Monthly Archives: July 2017

Areatha Pickens mugshot. Photo from SCPD

By Desirée Keegan

Suffolk County Police today arrested a nurse for assaulting a paraplegic man she was caring for at his Coram home last week.

Areatha Pickens, a licensed practical nurse, was caring for an 83-year-old man and Korean War veteran who became paraplegic in a 1975 motor vehicle crash, when she assaulted the man who was confined to a stretcher June 22. Pickens punched the man several times after the victim notified Pickens’ employer that she was late for work. The victim was treated at Stony Brook University Hospital for a fractured orbital bone.

Sixth Squad detectives charged Pickens, 44, of Coram, with second-degree assault. She was scheduled to be arraigned at First District Court in Central Islip.

Stock photo

Give blood and save a life! The Sound Beach Fire Department, located at 152 Sound Beach Blvd., Sound Beach is holding its 20th annual blood drive in memory of John Drews Jr. on Friday, July 7, from 3 to 9 p.m. All donors will receive two Mets tickets. Donor requirements include a valid ID, age requirement of 16 to 75 years old (over 75 need a doctor’s note) and a minimum weight of 110 pounds. Eat well and drink fluids before donating. No new tattoos for the past 12 months. Walk-ins are welcome. For more information, call John at 631-336-0626.

Exercise may be a step toward reversing the metabolic clock.
Obscenely short intervals of exercise can still generate significant benefit
Dr. David Dunaief

By David Dunaief, M.D.

What better way to start an article than with a pretest?

1) What minimum amount of exercise will reduce cardiovascular disease risk?

a. 5 to 10 minutes per day b. 30 minutes most days c. 60 minutes most days d. I don’t care — I don’t like pretests

2) How does inactivity affect menopausal symptoms?

a. Increases hot flashes b. Worsens risk of anxiety and depressive moods c. Decreases memory and concentration d. B and C

3) Exercise may have an impact on the following: a. Changing gene expression b. Metabolic aging c. Weight management d. All of the above

With all that’s been written about exercise in the past few years, I’ll bet you did well. The answers to the quiz are: 1) a, 2) d, 3) d. Before we go further, let’s differentiate between physical activity and exercise. Physical activity involves skeletal muscle contraction. It’s an umbrella term that includes exercise, but it also includes housework, yard work, movement on the job, etc. Exercise involves repetitive movements, structure and goal orientation such as walking, running, resistance training or playing sports (1). While you want to be physically active, exercise has more benefit.

We have long-held paradigms in medicine that may or may not be accurate. Medicine is always changing with the evolution of evidence-based research. We know that exercise has benefits for helping to prevent and possibly reverse some chronic diseases, but it also may have benefit for menopausal symptoms, slowing the metabolic aging process and even changing our genes, or at least gene expression.

The Fountain of Youth

Ponce de León sought a physical fountain of youth. While we tend to chuckle at that thought, metaphorically there may be at least some truth to the mythical fountain. Exercise may be a step toward reversing the metabolic clock. Until recently, we thought that when we hit 40 years old, we should expect a decline in physical abilities, with each passing year raising the probability of greater muscle atrophy. This may not actually be the case. Just because a paradigm has been around a long time does not make it correct.

In a small observational study, results showed that the participants, spanning ages 55 to 79, were unable to be differentiated based on age for the majority of tests (2). In other words, those who were in their 70s performed similarly to those in their 50s for many, but not all, parameters. It would be impossible to tell who was what age based purely on the data.

Participants were also compared to standards related to typical aging in each group, such as comparing 70-year-old cyclists versus inactive 70-year-olds. The ones who were cyclists were metabolically much younger. Thus, the researchers concluded that activity, rather than chronological age, may play a more important role in the aging process. The cyclists were not professional athletes, though they were required to pass a cycling endurance test prior to being accepted into the study. To at least some degree, we are more in control of our aging than we had thought. This is good news; we would all like to turn back the physical clock.

