The Dual Benefits of Golf: Physical Fitness and Mental Well-being 

Published on: 07-06-2024


Golf is often celebrated as a leisurely pastime, but its benefits extend far beyond casual enjoyment. This sport, which individuals of all ages can enjoy, offers a unique combination of physical exercise and mental relaxation. Understanding the multifaceted advantages of golf can inspire more people to take up this rewarding activity.


Enhancing Physical Health Through Golf


Cardiovascular Exercise

Engaging in golf can significantly benefit cardiovascular health. An average round of 18 holes involves walking approximately five to seven miles, which constitutes a substantial amount of aerobic exercise. This walking, coupled with the intermittent bursts of energy required to swing the club, increases heart rate, promotes blood circulation, and helps maintain a healthy cardiovascular system. Regular participation in golf can thus reduce the risk of heart disease, hypertension, and stroke.


Calorie Burning and Weight Management

Golf is an effective way to burn calories and manage weight. Depending on factors like the golfer's weight, the terrain of the course, and whether they carry their clubs or use a cart, a round of golf can burn between 500 to 1,000 calories. This consistent physical activity aids in weight control and reduces the risk of obesity-related conditions such as type 2 diabetes.


Muscle Strength and Endurance

The golf swing is a complex movement that engages multiple muscle groups. It requires strength and coordination from the core, back, legs, and arms. Repeating this motion helps tone and strengthen these muscles, improving muscular endurance and overall strength. Additionally, walking the course, especially on hilly terrain, enhances leg muscle strength and stamina.


Flexibility and Mobility

Flexibility is a key component of a successful golf game. The rotational movements in swinging the club enhance flexibility in the torso, hips, and shoulders. Regular practice can improve the range of motion in these areas, contributing to better posture and reduced risk of injuries. Maintaining flexibility and mobility is crucial for overall physical health, particularly as one age.


Coordination and Balance

Golf also improves coordination and balance. The precision required to execute a perfect swing involves fine motor control and stability. By continuously working on these aspects, golfers can enhance their coordination and balance, essential skills both on and off the course.


The Mental Health Benefits of Golf


Stress Relief

Golf is renowned for its stress-relieving properties. Spending time outdoors in the tranquil environment of a golf course can significantly reduce stress levels. The combination of physical activity, fresh air, and the soothing green landscape creates a peaceful atmosphere that allows players to unwind and disconnect from daily pressures. This relaxation helps lower cortisol levels, the body's primary stress hormone.


Cognitive Engagement and Mental Sharpness

Golf is a strategy game that requires mental acuity. Before each shot, players must assess various factors such as wind speed, distance, and terrain. This cognitive engagement enhances problem-solving skills, decision-making abilities, and mental focus. Regularly playing golf can keep the mind sharp and may even delay cognitive decline associated with aging.


Social Interaction and Community

One of the most enjoyable aspects of golf is the opportunity for social interaction. Whether playing with friends or family or meeting new people at the club, golf fosters a sense of community. Social engagement is vital for mental health, providing emotional support, reducing feelings of loneliness, and enhancing overall well-being. The shared experiences and camaraderie on the golf course can lead to lasting friendships and a supportive social network.


Connection with Nature

Golf courses are typically located in beautiful, natural settings. This connection with nature can have profound mental health benefits. Studies have shown that spending time in green spaces can reduce anxiety and depression and improve mood. The serene golf course environment offers a perfect backdrop for mindfulness and relaxation, allowing players to enjoy the therapeutic effects of nature.


Boosting Self-Esteem and Confidence

Golf provides numerous opportunities for personal achievement. Whether mastering a new technique, achieving a lower handicap, or winning a friendly competition, these accomplishments boost self-esteem and confidence. The sense of achievement and progress in golf can enhance overall self-worth and contribute to a positive outlook on life.


Tips for Integrating Golf into Your Lifestyle


To fully reap the benefits of golf, consider the following tips:


Golf is a multifaceted sport with numerous physical and mental health benefits. By incorporating golf into your routine, you can enjoy the holistic advantages of this enjoyable activity. Whether seeking a new way to stay fit, reduce stress, or connect with others, golf provides a fulfilling and enriching experience. So, grab your clubs and head to the course to start experiencing the myriad benefits of golf.

