CLOSE
Authors Posts by Daniel Dunaief

Daniel Dunaief

1642 POSTS 0 COMMENTS

by -
0 1888
Paolo Boffetta. Photo by Jeanne Neville/Stony Brook Medicine

By Daniel Dunaief

Screening for cancer can help people take steps to head off the development of a disease that could threaten the quantity and quality of their lives.

During the start of the pandemic, people around the world stopped screening for cervical, breast and colorectal cancer, according to a recent study led by Paolo Boffetta, Associate Director for Population Sciences at Stony Brook University’s  Cancer Center.

The results of the study were recently published in the journal JAMA Oncology.

Compared to 2019, screenings for breast cancer dropped in the first few months after the start of the pandemic by 35.6 percent for breast cancer, 41.8 percent for colorectal cancer, and 54.1 percent for cervical cancer compared to the same period in 2019.

Paolo Boffetta. Photo by Jeanne Neville/Stony Brook Medicine

Boffetta chose these three cancers because they are the ones public health authorities recommend for the population at large. Screenings can improve patient outcomes. 

“For some/ most cancer, the earlier the better for detection,” explained Stony Brook Cancer Center Director Yusuf Hannun.

Boffetta, who is also Adjunct Professor at the Icahn School of Medicine at Mount Sinai in New York City, suggested that the longer-term impact of a reduction in screenings in the early part of the pandemic won’t be clear to doctors or patients in the short term.

“It will take a little bit of time to have a full understanding of this,” said Boffetta. Depending on the specific type, cancers “that are detected by screenings would not otherwise appear for a few years.”

Boffetta suggested that the pandemic, apart from the illnesses and symptoms that threatened the health of people who were battling the virus itself, affected public health services. He believes several factors likely contributed to the decrease in screenings. Patients around the world were reluctant or restricted in their ability to leave their homes amid lockdowns.

Additionally, some cancer centers likely reduce the number of people they monitored to cut back on the density of patients in health care facilities, although Boffetta did not gather any data on the reduction in the number of screenings at health care centers.

The positive news amid this study, which surveyed cancer screening data in PubMed and other medical journals from 19 countries from January 2020 through December 2021, was that the number of patients screened returned to a more normal level within several months of the start of the pandemic.

“An important finding is that by the summer of 2020, the decrease in screenings for breast cancer and cervical cancer seem to have disappeared,” Boffetta said by phone from Italy, where he is a part-time professor at the University of Bologna. “For colorectal cancer [the decrease in screenings] lasted longer,” through the end of 2020.

Boffetta described the reduction in screenings and then a return to normal as a U-shaped curve, with an initial decline followed by a recovery. Doctors typically screen for colorectal cancers by using a colonoscopy. This technique requires several hours in the hospital. Patients may have been “more reluctant to go back to such a complex procedure, compared to the mammography or pap smear” which screen for breast and cervical cancers, respectively.

Boffetta is conducting a broad study of the cancer literature from early findings to clinical diagnosis to treatment. At this point, he has finished a paper on the frequency and types of clinical diagnoses amid the pandemic. He is collecting data for another study that will examine cancer treatment.

“We are interested in how the pandemic affected each of these stages,” he said.

Hannun suggested that Boffetta’s work expertise help address important health care questions related to the pandemic and other threats to public health, adding, “Epidemiology is essential for understanding the pandemic and many chronic diseases, especially cancer with exposure issues.

A lab update

Boffetta joined Stony Brook University in April of 2020, soon after the start of the pandemic.

Also a Professor in the Department of Family, Population and Preventive medicine at the Renaissance School of Medicine at Stony Brook University, Boffetta will return to the United States in a few weeks from Italy.

Boffetta has added Research Coordinator Germana Giupponi and postdoctoral fellow Malak Khalifeh to his research efforts at Stony Brook. 

Germana Giupponi

A native of Italy, Giupponi, who started working with Boffetta in July of 2020 and provides administrative support and coordination with Boffetta’s collaborators, earned her master’s degree from the University of Milan.

Khalifeh joined Boffetta’s lab in March, is originally from Lebanon and conducted her PhD research in France at the University of Bordeaux. She is studying the link between the exposure people have to various chemicals in drinking water and bladder cancer. The bladder is especially susceptible to toxins from the environment.

Boffetta, meanwhile, has started teaching some graduate level classes at Stony Brook on cancer epidemiology for master’s and PhD students. He will teach one class this fall.

He is also continuing his studies with survivors of the World Trade Center attacks.

He has been comparing the survival of these first responders to the overall population in New York, comparing how the risk of cancer changed over the course of the 21 years since the attacks.

Boffetta has been working with Ben Luft, Director of the Stony Brook WTC Wellness Program at the Renaissance School of Medicine. Luft has provided clinical and research support for WTC responders.

Boffetta continues to have academic affiliations with other academic institutions, including Harvard University and Vanderbilt University.

Boffetta and his wife Antonella Greco, who have been living in New York City, plan to move to the Stony Brook area. Their three daughters live in Brooklyn, Italy and Argentina. Now that pandemic restrictions have lifted, Boffetta has been able to return to the opera and museums and has done some skiing and hiking.