Can we really change our genes?

One of the greatest achievements of modern medicine has been mapping the human genome. However, gene therapy mostly has lagged. Well, there is a field called epigenetics. This word literally means “above” or “on” the gene. Epigenetics explores how to alter which of our genes get expressed and how. How can we do this? Methyl groups, one of the most basic groups of atoms in organic chemistry, latch on to genes and help to turn on and off their expression. Lifestyle modifications, like exercise, influence methylation groups to affect genes.

In a small study, results showed greater than 5,000 alterations in the genes of muscle cells such that there were different patterns of methyl groups that occurred in exercised legs compared to inactive legs (3). The genes that were affected are known to be involved in insulin sensitivity and inflammation. Let me explain further.

The researchers had 23 healthy volunteers use a stationary bike for 40 minutes, four times a day, for three months. Here is the catch: Participants only used one leg and did not exercise the other leg, limiting confounding variables. In the same participant, the leg that was exercised had dramatic changes in gene expression, whereas the other leg did not.

How can exercise elongate cell life?

In another study, exercise appeared to prevent or reduce the risk of shortened telomeres. Telomeres are important for protecting the DNA and, ultimately, the cell (4). There were four different categories of exercises surveyed. If respondents said yes to each category, there was an exponentially greater chance that they would not have very short telomeres.

The categories included walking, running, walking/riding a bike to work or school and weight lifting. When a participant was involved in one category in the previous month, there was a 3 percent reduced risk of shorter telomeres, whereas participants who were involved in all four categories had a 59 percent reduced risk of having very short telomeres. This greatest impact was seen in adults between ages 40 and 65.

Menopause symptoms

Although menopause is a rite of passage for women, not a disorder, there are symptoms that may negatively impact quality of life. Exercise may help alleviate menopausal symptoms. In a study, women who exercised regularly (resistance training twice weekly, plus either 150 minutes weekly of moderate activity, like walking, or 75 minutes weekly of intense exercise, like jogging or running) had a better overall sense of well-being and fewer symptoms during menopause compared to their less active counterparts (5). Those who were less active were more likely to be in depressed/anxious moods, have “brain fog,” difficulties with memory and concentration and experience increased vasomotor symptoms. Interestingly though, there was no change in hot flashes between the two groups.

I don’t have time to exercise!

There have been several studies that have shown that you can have obscenely short intervals of exercise and still get significant benefit. In one study, a one-minute intensive interval was broken into 20-second intervals within 10 minutes of exercise three times a week (6). Overweight participants had improved blood pressure and endurance capacity, as well as beneficial gains among other parameters.

In another study, as little as five to 10 minutes of running a day reduced the risk of dying from any cause by 30 percent and dying from heart disease by 45 percent (7). The best part of the results was that there was a significant difference between runners and nonrunners, but not between those who ran at a less-than-six-minute-mile pace and those who ran at a slower-than-10-minute-mile pace.

References: (1) uptodate.com. (2) J Physiol. online Jan. 6, 2015. (3) Epigenetics. Dec. 7, 2014. (4) Med Sci Sports Exerc. 2015;47(11):2347-2352. (5) Maturitas. 2015 Jan;80(1):69-74. (6) PLoS One. 2014;9(11):e111489. (7) J Am Coll Cardiol. 2014;64(5):472-481.

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, visit www.medicalcompassmd.com or consult your personal physician.

File photo by Bill Landon

By Fr. Francis Pizzarelli

Father Frank Pizzarelli

We are a nation out of control. The partisan divide has become almost unbridgeable. Our social media is feeding a frenzy that has little respect for human dignity and basic human rights. Where is the notion and concept of accountability? We need to hold each other accountable for the choices we make. We must lead by example and it must begin at the top!

The president is our president; he must lead by example, words and deeds. He should be the principal architect of our national social discourse. We should be able to engage in difficult conversations without the fear of demeaning responses because we disagree!