Navigating New Horizons: The Evolution of Sarcoma and GI Cancer Treatments 


6/24/2024


In the intricate dance of oncology, where every step and turn can determine the rhythm of a patient's journey, the fields of sarcoma and gastrointestinal (GI) cancers are witnessing a transformative era. This exploration delves into the groundbreaking strides being made in the treatment of these formidable foes, unveiling a landscape where science meets imagination and where new therapies bring hope and rejuvenation to those touched by these challenging diseases.

The Symphony of Precision Medicine

Imagine an orchestra where every instrument plays a pivotal role in creating a harmonious melody. In the realm of cancer treatment, precision medicine conducts a similar symphony, orchestrating a tailored approach that considers the unique genetic makeup of each tumor. For GI cancers, this means dissecting the molecular intricacies to discover specific mutations, like those found in the KRAS or BRAF genes, which can be targeted by novel therapies to disrupt cancer’s crescendo.

Sarcomas, with their myriad of subtypes, are akin to a complex musical composition requiring a nuanced understanding for effective intervention. Advances in genomic profiling have equipped oncologists with the tools to compose personalized treatment scores, targeting molecular aberrations specific to each sarcoma variant, leading to more effective and less invasive treatment modalities.

The Vanguard of Immunotherapy

Venture into the realm of immunotherapy, a frontier where the body's own defenses are tuned to recognize and combat cancer cells. This innovative approach has introduced a new chapter in the saga of cancer care, particularly for sarcoma and GI cancers. Immune checkpoint inhibitors, for example, act as liberators, unlocking the immune system’s natural ability to detect and destroy cancer cells, transforming it into a formidable ally in the battle against the disease.

Innovations in Radiation's Artistry

Radiation therapy, a long-standing pillar in cancer treatment, has undergone a renaissance with the advent of precision-guided technologies. Imagine a sculptor meticulously chiseling away at marble to reveal a masterpiece. Similarly, advanced techniques such as proton beam therapy and IMRT (intensity-modulated radiation therapy) allow oncologists to sculpt radiation beams with pinpoint accuracy, minimizing collateral damage to surrounding tissues and enhancing the therapeutic assault on tumors.

Surgical Renaissance

In the surgical theater, innovations have ushered in a new era of minimally invasive and robotic-assisted surgeries, marking a departure from the more invasive approaches of the past. These advanced techniques represent the fine brushstrokes of a painter, offering enhanced precision in removing tumors while preserving vital structures and functions, particularly crucial in the delicate landscapes of GI and sarcoma surgeries.

The convergence of multidisciplinary care

Treating sarcoma and GI cancers is akin to assembling a team of master craftsmen, each expert in their respective fields, collaborating towards a common goal. This multidisciplinary approach harnesses the collective expertise of surgeons, oncologists, radiologists, and supportive care specialists to forge individualized treatment plans that cater to the holistic needs of each patient.

Tomorrow's Canvas

Looking to the horizon, the journey of sarcoma and GI cancer treatments is propelled by continuous innovation. The promise of gene therapy, advanced immunotherapies, and the untapped potential of artificial intelligence in designing treatment protocols paint a future rich with possibility. Clinical trials and research endeavors act as the brushstrokes on tomorrow’s canvas, each one contributing to a more vibrant and hopeful picture for patients worldwide.

The treatment of sarcoma and GI cancers stands at a thrilling crossroads, marked by an era of unprecedented advances. As medical science pushes the boundaries of what is possible, the narrative of these diseases is being rewritten, offering patients not just a fighting chance but a pathway to recovery and resilience. In this evolving story, every breakthrough serves as a beacon of hope, guiding us towards a future where cancer’s shadow is eclipsed by the light of innovation and healing.

A Deep Dive into the Realm of Surgical Oncology: Exploring Innovations, Challenges, and Human Resilience

Published on: 06/13/2024

Surgical oncology stands at the forefront of the battle against cancer, embodying the relentless pursuit of healing and the convergence of cutting-edge science with compassionate care. As we embark on a journey into this multifaceted realm, we delve into the intricate web of challenges, triumphs, and the unwavering commitment of surgical oncologists to navigate the complexities of cancer treatment.