As for this study, Boffetta suggested that the findings about screenings were consistent with what he might have expected during the beginning of the pandemic.Delaying screenings could mean that some people discover cancers at a more advanced state by the time they diagnose them, he said.

by -
0 320
Monkeypox vaccines were made available at pop-up clinics on Fire Island. Stock photo

Amid an increase in cases of a virus caused primarily by close skin contact, Suffolk County started to provide vaccinations this week.

By appointment only, Suffolk County is administering 750 vaccinations to eligible people at pop-up clinics on Fire Island. Within under two hours, the county, with help from Northwell Health, had received requests for all of the available vaccines.

“It was heartwarming that so many people signed up for the vaccine right away in the at-risk community,” said Dr. David Galinkin, an infectious disease specialist at Port Jefferson-based St. Charles Hospital. People want to “stop this in its tracks.”

While monkeypox was discovered in 1958 and had its first reported cases in humans in 1970, the current limited outbreak is the first time health officials documented it spreading through person-to-person contact in the United States. Previous outbreaks involved a returning traveler from Africa or through contact with an infected animal.

As of the end of last week, Suffolk County had reported three cases of monkeypox.

About 98% of the cases in the country were reported among members of the gay and bisexual community of men who have sex with other men, Galinkin said.

A rare condition, monkeypox has symptoms including fever, headache, muscle aches, swollen lymph nodes, chills, exhaustion, and a rash that looks like pimples or blisters on people’s faces, inside their mouths and on hands, feet, chest
and genitals.

People who contract monkeypox can have symptoms that last for two to four weeks.

“While the current global outbreak appears to have heavily impacted [men who have sex with men], it is important to understand that this is a disease that is transmitted by intimate prolonged contact with an infected individual,” Dr. Susan Donelan, medical director of Healthcare Epidemiology at Stony Brook Medicine, explained in an email. 

Medical officials pointed out that monkeypox doesn’t present the same threat to public health as COVID-19, which can be spread by breathing in air contaminated with viral particles.

Health officials, however, are urging people to take steps to protect themselves against a virus that can be uncomfortable and that can spread to others through various levels of contact.

“Most important to understand is that monkeypox is not a sexually transmitted disease,” Dr. Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health. “It is sufficient to touch an active lesion to be exposed.”

Prevention

The Centers for Disease Control and Prevention has considerable information on a website dedicated to monkeypox, which people can access at the link: www.cdc.gov/poxvirus/monkeypox

The CDC urges people to avoid close skin to skin contact with the rash. The center also recommends that people not kiss, hug, cuddle or have sex with someone who has the virus.

People should not handle or touch the bedding, towels or clothing of someone who is sick. To protect themselves, those who might have come in contact with a person who has monkeypox should wash their hands with soap and water or use an alcohol-based hand sanitizer.

Adding to the list of concerns during pregnancy, women can spread the virus to their fetus through the placenta.

Unlike COVID, people who do not have monkeypox symptoms can’t spread the virus to others.

Vaccinations

The most commonly used vaccinations involve two shots that are 28 days apart. Like vaccines for COVID, the optimal protection is expected two weeks after the second dose, Donelan said.

The CDC recommends that people who are close personal contacts of those with the virus get the vaccine. The center also urges those who may have been at increased risk of exposure, through laboratory testing, to consider receiving shots as well.

The CDC suggested that people get the vaccines within four days from the date of exposure for the best chance to avoid developing the disease.

Vaccines given between four and 14 days after exposure may reduce symptoms but may not prevent the disease.

Combining the vaccination with self-isolation and other measures can control outbreaks and prevent further transmission of the virus, the CDC explained.

Monkeypox vaccines aren’t as readily available as those for COVID.

“As vaccine production ramps up, we will expand our operations to ensure that anyone who wants to get vaccinated is able to,” County Executive Steve Bellone (D) said in a statement.

Dr. Gregson Pigott, county health commissioner, also explained in a statement that he encourages “those who may be at risk to get the vaccine and, in the meantime, be cautious with your intimate relations.”

COVID-19 update

COVID, meanwhile, continues to spread through Suffolk County, despite the warmer weather and the greater opportunity for outdoor interactions.

As of July 10, the seven-day average for positive tests was 9.3%, according to the New York State Department of Health. That is up from 7.5% on a seven-day average in June.

“The incidence of COVID has increased in the last few weeks in Suffolk County,” wrote Popp, of Huntington Hospital, which, earlier this week, had 15 COVID patients at the hospital.

The high current positive rate is “likely due to the fact that most COVID-related prevention measures have been discontinued” including masks and social distancing and the current omicron subvariants are also more transmissible, Popp said.

As of July 11, Stony brook University Hospital had 52 positive COVID inpatients, compared with 39 on June 11, according to Stony Brook Medicine officials.

Over the past weekend, Galinkin admitted more patients with COVID at St. Charles Hospital than he had in months.

“It seems to be on the rebound,” he said, as the BA-5 strain is the “most contagious strain we’ve seen,” he said. He expects the numbers to continue to rise.

COVID symptoms from BA-4 and BA-5, which are the dominant variants in Suffolk County are milder than previous types. Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Disease at Stony Brook Children’s Hospital, wrote in an email. The hospital is also seeing much less frequent loss of smell or taste with the current variant.

Nachman is concerned about possible increased rates of infection in the fall and winter.

“Overlying that concern is the heightened risk of our routine, formerly seasonal viruses co-occurring with COVID leading to more illness visits and hospitalizations, especially among our most vulnerable populations,” Nachman said in an email.

