Monthly Archives: March 2014

by -
0 864

Warren Stern is helping win business for a department he just joined a year ago. A senior advisor in the Nonproliferation and National Security Department at Brookhaven National Laboratory, Stern is working on a domestic program through the National Nuclear Security Administration’s Global Threat Reduction Initiative that seeks to enhance security and response capabilities at facilities in the United States that use highly radioactive materials.

As a part of the Response Experts Group, he helps the program “ensure an effective response if there ever is an incident,” he said.

The work with the Office of Global Threat Reduction is “our first work in years” with that office, explained Carol Kessler, the chairwoman of the department where Stern works. Stern, who has helped the BNL group increase its business, “is an excellent proposal ideas person and writer, an important combination for success in this area.”

On a broader level, Stern’s work encompasses deterring potential diversion of nuclear energy into nuclear weapons, ensuring an effective response to any catastrophe, and finding the best use of technology to monitor nuclear sites. “We succeed when we deter others from taking steps,” he said. “The goal is to deter diversions by enhancing the chances of detection.”

Governments and the private sector acquire technology in a variety of ways, Stern said. He and experts at BNL and other national laboratories help these governments acquire the best technology. “When you’re thinking about something as broad as inspections and verifications” of nuclear material, it’s “not as straightforward as going to Consumer Reports,” he said.

Stern also works with a team at BNL to create a course that helps international inspectors prepare for certain types of monitoring. As the course director, he put the exercises together, which includes simulations where he plays the role of a state. The course, which is focused on hands-on work, is designed to train international inspectors related to nonproliferation.

When other countries come to the International Atomic Energy Association, the IAEA sometimes calls on experts like Stern and others at BNL to travel to other regions to compare these country’s laws, regulations and activities in the context of international standards.

Stern journeyed to Lithuania and Jordan to “examine and evaluate” their regulations. Each visit lasted about two weeks. He toured their facilities, had broad access to a range of government officials and emergency response teams.

“Often,” he said, “failures in response have nothing to do with technology and everything to do with basic lines of communication and responsibilities given to a variety of organizations. There is a false understanding of how things would work.”

Experts like Stern try to be aware of the politics of any international situation. If, for example, a nuclear facility is on the border of two countries that don’t have good international relations, he and the advisory team still encourage the need for a unified emergency response approach. “While that may not be feasible politically, it doesn’t keep us from recommending” that as a course of action, he said.

Stern is a “role model” for many people in the department “as a leader on how to think up new ideas for work that will help our customers achieve their goals,” Kessler said.

Stern spends much of his time in Washington, D.C., where many of the government agencies, such as the Department of Energy and the State Department, are headquartered.

Up until he joined BNL, Stern was a long-standing member of the government, where he worked at the State Department, directing the office responsible for developing and implementing U.S. nuclear safety and radiological security policies.

He also worked at the Central Intelligence Agency, where he acted as intelligence officer for the Office of Scientific and Weapons Research. He served as former Sen. Hillary Clinton’s nuclear fellow and adviser in 2002 and 2003, where he offered advice on nuclear energy, waste and safety and security. He was appointed by President Obama to lead the Domestic Nuclear Detection Office at the Department of Homeland Security.
Stern has two children, Benjamin, who is at Virginia Tech, and Matthew, who is in high school.
Stern prides himself on having relied on human energy to commute to his high-powered jobs in Washington, biking the five to seven miles to work each day. He has brought his two-wheeled ride to Long Island, where he enjoys pedaling along the North Shore.

As for what keeps him up at night, Stern said, “We have a long way to go to have an effective emergency response system for nuclear threats.”

by -
0 804

With spring officially here and — believe or not — beach weather around the corner, millions of American will expose their toes. Some will be more self-conscious about it than others, because of a disease called onychomycosis, better known as nail fungus.

Nail fungus usually affects toenails, but can also affect fingernails. It turns the nails yellow, makes them potentially brittle, creates growth underneath the nail (thickening of the nails) and may cause pain.