Unraveling Complexity: Understanding the Landscape of Surgical Oncology

Surgical oncology represents a specialized discipline within the broader field of oncology, focusing on the surgical management of cancer. It encompasses a diverse array of procedures, ranging from tumor resections to complex reconstructive surgeries, all aimed at eradicating cancerous tissue while preserving critical organs and functions. Central to the practice of surgical oncology is the principle of precision – the ability to target tumors with utmost accuracy, guided by advances in diagnostic imaging, molecular profiling, and intraoperative navigation.

The journey in surgical oncology begins with the pivotal moment of diagnosis. Through clinical evaluation, imaging studies, and pathological analysis, surgical oncologists work with multidisciplinary teams to stage the disease and devise a tailored treatment plan. This collaborative approach ensures that patients receive comprehensive care that addresses their cancer's unique biological and clinical characteristics.

Navigating the Terrain: Innovations and Technological Advancements

In recent years, rapid advancements in technology and surgical techniques have reshaped the landscape of surgical oncology. Minimally invasive approaches, such as laparoscopy and robotic-assisted surgery, have revolutionized cancer treatment by offering patients smaller incisions, reduced postoperative pain, and faster recovery times. These techniques, coupled with state-of-the-art imaging modalities and intraoperative navigation systems, empower surgical oncologists to navigate the complexities of tumor anatomy with unparalleled precision and accuracy.

Furthermore, the emergence of targeted therapies and immunotherapies has expanded the armamentarium of surgical oncologists, allowing for personalized treatment strategies based on each tumor's molecular profile. By harnessing the power of molecular biology and immunology, surgeons can selectively target cancer cells while sparing normal tissues, thereby improving therapeutic efficacy and minimizing treatment-related toxicity.

Overcoming Challenges: Triumphs and Resilience in the Face of Adversity

Despite the remarkable progress in surgical oncology, the journey is fraught with challenges that test the resilience of patients and practitioners alike. From surgical anatomy's intricacies to tumor biology's variability, each case presents hurdles that demand innovation, expertise, and unwavering determination.

One of the foremost challenges in surgical oncology is achieving optimal oncologic outcomes while minimizing morbidity and preserving the patient's quality of life. Balancing the imperative to eradicate cancerous tissue with the need to preserve functional integrity requires a delicate balance of surgical skill, clinical judgment, and compassion.

Moreover, the multidisciplinary nature of cancer care necessitates close collaboration between surgical oncologists, medical oncologists, radiation oncologists, and other allied health professionals. This collaborative model fosters synergy and coordination, ensuring that patients receive comprehensive, integrated care that addresses the physical aspects of their illness and its emotional and psychological impact.

The Human Connection: Empathy, Compassion, and the Healing Power of Connection

Beyond the technical intricacies and clinical complexities, the essence of surgical oncology lies in the human connection forged between patients and practitioners. This relationship is grounded in empathy, compassion, and shared humanity—a bond that transcends the confines of illness and treatment.

Surgical oncologists not only wield scalpels and sutures but also offer solace and support to patients facing the daunting prospect of cancer surgery. They serve as guides and advocates, empowering patients to navigate the uncertainties of their journey with courage and resilience. In turn, patients entrust their lives and livelihoods to the hands of their surgical oncologists, drawing strength from their expertise and compassion.

The journey in surgical oncology is a testament to the indomitable spirit of humanity and the transformative power of medical science. It is a journey marked by challenges, triumphs, and the unwavering commitment to healing. As we navigate the complexities of cancer surgery, let us draw inspiration from the courage of patients, the dedication of practitioners, and the boundless potential of the human spirit to conquer adversity and emerge stronger than before. Together, we chart a course towards a future where cancer is no longer a foe to be feared, but a challenge to be overcome with hope, perseverance, and compassion.

Advancing Surgery: Exploring the Frontiers of Robotic Innovation

Published on: 05-29-2024


Robotic surgery stands at the forefront of modern medical innovation, reshaping the landscape of surgical practice with its precision, versatility, and minimally invasive approach. From delicate procedures in neurosurgery to intricate interventions in cardiothoracic surgery, robotic systems have revolutionized surgical care, offering patients improved outcomes and faster recovery times. In this comprehensive exploration, we journeyed through the latest advancements in robotic surgery, examining cutting-edge technologies, emerging applications, and future directions shaping the field.