Galinkin said the higher level of COVID infections underscores the importance of vaccinations.

“It’s our best defense against this,” he said. “There’s talk of a new and improved vaccine coming out in the fall” that will provide protection against omicron variants. “Hopefully, people will take advantage of that.”

by -
0 818
Mice. Pixabay photo

By Daniel Dunaief

Daniel Dunaief

The English language makes no sense. As soon as you create a rule, exceptions crop up like mushrooms colonizing an open field.

Let’s start with the plural form of nouns.

“Add an ‘s’ and be done with it,” you might say. While that’s a simple solution, the language laughs in the face of such elegant simplicity.

Take the words “chief” and “thief.” Chief” becomes “chiefs” easily enough, as Kansas City football fans will readily tell you.

But then thief changes everything. The plural becomes “thieves,” as if someone robbed the word of its “f” and replaced it with something that sounds more vile and villainous.

The plural for hoof, as in the bottom of a horse’s foot, is hooves, but the acceptable plural for roof, which also only has one different letter way at the start of the word, is roofs. Yes, I know people say “rooves,” but that doesn’t make it accurate.

A root at the bottom of the tree that draws nutrients from the ground becomes roots. A single owl calling to another across the treetops utters a hoot. Several owls responding reply in hoots. So far, so good.

But then, what’s wrong with those things that are important for walking and that smell up a room when they sweat too much? How is it that foot, which also only differs in the initial letter, becomes feet?

Then there are the plural forms of animals. A mouse hunting for food with his rodent pals becomes mice, while a moose eating in a field with his family becomes, well, moose.

The moose, however, hasn’t cornered the market on words that describe an individual and a group. Deer, sheep, salmon and trout also don’t budge when switching from one to several. 

And why are the words for a group of animals different? Couldn’t they all be packs, herds, groups or schools?

Wolves banding together to hunt, live and howl form a pack. A family of giraffes is, fittingly, called a tower. That seems appropriate for animals that are born 6 feet tall.

But what about a collection of bears? They’re a sleuth, while a group of bats is a cloud.

One goose pooping on a field is inconvenient and messy, but is still a goose. Two of them are geese. A group of them walking on the ground is a gaggle, while those same birds in flight become a skein.

People often describe the challenge of bringing people together as akin to herding cats. While the verb is accurate, the name for a group of cats is not: they are a clutter, a glaring or a pounce, although numerous other words also describe a cat confab.

Now, more than one dolphin, those adorable marine mammals that make cool clicking sounds and perform at aquariums, becomes a school, which is also true of more than one fish, even though other marine mammals, such as walruses become herds or pods

When several ducks get together, they aren’t a flock, despite the fact that they are birds. They are a raft, perhaps reflecting the fact that they look like independent floats sitting on the water. Sea lions also become rafts when they’re together in the water.

Returning to those hooting owls, they become a parliament. Sure, that makes sense.

A group of hippos is called a bloat. While hippos average 3,310 pounds as an adult, the same word doesn’t apply to the larger elephant, which is part of a herd.

A number of crows is a murder, reflecting, perhaps, their ominous role in literature.

Penguins may take the word group crown, having a wide array of terms for them when they get together. A group is called a colony, rookery or huddles. It doesn’t end there. Swimming penguins, like ducks, are a raft. More likely than not, you might guess the name for walking penguins: they are a waddle.

by -
0 1430
Dr. Peter Igarashi is the incoming dean of the Renaissance School of Medicine. Photo from University of Minnesota

Stony Brook University’s Renaissance School of Medicine has named Dr. Peter Igarashi, a nephrologist and physician scientist, as its new dean, effective Sept. 12.

Igarashi comes to Stony Brook from the University of Minnesota Medical School, where he is the Nesbitt Chair, professor and head of the Department of Medicine.

At the University of Minnesota, the new dean oversaw 600 full-time and affiliate faculty, 100 adjunct faculty, and over 240 residents and fellows, all while increasing National Institutes of Health funding by 60%.

At UMN, he also helped to cut gender pay disparities, appointed women to leadership positions, developed new multidisciplinary programs, and created an Office of Faculty Affairs and Diversity.

“Dr. Igarashi is a superb, academically accomplished physician leader with a highly successful track record of clinical program growth and research advancement,” Dr. Hal Paz, executive vice president of Health Sciences at SBU and chief executive officer of Stony Brook University Medicine, said in a statement. 

Igarashi has received over $25 million in funding from the NIH during a career in which he has studied polycystic kidney disease, transcriptional regulation, epigenetics and kidney development.

Polycystic kidney disease, or PKD, is an inherited disorder that involves the development of clusters of cysts, primarily in the kidney. Symptoms of the disease can include high blood pressure, loss of kidney function, chronic pain and the growth of cysts in the liver, among others.

His lab developed unique lines of transgenic mice that he has used to study kidney-specific transgene expression and gene targeting.

In addition to writing nine chapters in textbooks, Dr. Igarashi has also authored more than 100 peer-reviewed journal articles.

Before his seven-year stint at the University of Minnesota, Dr. Igarashi had been Chief of the Division of Nephrology and founding director of the O’Brien Kidney Research Core Center at the University of Texas Southwestern Medical Center in Dallas.

