit the overall symptoms with treatment aimed at managing those symptoms as best as possible. The authors added that clinicians can now generate genetically defined diagnoses for individual patients, and these do not always align with established symptom-based neurological conditions.

One implication of these findings is that, if successful, these therapies could be applied to the small subset of FTD and ALS patients with that mutation as well. The authors noted that, while the number of FTD/ALS patients seen with the Huntington's-linked mutation is small (roughly 0.12-0.14%), adding genetic screening for the mutation to the standard diagnostic procedure for patients showing symptoms of FTD or ALS should be considered.

Source: NIH

Blood Vessel Damage and Inflammation in Brains of COVID-19 Patients with No Infection

January 19, 2021

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Pandemic

Although COVID-19 is primarily a respiratory disease, patients often experience neurological problems including headaches, delirium, cognitive dysfunction, dizziness, fatigue, and loss of the sense of smell. The disease may also cause patients to suffer strokes and other neuropathologies.

According to an article published in the New England Journal of Medicine (30 December 2020), an in-depth study shows how COVID-19 affects a patient's brain was performed. For the study, the authors consistently spotted hallmarks of damage caused by thinning and leaky brain blood vessels in tissue samples from patients who died shortly after contracting the disease. In addition, they saw no signs of SARS-CoV-2 in the tissue samples, suggesting the damage was not caused by a direct viral attack on the brain. Several studies have shown that the disease can cause inflammation and blood vessel damage. In one of these studies, evidence was found of small amounts of SARS-CoV-2 in some patients' brains.

In the present study, the authors conducted an in-depth examination of brain tissue samples from 19 patients who had died after experiencing COVID-19 between March and July 2020. Samples from 16 of the patients were provided by the Office of the Chief Medical Examiner in New York City while the other 3 cases were provided by the department of pathology at the University of Iowa College of Medicine, Iowa City. The patients died at a wide range of ages, from 5 to 73 years old and died within a few hours to two months after reporting symptoms. Many patients had one or more risk factors, including diabetes, obesity, and cardiovascular disease. Eight of the patients were found dead at home or in public settings. Another three patients collapsed and died suddenly.

Initially, the authors used a special, high-powered magnetic resonance imaging (MRI) scanner that is 4 to 10 times more sensitive than most MRI scanners, to examine samples of the olfactory bulbs and brainstems from each patient. These regions are thought to be highly susceptible to COVID-19. Olfactory bulbs control our sense of smell while the brainstem controls our breathing and heart rate. The scans revealed that both regions had an abundance of bright spots, called hyperintensities, that often indicate inflammation, and dark spots, called hypointensities, that represent bleeding.

When the authors then used the scans as a guide to examine the spots more closely under a microscope, they found that the bright spots contained blood vessels that were thinner than normal and sometimes leaking blood proteins, like fibrinogen, into the brain. This appeared to trigger an immune reaction. The spots were surrounded by T cells from the blood and the brain's own immune cells called microglia. In contrast, the dark spots contained both clotted and leaky blood vessels but no immune response. The authors were completely surprised as they originally expected to see damage that is caused by a lack of oxygen. Instead, they saw multifocal areas of damage that is usually associated with strokes and neuroinflammatory diseases. Finally, the authors saw no signs of infection in the brain tissue samples even though they used several methods for detecting genetic material or proteins from SARS-CoV-2.

Source: NIH

Dr. Rick A. Bright

January 19, 2021

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History of Medicine

Former BARDA Director, Dr. Rick A. Bright HHS.gov Public Domain  

Rick Arthur Bright is an American immunologist, vaccine researcher, public health official, and whistleblower. He was the director of the Biomedical Advanced Research and Development Authority (BARDA) from 2016 to 2020. In May 2020, he filed a whistleblower complaint, alleging that the Trump administration ignored his early warnings about the COVID-19 pandemic and illegally retaliated against him by ousting him from his role, and demoting him to a position at the National Institutes of Health. On October 6, 2020, Bright resigned from the government, and on November 9 he was named a member of President-elect Joe Biden's coronavirus advisory board.