Those men and women elected to lead us should be about leadership that builds bridges not walls, that unites not divides. They should be about a civil discourse that brings us together and does not polarize us. Unfortunately, there is no bipartisan dialogue or working together on building compromise.

The blame game must end. We must demand accountability from all who lead us in public life. Our elected representatives from both sides of the aisle must get about doing the people’s business. They must forge a bipartisan effort to solve the great problems facing our nation and work at creating a cooperative spirit that seeks common solutions that will resolve our problems and make America great!

Despite the social landscape, this year’s senior class is extraordinary. A growing number of our high school seniors are choosing career paths that serve the needs of others. There is such a positive spirit around community service and a spirit of inclusiveness that is refreshing, especially since we live in a world that seems more grounded in narcissism and self-centeredness, rather than thinking about others first, especially those in need.

Seniors, as you continue your journey do not let the social filters of our time enable bigotry, exclusivity and social injustice. Always try to realize that being human and sensitive to others is more important than a successful academic record. Showing compassion and understanding rooted in justice is more significant than a science formula. These are difficult lessons to learn because they demand that you risk all that you are now for what you could become tomorrow.

Look around you! We are living in a very challenging world. A new revolution is afoot. Your generation is moving away from the indifference and complacency of yesterday, and moving toward a new idealism of freedom and responsibility.

As you graduate from high school, keep these simple thoughts in mind: May you discover enough goodness in others to believe in a world of peace and to work for peace grounded in justice and human rights.

May a kind word, a reassuring touch and a warm smile be yours every day of your life. Remember the sunshine when the storm seems unending. Teach love to those who know hate and let that love embrace you as you continue in the world.

Don’t judge a book by its cover or stop at the introduction. Seek the meaning and messages it offers for life, for everyone’s life is sacred, even those who are different from you or who you do not like. Be more inclusive than exclusive. Don’t be blinded by those who tend to use shame, blame, guilt and religion to shackle people down and divide them. Set people free with your respect and nonjudgmental way.

May you never become too concerned with material matters, but instead place immeasurable value on the goodness in your hearts and the hearts of others. Find time each day to see beauty and love in the world around you. Realize you have limitless opportunities and possibilities.

Get up every day and be grateful for what you have. Suck the marrow out of life, as you face life’s challenges. Don’t see the glass as half empty; only see it as half full; see every life experience and human encounter as a learning experience, as an opportunity to grow and become more than you are now.

May your moral compass be grounded in respect for all human beings, no matter what their color, their race, their creed or their sexual orientation. May this compass guide you on a path that is committed to working for peace and social justice.

As Gandhi once said, “Be the change you hope for in the world.”

Congratulations graduates of 2017. Thanks for making the world a little richer, a little brighter and a better place to be!

Fr. Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.

Community Medicaid covers care at home, such as a home health aide to assist with daily activities.

By Nancy Burner, ESQ.

Nancy Burner, Esq.

For most of us, if a time ever comes when we need assistance, the preferred option would be to remain at home and receive whatever care services we need in our familiar setting surrounded by family. For many, the Community-Based Long-Term Care Program, commonly referred to as Community Medicaid makes that an affordable and viable option.

Often we meet with families who are under the impression that they will not qualify for these services through the Medicaid program due to their income and assets. In most instances, that is not the case.

Although an applicant for Community Medicaid must meet the necessary income and assets levels, often with planning we are able to assist in making an individual eligible with little wait. An individual who is applying for home care Medicaid may have no more than $14,850 in nonretirement liquid assets. Retirement assets will not be counted as a resource so long as the applicant is receiving monthly distributions from the account. An irrevocable prepaid burial fund is also an exempt resource.

The primary residence is an exempt asset during the lifetime of the Medicaid recipient. However, if the applicant owns a home, it is advisable to consider additional estate planning to ensure that the home will be protected once the Medicaid recipient passes away.