At the University of Texas, Dr. Igarashi created services to provide regular kidney dialysis to undocumented and other often marginalized patients. He also led an effort to use artificial intelligence to identify and optimize co-management of patients with hypertension, diabetes, and chronic kidney disease in primary care practices.

A recipient of the NIH Merit Award, Dr. Igarashi also won the 2015 Lillian Jean Kaplan International Prize in polycystic kidney disease. The award honored his contribution to the goal of developing treatments and a cure for polycystic kidney disease.

Dr. Igarashi earned his medical degree from the UCLA School of Medicine and completed an internal medicine residency at the University of California Davis Medical Center. He did a nephrology fellowship at Yale University and also taught at the Yale University School of Medicine.

Dr. Igarashi is board-certified by the American Board of Internal Medicine. He is a member of the American Heart Association Kidney Council, the American Physiological Society, the American Society for Clinical Investigation, the American Society of Nephrology and the Association of American Physicians.

Dr. William Wertheim had been the interim dean of the Renaissance School of Medicine since February 2021, following Dr. Kenneth Kaushansky’s retirement after serving as dean and senior vice president of health sciences for 11 years.

Dr. Wertheim will return to his role as vice dean for graduate medical education. He will also have a leadership role at the Stony Brook Medicine Community Medical Group, which is an arm of Stony Brook Medicine and includes over 35 community practices with over 50 locations across Long Island.

by -
0 1163
Sechrist model chamber for hyperbaric oxygen therapy. Photo courtesy Renee Novelle

Port Jefferson’s St. Charles Hospital will open its new Center for Hyperbaric Medicine & Wound Healing on July 18, as the hospital seeks to help people with chronic, nonhealing wounds.

The center, which will be located on the second floor of the hospital, will include two hyperbaric chambers that provide 100% pure oxygen under pressurized conditions and will have four examining rooms.

The chamber “provides patients with the opportunity to properly oxygenate their blood, which will increase wound healing and wound-healing time,” said Jason Foeppel, a registered nurse and program director for this new service.

Potential patients will be eligible for this treatment when they have wounds that fail to heal after other treatments for 30 days or more.

Residents with circulatory challenges or who have diabetes can struggle with a wound that not only doesn’t heal, but can cause other health problems as well.

More oxygen in people’s red blood cells promotes wound healing and prevents infection.

The treatment “goes hand in hand to deliver aid to the body’s immune system and to promote a healing environment,” Foeppel said.

Nicholas Dominici, RestorixHealth regional director of Clinical Operations; Ronald Weingartner, chief operating officer, St. Charles Hospital; Jim O’Connor, president, St. Charles Hospital; and Jason Foeppel, program director. Photo courtesy Renee Novelle

St. Charles is partnering with RestorixHealth in this wound healing effort. A national chain, RestorixHealth has created similar wound healing partnerships with other health care facilities in all 50 states.

The new wound healing center at St. Charles is one of several others on Long Island, amid an increased demand for these kinds of services.

Partnering with Healogics, Huntington Hospital opened a hyperbaric chamber and wound healing center in May 2021. Stony Brook Southampton Hospital also has a wound care center.

“There’s a great need for this in our community,” said John Kutzma, program director at the Huntington Hospital center. “We know that there are 7 million Americans living with chronic wounds,” many of whom did not receive necessary medical attention during the worst of the pandemic, as people avoided doctors and hospitals.

Concerns about contracting COVID-19 not only kept people from receiving necessary treatment, but also may have caused nonhealing wounds to deteriorate for people who contracted the virus.

Although Kutzma hasn’t read any scientific studies, he said that, anecdotally, “We’ve had patients that had COVID whose wounds haven’t healed as quickly as non-COVID patients.”

Patients at the Huntington Hospital center range in age from 15 to 100, Kutzma said. People with diabetes constitute about one-third of the patients.

Treatment plan

For the hyperbaric chamber to have the greatest chance of success, patients typically need daily treatments that last between one and a half to two hours, five days a week for four to six weeks. While the time commitment is significant, Foeppel said it has proven effective in wound healing studies.

“We pitch it as an antibiotic treatment,” he said. “You want to complete that full cycle to ensure the body has enough time to complete the healing process.”

Kutzma said Huntington Hospital reviews the treatment plan with new patients.

In following the extensive treatment protocol to its conclusion, he said, “The alternative is to live with this very painful, chronic wound that may lead to amputation.” Given the potential dire alternative, Huntington Hospital doesn’t “have a problem getting that kind of commitment.”

While the treatment has proven effective for many patients, not everyone is medically eligible for the hyperbaric chamber.

Colin Martin, safety director. Photo courtesy Renee Novelle

Some chemotherapy drugs are contraindicators for hyperbaric oxygen treatments. Those patients may have other options, such as skin grafts, extra antibiotics or additional visits with physicians for debridement, which involves removing dead, damaged or infected tissue.

“We invite patients to come in, go through the checklist and see what their plan of attack” includes, Foeppel said.

The cost of the hyperbaric treatment for eligible conditions is generally covered by most health insurance plans, including Medicaid and Medicare, he said. 

The two hyperbaric chambers at St. Charles can treat eight to 10 patients in a day.

Aside from the cost and eligibility, patients who have this treatment frequently ask what they can do during their treatments. The center has a TV that can play movies or people can listen to music.

“We don’t expect you to sit there like in an MRI,” Foeppel said.