Bright was born and raised in Hutchinson, Kansas. Following two years at the University of Kansas, he received a Bachelor of Science degree with a double major in biology (medical technology) and physical science (chemistry) from Auburn University-Montgomery. In 2002, Bright earned a Ph.D. in immunology and molecular pathogenesis (virology) from the Division of Biological and Biomedical Sciences at Emory University School of Medicine. His dissertation was titled Studies on pathogenicity and control of H5N1 influenza A viruses in mice. Bright completed the Advanced Course in Vaccinology (ADVAC) from the Fondation M?rieux and University of Geneva in Annecy, France.

From 1990 to 1992, Bright worked as a product manager in the Research & Development Department of Osborn Laboratories in Olathe, Kansas. From 1994 to 1995, he was a research assistant in the Flow Cytometry Department of the Alabama Reference Lab in Montgomery, Alabama. From 1997 to 2000, Bright worked at the Emory University Department of Microbiology and Immunology and in the Vaccine Research Center at the Yerkes National Primate Research Center in Atlanta, Georgia. From 1998 to 2002, Bright worked at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, in the Influenza Branch, Immunology and Viral Pathogenesis Section, where he studied Influenza A virus subtype H5N1. From 2002 to 2003, Bright shifted to working at the pharmaceutical company, Altea Therapeutics (a subsidiary of Nitto Denko) in Atlanta, Georgia, where he was a senior research scientist in their Vaccine and Immunology Programs.

In 2003, Bright rejoined the CDC as an immunologist/virologist in their Disease Control and Prevention, Influenza Division, Strain Surveillance Branch in Atlanta, Georgia, where he worked on their influenza antiviral drug program and focused on avian influenza. He held that position until 2006.

From 2006 to 2008, Bright returned to working in the private sector of the biotechnology industry at Novavax in Maryland, where he was vice president of their global influenza programs as well as of their vaccine research and development. For his work there, he was an adviser to the WHO and the U.S. Department of Defense (DOD) and became the recipient of the prestigious Charles C. Shepard Science Award for Scientific Excellence, jointly awarded by the CDC and the WHO. During that time, he also participated in World Health Organization (WHO) committees on vaccine development and pandemic preparedness. In February 2008, Bright worked at the non-profit PATH on a Bill & Melinda Gates Foundation grant funded project as the director in vaccine manufacturing capacity building in Viet Nam. He was also the scientific director of the influenza vaccine project as well as the global vaccine development program, a position he held until October 2010.

In 2010, Bright joined the U.S. Department of Health and Human Services (HHS) governmental agency Biomedical Advanced Research and Development Authority (BARDA). He was the program lead of BARDA International Programs, then in June 2011 became acting chief of the influenza antiviral drug advanced development program, a position he held until December 2011. From June 2011 to December 2015, he was both deputy director and acting director of BARDA's Influenza and Emerging Diseases Division, eventually serving as director of the division from December 2014 to November 2016. From February 2016 to November 2016, he was an incident commander in the ASPR/BARDA Zika Response.

On November 15, 2016, President Obama appointed Bright to the position of director of BARDA. Bright succeeded founding director Robin Robinson. In addition to his role as director of BARDA, Bright was also deputy assistant secretary for Preparedness and Response in the Office of the Assistant Secretary for Preparedness and Response (ASPR). On April 20, 2020, in the midst of the COVID-19 pandemic in the United States, Bright was reassigned to the National Institutes of Health.

In written testimony at a May 14, 2020 hearing before the House Energy and Commerce Committee's Health Subcommittee (issued the previous day), Bright warned that “the darkest winter in modern history“ could come in 2020 if the country failed to undertake a vigorous response to fight the virus: “Our window of opportunity is closing. If we fail to develop a national coordinated response, based in science, I fear the pandemic will get far worse and be prolonged, causing unprecedented illness and fatalities.“ Bright told the subcommittee that “Lives were endangered, and I believe lives were lost“ as a result of the administration's failure to heed his earlier warnings.

On October 6, 2020, Bright resigned from the government. In an addendum to his whistleblower complaint, Bright stated that, following his demotion, he had been given “no meaningful work“ since September 4; that NIH officials had rejected his proposals for a national COVID-19 testing strategy “because of political considerations“; and that officials had ignored his request that he join the $10 billion Operation Warp Speed initiative to develop a COVID-19 vaccination

On November 9, 2020 President-elect Joe Biden named Bright to be one of the 13 members of his coronavirus task force.