The Evolution of Robotic Surgery: A Brief Overview


The genesis of robotic surgery can be traced back to the 1980s when early robotic systems aimed at assisting surgeons in performing minimally invasive procedures were developed. These systems, characterized by their limited capabilities and cumbersome interfaces, laid the foundation for future innovations in robotic-assisted surgery. The breakthrough came in the early 2000s with the introduction of the da Vinci Surgical System. This pioneering platform revolutionized surgical practice with its advanced instrumentation, three-dimensional visualization, and intuitive control interface.


Revolutionary Robotic Platforms


Several robotic platforms have emerged in recent years, each offering unique features and capabilities tailored to specific surgical specialties and procedures. These platforms leverage cutting-edge technologies such as artificial intelligence, augmented reality, and advanced imaging modalities to enhance surgical precision, improve patient outcomes, and expand the scope of minimally invasive surgery.


Da Vinci Surgical System: The da Vinci Surgical System remains the gold standard in robotic-assisted surgery, with its sophisticated instrumentation and intuitive control interface. It enables surgeons to perform complex procedures with enhanced precision and skill, featuring wristed instruments, high-definition cameras, and ergonomic consoles. Applications of the da Vinci system span a wide range of specialties, including urology, gynecology, and general surgery, where it has revolutionized surgical practice and improved patient outcomes.


Medtronic Hugo Surgical System: The Medtronic Hugo Surgical System is a next-generation robotic platform designed to enhance surgical capabilities and streamline procedural workflows. Featuring modular components and advanced imaging technologies, the Hugo system offers surgeons greater flexibility and versatility in the operating room. With intuitive controls, haptic feedback, and real-time data analytics, the Hugo system empowers surgeons to perform complex procedures confidently and efficiently, setting new standards for robotic-assisted surgery.


Verb Surgical System: The Verb Surgical System, developed by Verb Surgical Inc. (a collaboration between Verily, an Alphabet company, and Johnson & Johnson), represents a paradigm shift in robotic surgery with its innovative design and integrated technologies. Combining robotics, artificial intelligence, and advanced imaging, the Verb system aims to revolutionize surgical care by enabling more precise, efficient, and personalized interventions. With its cloud-based analytics platform and seamless integration with existing surgical workflows, the Verb system promises to transform how surgeries are performed and outcomes are measured.


Emerging Applications in Robotic Surgery


Robotic surgery expands beyond traditional boundaries, with innovative applications emerging in various surgical specialties and subspecialties. From microsurgery in ophthalmology to complex reconstructions in plastic surgery, robotic systems are pushing the boundaries of what is possible in surgical care, offering patients new treatment options and improved quality of life.


Neurosurgery: In neurosurgery, robotic systems are revolutionizing the treatment of brain tumors, vascular malformations, and spinal disorders. With their precision and skill, robotic platforms enable neurosurgeons to navigate delicate anatomical structures with greater accuracy and control, minimizing the risk of injury to surrounding tissues and improving patient outcomes.


Orthopedic Surgery: Robotic-assisted orthopedic surgery transforms the management of musculoskeletal conditions such as joint arthritis, fractures, and deformities. With their advanced imaging capabilities and intraoperative guidance systems, robotic platforms enable orthopedic surgeons to perform more precise implant placements, soft tissue balancing, and bone resections, improving joint function and patient longevity.


ENT Surgery: In otolaryngology (ear, nose, and throat) surgery, robotic systems facilitate minimally invasive procedures for treating head and neck cancers, sleep apnea, and sinus disorders. With their small, articulating instruments and high-definition cameras, robotic platforms enable ENT surgeons to access difficult-to-reach anatomical sites with enhanced visualization and control, reducing trauma to surrounding tissues and improving patient comfort.

Future Directions and Challenges


As robotic surgery continues to evolve, researchers and innovators are exploring new frontiers and overcoming key challenges to advance the field. From enhancing robotic instrumentation to integrating artificial intelligence and machine learning, the future of robotic surgery holds promise for continued innovation and transformation in surgical care.


Next-Generation Instrumentation: Future advancements in robotic surgery will focus on developing next-generation instrumentation with enhanced agility, flexibility, and functionality. Innovations such as miniature robots, steerable catheters, and soft robotics will enable surgeons to perform even more complex procedures with greater precision and efficiency, opening up new possibilities for minimally invasive surgery.