As for complaints, patients sometimes say they have pressure in their ears, the way they would if they ascend or descend in an airplane. The center urges people to hold their nose and blow or to do other things to relieve that pressure.

Foeppel encourages patients to use the restroom before the treatment, which is more effective when people don’t interrupt their time in the chamber.

Prospective patients don’t need a referral and can call the St. Charles center at 631-465-2950 to schedule an appointment.

by -
0 1226
Markus Seeliger, third from left, with members of his lab, from left, Terrence Jiang. Aziz Rangwala, Ian Outhwaite, Victoria Mingione,YiTing Paung, and Hannah Philipose. Photo from Markus Seeliger

By Daniel Dunaief

When a dart hits the center of a target, the contestant often gets excited and adds points to a score. But what if that well-placed dart slipped off the board before someone could count the points, rendering such an accurate throw ineffective?

With some cases of cancer treatments, that’s what may be happening, particularly when a disease develops a mutation that causes a relapse. Indeed, people who have chronic myeloid leukemia typically receive a treatment called Imatinib, or Gleevac.

The drug works, hitting a target called a kinase, which this white blood cell cancer needs to cause its cells to continue to divide uncontrollably. Patients, however, develop a mutation called N368S, which reduces the effectiveness of the drug.

While mutations typically make it more difficult for a drug to bind to its target, that’s not what’s happening with this specific mutation. Like the dart hitting the center of a board, the drug continues to reach its target.

Instead, in a model of drug resistance several scientists have developed, the mutation causes the drug to decouple.

Pratyush Tiwary with this year’s US top 20 students who are going to the international chemistry olympiad. Photo from Toward

A team of experimental and computational researchers including Markus Seeliger, Associate Professor of Pharmacological Sciences at Stony Brook University, and Pratyush Tiwary, Associate Professor in the Department of Chemistry & Biochemistry at the University of Maryland, published two research papers explaining a process that may also affect the way mutations enable resistance to other drugs.

Seeliger described how different disease-associated mutations bind to Gleevac in a paper published in the Proceedings of the National Academy of Sciences. 

Working with scientists at Memorial Sloan Kettering Cancer Center and Goethe University in Frankfurt, Germany, Seeliger used nuclear magnetic resonance spectroscopy, or NMR. The researchers showed how the drug bound to its target and then released.

Understanding the way diseases like cancer develop such resistance could affect drug discovery, giving pharmaceutical companies another way to prepare for changes diseases make that reduce the effectiveness of treatments.

A ‘hot paper’

Tiwary published research in which Seeliger was a coauthor in late April in the journal Angewandte Chemie that the publication labeled a “hot paper” for its implications in the field. Tiwary developed a way to simulate the kinetic processes that enable the mutated kinases to release the drug.

Tiwary created an artificial intelligence model that extended the time he analyzed the drug-protein interaction from milliseconds all the way out to thousands of seconds.

“Even within the simulation world, if you can quantitatively predict a binding affinity, that’s amazing,” Seeliger said. “It’s extremely hard to calculate kinetics, and he got that right.”

Tiwary, who started talking with Seeliger about five years ago and has been actively collaborating for about three years, uses experimental data to inform the dynamics that affect his simulations.

Seeliger “had done the experiments of the dissociation rates beforehand, but did not have a way to explain why they were what they were,” Tiwary explained in an email. “Our simulations gave him insights into why this was the case and … insight into how to think about drugs that might dissociate further.”

Drug discovery

Tiwary hopes the work enables researchers to look at structural and kinetic intermediates in reactions, which could provide clues about drug design and delivery. While he worked with a single mutation, he said he could conduct such an analysis on alterations that affect drug interactions in other diseases.

He wrote that the computations, while expensive, were not prohibitive. He used the equivalent of 16 independent 64 CPUs for one to two weeks. He suggested that computing advances could cut this down by a factor of 10, which would enable the exploration of different mutations.

“The methods are now so easy to automate that we could run many, many simulations in parallel,” Tiwary explained. Machine learning makes the automation possible.

Given what he’s learned, Tiwary hopes to contribute to future drug begin that addresses mutation or resistance to treatment in other cancers. He also plans to continue to work with Seeliger to address other questions.

Next steps

Seeliger said he plans to extend this work beyond the realm of this specific type of cancer.

He will explore “how common these kinetic mutations are in other systems, other diseases and other kinases,” Seeliger said.

He would also like to understand whether other proteins in the cell help with the release of drugs or, alternatively, prevent the release of drugs from their target. The cell could have “other accessory proteins that help kick out the drug from the receptor,” Seeliger said.

The concept of drug resistance time comes from infectious disease, where microbes develop numerous mutations.

Seeliger, who is originally from Hanover, Germany, said he enjoys seeing details in any scene, even outside work, that others might not notice. 

He described how he was driving with postdoctoral fellows in Colorado when he spotted a moose. While the group stopped to take a picture, he noticed that the moose had an ear tag, which is something others didn’t immediately notice.

As for the research collaboration, Seeliger is pleased with the findings and the potential of the ongoing collaboration between experimental and computational biologists.

“The computational paper, aside from using interesting new methodology, describes why things are happening the way they are on a molecular level,” he said.

by -
0 267
Pixabay photo

By Daniel Dunaief

Daniel Dunaief

I read bumper stickers, buttons, fortune cookies and messages on T-shirts. They are a form of poetry that captures a moment, an approach, an attitude, and a message in fewer words than some of the soupier birthday cards.

