Monthly Archives: December 2014

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Linda Ventura memorializes her late son Thomas by putting her face at the forefront of the ongoing battle to curb illegal drug use and its unintended consequences. Photo from Linda Ventura
Linda Ventura memorializes her late son Thomas by putting her face at the forefront of the ongoing battle to curb illegal drug use and its unintended consequences. Photo from Linda Ventura

By Chris Mellides

The legislative office building in Albany hums with activity as concerned Long Island parents and members of the addiction treatment community prepare to convene with state assemblymen and insurance company executives for a roundtable discussion.

King’s Park residents Linda Ventura and Maureen Rossi, who both endured the long drive to the state capital the previous night, break away from their group moments before the meeting and casually walk to the nearest bathroom.

Inside the brightly lit lavatory, where toilet paper lines the old tiled floor, Ventura reaches into her purse and retrieves a piece of Tupperware, like she has many times before, and together with Rossi the two of them pray.

Ventura, a mother of three, watched helplessly as her eldest son Thomas succumbed to his heroin addiction two years ago. And now his ashes, tucked neatly inside that plastic container, serve as a reminder of why she tirelessly works toward spreading opiate awareness and tirelessly lobbies for political change. For such efforts Linda Ventura has been selected as one of the People of the Year by this paper.

Jeffrey Reynolds, president and chief executive officer of the Family and Children’s Association, was among those concerned parents and addiction treatment advocates who joined the dozens of insurance executives at the round table meeting.

He recalls the tension choking the room and the moment a state legislator asked Ventura to make her case for why she thinks insurance companies are handling treatment coverage poorly.

“Linda opened her purse, took out a Tupperware, put it on the table and said, ‘This is my son Thomas. This is what outpatient treatment looks like.’ And the room was stunned,” said Reynolds. “You know I’ve seen it all and done it all and heard it all, and it left me and everybody else in the room speechless.”

Reynolds says that he met Ventura roughly two years ago through a mutual contact and that his work with her became much more focused when they started their legislative push.

“She has been at the forefront of our push for a number of bills in Albany. The thing about Linda is that addiction messed with the wrong mom,” Reynolds said.

Ventura, 54, was born and raised in Oceanside and moved to Kings Park in 1993, where she’s continued her work as a financial advisor.

In March 2012, her son Thomas died from a heroin overdose. He was 21. In the years leading up to his death, Ventura says that a tumultuous family life had put stress on her children.

“My mom and dad passed and my ex-husband’s mom passed. Every year we lost one of them and him and I were going through a divorce,” Ventura said. “So there was a lot of loss, tremendous loss in the family and Thomas was especially sensitive.”

At 15 years old, Thomas began smoking marijuana and drinking beer, and by his senior year of high school Ventura recognized that her son had a problem with prescription painkillers. During the fall after his graduation, Thomas went to his first rehab.

That’s when Ventura said she realized how difficult it was to get insurance coverage for her son’s treatment.

“While he was covered under his dad’s policy, the family as a whole was entitled to one stay at a rehab. So we used that the first time that he went. It was then covered under me,” Ventura said. “We heard things through the next few years and [were told] that he’s not high enough for treatment, which still boggles my mind.”

In order to receive continued coverage for treatment services, Thomas had to continually fail at outpatient services before he could be approved for more comprehensive residential treatment, according to Ventura, who claims that this rule was “insane.”

After her son’s fatal overdose, Ventura said she knew that she needed to bring awareness to the opiate problem affecting Long Islanders, and help to change how insurance providers offer coverage to families seeking help for their sons and daughters struggling with addiction.

On the one-year anniversary of her son’s death, she launched Thomas’ Hope, a nonprofit foundation that promotes drug awareness, prevention and advocacy. Through this effort, Ventura has spoken at numerous events to raise awareness and has raised money to assist families battling with substance abuse.

During a Thomas’ Hope fundraiser Ventura met Maureen Rossi, chairperson of Kings Park in the kNOw (KPITK), a grassroots nonprofit designed to help eradicate illegal drugs from the Kings
Park Community.

“From the first time I heard Linda speak, I knew she had the gift — she has an outstanding ability to reach people,” Rossi said. “I was impressed with her work and shortly after I hired her to speak at our annual Preventing Destructive Decisions event. Linda’s actions and words move mountains.”

Together, Ventura and Rossi joined parents and community leaders in what would be several legislative visits to Albany.

Late this spring, they pushed for passage of Senate Bill S4623, which would reign in the insurance companies and force them to pay for treatment when it’s warranted. That bill and a number of others passed the state Senate and will go into effect April 1, 2015.

County Legislator Robert Trotta (R-Fort Salonga) represents Suffolk’s 13th District, has followed Ventura’s work with KPITK and has recognized the impact she’s made on the local community and on New York state as a whole.

“She went up to Albany and she got 13 different pieces of legislation passed, and the most important one is that insurance companies will be paying for treatment programs,” Trotta. “She’s driven, she’s smart, capable and she knows what’s going on. She’s really led the charge.”