The Germ Theory of Disease, Focusing on Viruses

January 19, 2021

,
Quiz

Scanning electron microscope image of Vibrio cholerae. This is the bacterium that causes cholera.   Electron Photo credit: Copyrighted free use https://commons.wikimedia.org/w/index.php?curid=197609“

The 1) _____ theory of disease is the currently accepted scientific theory for many diseases. It states that microorganisms known as pathogens or “germs“ can lead to disease. “Germ“ may refer to not just a bacterium but to any type of microorganism or even non-living pathogens that can cause disease, such as protists, fungi, viruses, prions, or viroids. Basic forms of germ theory were proposed in the late Middle Ages by physicians including Ibn Sina in 1025, Ibn Khatima and Ibn al-Khatib in the 14th century, Girolamo Fracastoro in 1546, and expanded upon by Marcus von Plenciz in 1762. However, such views were held in disdain in Europe, where Galen's (129 CE) miasma theory remained dominant among scientists and doctors.

Editor's note: In 1830, French novelist Honore de Balzac used "idee fixe" in Gobseck to describe an obsessive idea. By 1836, Balzac's more generalized use of the term had carried over into English, where "idee fixe" was embraced as a clinical and literary term for a persistent preoccupation or delusional idea that dominates a person's mind. Nowadays "idee fixe" is also applied to milder and more pedestrian obsessions. However, readers, consider the amount of time passed, from the pronouncements of Galen, famous prescient physician of the Roman Empire, in 129 CE, to the middle of the nineteenth century and the research of Pasteur, in 1850 - approximately 1,720 years - you could say a cultural "idee fixe," of monumental proportions. Did you ever wonder why it takes humans so long to relinquish old invalid ideas, in favor of newer more cogent ones?

By the early nineteenth century, 2) _____ vaccination was commonplace in Europe, though doctors were unaware of how it worked or how to extend the principle to other diseases. A transitional period began in the late 1850s with the work of Louis Pasteur. This work was later extended by Robert Koch in the 1880s. By the end of that decade, the miasma theory was struggling to compete with the germ theory of disease. Viruses were initially discovered in the 1890s, and eventually, a "golden era" of bacteriology ensued, during which the germ theory quickly led to the identification of the actual organisms that cause many diseases.

The word virus is from the Latin neuter virus referring to poison and other noxious liquids, from the same Indo-European base as Sanskrit visa, Avestan visa, first attested in English in 1398 in John Trevisa's translation of Bartholomeus Anglicus' De Proprietatibus Rerum. Virulent, from Latin virulentus (poisonous), dates to c. 1400. A meaning of "agent that causes infectious disease" is first recorded in 1728, long before the discovery of viruses by Dmitri Ivanovsky in 1892.

Viruses are by far the most abundant biological entities on Earth and they outnumber all the others put together. They infect all types of cellular life including animals, plants, bacteria and fungi. Different types of viruses can infect only a limited range of hosts and many are species-specific. Some, such as smallpox virus for example, can infect only one species, in this case humans. Other viruses, such as rabies virus, can infect different species of mammals and are said to have a broad range. The viruses that infect plants are harmless to animals, and most viruses that infect other animals are harmless to humans. The host range of some bacteriophages is limited to a single strain of bacteria and they can be used to trace the source of outbreaks of infections by a method called phage typing. Examples of common human diseases caused by viruses include the common 3) _____, influenza, chickenpox, and cold sores. Many serious diseases such as rabies, Ebola virus disease, AIDS (HIV), avian influenza, and SARS are caused by viruses.

When infected, a host cell is forced to rapidly produce thousands of identical copies of the original virus. When not inside an infected cell or in the process of infecting a cell, viruses exist in the form of independent particles, or 4) _____, consisting of: (i) the genetic material, i.e., long molecules of DNA or RNA that encode the structure of the proteins by which the virus acts; (ii) a protein coat, the capsid, which surrounds and protects the genetic material; and in some cases (iii) an outside envelope of lipids. The shapes of these virus particles range from simple helical and icosahedral forms to more complex structures.