Like birthday cards, sometimes these messages work, are amusing, evoke a reaction, or make me laugh for intentional and unintentional reasons.

In the modern world, in which so many interactions seem less than optimal or contrary to the intentions, I have some suggested messages that reflect the current state of customer service and civility, or lack thereof.

— Please don’t interrupt. I’m in the middle of looking busy. When I started working many years ago, someone told me to balance between looking busy and being under control. She suggested I walk quickly and purposefully, even if just to the bathroom, to suggest that I’m too busy to tackle something new that might involve lots of administrative work.

— Yes, I am talking to you. Those of you old enough to have seen the Robert De Niro film “Raging Bull” will understand this one instantly. This message captures the prevalence of confrontations.

— I have no idea what’s good. I don’t eat here. Diners often ask waiters and waitresses, “what’s good.” More often than not, they tell people what’s popular dishes or their specials. The subtext here is that some of them don’t, can’t or wouldn’t eat where you’re eating, especially after spending considerable time in the kitchen.

— Everything and nothing is special today. Keeping with the dining theme, while blending in some grade inflation, waiters could provide something philosophical for their diners to consume.

— I believe in building suspense. The assignment, the job, or even the entree may be later than someone wanted. This message could suggest the tardiness was deliberate and was designed to enhance appreciation and add drama. So, you’re welcome.

— Sure, you can ask. I like the buttons people wear at Yankees games that encourage fans to ask a question. On a day when these customer service professionals are feeling tired or hung over, they could don messages that encourage people to move along or to figure out how to drive home to Pennsylvania from the Bronx on their own.

— How can I appear to help you? Life is all about optics. Yes, we should be helping and yes, people are paid to help each other, in person, on phone and on the Internet. Sometimes, the person (or artificial intelligence programs) that is offering assistance isn’t delivering much.

— I brought my own questions, thanks. I would love it if a politician wore this button to a debate. On one level, it could suggest the candidate has questions that are hopefully substantive for his or her opponent. On the other, it could be an honest way of acknowledging the disconnect between a question about the environment and an answer about the person’s commitment to family.

— What can you do for me? This is a way of turning the tables, literally, on a hostile or inappropriate customer. It also discourages people from asking too much of someone who is not eager to deliver.

— Is there anything else I can’t do for you? I’ve been on numerous calls with people who haven’t done anything, particularly when dealing with traveling details, who then ask if there’s anything else they can help me with. When they haven’t helped me with the first question, it’s hard to imagine they can help with a second. A more honest message might suggest that they also anticipate not being able to provide any help with a second problem or question.

— What did you get me for my birthday? People often want, or expect, something, even from strangers, on their birthday. They don’t often consider that the person from whom they expect service, help or extra treatment had a birthday they likely missed.

by -
0 1789
Members of the CanCan team, from left,Oliver Maddocks, David Lewis, Johan Vande Voorde, Bette Caan, Marcus Goncalves, Eileen White, Mariam Jamal-Hanjani, Tobias Janowitz, Karen Mustian, Janelle Ayres andToni Hui

By Daniel Dunaief

If a team Cold Spring Harbor Laboratory Assistant Professor Tobias Janowitz co-leads succeeds, researchers will know more about the end stage of numerous types of cancer that involves the loss of tissue and muscle mass.

Tobias Janowitz

Recently, lead scientists Janowitz; Eileen White, Rutgers Cancer Institute of New Jersey Deputy Director and Chief Scientific Officer; and Dr. Marcus DaSilva Goncalves, Assistant Professor of Medicine at Weill Cornell Medicine received $25 million in funding as a part of a Cancer Grand Challenge, which is a combined trans-Atlantic funding effort between Cancer Research UK and the National Cancer Institute in the United States.

The cachexia group was one of four teams to receive funding among 11 finalists.

Bruce Stillman, president of Cold Spring Harbor Laboratory, described cachexia as “one of the most difficult clinical problems with late stage cancer.”

Stillman added that the collaboration is promising because it brings together a group of “remarkable” scientists, including White, who was a postdoctoral fellow in Stillman’s lab. “It has great potential for making a difference in the lives of patients.”

Stillman believes Janowitz is an ideal co leader for this challenging project because he has an MD and a PhD and is clinically certified as an oncologist.

CanCan team

For his part, Janowitz is looking forward to the opportunity to team up with other ambitious research efforts to create a virtual institute.

Eileen White

“It’s incredibly exciting to get the chance to do something you think is higher risk with a large group of people who have come together around this problem,” said Janowitz. “We often talked about how it would be nice to bring team members from other disciplines into this area.”

Indeed, the cachexia team, which White named CanCan for Cancer Cachexia Action Network believes cachexia is a tumor-driven metabolic imbalance. The group is pursuing different areas of research, including metabolism, neuroendocrinology, clinical research, and immunology, among others, to define clinical subtypes with the hopes of creating individualized therapies.

While the effort brings together a range of scientists with different expertise and technological skills, researchers don’t expect an immediate therapeutic solution within that time frame. Rather, they anticipate that their experiments and clinical data will help inform future approaches that could enhance efforts to prevent and treat a wasting disease that causes severe declines in a patient’s quality of life.