Ventura said she hopes to see a sober high school brought to Long Island this year that would serve as “a place kids can come back to and be treated differently when they come out of rehab.” She also said she plans to discuss prescription protocol and the need for better education among medical professionals who prescribe controlled substances when she returns to Albany.

When it comes to stomping out the heroin and opiate epidemic on Long Island Ventura said it’ll have to be done as a group effort.

“New York and Long Island is the epicenter of the epidemic, which is something we should not be proud of,” Ventura said. “We can’t legislate ourselves out of it and we can’t police our way out of it. Those things are important measures to take, but everybody’s got to step up to the plate.”

Board approves zone change for Heatherwood housing community

Port Jefferson Station/Terryville Civic Association President Ed Garboski speaks against the housing proposal on Tuesday, as Shawn Nuzzo, Three Village’s civic leader, looks on. Photo by Erika Karp

Despite numerous objections from residents, local civic associations and the community’s own councilwoman, the Town of Brookhaven has paved the way for a 200-unit retirement community at the Heatherwood Golf Club in Terryville.

Councilman Dan Panico (R-Manorville) sponsored the resolution for a zone change from A Residence 5 to Planned Retirement Community for the property, which is located at Arrowhead Lane and Route 347 and falls in both the Comsewogue and Three Village school districts. The town board approved it in a 4-3 vote, with Councilwomen Valerie Cartright (D-Port Jefferson Station) and Connie Kepert (D-Middle Island) and Supervisor Ed Romaine dissenting.

The planning board still must approve the project’s site plan before the project can move forward.

According to the site plan application, about 25 acres of the property would be developed into the 55-and-over community, while about 45 acres would remain open, leaving a nine-hole golf course.

Since the property would be developed at an increased density, owner Doug Partrick in exchange would donate a 40-acre lot he owns in the Manorville Farm Protection Area — in Panico’s district — for open space.

While the zone change public hearing was held on Tuesday, the project had been discussed for months at Port Jefferson Station/Terryville Civic Association meetings, and that group, along with the neighboring Civic Association of the Setaukets and Stony Brook, came out strongly against it.

However, the Town of Brookhaven Planning Department supported the project — Planning Commissioner Tullio Bertoli said the proposal is compatible with existing development in the area and fits in with the town’s smart growth efforts, as it is located along a commercial corridor.

Residents and civic leaders who attended the public hearing expressed concerns about traffic and losing open space in their community. In addition, many were displeased to see the development proposed for the golf course, as the community is preparing to redevelop and revitalize the Route 112 corridor, on another side of town.

“[It’s] dismaying to see a town planning commissioner come before you and say this is a location that meets all criteria,” Bob de Zafra, of the Setaukets and Stony Brook civic, said at the public hearing. “It does not.”

He also criticized Panico for bringing forth the resolution.

De Zafra asked Panico and new Councilman Neil Foley (R-Blue Point) to recuse themselves from the vote, as the officials received campaign contributions from a company under the umbrella of Partrick’s Heatherwood Communities, the retirement community developer.

According to campaign financial disclosure records, Friends of Dan Panico received a $500 contribution from Heatherwood House at Coram LLC in September 2013, while Friends of Neil Foley received a $1,000 contribution in October 2014.

“There’s nothing illegal in that,” de Zafra said. “There’s nothing dishonest in that and I certainly don’t mean to imply that, nor am I due a lecture about it.”

Panico, who said he brought forth the zone change resolution because it was in the best interest of the whole town, interjected during de Zafra’s comments and said, “Why would you bring it up?”

Frank Gibbons, a board member of the Port Jefferson Station/Terryville Civic Association, said he was concerned about the development’s impact on traffic.

“There are good arguments on both sides of this question, but I think that when we look at the best thing for the entire township, Mr. Panico, … how about taking care of Terryville, Port Jefferson Station and South Setauket,” Gibbons said.

The town board placed conditions on its zone change approval, including that Partrick must make the land donation, remove a billboard at the golf course, construct a sidewalk on the east side of Arrowhead Lane and complete a new traffic study for the Terryville site.

Heatherwood’s attorney, David Sloane, of Certilman Balin Adler & Hyman LLP, spoke about the positives of the project, including a decrease in the use of pesticides and more property taxes to the school districts without an influx of students.

“This proposal is the least intensive use that could be developed on this site,” he said.

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It took a year to plan for something that would last about ten seconds. All the safeguards were in place, which meant no one could touch any of the seven spheres that were about 1/8 the size of a Ping-Pong ball.

The first five balls didn’t make it into the right spot, leaving the team with only two more attempts to make it work.

“It was the equivalent of the bottom of the ninth inning and there were two pitches left,” said John Parise, a distinguished professor in the department of geosciences at Stony Brook. “If you don’t hit a home run, you’re going away empty-handed.”