Many patients are bothered by this disorder. Most patients consider getting treatment for cosmetic reasons, but there are also medical reasons to treat, including the chronic or acute pain caused by nail cutting or pressure from bedsheets and footwear. There is an increased potential risk for infections, such as cellulitis, in those with compromised immune systems (1). Onychomycosis is not easy to treat and can be quite uncomfortable.

Onychomycosis affects approximately 8 percent of the population (2). The risk factors are unclear, but may be relate to family history, tinea pedis (athlete’s foot), older age, swimming, diabetes, psoriasis, suppression of the immune system and/or living with someone affected by it (3).

There are a number of organisms that can affect the nail. The most common class is dermatophytes, but others are yeast (Candida) and nondermatophytes. A test commonly used to differentiate the organisms is a KOH (potassium hydroxide) preparation, which is a simple microscopic exam of skin and nail shavings. This is important since some medications work better on one type than another. Also, yellow nails alone may not be caused by onychomycosis; they can be a sign of the autoimmune disease psoriasis.

There are a plethora of therapies available for treatment. These range from over-the-counter alternative therapies to prescription topical medications to systemic, or oral, prescription therapies to laser therapies and, finally, surgery. I am regularly asked which treatment works best.

With all of these options, how is one to choose? Well, there are several important criteria, including effectiveness, length of treatment and potential adverse effects. The bad news is that none of the treatments are foolproof, and the highest “cure” rate is around two-thirds. Oral medications tend to be the most efficacious, but they also have the most side effects. The treatments can take from around three months to one year. So there is no overnight success. Unfortunately, the recurrence rate of fungal infection is thought to be approximately 20 to 50 percent with patients who have experienced “cure” (4).

Fortunately, most cases of nail fungus are benign, with only a fraction leading to infections. Infection is most common in those with diabetic neuropathy, where the patient loses feeling in their feet.

Let’s look at the evidence.

Oral antifungals

There are several options for oral antifungals, including terbinafine (Lamisil), fluconazole (Diflucan) and itraconazole. These medications tend to have the greatest success rate, but the disadvantages are their side effects.

In a small but randomized controlled trial, terbinafine was shown to work better in a head-to-head trial than fluconazole (5). Of those treated, 67 percent of patients experienced a clearing of the fungus in their toenails with terbinafine, whereas 21 percent and 32 percent experienced these benefits with fluconazole, depending on the duration. The patients in the terbinafine group were treated with 250 mg of drug for 12 weeks. Those in the fluconazole group were treated with 150 mg of drug for either 12 weeks or 24 weeks, with those in the 24-week group experiencing the better results. Thus, this would imply that terbinafine is the more effective drug. This is a small trial, but the results are intriguing. The disadvantage of terbinafine is the risk of potential hepatic (liver) damage and failure, though it’s an uncommon occurrence. Liver enzymes need to be checked while using terbinafine. Its advantages are the efficacy and the duration.

Another approach to reduce side effects is to give oral antifungals in a pulsed fashion. In a RCT, fluconazole 150 mg or 300 mg was shown to have significant benefit compared to the control arm when given on a weekly basis (6). However, the efficacy was not as great as with terbinafine or itraconazole (7).

Topical medication

A commonly used topical medication is ciclopirox (Penlac). The advantage of this lacquer is that there are minor potential side effects. However, the disadvantages are that it takes approximately a year of daily use, and its efficacy is not as great as the oral antifungals. In two randomized controlled trials, the use of ciclopirox showed a 7 percent “cure” rate in patients, compared to 0.4 percent in the placebo groups (8). There is also a significant rate of fungus recurrence. In this trial, ciclopirox had to be applied daily for 48 weeks. These results were in patients with mild to moderate levels of fungus in the surface area of the infected nails.

Laser therapy

Of the treatments, laser therapy would seem to be the least innocuous. However, there are very few trials showing significant benefit with this approach. A study with one type of laser treatment (Nd:YAG 1064-nm laser) did not show a significant difference after five sessions (9). This was only one type of laser treatment, but it does not bode well. To make matters worse, many of the laser treatments are not covered by insurance, and they can be expensive. Another research paper that reviewed the current literature concluded that laser therapies are lacking in randomized clinical trials (10).

