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Daniel Dunaief

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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

Sure, the book “What to Expect When You’re Expecting” could be helpful.

Until you’ve gone through pregnancy and had a child, you don’t really know what’s around the corner. Other parents sometimes expect you to follow their footprints to the promised land, which somehow didn’t always seem like the happiest place on Earth for them or their screaming kids.

You hear about terms like first, second and third trimester, which sound like safe little building blocks you might want to play with on the floor, stacking one on top of another while Mozart plays blissfully in the background.

But, really, so much of life, even during those days before childbirth, when moms are expecting, doesn’t follow a script or textbook cue cards.

My wife and I tried to keep at least a month ahead of the “nesting phase” and the “tired phase” among so many others in the books.

We went to Lamaze classes where, despite being in our mid 30s, we felt remarkably young in New York City compared to so many other first-time parents in their late 30s and early 40s who were sharing pregnancy stories and preparing to “breathe, honey,” and to count the time in between contractions.

Our birth plan went out the window when, after my wife’s three valiant days of pushing, our doctor decided to do a C section. How do you make important decisions when you’re beyond exhausted and when your excitement and anxiety seem to be in an extended foot race for your attention?

Just before the doctor started the procedure, she told me that if I passed out at any time, they were going to leave me on the cold, concrete floor, stepping over me to tend to my wife and daughter.

Fortunately, everything worked out, despite the challenges for my wife of recovering from abdominal surgery that made even the simplest of motions, like rising out of a chair, difficult and painful.

So, here we are, over two decades later, and we and others are still maneuvering around playbooks we’ve had to rewrite. It seemed fitting, given that it’s Mother’s Day this Sunday, to reach out to a few successful scientists — I cover science, so these are my peeps — to ask them a few questions.

IACS Endowed Chair of Ecology & Evolution at Stony Brook University Heather Lynch explained some of the best parenting advice she got was to think of “running the household like running a business, and outsource what can be outsourced with zero guilt.”

Cold Spring Harbor Laboratory Professor and HHMI Investigator Leemor Joshua-Tor, meanwhile, said she learned to trust her gut, especially for the timing of discussions with her daughter. As her daughter enters her teenage years, Joshua-Tor has taken more of an advisory role, letting her have more control over her life while offering a calming presence.

Joshua-Tor wrote in an email that she thought “my daughter would have a good role model with a mom that had a fulfilling career and work life.”

Joshua-Tor was pleased to hear her daughter bragging about her mom’s career.

Lynch, who studies penguins that share parenting duties, credits marrying well for her parental success.

She and husband, Matthew Eisaman, who has a joint appointment at Stony Brook and Brookhaven National Laboratory, “split things 50-50 and if I had to do even 51% of everything, I think this whole house of cards would collapse,” she explained in an email.

Amid the pandemic, which wasn’t in any parenting textbooks (but probably will be in the future), Joshua-Tor said she tried to keep her daughter positive while ensuring her safety.

As a parent, Joshua-Tor added, “nothing was as I expected, but how deep things hit you is a biggy.”

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A. Laurie Shroyer Photo by Jeanne Neville/Stony Brook University

By Daniel Dunaief

Publish or perish.

It’s the academic paradigm that defines the importance of getting great research and ideas in front of the public. Not only does publishing enable researchers to share discoveries, but it also provides additional rungs on a career ladder.

Science journals with greater impact can raise the visibility of up-and-coming researchers, helping them win more competitive grants, get papers published in other journals, and receive coveted promotions and tenure.

In a recent study led by A. Laurie Shroyer, Professor of Surgery and Vice Chair for Research at the Renaissance School of Medicine at Stony Brook University, women authors in positions considered significant — first, second or last — appeared at a rate that was below their representation in academic medical school faculty for the three top ranking medical journals.

Published in the journal PLOS ONE of 1,080 author citations from 2002 to 2019 in The Lancet, the Journal of the American Medical Association and the New England Journal of Medicine, a team of researchers determined that women were listed as senior, or last, authors 18.6 percent of the time. Meanwhile, 26.8 percent of women were first authors.

The first and last author rates for women were lower than the 37.2 percent of women full-time academic faculty members, according to Shroyer. “This is truly striking. I never in my wildest dreams thought [the publication rate for women] was this low” particularly for last authors.