Instead of baseballs, the group was working with forms of uranium dioxide, the major nuclear fuel component of fission reactors, which produce nuclear power. Scientists at Argonne National Laboratory in Lemont, Illinois, and Stony Brook were trying to get a clearer picture of the structure of this compound at extreme temperatures. In nuclear reactor accidents, like Chernobyl in 1986 and Fukushima in 2011, uranium dioxide can reach temperatures of over 3,000 degrees Celsius. At that level, uranium dioxide can melt many of the containers designed to hold the radioactive liquid.

Scientists had come up with several theories about what the structure of this compound is at these extreme temperatures, but no experiments had provided direct evidence.

Fortunately, the team, led by Lawrie Skinner, a research assistant professor at Stony Brook, was able to get the final pellets in the correct spot, giving the researchers a chance to heat it to these extreme temperatures and then study its structure with specialized x-rays produced by the synchrotron at the Advanced Photon Source at Argonne.

The researchers discovered that each atom of uranium starts with 8 oxygen atoms nearby and, at extreme temperatures, has that number reduced to 6.7 oxygen neighbors. This, Skinner explained, affects the physical properties of the liquid, like its viscosity.

Parise, Skinner, scientists at Argonne National Laboratory and colleagues including Richard Weber, the founder of Materials Development Inc. in Evanston, Illinois, recently published their findings in Science.

Levitating the uranium dioxide pellets was critical because it prevented the compound from coming into contact with anything else. Skinner likened the process to keeping a ping pong ball afloat by using a hair dryer. To heat the compound in the experiment, which was not radioactive, the scientists hit it with a carbon dioxide laser that is about 100,000 times more powerful than a bright laser pointer, Skinner offered.

Scientists and those involved with nuclear reactors need to understand the viscosity of uranium dioxide so they “know how it will behave in a reactor meltdown,” said Parise. “The chief motivation behind studying the structure of uranium dioxide is to provide theoreticians with an accurate set of data that they can use to derive the atomic interactions that’ll allow them to predict behavior,” Parise said.

Skinner and Parise started working together over four years ago, when Skinner was a postdoctoral researcher in Parise’s lab. Since then, Skinner has gone on to conduct his own research.

Parise explained that he and his colleague will continue to try to understand how atomic interactions give rise to physical properties and behaviors. They would like to understand how liquids evolve as a function of pressure and temperature.

The next material Parise is planning to study is iron-containing liquids, including those involved in steelmaking.

Parise sees considerable potential for work with lava. The hot magma that comes from the center of the Earth behaves differently depending on the conditions and location where it erupts. In Hawaii, for example, lavas are much more liquid, while those in the Pacific Northwest are more explosive.

The next challenge, Parise said, is to understand how the composition of gas that’s over the liquids affects the viscosity and internal structure of those liquids.

Parise and Skinner each grew up far from Long Island. A native of Far North Queensland, Australia, Parise now lives in Poquott with his wife Alyse, who is the owner of a business- coaching company called Power Outcomes.

Skinner, who spends much of his time in Illinois at Argonne National Laboratory, grew up in the United Kingdom. He is married to Sonia, who works as an engineer for S&C Electric Company, which makes parts for an electric power grid.

As for the experiment, Skinner said he was “a little tense,” when the first few uranium dioxide balls didn’t make it into the levitator, but he “had faith.” It’s important, he urged, to stay positive in the face of failure. “If we just did things that were easy, we would not progress [in] our knowledge as much.”

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Suffolk County Legislator Rob Trotta holds a copy of a troubling letter sent to over 200 recipients operating home furnishing businesses in Suffolk County. Left to right: Ralph Mondrone, Natalie Weinstein, Robert Trotta and Charlie Gardner. Photo by Chris Mellides

By Chris Mellides

Housed in a building that was originally a vaudeville theater built in the early 1900s, Uniquely Natalie is a St. James-based consignment store catering to shoppers looking for affordable home and office furnishing.

Its owner, Natalie Weinstein, launched this space last year as a designer-driven shop adjoining the headquarters of Natalie Weinstein Design Associates — a full-service interior design firm.

Aside from contending with the challenges of owning her own business, Weinstein was recently served with some bad news from the county.

In a letter dated Oct. 27, Weinstein and several other small business owners with storefronts operating in Suffolk County were introduced to county code Chapter 563-106-A, which among other things states it is unlawful for any person to engage in the selling of furniture or carpets without obtaining a license.

“When I received the letter my first inclination was to say, since I’m a good law-abiding citizen, we’ve got to pay this, [but] how are we going to do this now?” said Weinstein. “This is my first retail operation … I felt it would be helpful to people who really couldn’t go to the big box stores or pay for expensive furniture and still get quality things.”

The code makes no distinction between “new, used or antique furniture,” and there are no exemptions that exist for “antique furniture dealers, churches or other nonprofit organizations.”

This means that Weinstein and others specializing in the sale of home furnishings in Suffolk County are required to apply for licensing at the initial cost of $200 with $400 needed to be paid every two years for relicensing.