The origins of viruses in the evolutionary history of life are unclear: some may have evolved from plasmids, pieces of DNA that can move between cells, while others may have evolved from bacteria. Viruses are considered by some biologists to be a life form, because they carry genetic material, reproduce, and evolve through natural selection, although they lack the key characteristics, such as cell structure, that are generally considered necessary criteria for life. Because they possess some but not all such qualities, viruses have been described as "organisms at the edge of life", and as self-5) _____.

Viruses spread in many ways. One transmission pathway is through disease-bearing organisms known as vectors: for example, viruses are often transmitted from plant to plant by insects that feed on plant sap, such as aphids; and viruses in animals can be carried by blood-sucking insects. Influenza viruses are spread by coughing and sneezing. Norovirus and rotavirus, common causes of viral gastroenteritis, are transmitted by the fecal-oral route, passed by hand-to-mouth contact or in food or water.

One of three main hypotheses that aim to explain the origins of viruses is the 6) _____ hypotheses. Viruses may have once been small cells that parasitized larger cells. Over time, genes not required by their parasitism were lost. The bacteria rickettsia and chlamydia are living cells that, like viruses, can reproduce only inside host cells. They lend support to this hypothesis, as their dependence on parasitism is likely to have caused the loss of genes that enabled them to survive outside a cell.

A virus has either a DNA or an RNA genome and is called a DNA virus or an RNA virus, respectively. The vast majority of viruses have 7) _____. Plant viruses tend to have single-stranded RNA genomes and bacteriophages tend to have double-stranded DNA genomes.

Viral populations do not grow through cell division, because they are acellular. Instead, they use the machinery and metabolism of a host cell to produce multiple copies of themselves, and they assemble in the cell. When infected, the host cell is forced to rapidly produce thousands of identical copies of the original virus.

Their life cycle differs greatly between species, but there are six basic stages in their life cycle.

Viral 8) _____ is the branch of medical science that deals with the transmission and control of virus infections in humans. Transmission of viruses can be vertical, which means from mother to child, or horizontal, which means from person to person. Examples of vertical transmission include hepatitis B virus and HIV, where the baby is born already infected with the virus.[159] Another, more rare, example is the varicella zoster virus, which, although causing relatively mild infections in children and adults, can be fatal to the fetus and newborn baby

The new virus, "Severe acute respiratory syndrome coronavirus 2" 9) _____, a member of the subfamily Coronavirinae, is the cause of the present pandemic 10) _____.

ANSWERS: 1) germ; 2) smallpox; 3) cold; 4) virions; 5) replicators; 6) reduction; 7) genomes; 8) epidemiology; 9) SARS-CoV-2; 10) COVID-19

To a "Better Year" to Our Friends and Colleagues World-Wide

January 19, 2021

,
What's New

2020 was not an easy time globally as COVID-19 walloped the world and continues to impact all of us with weekly reports of new variants. The death toll has left a deep impression on every family on the planet. We all know those who have died, gotten sick and still remain so. Now is the time for serious science and data to be allowed to lead. Because one is convinced that the earth is flat, does not make it true. Nor is it to an option for any decision-making. Many of us have been home-bound since March 2020, with no travel and no face-to-face interactions. Fortunately, TEAMS, ZOOM and SKYPE, to mention a few technology solutions came to the rescue. The pharmaceutical industry has also come to the rescue with safe and effective vaccines and therapeutics reaching the market in record times.

Target Health's staff are dedicated to all aspects of Drug, Biologics, Device and Diagnostic Development, including: Strategic Planning, Regulatory Affairs, Toxicology, Clinical Research, Biostatistics, Data Management and Medical Writing. In addition, Target Health has developed innovative web-based software tools supporting the paperless clinical trial that provides our clients with a significant productivity edge. For more information about Target Health, contact Kathleen Kane Tremmel, Vice President, Business Development. For those who have been working with Warren Pearlson, Director, New Business Development, please continue to do so. Also visit the Target Healthy Eating Website, created by Joyce Hays, founder of Target Health, to see all of the fantastic recipes since 2012.

Joyce Hays, Founder and Editor in Chief of On Target

Dr. Jules T. Mitchel, Editor

TARGET HEALTH NEWS - HAPPY HOLIDAYS

December 24, 2020

,
What's New

To our friends and colleagues, a Happy and Safe New Year.