With respect to income, an applicant for Medicaid is permitted to keep $825 per month in income plus a $20 disregard. However, if the applicant has income that exceeds that $845 threshold, a pooled income trust can be established to preserve the applicant’s excess income and direct it to a fund that can be used to pay his or her household bills.

It is important to note that there is no “look-back” for Community Medicaid. These pooled trusts are created by not-for-profit agencies and are a terrific way for persons to take advantage of the many services available through Community Medicaid while still preserving their income for use in meeting their monthly expenses.

Functionally, the way that these trusts work is that the applicant sends a check to the fund monthly for the amount that exceeds the allowable limit. Together with the check, the applicant submits household bills equal to the amount sent to the trust fund. The trust deducts a small monthly fee for servicing these payments and then, on behalf of the applicant, pays those household bills.

This process allows the applicant to continue relying on his or her monthly income to pay his or her bills and, at the same time, reduce the countable income amount to the amount permitted under the Medicaid rules. Once an individual is financially approved by the local Department of Social Services for Community Medicaid, he or she must enroll with a Managed Long-Term Care agency. This is the agency that will coordinate care services for the Medicaid recipient.

The MLTC will send a nurse to the Medicaid recipient in order to evaluate and create a care plan. The evaluation will result in an award of hours to the Medicaid recipient for a home health aide to come to the home and assist the recipient with activities of daily of living.

The amount of hours can vary from a few hours per day where the needs are less all the way to live-in care. This award of hours depends solely on the needs of the Medicaid recipient. If the Medicaid recipient is satisfied with the care plan, he or she may choose to enroll with the MLTC. Otherwise, he or she can request another evaluation with a different MLTC. What this means is that for most people, with minimal planning, both the income and asset requirements can be met with a minimal waiting period, allowing families to mitigate the cost of caring for their loved ones at home.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

Annabelle

MEET ANNABELLE!

Hi, I’m Annabelle. I have lived in a house with a family my whole life, but now someone in that family has developed allergies and I need to find a new place to live. I am extremely sweet and enjoy being petted. I will sit on your lap and watch TV with you if you’ll let me. All I want is a nice, quiet home where I can spend the rest of my life being someone’s best friend. I come spayed, microchipped and I’m up to date on all my vaccines. Come visit me at Kent Animal Shelter, 2259 River Road in Calverton and see for yourself what a sweetheart I am. For more information on me and other adoptable pets at Kent, please call 631-727-5731 or visit www.kentanimalshelter.com.

HXN team members, from left, Evgeny Nazaretski, Ken Lauer, Sebastian Kalbfleisch, Xiaojing Huang, Yong Chu, Nathalie Bouet and Hanfei Yan. Photo courtesy of BNL

By Daniel Dunaief

There’s precision in measurements and then there’s the world of Yong Chu. The head of a beamline that’s housed off to the side in a separate, concrete structure from similar efforts at Brookhaven National Laboratory, Chu led the design, construction and commissioning of a sophisticated beamline with a resolution of as low as 3 nanometers, which he hopes will get down to 1 nanometer within a year.

Just as a measure of contrast, a human hair is about 80,000 nanometers wide. Why so fine a resolution? For starters, seeing objects or processes at that high level can offer insights into how they function, how to improve their manufacture or how to counteract the effects of harmful processes.

With a battery, for example, the Hard X-ray Nanoprobe, or HXN beamline, could help reveal structural weaknesses in the nanostructure that could cause safety issues. In biology, numerous functions involve sub-cellular organelles that respond to proteins. Proteins are typically smaller than the HXN beamline can image, although researchers can tag the proteins with metals, which allows Chu, his colleagues and visiting scientists to see an aggregate of these proteins.

The HXN beamline can also help explore environmental problems, such as how plants transport harmful nanoparticles to their fruits or how artificial compounds absorb nuclear waste. Imaging beamlines that use micro-focused beams typically offer spatial resolution of 10 microns, 1 micron or even 100 nanometers, according to Ryan Tappero, the head scientist at the X-ray Fluorescence Microprobe at BNL, who has used the HXN for his research. Using the NSLS II source properties and a new x-ray optics development routinely offers resolution of 10 nanometers, which pushes the spatial resolution down by another factor of 10, which makes the HXN, according to Tappero, a “game changer.”