The advantage of laser treatment is the mild side effects. The disadvantages are the questionable efficacy and the cost. We need more research to determine if it is effective.

Alternative therapy

Vicks VapoRub may have a place in the treatment of onychomycosis. In a very small pilot trial with 18 patients, 27.8 percent or 5 of the patients experienced complete “cure” of their nail fungus (11). Additionally, partial improvement occurred in the toenails of 10 patients. But what is more interesting is that all 18 patients rated the results as either “satisfying” or “very satisfying.” The gel was applied daily for 48 weeks. The advantage is low risk of side effects and low cost. The disadvantages are a lack of larger studies for efficacy, the duration of use and the lower efficacy compared to oral antifungals.

So when it comes to onychomycosis, what should one do? None of the treatments are perfect. Oral medications tend to be the most efficacious, but also have the most side effects. If treatment is for medical reasons, then oral may be the way to go. If you have diabetes, then treatment may be of the utmost importance. If you decide on this approach, discuss it with your doctor; there are appropriate precautionary tests, such as liver enzyme monitoring with terbinafine (Lamisil), that need to be done on a regular basis. However, if treatment is for cosmetic reasons, then topical medications or alternative approaches may be the better initial choice. No matter what you and your physician agree upon as the appropriate treatment, have patience. The process may take a while; nails, especially in toes, grow very slowly.

References:

(1) J Am Acad Dermatol. 1999 Aug.;41:189–196;Dermatology. 2004;209:301–307. (2) J Am Acad Dermatol. 2000;43:244–248. (3) J Eur Acad Dermatol Venereol. 2004;18:48–51. (4) Dermatology. 1998;197:162–166; uptodate.com. (5) Pharmacoeconomics. 2002;20:319–324. (6) J Am Acad Dermatol. 1998;38:S77. (7) Br J Dermatol. 2000;142:97–102; Pharmacoeconomics. 1998;13:243–256. (8) J Am Acad Dermatol. 2000;43(4 Suppl.):S70-S80. (9) J Am Acad Dermatol. 2013 Oct.;69:578–582. (10) Dermatol Online J. 2013 Sep. 14;19:19611. (11) J Am Board Fam Med. 2011;24:69–74.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website medicalcompassmd.com or consult your personal physician.

by -
0 937

Despite the back pain, foot problems, and other stresses and strains humans feel when walking, we’re pretty good at it. That’s especially true when you compare humans to chimpanzees or other primates.

“Chimpanzees, our closest primate relative, use a lot of energy to walk around,” explained Matthew O’Neill, an instructor in the Anatomical Sciences Department at Stony Brook. “Their cost of walking is 75 percent higher than human walking.”

O’Neill is broadly interested in understanding what role energy use played in human evolutionary history. He believes part of what makes humans unique is the low energy we expend when we walk.

“The energy cost of walking is largely determined by the mechanics of how our pelvis and hind limbs work,” he said. He explores what is different about the way humans walk. If energy were the equivalent of a financial budget, spending less on walking and getting around would allow humans to use those resources in other areas.

“The less we have to use in a given day for locomotion, the more we can allocate to things like maintaining tissue health or on other aspects of living our lives,” O’Neill said.

O’Neill is interested in understanding when and why the human body began to look and work the way it does. Fossils, he said, tell him when humans might have changed the way they walked from our ancestors, while studying humans and chimpanzees may help explain why.

He looks at the forces humans and chimps apply to the ground and the way their limbs move. He uses musculoskeletal models to calculate how bones, muscles and tendons work while walking. He can then try to understand how these different tissues work. One of the areas where he’s collecting data is in how much energy individual muscles consume.

O’Neill’s colleague at Stony Brook, anatomical sciences professor Susan Larson, who has worked with him for five years, called his work “ground-breaking.” For many years, she said, “researchers have been compiling observations characterizing how primates walk, but we didn’t really have much in the way of mechanical explanations for why they display many of these characteristics.”

Larson said O’Neill’s work moves beyond simple descriptive studies to explore “potential underlying mechanical reasons governing their manner of walking.”