This is our Holiday Card from 2003, designed by Joyce Hays, the Founder of Target Health and now, VP of Operation and Administration. The only change to date is that we are now Target Health, LLC, a dMed Company.

Target Health's staff are dedicated to all aspects of Drug, Biologics, Device and Diagnostic Development, including: Strategic Planning, Regulatory Affairs, Toxicology, Clinical Research, Biostatistics, Data Management and Medical Writing. In addition, Target Health has developed innovative web-based software tools supporting the paperless clinical trial that provides our clients with a significant productivity edge. For more information about Target Health, contact Kathleen Kane Tremmel, Vice President, Business Development. For those who have been working with Warren Pearlson, Director, New Business Development, please continue to do so. For additional information about software tools for paperless clinical trials, please also feel free to contact Dr. Jules T. Mitchel. The Target Health software tools are designed to partner with both CROs and Sponsors. Also visit the Target Healthy Eating Website to see all of the fantastic recipes, created by Joyce Hays, since 2012.

Joyce Hays, Founder and Editor in Chief of On Target

Dr. Jules T. Mitchel, Editor


A Gift From Adam Harris, Employee Extraordinaire, and His Son Jordan

November 24, 2020

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Happy Holidays

Adam Harris (Tenor) and His Son Jordan (Violinist), Performing at Christ Church, NYC

Hang on, Dear Colleagues and Friends, Hope is just up ahead, with vaccines and antivirals, as we enter the New Year 2021.  All of us who are working full-time (remotely) are thankful for all that we have.  Consider spreading your good fortune with those around you, even if it's one simple act of kindness.

Let's make this New Year far happier than the one we leave behind!

Turkey (left-overs) Salad with Apples, Grapes, Walnuts & Blue Cheese

November 23, 2020

,
Target Healthy Eating

Beautiful healthy ingredients, before dressing is added. ©Joyce Hays, Target Health LLC
Beyond delicious! ©Joyce Hays, Target Health LLC
This is one of my best recipes for left-over turkey, after Thanksgiving. However, it's so delicious, that if you wanted to make a meal out of it during the rest of the year, the most simple way, is to buy a whole rotisserie chicken and cut up the whole chicken to be used in place of left-over turkey. ©Joyce Hays, Target Health LLC
Every ingredient in my recipe is a must. The fresh apples and two kinds of grapes add sweetness and texture, whereas the lemon zest adds a sour but bright note. Slice the apples with a mandolin, for lovely thin slices trimmed in red. Be sure to leave the red skin on. ©Joyce Hays, Target Health LLC
Make a lot of this salad. The flavors are so yummy, people will snack on it if there's any left in the fridge. BTW, I grew up on Hellmann's mayonnaise, however, later I discovered Kraft. For me, Kraft mayonnaise has more flavor, so that's what I recommend for my turkey salad. ©Joyce Hays, Target Health LLC
Although the candied walnuts or candied pecans, may seem frivolous, they are only frivolous if you eat them plain. When chopped and added to my salad, you will see, they add a sweetness and crunch, that's different from the fresh fruit. Trader Joe sells candied walnuts, so does Amazon. If you can't find any, try making your own and Google for a recipe. Use a recipe that calls for brown sugar and not white. ©Joyce Hays, Target Health LLC
Of course, there will be no guests this Thanksgiving or in the following days. But in the past, when we did fill our table with guests during and after T-day, I would serve this turkey-apple salad as an appetizer a day or two after. Guests loved it so much, they requested that we eat it for the whole meal. I learned to make a large amount, to accommodate. ©Joyce Hays, Target Health LLC
Hopefully, dear readers, you'll try my recipe. Family and friends will eat it morning, noon and night and ask you for your recipe. ©Joyce Hays, Target Health LLC

Ingredients

2 Cooked left-over turkey breasts, cut into bite-size cubes

4 fresh Garlic cloves, ground with 4 anchovy fillets = paste

2 longest celery stalks from heart of celery, mince celery to teeny tiny pieces

1 teaspoon curry powder

Zest of one lemon

Pinch black pepper (or to your taste)

2 Pinches chili flakes

2 scallions, chopped up to half the white part

2 Fuji apples sliced very thin, then cut in half, (leave red skin on) (slice with mandolin). Substitute with your favorite (or what's available) apples

1 endive, leaves separated, cut lengthwise, or cut your way.