Frustrated and looking for outside assistance, Weinstein reached out to Legislator Rob Trotta, who admitted his outrage over the county mandate.

“This is strictly an attack on small business,” said Trotta (R-Fort Salonga). “Over 200 letters were sent out right before the Christmas season. Downtowns are struggling, small businesses are struggling and this [code] said that you need to get a license.”

Trotta said the foundation of this law had shifted from its original intent and that this mandate was just “another attempt to hurt small business and to raise revenue.”

Aligning himself with Trotta is former Commissioner of Consumer Affairs Charlie Gardner. Gardner believes that this mandate aimed at small-business owners subverts the original intent of its legislation, which was to safeguard consumers from unlawful business practices.

“This legislation was aimed at regulating those businesses that would routinely go out of business, would take consumers’ deposits for money, fail to deliver furniture, deliver damaged furniture, and many times consumers had no recourse,” said Gardner. “Since the inception of this legislation the number of complaints dramatically decreased, but it was certainly not aimed at antique stores, antique dealers [or] roadside vendors.”

Gardner, who is now chair of the Government Relations Committee for the Kings Park Chamber of Commerce, said if any of his town members were burdened with the mandate, he would suggest they appear before the Legislature to vent and demand that the legislation revert to its original intent.

In an attempt to resolve this issue, Trotta asked legislative counsel to draft legislation that would clarify the definition of “antique dealer” and “seller” and save Weinstein and others from additional hardship.

“I believe that the original intent of the law was to protect consumers when primarily furniture and carpet retailers failed to deliver the merchandise promised,” said Trotta. “Now it appears that the county is going after the small-business person who sells a few pieces of furniture and [the consumer] takes the merchandise with him or her.”

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Increases mortality and chronic disease burden

Holidays are when many people add pounds. With that in mind, let’s start off with a quiz to test your knowledge of obesity-related issues. The answers and research are provided below. Regardless of your quiz score, it is important to understand the research.

Obesity reduces lifespan by up to:

A) Not at all

B) 4 years

C) 8 years

D) 10 years

Obesity shortens healthy years of life by:

A) 8 years

B) 12 years

C) 15 years

D) 20 years

Food cravings can be reduced for the short term by:

A) Counting to 20

B) Tapping your finger against your head

C) Watching TV

D) Texting on your cellphone

Obesity can lead to the following complication(s):

A) High blood pressure

B) Diabetes

C) Cancer

D) All of the above

Are you eager to find out the answers? I hope so, because there are some very salient points I am trying make by providing multiple choice questions. The answers are: 1. D; 2. D; 3. B; 4. D.

So how did you do? One of the questions was actually similar to a question on a medical website for doctors, so don’t be too hard on yourself if you did not get them all right. Let’s look at the research.

Mortality & effect

on healthy lifespan

Many of you know that obesity would have an impact on development of other chronic diseases and a decrease in quality of life, but to what extent? A 2013 study indicated that almost as many as one in five deaths in the U.S. are associated with obesity (1).

In a recent computer modelling study, the results showed that those who are obese may lose up to eight years, almost a decade, of their lifespan (2). But that is only part of the results. The other, more compelling result is that patients who are very obese, defined as a BMI >35 kg/m2, could lose almost two decades of healthy living. According to the researchers, this means you may have diseases such as diabetes and cardiovascular disease. However, even those patients who were obese and those who were overweight also could have reductions in lifespan, up to 6 years and 3 years respectively.

There were 3,992 adults between the ages of 20 and 79 evaluated in this study. The data was taken from an NHANES database from 2003 to 2010, which looked at participants who went on to develop diabetes and cardiovascular disease. Though this is not a clinical trial, and there is a need for more study, the results are eye-opening, with the youngest and very obese negatively impacted the most.

Cancer impact

Since it is very difficult to “cure” cancer, although hopefully someday soon we will, it is important to reduce modifiable risk factors. Obesity may be one of these contributing factors, although it is hotly debatable how much of an impact obesity has on cancer development.  The American Society of Clinical Oncologists, in a position paper, supported the idea that it is important to treat obesity in the fight against cancer (3). The authors indicate obesity may make the prognosis worse, may hinder the delivery of therapies to treat cancer, and may increase the risk of malignancy.

Also, possibly reinforcing ASCO’s stance, a recent study suggested that upwards of a half-million cases of cancer worldwide were related to being overweight or obese, with the overwhelming concentration in North American and Europe (4).

Possible solutions

A potential counterweight to both the reductions in life quality and life expectancy may be the Mediterranean diet. In a newly published analysis of the Nurses’ Health Study, results show that the Mediterranean diet helped slow shortening of the telomeres (5). Repeat sequences of DNA found at the end of chromosomes, telomeres shorten with age; the shorter the telomere, the shorter life expectancy. Thus, the Mediterranean diet may decrease occurrence of chronic diseases, increase lifespan and decrease premature mortality. Hence, the opposite effect of obesity. In fact, it may help treat obesity, though this was not mentioned in the study.