Artificial Intelligence and Machine Learning: Integrating artificial intelligence and machine learning algorithms into robotic surgical systems promises to revolutionize surgical decision-making and planning. AI-driven technologies can analyze large datasets, predict surgical outcomes, and optimize procedural workflows in real time, empowering surgeons to make more informed decisions and deliver personalized patient care.


Global Access and Affordability: Despite robotic surgery's transformative potential, access to robotic systems remains limited in many parts of the world due to cost constraints and infrastructure limitations. Efforts to reduce the cost of robotic technology, increase affordability, and expand access to training and support are essential for ensuring that all patients can benefit from advancements in surgical care.


Innovations in robotic surgery are revolutionizing the practice of surgery, offering unprecedented precision, versatility, and patient outcomes. From neurosurgery to orthopedics, robotic platforms are pushing the boundaries of what is possible in surgical care, enabling surgeons to perform complex procedures with enhanced accuracy and efficiency. As robotic surgery continues to evolve, the future holds promise for further technological advancements, expanded applications, and improved patient care. Robotic surgery will continue to shape the future of surgical practice and improve patient outcomes worldwide through continued innovation, collaboration, and a commitment to excellence.


Exploring the Cutting Edge: Breakthroughs in Pioneering Cancer Research

Published on: 05-14-2024


In the quest to conquer cancer, the field of oncology stands at the forefront of scientific innovation and discovery. Pioneering cancer research represents a beacon of hope in the battle against this complex and relentless disease. From deciphering the intricacies of tumor biology to developing novel therapeutics and precision diagnostics, researchers around the globe are pushing the boundaries of knowledge and transforming the landscape of cancer care. This article delves into the latest breakthroughs and cutting-edge advancements in pioneering cancer research, offering insights into the promising avenues to revolutionize cancer treatment and improve patient outcomes.

Understanding Cancer: Unraveling the Mysteries of Tumor Biology

Cancer is a multifaceted disease characterized by abnormal cells' unchecked growth and proliferation. While each cancer type possesses unique traits, underlying mechanisms such as genetic mutations, dysregulated signaling pathways, and immune evasion are common threads woven throughout the diverse spectrum of malignancies.

At the forefront of pioneering cancer research lies the quest to unravel the complexities of tumor biology. Through genome sequencing, functional genomics, and single-cell analysis, researchers uncover the genetic, epigenetic, and metabolic alterations that drive tumorigenesis and fuel cancer progression. By elucidating the molecular underpinnings of cancer, scientists aim to identify novel therapeutic targets and biomarkers that can guide personalized treatment strategies tailored to individual patients.

Harnessing the Power of Immunotherapy

Immunotherapy has emerged as a transformative approach to cancer treatment, harnessing the body's immune system to recognize and eradicate cancer cells. Fundamental breakthroughs in immunotherapy include the development of immune checkpoint inhibitors, chimeric antigen receptor (CAR) T-cell therapy, and cancer vaccines, each offering unique mechanisms to unleash the immune system's potential in the fight against cancer.

Immune checkpoint inhibitors, such as anti-PD-1 and anti-CTLA-4 antibodies, have revolutionized the treatment of various cancer types, including melanoma, lung cancer, and bladder cancer, by releasing the brakes on the immune system and restoring antitumor immunity. Similarly, CAR T-cell therapy has shown remarkable efficacy in hematologic malignancies, enabling the reprogramming of patients' T cells to target and destroy cancer cells expressing specific surface antigens.

Moreover, cancer vaccines, designed to stimulate the immune system to recognize and attack cancer cells, offer a promising cancer prevention and treatment avenue. By targeting tumor-specific antigens or neoantigens, cancer vaccines prime the immune system to mount a robust and targeted antitumor response, potentially leading to long-lasting remissions and improved survival outcomes.

precision Medicine: Tailoring Treatment to the Individual

Precision medicine, also known as personalized medicine, is revolutionizing cancer care by tailoring treatment strategies to individual patient's unique genetic, molecular, and clinical characteristics. By integrating genomic profiling, biomarker analysis, and advanced imaging techniques, precision medicine enables oncologists to make informed treatment decisions and select therapies most likely to benefit each patient.

Critical advancements in precision medicine include the identification of actionable genetic mutations and the development of targeted therapies that specifically inhibit aberrant signaling pathways driving tumor growth. For example, targeted therapies such as tyrosine kinase inhibitors (TKIs) and PARP inhibitors have shown efficacy in cancer types harboring specific genetic alterations, such as EGFR mutations in lung cancer and BRCA mutations in breast and ovarian cancer.