1 cup Red seedless grapes cut in half

1 cup green seedless grapes, cut in half

1 cup (or more to your taste) chopped (candied) walnuts

2 cups Blue cheese dressing (see below)

Easily obtained ingredients. Candied walnuts or pecans can be found at Trader Joe's or Amazon. It's easy to make you own. Ask Google for a recipe and pick one that uses brown sugar, not white. ©Joyce Hays, Target Health LLC

Easy Directions

  1. Prepare all of the ingredients and put into a large salad serving bowl.
  2. Next, prepare the dressing and put into a food processor. Pulse, until you get a well combined creamy dressing.
  3. Pour the dressing over the contents of the salad bowl and toss until dressing is well combined with the salad ingredients.
  4. Garnish with extra chopped candied nuts and/or well chopped chives
  5. Serve with your favorite chilled white wine.

Enjoy!

If I serve this turkey & fruit salad as the entr?e for guests, after Thanksgiving dinner, I like to keep the amount of work and time, down to a minimum. We start dinner with chilled white wine in a cozy corner near our koi tank, and a family favorite, warm French baguettes with European butter. My sister brings the baguettes and we warm them up, if not already warm. We love this part of the meal so much, we could easily stop here and make warm French bread or baguettes and butter with wine, the whole meal. I often serve shrimp with cocktail sauce, as well. When we move to the dining table, with our wine glasses, waiting on each small plate is a simple appetizer like salmon terrine or pate with more bread and butter. I either buy or make a very easy salmon pate, (made in advance). Then the ever popular turkey & fruit salad (more bread and butter) and more wine. For dessert, on a separate table, I get out all left-over desserts, like pecan and pumpkin pie, ice cream, etc. and let guests help themselves to dessert and coffee.

Chopping scallions. ©Joyce Hays, Target Health LLC
Chopping celery. The pieces above are still way too big. They will be chopped down to one quarter or less, the size of what you see above. ©Joyce Hays, Target Health LLC
Keep the beautiful red skins on and slice (paper-thin) the apples, using a mandolin. ©Joyce Hays, Target Health LLC
Chop the left-over turkey into bite-size pieces. ©Joyce Hays, Target Health LLC
Chop the candied walnuts (or candied pecans), save some for garnish, and put the rest into the salad bowl before adding the dressing. ©Joyce Hays, Target Health LLC
Once all ingredients are in your serving salad bowl, add the dressing and toss. ©Joyce Hays, Target Health LLC

Blue Cheese Dressing

1/4 cup Kraft mayonnaise

1/4 cup almond milk

1/4 cup sour cream

1/3 cup blue cheese

1 teaspoon ground curry

1 pinch black pepper

1 pinch chili flakes

4 garlic cloves

Garnish: minced chives

Directions

Add all ingredients to food processor and pulse until you get a smooth creamy dressing. Pour over salad and toss. Sprinkle just a few minced chives on top of tossed salad, with a few chopped nuts.

In retrospect, this measuring of Kraft mayonnaise, is a waste of time. Simply, add the mayo amount you want to use, to your food processor directly, and that's it. ©Joyce Hays, Target Health LLC
Here's my food processor. I'm simply adding all the ingredients for the dressing into my food processor. BTW, I added the garlic cloves and anchovy fillets, first and ground them in food processor, before adding other ingredients. Add everything, then pulse, until you get the creamy dressing consistency, you want. ©Joyce Hays, Target Health LLC
Needs just a little more dressing. ©Joyce Hays, Target Health LLC
We wish all of our over 7,000 loyal readers around the world, a Happy Thanksgiving (in the U.S.) and a safe weekend, wherever you are. If you would care to share a special pandemic experience you've had, please email it to me at: jhaysmitchel@targethealth.com and I will post it in our next ON TARGET newsletter. It helps to know what others are going through, and that you are NOT alone during this awful stressful part of our lives.


Imagine (by John Lennon)

What the World Needs Now

You can carry on, the torch of peace and brotherhood and simply live by the Golden Rule!

Bon Appetit!

From   Our Table to Yours

Have a Great Week Everyone!

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