Interestingly, the effects of the Mediterranean diet were on a dose-response curve. The greater the adherence to the diet, rated on a scale of 0 to 9, the better the effect. Those who had an increase in adherence by three points saw a corresponding decrease in telomere aging by 4.5 years. There were 4,676 middle-aged women involved in this analysis. The researchers believe that the anti-inflammatory and antioxidant effects could be responsible for the diet’s effects.

According to an accompanying editorial, no individual component of the diet was identified as having beneficial effects by itself, so it may be the diet as a whole that is important (6).

Short-term solution

There are easy-to-use distraction tactics that involve physical and mental techniques to reduce food cravings. These include tapping your foot on the floor, staring at a blank wall and, yes, alternating tapping your index finger against your forehead and your ear (7). The forehead and ear tapping was most effective, although probably most embarrassing in public. Among mental techniques, seeing pictures of foods that were unhealthy and focusing on their long-term detriments to health had the most impact (8). All of these short-term distractors were done for 30 seconds at a time. The results showed that in obese patients they indeed decreased food cravings.

Exercise impact

I recently wrote about exercise and that it does not lead to fat percentage loss in adults. Well, before you write off exercise for fat loss, it seems that adolescents may benefit from exercise. In a randomized controlled trial, the gold standard of studies, results show that those in the resistance training group alone and those in a combined resistance and aerobic training group had significantly greater percentages of fat loss compared to a control group (9).

However, the aerobic group alone did not show a significant change in fat percent versus the control. There were 304 study participants, ages 14 to 18, followed for a six-month duration, and results were measured with MRI. The reason that resistance training was effective in reducing fat percentage may have to do with an increase in muscle mass rather than a decrease in actual fat. Still, exercise is important. It doesn’t matter if it decreases the fat percentage; it is still getting you to the goal.

Obesity can have devastating effects, from potentially inducing cancer or worsening it, to shortening life expectancy and substantially decreasing quality of life. Fortunately, there may be ways to help treat obesity with specific lifestyle modifications. The Mediterranean diet as a whole may be an effective step toward decreasing the burden of obesity and reducing its complications. Kids, teenagers specifically, should be encouraged to “Play 60,” as the NFL has encouraged, but also to do some resistance training. As we mentioned, there are simple techniques that may help reduce short-term food cravings.

References

(1) Am J Public Health. 2013;103:1895-1901. (2) The Lancet Diabetes & Endocrinology, online December 5, 2014. (3) J Clin Oncol. 2014;32(31):3568-74. (4) The Lancet Oncology. online November 26, 2014. (5) BMJ. online December 2, 2014. (6) BMJ 2014;349:g6843. (7) Obesity Week 2014 abstract T-2658-P. (8) Obesity Week 2014 abstract T-3023-OR. (9) JAMA Pediatr. 2014;168(11):1006-1014.

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 www.medicalcompassmd.com and/or consult your personal physician.

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Imagine a pizza restaurant. Every day, the chef cooks a certain number of pies. At a specific point, the kitchen reaches a maximum. What if that restaurant could double its production?

That’s what Zachary Lippman, an associate professor at Cold Spring Harbor Laboratory, and colleagues in Israel did, except that instead of doubling his pizzas, he doubled the amount of fruit his tomato plants produced.

Lippman used the same kind of mutations that agriculturalists have employed for centuries to increase crop yields.

“The approach we took was to find new mutations and design specific screens” that would favor flowering instead of bushiness, Lippman said.

Lippman and collaborators from Israel created a tool kit of genes that balance between the hormones florigen and anti-florigen. The first one, florigen, promotes flowering and flower and fruit production. The second one, anti-florigen, promotes shoot and leaf production.

Florigen and anti-florigen are “like this yin and yang,” Lippman said. “We found mutations in genes that affect the florigen/anti-florigen paradigm.”

By cross breeding these mutations, Lippman and his associates were able to pinpoint what he described as “an optimal architecture,” which originates from an optimal balance of flowering signals, he said.

This genetic tool kit could have applications to other agricultural crops, such as soybeans, which, Lippman explained, share many growth similarities to tomatoes.

With the world population expected to reach 9 billion by the middle of this century, these kinds of discoveries could prove important in increasing food production, Lippman said. He is thinking of testing this tool kit in cowpea, a major crop related to soybean that is grown in Africa.

“The major advance in the present work is the illustration that fine tuning of signals from these hormones can help improve tomato field performance and thus, similar, directed changes can be applied in other plants,” explained Yuval Eshed a professor in the Department of Plant and Environmental Sciences at the Weizmann Institute of Science in Israel who collaborated with Lippman on this study. Eshed has worked with Lippman for almost a decade and called his partner “an outstanding scientist” who is “original, thorough and trustable.”

The approach Lippman and his team took does not involve inserting DNA into the plant but rather comes from the development of mutations, Lippman said.

“It’s the standard idea of classic genetic modification,” Lippman said. “We were able to design a way to find and select for mutations much faster than what Mother Nature has given us by using what people have been doing for decades.”