O’Neill was recently a collaborator on a broader study on energy use in humans compared with other primates. The main result from that study showed that humans, chimps and other primates use about half as much energy in a 24 hour period as do other mammals, such as mice, antelopes and sea lions. That, O’Neill said, may be information for understanding why primates seem to live longer than other mammals.“There’s simply less wear and tear on our bodies” because of the lower energy lifestyle than other animals have.”

In that study, O’Neill contributed data from research he had done in North Carolina when he was at Duke University on ring-tailed lemurs. There, he had measured daily energy use for these primates, who normally live in Madagascar.

O’Neill is involved in other collaborations as well, including one with Larson, two other Stony Brook faculty members and a researcher from the University of Massachusetts, on a project to develop a computational model of an ape walking on two legs. Once completed, they can use the model to run simulation studies to explore different suggested characteristics of the earliest form of bipedal locomotion, Larson said.

O’Neill is “one of a handful of a new generation of biological anthropologists who are bringing new rigor in the analytical methods applied to studying our own evolution,” Larson added.

O’Neill said he would like to know more about how walking and human walking capabilities evolved. “What I want to do is take information that’s available now and combine it with what we know of living species and get reliable predictions about how a [taxon] might have walked,” he said.

A resident of St. James, O’Neill lives with his wife, Karen Baab, an assistant professor in the Department of Anthropology at Stony Brook, and their infant daughter. The snow has kept them from enjoying rides out on the North Fork, which they hope to resume this spring.

As for looking out at how walking might change in humans, O’Neill, who described his own walk as “slow and lumbering,” said humans don’t need to walk the way we used to, when our “survivorship depended on walking.” As a result, he doesn’t see “a lot changing” in the foreseeable future in the way humans walk.

by -
0 1002

By Linda M. Toga, Esq.

The Facts: When I got married in 2000 my wife named me as the beneficiary on her life insurance policy. We were divorced two years ago. Our divorce settlement provides that my ex-spouse is required to continue paying her life insurance premiums and is prohibited from removing me as the beneficiary. I was told that our divorce automatically voids the beneficiary designation on her policy.

The Questions: Is that true? If so, what can I do to protect my right to receive the life insurance proceeds?

The Answer: In 2008 the law in New York changed so that a divorce does sever and/or negate the rights of an ex-spouse to bequests made in a will, appointments made in healthcare proxies and powers of attorney and beneficiary designations made on life insurance policies, to name a few. However, the law provides that the ex-spouse will retain rights and benefits in certain circumstances despite the divorce if there is a controlling document that states as much. If, in fact, your divorce settlement is deemed a controlling document, it is likely that the terms of your settlement will trump the statute. However, unless the insurance company is aware of the term of your divorce, they could very well pay the life insurance benefits to the contingent beneficiary named on your ex-spouses policy or to her estate. To avoid this outcome, you should contact an attorney who can protect your rights and enforce the terms of your divorce settlement.

Linda M. Toga, Esq. provides legal services in the areas of litigation, estate planning and real estate from her East Setauket office.

by -
0 927

What humans, or any other animals, think about the world can be seen in pathways that flash around in the brain, forming connections that inform a view of anything from the smell of steaming hot pizza to directions to a rink for a roller-skating party.

Combining behavioral electrophysiology with quantitative psychophysics and optogenetics, Adam Kepecs, an associate professor at Cold Spring Harbor Laboratory, is specifically looking at how rats report confidence in their decisions.

Looking at the frontal cortex in the brain, Kepecs studies the kinds of neurons that fire as the rat is weighing its options in the face of uncertainty. He likens the process to receiving directions to a restaurant and then following a route until there is no sign of the dining establishment.

“At some point, you will wonder, ‘Is the restaurant coming up or should I turn around?’” he said. “Presumably, the more confident you are, the longer you will keep driving. That’s exactly what we can do with rats. We can repeat [this experiment] hundreds of times a day by manipulating the instructions.”

To further the restaurant search analogy, that would be the equivalent of receiving instructions that were slightly garbled through a cell phone or where foliage obscured a sign a driver was expecting to see.
The directions the rat receives, Kepecs said, come from olfactory or auditory cues rather than visual ones. “We’re testing how you could turn this initial confidence into a choice,” he said. “We want to see how long do [they] wait.”