Furthermore, liquid biopsy techniques, which involve analyzing circulating tumor DNA (ctDNA) and other biomarkers in blood samples, offer a non-invasive approach to monitor treatment response, detect minimal residual disease, and identify emerging resistance mechanisms. By enabling real-time monitoring of tumor dynamics, liquid biopsy holds promise in guiding treatment decisions and optimizing therapeutic strategies throughout a patient's cancer journey.

Advancements in Early Detection and Screening

Early detection and screening play a critical role in reducing cancer mortality by enabling timely diagnosis and intervention when tumors are still localized and more amenable to treatment. Pioneering research efforts focused on developing sensitive and specific screening tests, imaging modalities, and biomarkers are driving advancements in early cancer detection across a spectrum of cancer types.

For example, advancements in imaging technologies such as magnetic resonance imaging (MRI), positron emission tomography (PET), and molecular imaging enhance the detection and characterization of tumors, facilitate early diagnosis, and guide treatment planning. Similarly, developing novel biomarkers and risk assessment tools, coupled with advances in artificial intelligence (AI) and machine learning, enables more accurate and personalized approaches to cancer screening and risk stratification.

Moreover, liquid biopsy-based approaches, which involve the analysis of circulating tumor DNA (ctDNA), microRNAs, and other biomarkers in blood samples, offer a minimally invasive and accessible method for early cancer detection and monitoring of treatment response. By detecting tumor-derived genetic alterations and molecular signatures, liquid biopsy holds promise as a complementary tool to existing screening modalities, particularly for cancers with limited screening options or high recurrence rates.

Overcoming Therapeutic Resistance and Disease Recurrence

Despite significant advancements in cancer treatment, therapeutic resistance, and disease recurrence remain formidable challenges that limit the long-term efficacy of many therapies. Pioneering research efforts to understand the mechanisms of resistance and identify strategies to overcome treatment failure are paving the way for more durable and effective cancer therapies.

One approach to overcoming therapeutic resistance involves the development of combination therapies that target multiple signaling pathways or immune checkpoints simultaneously, thereby reducing the likelihood of tumor escape and resistance development. Researchers aim to achieve synergistic effects and improve treatment responses in patients with refractory or resistant diseases by combining targeted therapies with immunotherapy or other treatment modalities.

Moreover, advances in tumor microenvironment modulation, such as targeting the stroma, vasculature, or immune-suppressive cells within the tumor microenvironment, offer new opportunities to enhance the efficacy of existing therapies and overcome resistance mechanisms. By disrupting the supportive networks that promote tumor growth and immune evasion, researchers hope to create a hostile environment for cancer cells and sensitize them to therapeutic interventions.

Novel Therapeutic Modalities and Emerging Targets

In addition to targeted therapies and immunotherapies, researchers are exploring novel therapeutic modalities and emerging targets that offer new avenues for cancer treatment. These include strategies such as epigenetic modulation, RNA interference (RNAi) therapy, and cancer metabolism targeting, each offering unique mechanisms of action and potential clinical applications.

Epigenetic modulation, which involves targeting enzymes and regulatory proteins that control gene expression, holds promise in reprogramming cancer cells to adopt a less aggressive phenotype and become more susceptible to standard therapies. By reversing aberrant epigenetic modifications associated with cancer progression, researchers aim to restore normal cellular function and sensitize tumors to conventional treatments.

RNA interference (RNAi) therapy, which utilizes small interfering RNAs (siRNAs) or microRNAs (miRNAs) to silence specific genes or signaling pathways implicated in cancer, offers a targeted and selective approach to gene regulation. By harnessing the natural RNA interference machinery within cells, RNAi therapy can downregulate oncogenes, upregulate tumor suppressor genes, and modulate cellular processes such as proliferation, apoptosis, and metastasis.

Furthermore, targeting cancer metabolism, which involves exploiting the unique metabolic dependencies of cancer cells to inhibit critical metabolic pathways selectively, offers a promising strategy for cancer therapy. By disrupting the metabolic reprogramming that fuels tumor growth and survival, researchers aim to starve cancer.


Sam Yoon | Chief, Division of Surgical Oncology | New York, NY