The genetic tool kit, with several specific mutations, gives scientists and, potentially, tomato producers a chance to boost the production without compromising the plant or the taste of the tomato.

At the same time there is no difference in the fruit quality or the plant, he said. “Sugar is unaffected,” he offered.

To be sure, like some animals bred in a zoo or plants farmers have used for hundreds or even thousands of years, these new tomato plants, with their collection of mutations designed to increase yield, would not fair as well outside of the confines of a farm. “What’s optimal in nature is not what’s optimal in agriculture,” Lippman explained. “We’re selecting for growing in greenhouses or fields.”

Lippman used this tool kit in cherry, plum and beefsteak tomatoes. He is hoping to test all major varieties of tomato, including slicing tomatoes for burgers, grape tomatoes and cocktails. This approach should work across the types of tomatoes, but he hasn’t conducted those tests yet. He has had some contact from companies that grow tomatoes and will likely enter a collaboration soon.

Lippman said introducing these new mutations into the elite breeding lines of tomato farmers may create some complications. “We don’t know how those mutations will respond” in the designer tomatoes agricultural companies use, he said. “One combination might work in one variety, whereas another combination might work in another variety.” The tool kit, however, provides a genetic resource.

“This summer, we repeated the experiment for a fourth time,” he said. He organized these plants in a row according to their mutations. “If you walk down the row, you could see the progressive quantitative increase,” with the plants going from bushy to less bushy to almost a tree. To see the yield [change] was even more impressive.”

Lippman, who has been working for for six years at CSHL, said these results are “by far the most important work to come out of my lab. This is the most fun” he’s had conducting research.

County Executive Steve Bellone outlines plans to kill a potential speed camera program near schools throughout Suffolk. Photo from Bellone’s office

By Chris Mellides

Suffolk County is putting the brakes on its speed
camera project.

County Executive Steve Bellone announced at a press conference Monday that he would terminate the county’s school speed camera program amid strong opposition of the plan’s rollout from county legislators.

The program called for the installation of speed cameras in a number of school zones across Suffolk County, which while being in the interest of public safety, would have
admittedly generated additional revenue for the county, officials said.

Supporters of the program on Long Island sought and received approval for its implementation from New York State following the state approval for a rollout in New York City earlier this year.

In Nassau, officials said the program’s initial implementation in July was problematic and resulted in the dismissal of thousands of citations by County Executive Ed Mangano, who admitted to there being faults in
the system.

Having analyzed the negative experiences endured by Nassau County, and finding bitter disapproval from local residents over the possibility of a school speed zone camera rollout in Suffolk, Bellone admitted to there being further impediments to the program’s implementation.

“We looked at what was happening and what we saw is similar to what’s been happening in Nassau County [where] you’ve seen a lot of issues with implementation,” Bellone said. “A lot of the programs [are] having problems, in terms of accuracy, and a lot of the programs [are] actually being rolled back in certain jurisdictions.”

Bellone continued by stating that in working through the different issues associated with installing speed cameras here in Suffolk, the job has proven to be “complex,” and “not easy to do.”

Coinciding with Bellone’s announcement on Monday, five Suffolk County legislators including Presiding Officer DuWayne Gregory filed for legislation that would halt the county’s move to install school speed
zone cameras.

“The more we saw the problems Nassau County has had with its school speed zone cameras it became obvious we were not going to install the cameras in Suffolk County,” Gregory said. “It is unclear if the safety improvements for our children would occur if we installed the cameras, and without clear evidence that they would improve safety we are not going to proceed.”

Of the three Suffolk lawmakers who voted against the original speed camera legislation, Legislator Robert Trotta has been firm and unflinching in his opposition.

“As I have said from the start and when I voted against this legislation, speed zone cameras are nothing more than a money grab,” Trotta said. “When the county executive gets caught trying to put his hands in the taxpayer’s pocket, there is little choice but to pull the plug.

“This is no different from the overwhelming majority of red light tickets, which is simply taxation by citation,” he continued.

Feeling confident in his decision to kill the anticipated speed camera program in Suffolk County, Bellone maintains that the entire process leading to this week’s announcement had been a bipartisan initiative from the very beginning.

“I consulted with legislative leaders on both sides of the aisle and we came to this decision jointly as what makes sense for Suffolk County,” Bellone said. “And that’s why I made the decision to, at the end of the day, terminate the speed camera program.”

Determined to keep moving forward, Bellone also said that there’s still a lot that the county can do to enhance school zone safety and is willing to explore other alternatives.

“It can be anything from additional signage, increased enforcement, education, different types of partnerships like that and that’ll be unfolding over the next several months,” he said.

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Milk may not be what is good for the body

The prevalence of osteoporosis is increasing especially as the population ages. Why is this important? Osteoporosis may lead to increased risk of fracture due to a decrease in bone strength (1).

That is what we do know. But what about what we think we know?