Indeed, the percentages varied by journal, with the New England Journal of Medicine coming in the lowest for first authors, at 15.83 percent, and the Journal of the American Medical Association showing the highest rate, at 35.39 percent. Lancet had 29.39 percent.

In response to emailed questions about the study, officials at the New England Journal of Medicine indicated that the journal does not ask authors to self-identify.

“With a group of publishers lead by the Royal Society of Chemistry, we’re developing best practices for encouraging diversity among authors,” said Eric Rubin, M.D., PhD and Editor-in-Chief of the NEJM. “Diversity in medicine is important, and we are taking steps where we can to encourage change or highlight inequities.”

In September 2021, the NEJM published an editorial that said having more diversity among researchers is one way to help make trials more representative. Additionally, in April 2021, the NEJM published a Special Report about the diversity of the medical student body.

“We believe we must diversify our own ranks and encourage diversity at all stages of medical training,” Dr. Rubin added.

The Lancet, meanwhile, indicated that the data they collected on gender representation among their authors, peer reviewers and Editorial Advisory Board members led them to develop new strategies to improve gender representation in the editorial process, including a diversity pledge and no all-male panel policy, according to a public relations statement. All Lancet International Advisory Boards are now 50 percent women. This past March, the Lancet hosted a webinar on gender equity.

Shroyer lauded The Lancet for providing a public disclosure of their author gender profiles. The Lancet’s “positive actions are admirable,” she said..

A request for comment from the Journal of the American Medical Association was not returned by press time.

While the JAMA women first author rate did not demonstrate a statistically significant difference from the Association of American Medical Colleges, it was different, at 20.8 percent for last authors and for any significant author role, at 32.8 percent compared to 37.2 percent overall.

To be sure, Shroyer and co-author Henry Tannous, chief of Cardiothoracic Surgery Division and co-director of the Stony Brook Heart Institute, didn’t receive the kind of information that would help shed greater light on the publishing process.

Shroyer explained that it would be helpful to have journal-specific editorial office data on author specific and publication specific details for manuscripts received, reviewed and accepted.

Without access to editorial office databases, “it will not be possible to discern the potential reasons behind the lower women author publication rates,” Shroyer explained, adding that with the unknown rate of gender-based submissions, it is possible that the relative proportion of submitted articles published might not be different between men and women.

“My hope is that this publication may inspire all of these top medical journals to publish their own summary reports and to share their own editorial office databases to facilitate future research in this field,” she said.

An ongoing pattern

Shroyer began investigating the author and publication characteristics associated with multiple successful publications in top medical research journals in late 2017.

To determine if the pattern had changed over time, Shroyer and Tannous divided the publication rates into early, 2002 to 2008; mid, 2009 to 2014; and late, 2015 to 2019. Using samples from these years, Shroyer concluded that there were no differences over time.

Among other conclusions, Shroyer said women first authors less commonly published clinical trials as compared with observational study designs. Their projects were also more frequently focused on infectious disease topics. Men, on the other hand, published more work focused on cardiovascular topics.

Shroyer added that the sampling of three journals’ records does not prove a gender bias. She could only show a discrepancy in the author publication rates.

She’s an advocate for individual investigator-based identifiers that are just numbers, which would allow for a more thorough and detailed analysis of any trends in publication rates.

This research provides a call for “greater transparency and accountability” Shroyer said.

As a potential optimistic sign, Shroyer found that first/ last authors with the same gender more often published clinical trials and had higher Web of Science citation counts, compared with first authors with different genders. First authors who were the same gender as last authors also had higher multiple top medical research journal publications.

While this doesn’t necessarily point to a clear mentor benefit, Shroyer suggests this connection between women principal investigators and their research staff may create greater publishing opportunities and advancement for women in science.

“My hope is that we can find ways to help each other,” she said. “Preliminary analysis shows potential promise.”

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Melissa Cohen with her children Andrew and Alice Turner. Photo courtesy of Alan Turner

Port Jefferson will likely be greener at this time next year, thanks to the efforts of 59 first graders at Edna Louise Spear Elementary School, their families and village trustees.

As a part of what Trustee Rebecca Kassay hopes will be an annual tradition, first graders will hear a talk in their class this Friday, April 29, on National Arbor Day, by Heather Lynch, IACS endowed chair of Ecology & Evolution at Stony Brook University. At that point, the students will also get coupons for free saplings of white oak, red spruce or winterberry shrubs.