The analysis of the data he and his team of eight people collect comes from comparing a statistical evaluation of neurons that are within tens of microns of each other and the decisions that come from a rat that is faced with a choice about staying the course.

“This is a great statistical evaluation of how likely a decision was correct,” Kepecs said. Kepecs said these kinds of experiments enable him to study basic behaviors that get to the heart of how the rats process information and weigh that against what’s happening around them. “We’re trying to ask a big psychological question and we need to reduce it to an elemental behavior and turn it into something we can study as neuroscientists,” he said.

While Kepecs isn’t yet ready to extend his research to humans, he said the implications and applications of this research could include helping people who struggle with problems such as obsessive compulsive disorder. “If you lose confidence about your actions, you might repeat them,” he said. “This is the kind of thing [his research] is moving towards.”

Kepecs’ colleagues appreciate his approach to his research. “He is an outstanding scientist,” said Anthony Zador, the program chair of neuroscience at CSHL. He has a “well-earned reputation for being creative and innovative.”

In a separate line of experiments, Kepecs is also working with a region deep within the brain, called the nucleus basalis. Degeneration in this area has been linked to Alzheimer’s disease, Parkinson’s dementia and age-related cognitive declines.

Indeed, Kepecs recently received the 2014 Memory and Cognitive Disorders Award from the McKnight Endowment Fund for Neuroscience, which provides $100,000 a year for three years. The award supports research designed to solve problems of neurological and psychiatric diseases, with an emphasis on those that affect cognition and memory.

“This area has been a puzzle,” said Kepecs. “It’s made up of many cell types. Until now, there was no way of recording identified cells. What we’re trying to do is record from identified cholinergic neurons, to figure out what they’re telling the rest of the brain.”

Kepecs studied computer science in his native Budapest, Hungary. He was fascinated with the way the mind works. “I have a deep interest in the mind and computer science was my route,” he explained. A resident of Huntington, Kepecs is married with two children.

Kepecs said he is excited to take the next steps in linking activity in neural circuits to confidence. “How can you study anything that’s internal to your brain?” he asked. That is what his experiments on neurons and behavior are designed to examine.

by -
0 861

Most of us know that type 2 diabetes is an epidemic in America and continues to grow. Type 2 diabetes was thought to be an adult-onset disease, but more and more children and adolescents are affected as well. The most recent statistics show that 50% of teens with diabetes between the ages of 15 and 19 have type 2 (1). Thus, this disease is pervasive throughout the population.

Let’s test our diabetes IQ. See if you can determine if the following are true or false. Don’t worry, you won’t be judged or graded for wrong answers; this is meant to encourage you to learn more.

1) Whole fruit should be limited or avoided.

2) Soy has detrimental effects with diabetes.

3) Plant fiber provides too many carbohydrates.

4) Coffee consumption contributes to diabetes.

5) Bariatric surgery is an alternative to lifestyle changes.

My goal is to help debunk type 2 diabetes myths. All of these statements are false.

Let’s look at the evidence.

Fruit

Fruit, whether whole fruit or fruit juice, has always been thought of as taboo for those with diabetes. This is only partially true. Yes, fruit juice should be avoided because it does raise or spike glucose (sugar) levels. The same does not hold true for whole fruit. Recent studies have demonstrated that patients with diabetes don’t experience a spike in sugar levels whether they limit the number of fruits consumed or have an abundance of fruit (2).  In another study, whole fruit actually was shown to reduce the risk of type 2 diabetes (3).

In yet another study, researchers looked at different whole fruits to determine their impacts on glucose levels. They found that berries reduced glucose levels the most, but even bananas and grapes reduced these levels (4). That’s right, bananas and grapes, two fruits people associate with spiking sugar levels and increasing carbohydrate load. The only fruit that seemed to have a mildly negative impact on sugars was cantaloupe. To read more detail about some of these studies, please see my article, “Sugar, Sugar.” Fruit is not synonymous with sugar. One of the reasons for the beneficial effect is the flavonoids, or plant micronutrients, but another is the fiber.