For decades we have been told that if we want strong bones, we need to drink milk. Advertising slogans have morphed from “Milk does a body good” to “Got Milk?” to this year’s “Milk Life.” Celebrities have worn milk mustaches to show how important it is to our diet. This has been drilled into our brains since we were toddlers. Milk has calcium and is fortified with vitamin D, so milk could only be helpful, right?

Not necessarily.

The data is mixed, but studies indicate that milk may not be as beneficial as we have been led to believe and, even worse, it may be harmful. The operative word here is “may.” We will investigate this further.

Vitamin D and calcium are good for us. But do supplements help prevent osteoporosis and subsequent fractures? Again the data is mixed, but supplements may not be the answer for those who are not deficient.

Of course, we know which drugs are potentially beneficial for osteoporosis, however, which one works the best for whom may be unclear. There are minimal head-to-head trials comparing different drugs (2). They all have beneficial reductions in fracture risk in patients with osteoporosis, but also have side-effects.

What do the guidelines tell us about those who are at potential risk for osteoporosis and fracture? Recently a study looked at the predictability, or reliability, of the United States Preventive Services Task Force (USPSTF) recommendations for screening patients for osteoporosis. Unfortunately, the study showed that USPSTF guidelines were a nominal improvement over chance (3). In other words, the guidelines were able to predict only 24 percent of patients who ended up developing osteoporosis between the ages of 50 and 64.

Milk – it’s not what you think

The new slogan for milk is, “Milk Life.” It’s a catchy phrase. However, is it appropriate?

The results of a newly published large observational study involving men and women in Sweden showed that milk may be harmful (4). When comparing those who consumed three or more cups of milk daily to those who consumed less than one, there was a 93 percent increased risk of mortality in women between the ages of 39 and 74. There was also an indication of increased mortality based on dosage. For every one glass of milk consumed there was a 15 percent increased risk of death in these women. There was a much smaller, but significant, 3 percent per glass increased risk of death in men. Women experienced a small, but significant, increased risk of hip fracture, but no increased risk in overall fracture risk. There was no increased risk of fracture in men, but there was no benefit either. There were higher levels of biomarkers that indicate oxidative stress and inflammation found in the urine.

This study was 20 years in duration and is eye-opening. We cannot make any decisive conclusions, only associations, since it is not a randomized controlled trial. But it does get you thinking. The researchers surmise that milk has high levels of D-galactose, a simple sugar that may increase inflammation and ultimately contribute to this potentially negative effect, whereas other foods have many-fold lower levels of this substance.

Ironically, the USDA recommends that, from nine years of age through adulthood, we consume three cups of dairy per day (5). This is interesting, since the results from the previous study showed the negative effects at this recommended level of milk consumption. The USDA may want to rethink these guidelines.

Prior studies show milk may not be beneficial for preventing osteoporotic fractures. Specifically, in a meta-analysis that used data from the Nurses’ Health Study for women and the Health Professionals Follow-up Study for men, for each additional glass of milk per day during the teenage years there was a nine percent increased risk of hip fracture in men only (6). However, this effect was negated when height was taken into account. Neither men nor women saw any benefit from milk consumption in preventing hip fractures. In other words, the milk you drank during your teenage years might not reduce hip fractures later in life.

Calcium disappointments

Unfortunately, it is not only milk that may not be beneficial. There was a meta-analysis that included observational studies and clinical trials. In the meta-analysis involving a group of observational studies, there was no statistically significant improvement in hip fracture risk in those men or women ingesting at least 300 mg of calcium from supplements and/or food on a daily basis (7). The researchers did not differentiate the types of foods containing calcium. In a group of randomized controlled trials analyzed in the same study, those taking 800 to 1600 mg of calcium supplements per day also saw no increased benefit in reducing nonvertebral fractures. In fact, in four clinical trials the researchers actually saw an increase in hip fractures among those who took calcium supplements. A weakness of the large multi-varied meta-analyses is that vitamin D baseline levels, exercise and phosphate levels were not taken into account.

Vitamin D benefit

Finally, though the data is not always consistent for vitamin D, when it comes to fracture prevention, it appears it may be valuable. In a meta-analysis (involving 11 randomized controlled trials), vitamin D supplementation resulted in a reduction in fractures (8). When patients were given a median dose of 800 IUs (ranging from 792 to 2000 IUs) of vitamin D daily, there was a significant 14 percent reduction in nonvertebral fractures and an even greater 30 percent reduction in hip fractures in those 65 years and over. However, vitamin D in lower levels showed no significant ability to reduce fracture risk.

Just because something in medicine is a paradigm does not mean it’s correct. Milk may be an example of this. Also, ironically, the new “Milk Life” slogan may need an overhaul, especially in women between the ages of 39 and 74 years old, where there is a potential increased risk of mortality. No definitive statement can be made about calcium, although even in randomized controlled trials with supplements there seemed to be no significant benefit. Of course, the patients in these trials were not necessarily deficient in calcium or vitamin D.