“What we would deem as a success is, if in five years time, we have maybe one to three strong lead hypotheses that comes out of our shared work on how we can either prevent or treat cachexia as it emerges,” Janowitz said.

The complexity of cachexia

Dr. Marcus DaSilva Goncalves

As a complex process that involves an understanding of numerous interconnected dynamics, cachexia has been a challenging field for researchers and a difficult one for funding agencies looking for discrete problems with definable results and solutions.

Cachexia research had “never reached this critical mass that people were seeing where we can say, ‘Okay, there’s enough work going on to really unravel this,’” Janowitz said.

The CanCan team has several scientific themes. Janowitz will be involved with metabolic dysregulation. He would like to understand the behavioral changes around appetite and food intake.

Additionally, the group will explore the interaction of normal cells and cancer cells by looking at the tumor micro environment. This research will explore how cancer cells can reprogram healthy host cells.

“We’ve got a really exciting axis of research” within the network, Janowitz said.

Searching for signaling molecules

Janowitz said Norbert Perrimon, James Stillman Professor of Developmental Biology at Harvard Medical School is one of the leading experts in fly genetics and fly biology. Perrimon has created a model of cachexia in the fruit fly. While that sounds far from patients, Perrimon can use single molecule resolution of the entire organism to get an insight and understanding of candidate molecules.

“We are hoping to search for new signaling molecules that might get involved” in cachexia, Janowitz said. Once the research finds new candidates, he and others can validate whether they also work in mouse models of cancer and cancer cachexia.

With numerous clinical groups, Janowitz hopes to contribute to the design and execution of experimental medicine studies.

The Cancer Grand Challenge will distribute the funds based on what members need. Janowitz described the allocation of funds as “roughly equitable.” He will use that funding to support a postdoctoral researcher, a PhD student and a technician, who can help with specific projects he’s merging in his lab to combine with the team effort.

The funds will also support his salary so he can supervise the work in his lab and help with the coordination of this effort.

The funding agencies have an additional budget to organize conferences and meetings, where researchers can discuss ideas in person and can ensure that any clinical and laboratory work is standardized and reproducible in different facilities.

Cold Spring Harbor Laboratory will host the first full gathering of the cachexia team in November.

Challenging beginnings

When he was a doctor in the United Kingdom, Janowitz was fascinated and confounded by cachexia. In the early years of his training, he saw patients who had a small tumor burden, but were so sick that they died. Those experiences made “such a strong imprint” that he wanted to help unravel this process as a junior oncologist, he said.

Getting funding was challenging because cachexia was complex and didn’t involve a finely defined project that linked a receptor protein to a cell type that led to a diseased condition.

Janowitz, among others in this field, felt passionate enough about this area to continue to search for information about cachexia. After he restructured his research into a narrower focus, he secured more funding.

An unsolved mystery

With enough researchers continuing along this path, Janowitz said the group developed an awareness that this is “one of the big, unsolved mysteries of cancer progression.”

Janowitz appreciates the opportunity to work with a team that has accomplished researchers who work in fields that are related or synergistic, but aren’t necessarily considered part of the cachexia field.

The significant funding comes with expectations.

“The grant is both a great joy, but also, essentially, a mandate of duty,” he said. “Now, you have to utilize this grant to make significant contributions to understand and hopefully treat this debilitating condition.”

by -
0 300

By Daniel Dunaief

Daniel Dunaief

We don’t usually go to bed thinking, “what if I’m wrong?” We don’t get up asking ourselves the same question.

We develop our beliefs, stick with them and, as time goes on, we defend them or push for change based on something we think, or are fairly certain, we know.

But it’s worth considering the possibility that we might be wrong, particularly in connection with something as important as the only habitable planet we know.

If you don’t believe climate change is a threat and you think rules restricting environmental pollution are unnecessary and a federal government overreach, have you considered the consequences of being wrong?

I won’t trot out all the climate science experts who have what they consider incontrovertible proof that the climate is warming based on years of data.

You’d probably come back with the argument that the data can be interpreted in other ways or that science itself rarely has complete certainty.

You might even suggest that a warmer climate would mean we wouldn’t need to use as much heat during the winter months and that some crops might grow better during a longer, hotter growing season.

While I don’t ascribe to those thoughts —which a headline grabbing Republican recently espoused — because of the danger to so many staple crops from a warmer season that could include droughts and storms that cripple cities and destroy crops, I want those who don’t believe climate change is real to consider what might happen if they are wrong.

At the time of this writing, the Supreme Court hadn’t ruled on West Virginia vs. Environmental Protection Agency. If the conservative majority, who have been reshaping the political and legal landscape at a rapid pace, rules as expected, the EPA will have less authority to regulate power plant pollution.

That would mean power plants won’t have to comply with federal rules that limit the gases they emit into the environment and the pollutants they send into the air.

These companies may be able to make more money by continuing to operate as they had in the past. Yay for them? Right? Well, not so fast.

What’s the risk if they are wrong? We all make decisions when weighing risks, whether it’s the types of stocks we invest in, the places we go that might be dangerous at night, or the undercooked foods we eat.

So, if they’re wrong, the world continues to heat up, storms such as hurricanes move more slowly, dumping more rain on any one area, crops get destroyed, glaciers continue to melt causing sea levels to rise, and biodiversity declines, wiping out species that might have otherwise led to cures for disease or provide future food sources.