Fiber

We know fiber is important in a host of diseases, and it is not any different in diabetes. In the Nurses’ Health Study and NHS II, two very large prospective (forward-looking) observational studies, plant fiber was shown to help reduce the risk of type 2 diabetes (5). Researchers looked at lignans, a type of plant fiber, specifically examining metabolites enterodiol and enterolactone. They found that patients with type 2 diabetes have substantially lower levels of these metabolites in their urine, compared to the control group without diabetes. There was a linear, or direct, relationship between the amount of metabolites and the reduction in risk for diabetes. The authors therefore encourage patients to eat more of a plant-based diet to get this benefit.

Foods with lignans include: flaxseed; sesame seeds; cruciferous vegetables, such as broccoli and cauliflower; and an assortment of fruits and grains (6). The researchers could not determine which plants contributed the most benefit. They believe the effect is from antioxidant activity.

Soy and kidney function

Soy sometimes has a negative association. However, in diabetes patients with nephropathy (kidney damage or disease), soy consumption showed improvements in kidney function (7). There were significant reductions in urinary creatinine levels and reductions of proteinuria (protein in the urine), both signs that the kidneys are beginning to function better. This was a small but randomized controlled trial, considered the gold standard of studies, over a four-year period with 41 participants. The control group’s diet consisted of 70% animal protein and 30% vegetable protein, while the treatment group’s consisted of 35% animal protein, 35% textured soy protein and 30% vegetable protein. This is very important since diabetes patient are 20-to-40 times more likely to develop nephropathy than those without diabetes (8). It appears that soy protein puts substantially less stress on the kidneys than animal protein, which creates nitrogenous waste products. However, those who have hypothyroidism should avoid soy.

Coffee

Coffee is a staple in America and in my household. It is one thing my wife would never let me consider taking away. Well she and the rest of the coffee-drinking portion of the country can breathe a big sigh of relief when it comes to diabetes. There is a new meta-analysis (involving 28 prospective studies) that shows coffee decreases the risk of developing diabetes (9). It was a dose-dependent effect; two cups decreased the risk more than one cup. Interestingly, it did not matter whether it contained caffeine or was decaffeinated. This suggests that caffeine is not necessarily the driving force behind the effect of coffee on diabetes. The authors surmise that other compounds, including lignans, which have antioxidant effects, may play an important role. The duration of the studies ranged from 10 months to 20 years, and the database was searched from 1966 to 2013, with over one million participants.

Bariatric Surgery

In the last few years, bariatric surgery has grown in prevalence for treating severely obese (BMI>35 kg/m2) and obese (BMI >30 kg/m2) diabetes patients. In a meta-analysis of bariatric surgery (involving 16 RCTs and observational studies), the procedure illustrated better results than conventional medicines over a 17-month follow-up period in treating HbA1C (three-month blood glucose measure), fasting blood glucose and weight loss (10). During this time period, 72% of those patients treated with bariatric surgery went into diabetes remission and had significant weight loss. However, after 10 years without proper management involving lifestyle changes, only 36% remained in remission with diabetes, and a significant number regained weight. Thus, whether one chooses bariatric surgery or not, altering diet and exercise are critical to maintain long-term benefits.

There is still a lot to be learned with diabetes, but our understanding of how to manage lifestyle modifications, specifically diet, is becoming clearer. The take-home messages are: don’t avoid whole fruit; soy is potentially valuable; fiber from plants may play a very powerful role in preventing and treating diabetes; and coffee may help prevent diabetes. Thus, the overarching theme is that you can’t necessarily go wrong with a plant-based diet focused on fruits, vegetables, beans and legumes. And if you choose a medical approach, bariatric surgery is a viable option, but don’t forget that you need to make significant lifestyle changes to increase the likely durability over 10 or more years.