The students and their families can plant the trees or shrubs in their backyards if they have space and clearance or at the Port Jefferson Country Club. The trees planted at the country club will not interfere with any golf games or other activities.

“We want to help foster that relationship between our young, upcoming stewards of Port Jefferson and the natural environment,” said Kassay, who spearheaded the project.

Planting trees will help offset losses incurred during storms and as some of the older trees die.

While sharing games like bird bingo, Lynch also hopes to speak with first graders about the role that native plants can play on Long Island.

“Planting trees is like a gift to their future selves,” said Lynch, who also described the effort as “paying it forward.” She hopes first graders see the role they play in Port Jefferson history by planting trees that will grow as they do and that will become a part of their enduring legacy.

While first grade students will receive saplings for free as a part of the project, Port Jefferson residents can also buy them for $1 at the farmers market on Sunday, May 8, while supplies last.

Kassay is describing the purchase for residents as a “dollar and a dream.”

Planting these trees will strengthen the ecology of the area, providing homes and food sources for local birds and insects and reducing runoff, Lynch added.

The trustees will invite the first graders, as well as community members, to help plant the tree nursery at the country club on Thursday, May 5, between 5 p.m. and 7 p.m., with a rain date of May 6. Residents can park at the country club and follow signage from The Turn restaurant to the tree nursery beyond the driving range. 

Family response

For several families in Port Jefferson, this kind of effort validates their commitment and interest in the village.

Nadine and Richard Wilches moved to Port Jefferson last year with their 9-year old son Lucas and their 7-year old daughter Cecilia.

“One of the reasons we moved to Port Jefferson is to experience a closer-knit community that includes taking care of the environment,” Nadine Wilches said. “Planting this tree will be a learning experience.”

Cecilia, who is in first grade at Edna Louise Spear school, shared some of her awareness of trees.

Without trees, “there would be no air,” Cecilia said. “The tree eats carbon dioxide. We eat the opposite, which is air, so the tree does the opposite.”

Cecilia has learned some of what she knows about trees from the work her brother Lucas is doing on photosynthesis in his class.

Lucas was born on Earth Day and also appreciates the connection to preserving the planet, the mother said.

Wilches added that the family tries to be cautious about their carbon footprint and has a hybrid car and an electric car.

She appreciates that the school and the village are “reinforcing our home values around the environment.” 

If Cecilia could ask a tree a question, she would want to know if it hurts a tree when it loses its leaves.

First grader Andrew Turner appreciates how trees provide a home for animals. He will join the group planting saplings at the country club, and wants to know how long it takes a tree to grow.

Andrew, who likes woodpeckers and who currently wants to be a paleontologist like his father, Alan Turner at Stony Brook University, enjoys jumping in leaf piles in the fall.

“The best time to plant a tree is 20 years ago, and the second best time is today.”

— Rebecca Kassay

Andrew’s mother Melissa Cohen, who is a graduate program coordinator in Ecology & Evolution at Stony Brook University, said she appreciates how this effort will help children in the school develop an understanding of trees and the benefits they bring to the community.

Longer term, Lynch, Kassay and others hope the first graders who participate in this effort develop a connection to the trees they plant.

“We envision these kids growing up with their trees,” Lynch said. “It would be amazing if the kids could all take pictures with their trees now and we can [see] them taking pictures when they graduate high school as a rite of passage.”

Kassay said these trees offer numerous benefits, including lowering heating costs from the shade they produce, increasing property values and stabilizing the soil by soaking up runoff from storms.

“The best time to plant a tree is 20 years ago, and the second best time is today,” Kassay said.

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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

Finally, two years later, we were going to see Billy Joel. We had bought tickets to a concert in April of 2020, which was canceled because of the pandemic. The rescheduled event last year was also delayed.

An anticipation had been building that reminded me of the seemingly endless three years between the end of the Star Wars film “The Empire Strikes Back” and “Return of the Jedi.”

Within a few blocks of the stadium, we ran into the heaviest traffic we’d experienced in Charlotte, North Carolina since we arrived four years ago. My wife asked if I wanted her to park the car so I could make sure I was in our seats on time. I declined, knowing I didn’t want to experience any part of the evening without her.