Tappero described Chu as a “rock star” and suggested he was an “exceptional beamline scientist” who is “very knowledgeable about X-ray optics.”

BNL houses 19 beamlines at the National Synchrotron Light Source II, a state-of-the-art facility large enough that scientists ride adult tricycles inside it to travel from one beamline to another and to transport supplies around the facility. BNL is building another nine beamlines that it hopes to have operational within the next 18 months. Each of these beamlines offers a different way to explore the world of matter. Some beamlines do not use a focused beam, while others produce beams with high angular or high energy resolution. Imaging beamlines such as the HXN produce a small beam size.

The HXN beamline has the highest spatial resolution of any beamline at the NSLS-II. Scientists building the HXN grew a nanofocusing lens with a dedicated deposition system that was constructed at the NSLS-II Research and Development lab. The system grew a nanofocusing lens a layer at a time, alternating materials and controlling the thickness at better than 1 nanometer, Chu explained.

The beamline where Chu works has padded walls, a door separating it from the rest of the light source and a monitor that records the temperature to the thousandths of a degree. “We are constantly monitoring the temperature around the X-ray microscope and inside of the X-ray microscope chamber,” he said. Around the microscope, he can keep the temperature stable within 0.03 degree Celsius. In the chamber, the scientists maintain the temperature at better than 0.003 degree Celsius.

So, now that Chu and his colleagues built their beamline, have the scientists come? Indeed, the interest in using the HXN has been well above the available time slots. For the three cycles each year, BNL receives about four requests for each available time. This reflects the unique qualities of the instrument, Chu said, adding that he doesn’t expect the rate to drop considerably, even as the HXN continues to operate, because of the ongoing demand.

Researchers have to go through a peer review process, where their ideas are graded for the likelihood of success and for the opportunity to learn from the experiments. All beam time proposals are reviewed by external expert panels, which examine the scientific merit, appropriateness of use of the facility, capability of proposers and quality of prior performance and the research plan and technical feasibility.

Chu fields about 10 calls per month from scientists who want to speak with him about the feasibility of their ideas. He may suggest another station at the NSLS-II or at the Advanced Photon Source at Argonne National Laboratory in Chicago, where he was a beamline scientist starting in 1999.

“I know many of the beamlines” at the Advanced Photon Source, he said. “I recommend some of the potential users to perform experiments at the APS first before coming to the HXN.” By the time scientists arrive at his beamline, Chu said he’s gotten to know them through numerous discussions. He considers them “as a guest” at the HXN hotel. “We try to make sure the experimental needs for the users are met as much as possible,” he said.

The HXN beamline has three staff scientists and two postdoctoral fellows who remain in contact with scientists who use the facility. “For most of the users, at least one of us is working throughout the weekends and late evenings,” said Chu.

Not just a staff scientist, Chu is also a user of the HXN, with currently one active general user proposal through a peer review process in which he is collaborating with Stony Brook University and BNL scientist Esther Takeuchi to explore the nanostructure of metal atoms during phase separation in batteries.

Chu and his wife Youngkyu Park, who works at Cold Spring Harbor Laboratory as a research investigator in basic and preclinical cancer research, live in Northport. The couple’s 22-year-old son Luke is attending Nassau Community College and is planning to transfer to Stony Brook this fall to study engineering. Their daughter Joyce is 18 and is enrolled in the Parsons School of Design in New York.

Chu grew up in Seoul, South Korea, and came to the United States when he was 18. He attended Caltech. While Chu’s parents wanted him to become a doctor, he was more inspired by a cartoon called Astro Boy, in which a scientist, Dr. Tenma, is a hero solving problems. As for the work of the scientists who visit his beamline, Chu said the “success of individual users is the success of the beamline.”