References:

(1) JAMA. 2007;297:2716-2724. (2) Nutr J. 2013 Mar. 5;12:29. (3) Am J Clin Nutr. 2012 Apr.;95:925-933. (4) BMJ online 2013 Aug. 29. (5) Diabetes Care. online 2014 Feb. 18. (6) Br J Nutr. 2005;93:393–402. (7) Diabetes Care. 2008;31:648-654. (8) N Engl J Med. 1993;328:1676–1685. (9) Diabetes Care. 2014;37:569-586. (10) Obes Surg. 2014;24:437-455.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website medicalcompassmd.com or consult your personal physician.

by -
0 996

His previous passport had close to 100 extra pages. His current passport, which he started using in 2010, may well exceed that. “My passport is a source of never-ending amusement for my friends,” said Russell Mittermeier, an adjunct professor at Stony Brook.

What drives the 64-year-old scientist to travel to places like Brazil, Madagascar and Suriname is the need to monitor the health of ecosystems where rare, threatened or endangered animals, including many non-human primates, live.

Mittermeier, who is the president and one of the leaders of Conservation International, encourages local communities to rally around the animals that live in their areas, meets with the leaders of national governments, and seeks donors who will support efforts to preserve hot spots — important regions where the density of threatened species is high. At these hot spots, 2.3 percent of Earth’s land surface contains more than half of all plant species and over 40 percent of all vertebrates, he said.

He helps develop “primate ecotourism, which is based on the model of bird-watching, to help get more people to see primates and get excited about them,” Mittermeier said. Ecotourism generates revenue for the communities living close to priority areas for primates, he explained. “Species are not evenly distributed across the planet,” Mittermeier said from an airport in Miami on his way to Suriname. “They are heavily concentrated in some areas. Many of those areas are severely impacted by human activities.”

Conservation International Funds, including the Critical Ecosystem Partnership Fund and the Global Conservation Fund “have been instrumental in funding conservation in these hot spots,” he said.

Mittermeier’s research and conservation efforts recently earned him a second nomination as a finalist for the Indianapolis Prize, a highly prestigious award given every two years to someone who contributed to conservation of a species or species. The winner receives a $250,000 cash award. Mittermeier said he is honored to be a finalist and called the award “the premier prize in wildlife conservation.”

Patricia Wright, a professor in the Anthropology Department at Stony Brook, said Mittermeier “has a reputation of being a conservation leader, putting together the big picture on conservation policy.”

Wright said the books “Lemurs of Madagascar” (2010) and last year’s “Handbook of the Mammals of the World,” in which Mittermeier was the lead editor, are a “life’s work in themselves. These field guides and references are treasures for spurring conservation awareness.”

Mittermeier’s career has taken him to places where he has been the first to see or recognize a new species of animal.

In 1974, as a graduate student at Harvard, Mittermeier was in the Northern Peruvian Andes, looking for a yellow-tailed woolly monkey when he found a small brown frog. A few days later, he collected a lizard.

About 15 years later, an expert in frogs studied some of the individual brown frogs Mittermeier had brought back with him and determined it was an unknown species. He named it after Mittermeier. Some time later, the lizard he found from that trip took his name, too. Mittermeier has had seven species, including two lemurs and an ant, named after him, while he has been the first to describe 14 species.

On his journeys around the world, Mittermeier has created some amusing, and hair-raising, memories. He has come face-to-face with tigers and jaguars. In 2010, Mittermeier was on a trip in Suriname with his two sons, John, now 28, and Mickey, now 21. He was traveling with the U.S. ambassador to that country, John Nay. On the way back from climbing a mountain, their boat turned over. The group lost sight of Nay, who was wearing a life vest, for a few moments.

“About 200 meters over, he had floated to another pile of rocks,” Mittermeier recalled. “He had a great story to tell” after his return.

Mittermeier’s children have followed in his world-traveling footsteps. An ornithologist, John, who saw over 2,000 bird species in the past year, is working towards his doctorate at Louisiana State University. A junior at Eckerd College in St. Petersburg, Fla, Mickey is doing a term abroad in Australia, where he studies reptiles and is also interested in anthropology. His daughter Juliana is a senior in high school.

Mittermeier has no intention of slowing down in his conservation efforts and remains optimistic about his work. He said he “wont be stopped by anything.” He either “runs over an obstacle or moves around it.” His passport is proof of that.