Some areas also become uninhabitable.

Our children, grandchildren and future generations can’t come back to tell us who was right. What we do or don’t do, however, will undoubtedly affect them.

Using the same logic climate change deniers use to suggest that nothing is certain, it seems critical to hedge their bets, protecting us from a future they believe is possible but unlikely.

Even if the Supreme Court acts (or acted, depending on the timing) as expected, we don’t have to be fatalistic or cynical about the next steps in the battle against our own gaseous waste.

Utilities and other companies that produce these gases have to take responsibility for their actions, regardless of what the Supreme Court says or does. Even reluctant legislators have to consider what might happen if they are wrong. Yes, leaders have numerous other problems.

We can’t ignore the Earth. If some people consider the consequences of freeing up companies to send carbon dioxide into the only air we have, they might be making a one-way mistake. They must consider what will happen if they are wrong.

by -
0 597
Photo from Stony Brook Medicine

By Daniel Dunaief

[email protected]

While looking after the physical and mental well-being of patients who come in for care, Suffolk County hospitals are also focused on protecting staff, patients and visitors from the kind of violence that has spread recently throughout the country.

Over the past six months, hospital security staff and administrators have added a host of procedures to enhance safety and are considering additional steps.

“New measures have been put in place to minimize risk and better secure our buildings from a variety of threats,” Frank Kirby, Catholic Health Service line manager, wrote in an email. Catholic Health includes St. Catherine of Siena in Smithtown and St. Charles in Port Jefferson, among others.

“All Catholic Health facilities have an ‘active shooter’ contingency policy, which includes training for our employees on what to do in such an event,” Kirby wrote.

Executives at several health care facilities shared specific measures they have put in place.

The safe room

“Over the last six months or so, we have created something called the safe room,” said Dr. Michel Khlat, director at St. Catherine of Siena. Inside that room, hospital staff can hide and can find emergency items, like a door stop, medical supplies, gauze and first aid equipment.

St. Catherine recommends putting all the tables down in the safe room and hiding.

Khlat added that the hospital recommends that staff not open a door where another staff member knocks, in case a criminal is squatting nearby, waiting for access to the hospital.

Kirby added that Catholic Health facilities actively conducts drills across their hospitals, medical buildings and administrative offices to “sharpen our preparedness for any potential crisis that could impact safety and security.”

Catholic Health hospitals have onsite security guards and field supervisors who have prior military or law enforcement experience, Kirby added.

Northwell Health

As for Northwell Health, which includes Huntington Hospital, Scott Strauss, vice president of Corporate Security at Northwell, said the hospitals have an armed presence that includes many former and active law enforcement officers.

Strauss himself is a retired New York Police Department officer who, as a first responder on 9/11, rescued a Port Authority officer trapped by the fall of the World Trade Center.

Northwell is researching the possibility of installing a metal detection system.

Strauss suggested that the security program could not be successful without the support of senior leadership.

He suggested that staff and visitors can play a part in keeping everyone safe by remaining vigilant, as anyone in a hospital could serve as the eyes and ears of a security force.

The security staff has relied on their 15 to 35 years of experience to deescalate any potentially violent situations, Strauss said.

Northwell hospitals also offer guidance to staff for personal relationships that might
be dangerous.

“People don’t realize they’re in a poor relationship, they might think it’s normal,” Strauss said.

Across social media and the Internet, the communications team at Northwell monitors online chatter to search for anything that might be threatening.

“We evaluate it and notify the police as needed,” said Strauss.

Aggressive behavior

Strauss urged people who see something threatening online to share it with authorities, either at the hospitals or in the police force. “You can’t take a chance and let that go,” he said.

At this point, Northwell hasn’t noticed an increase in threats or possible security concerns. It has, however, seen an increase in aggressive behavior at practices and in
the hospitals.

In those situations, the security team investigates. They offer to get help, while making it clear that “threatening in any way, shape or form is not tolerated,” Strauss said. “There could be consequences” which could include being dismissed from the practice and filing police reports, Strauss said.

Anecdotally, Strauss believes Northwell has seen an increase in police reports.

When the draft of the Supreme Court’s decision that will likely overturn Roe vs. Wade, the landmark 1973 case that made it unconstitutional for states to restrict abortions, became public, Strauss was concerned about the potential backlash for health care providers.

So far, Strauss said gratefully, Northwell hasn’t seen any violence or threats related to the pending decision.

Stony Brook

Stony Brook University Hospital has an accredited and armed law enforcement agency on campus, in addition to a team of trained public safety personnel within the hospital, explained Lawrence Zacarese, vice president for Enterprise Risk Management and chief security officer at Stony Brook University.

Zacarese indicated that university officers are extensively trained in active shooter response protocols and are prepared to handle other emergency situations.

He added that the staff looks for ways to enhance security.

“Our training and security activities are continuous, and we are committed to exploring additional opportunities to maintain a safe and secure environment,” he explained in an email.

Kirby of Catholic Health Security suggested that hospitals do “more than provide care for surgical and medical inpatients. They also need to guarantee safety for all who enter our grounds.”

Prev1...454647...165Next Page 46 of 165
TBR News Media is your local news and entertainment website.
We provide you with the latest breaking news and information for your community.
Contact us: [email protected]

Most Viewed

©