While we sat in our car, waiting for the slow line to move, we watched as many of the people heading to the stadium were our age or older. We were either being nostalgic or hoping Billy Joel’s music could be our musical time machine.

We arrived at the stadium well before the 8 pm start time, where every seat gradually filled. When Joel started the concert at 8:30 with “My Life,” the packed crowd roared its heartfelt approval.

The weight of time — the two years anticipating this concert and the decades that passed since I first enjoyed the song’s lyrics and melody — quickly slipped off my shoulders.

Flashing lights from the stage and enlarged images of Billy Joel’s 72-year old fingers dancing across the piano keys created a visual spectacle. Accompanied by saxophone and trumpet players who would have blown the roof off the building if there were one, Joel thanked the crowd for coming after a long delay.

With songs from several albums through the 70s and 80s, Joel shared some of his biggest hits. People in the crowd played their own version of the show “Name that tune,” shouting out the song’s title as quickly as possible.

Thanks to Linda Ronstadt, who Joel said encouraged him to play “Just the Way You Are,” he included that love song. Joel said he and his wife, for whom he wrote that song, got divorced, so people shouldn’t listen to him.

But listen to him and his music we did. When the lights were off, the packed crowd swayed back and forth, holding up cell phones with lit camera lights, the way previous generations of concertgoers held up their lighters.

As he’s done at other concerts I attended, Joel stopped singing and the band stopped playing during “Piano Man” while the audience sang the chorus, “Sing us a song you’re the piano man. Sing us a song tonight. Well, we’re all in the mood for a melody and you’ve got us feeling alright.” I’m sure I wasn’t the only one with a smirk and goosebumps.

Swaying and singing in our seats, we were active participants in this long-awaited evening out, allowing ourselves to enjoy moments of unity.

Not as spry as he’d been decades ago, Joel moved more gingerly. He still shared his storytelling and lyrical voice, captivating an appreciative crowd. In between tunes, he noodled at the piano, as if he weren’t in an enormous football stadium in North Carolina below the image of a ferocious panther but was, rather, in a piano bar somewhere in New York City. He said the “key” to his longevity was “not dying.”

When the nighttime air got too hot for us, a light wind, which is uncharacteristic for Charlotte, washed over our skin. Leaning in, my wife smiled and whispered, “cue the breeze.”

The music itself reached much deeper than the wind, refreshing our souls and allowing us to revisit people like Sergeant O’Leary, the old man making love to his tonic and gin, and the “Big Shot.”

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Kevin Reed. Photo courtesy of Stony Brook University

By Daniel Dunaief

Rain, rain go away, come again some other day.

The days of wishing rain away have long since passed, amid the reality of a wetter world, particularly during hurricanes in the North Atlantic.

In a recent study published in the journal Nature Communications, Kevin Reed, Associate Professor and Associate Dean of Research at the School of Marine and Atmospheric Sciences at Stony Brook University, compared how wet the hurricanes that tore through the North Atlantic in 2020 would have been prior to the Industrial Revolution and global warming.

Reed determined that these storms had 10 percent more rain than they would have if they occurred in 1850, before the release of fossil fuels and greenhouse gases that have increased the average temperature on the planet by one degree Celsius.

The study is a “wake up call to the fact that hurricane seasons have changed and will continue to change,” said Reed. More warming means more rainfall. That, he added, is important when planners consider making improvements to infrastructure and providing natural barriers to flooding.

While 10 percent may not seem like an enormous amount of rain on a day of light drizzle and small puddles, it represents significant rain amid torrential downpours. That much additional rain can be half an inch or more of rain, said Reed. Much of the year, Long Island may not get half an inch a day, on top of an already extreme event, he added.

“It could be the difference between certain infrastructure failing, a basement flooding” and other water-generated problems, he said. The range of increased rain during hurricanes in 2020 due to global warming were as low as 5 percent and as high as 15 percent.

While policy makers have been urging countries to reach the Paris Climate Accord’s goal of limiting global warming to 2 degrees Celsius above the temperature from 1850, the pre-Industrial Revolution, studies like this suggest that the world such as it is today has already experienced the effects of warming.