In order to get benefit from vitamin D supplementation to prevent fracture, patients may need at least 800 IUs per day, which is the Institute of Medicine’s recommended amount for a relatively similar population as in the study. Also, different drugs have different benefits and side-effect profiles.

Remember that studies, though imperfect, are better than tradition alone. Prevention and treatment therefore should be individualized, and deficiency in vitamin D or calcium should usually be treated, of course. Please, talk to your doctor before adding or changing any supplements.

References

(1) JAMA. 2001;285:785-95. (2) Ann Intern Med. 2014;161(10):711-723. (3) NAMS 2014 Meeting: Abstract S-13. October 16, 2014. (4) BMJ 2014;349:g6015. (5) choosemyplate.gov. (6) JAMA Pediatr. 2014;168(1):54-60. (7) Am J Clin Nutr. 2007 Dec;86(6):1780-90. (8) N Engl J Med. 2012 Aug 2;367(5):481.

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 www.medicalcompassmd.com and/or consult your personal physician.

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This group will not let pain or loss defeat them. Instead, they are banding together to fight a common enemy.

Several foundations, the Friends of T.J. Foundation, the Christina Renna Foundation, the Michelle Paternoster Foundation for Sarcoma Research and the Clark Gillies Foundation, are contributing about $300,000 to fund research into a rare form of deadly pediatric cancer called rhabdomyosarcoma. RMS is a tumor of the connective tissue that typically involves muscle cells attached to bones.

The groups are backing a research partnership between Cold Spring Harbor Laboratory Assistant Professor Chris Vakoc and Charles Keller, the scientific director at the Children’s Cancer Therapy Development Institute, Fort Collins, Colo., to find a cure for a disease that afflicts adults and children equally. For children who get cancer, it is the most common soft tissue cancer.

The directors from these groups got together at a special Banbury conference of world leaders in RMS in May and pooled their resources.

The foundations “all gelled,” said Phil Renna, the director of operations for public affairs at CSHL and the co-founder of the Christina Renna Foundation. Renna’s foundation is named after his daughter, who died in 2007, a year after her diagnosis. Renna is “happy to say that we are able to put together” this research focus.

Vakoc and Keller have “hit it off” after CSHL president and CEO Bruce Stillman helped form the collaboration, Vakoc said. The research team hopes to “leverage what my lab does with epigenetics with [Keller’s] expertise in the clinical realm.”

Vakoc said his lab is invested in the discovery of cancer drug targets. He asks “cancer cells what they need to grow,” while they also explore what makes cancer cells different from normal cells.

Working on leukemia, Vakoc has already found a drug target, called Brd4. He plans to take a similar approach to RMS.

Vakoc explained that his lab uses a technique called RNA interference, in which he methodically searches for protein targets. He also uses a gene knockout technique called CRISPR. Vakoc is inhibiting parts of proteins in animal models of this disease and examining how the sarcoma responds.

“This is a way to provide a road map for where drug discovery should be,” Vakoc said.

Once he and his lab finds these targets, they can look for existing drugs approved for other clinical applications that might work against this cancer. His first round of screens have nominated some targets, although it is too early to know if these will prove useful in treating RMS, Vakoc said.

With Brd4, Vakoc found a target in which an inhibitor already existed. Based on his research, scientists are now conducting a clinical trial to study its effects.

Keller used to see patients but now conducts research full time. Any discovery with RMS might have implications for other diseases, he said. The most commonly known inherited predisposition to cancer, called Li-Fraumeni syndrome, was originally reported as a condition of inherited RMS. This syndrome, Keller added, has mutations in the p53 genes, which is one of the most well-studied genes in cancer of any type.

“Pediatric cancers can lead to fundamental types of discoveries that are later paradigms for adults cancers,” Keller explained. Keller also recognized Stillman’s role in creating the partnership with Vakoc. “There is something very personal about [Stillman’s] desire to make a change for this disease,” Keller offered.

Indeed, after meeting with some of the families affected by RMS, the members of Vakoc’s lab have contributed more of their time to seeking a cure. Vakoc said his lab members attended a one-hour talk Keller gave that included people from the foundations. Keller discussed the unique challenges of this cancer.

“Seeing the reactions and hearing the questions families have puts a different perspective on cancer research” from what scientists who study molecules in a lab “normally encounter,” Vakoc said.

He praised his lab mates for coming in on the weekends for a few extra hours of work. They are also planning to volunteer at the Morgan Center, a group that supports preschool children with cancer.

Keller said he’s thrilled with his collaborator. He said his mentor, Nobel Prize winner Mario Capecchi had a saying: “Go with the best, no matter where they are.” That, he explained, is Vakoc.

Keller and Vakoc are using the philanthropic support to involve Novartis in a grant they have submitted to the National Institutes of Health, Keller said.

Paul Paternoster, who lost his wife Michelle to RMS last year, explained that it is “nice to drive by Cold Spring Harbor Laboratory every day and think about” how researchers are working toward a cure. “We took all the pain and negative energy” that comes from battling this disease “and turned it into something positive.”

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