“This is another data point for understanding that climate change is a not only a challenge for the future,” Reed said. It’s not this “end of the century problem that we have time to figure out. The Earth has already warmed by over 1 degrees” which is changing the hurricane season and is also impacting other severe weather events, like the heatwave in the Pacific Northwest in 2021. That heatwave killed over 100 people in the state of Washington.

Even being successful in limiting the increase to 2 degrees will create further increases in rainfall from hurricanes, Reed added. As with any global warming research, this study may also get pushback from groups skeptical of the impact of fossil fuel use and more carbon dioxide in the atmosphere.

Reed contends that this research is one of numerous studies that have come to similar conclusions about the impact of climate change on weather patterns, including hurricanes.

“Researchers from around the world are finding similar signals,” Reed said. “This is one example that is consistent with dozens of other work that has found similar results.”

Amid more warming, hurricane seasons have already changed, which is a trend that will continue, he predicted.

Even on a shorter-term scale, Hurricane Sandy, which devastated the Northeast with heavy rain, wind and flooding, would likely have had more rainfall if the same conditions existed just eight years later, Reed added.

Reed was pleased that Nature Communications shared the paper with its diverse scientific and public policy audience.

“The general community feels like this type of research is important enough to a broad set of [society]” to appear in a high-profile journal, he said. “This shows, to some extent, the fact that the community and society at large [appreciates] that trying to understand the impact of climate change on our weather is important well beyond the domain of scientists like myself, who focus on hurricanes.”

Indeed, this kind of analysis and modeling could and should inform public policy that affects planning for the growth and resilience of infrastructure.

Study origins

The researchers involved in this study decided to compare how the 2020 season would have looked during cooler temperatures fairly quickly after the season ended.

The 2020 season was the most active on record, with 30 named storms generating heavy rains, storm surges and winds. The total damage from those storms was estimated at about $40 billion.

While the global surface temperature has increased 1 degree Celsius since 1850, sea surface temperatures in the North Atlantic basin have risen 0.4 to 0.9 degrees Celsius during the 2020 season.

Reed and his co-authors took some time to discuss the best analysis to use. It took them about four months to put the data together and run over 2,500 model simulations.

“This is a much more computationally intensive project than previous work,” Reed said. The most important variables that the scientists altered were temperature and moisture.

As for the next steps, Reed said he would continue to refine the methodology to explore other impacts of climate change on the intensity of storms, their trajectory, and their speed.

Reed suggested considering the 10 percent increase in rain caused by global warming during hurricanes through another perspective. “If you walked into your boss’s office tomorrow and your boss said, ‘I want to give you a 10 percent raise,’ you’d be ecstatic,” he said. “That’s a significant amount.”

Ecstatic, however, isn’t how commuters, homeowners, and business leaders feel when more even more rain comes amid a soaking storm.

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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

We all try, more or less, to say the right thing in the moment.

“Wow, so nice to see you again. You look wonderful.”

“How are your children?”

“How’s work? How many days a week are you back in person?”

But after cutting up turkeys, ham and other food, the real carving occurs in the hours and days after gatherings, when we separate into smaller groups and snicker, judge and let loose the parts of our sinister souls for which we seek atonement during religious and other holidays.

Now that family gatherings have restarted in earnest, despite the COVID clouds still hovering over us, we have a chance to turn moments of discomfort into a collage of complaints.

While I’m sure there might be a few people who don’t practice the fine art of conducting post-gathering analysis about friends, family members and loved ones, I have yet to meet them.

We ought to break the process, lighthearted ideally though it may, into various categories.

Clothing: Wardrobe choices are often the subject of discussion. We sometimes marvel at how revealing or tight an outfit was or how casually someone dressed for a larger gathering.

Defensive guests: Sometimes, what people say, or hear, has nothing to do with a question they were asked or even a conversation in which they participated. While I was recently cleaning dishes, another guest walked in and told me everything he had contributed to the confab. His need to share his contribution, or to allay any guilt he might have felt, was revealing.

Conversation interrupters: While many families have long-winded storytellers, some gatherings include a conversation interrupter. They are the people for whom any dialog that doesn’t revolve around them or their opinions is unwelcome and unworthy. They interrupt other people’s stories to interject their views on a topic or, perhaps, on something completely unrelated to the discussion.

Exacerbaters: These are the people for whom conflict is nearly as delicious as the homemade apple pie or fruit cobbler that awaits after dinner. Sensing conflict in a marriage or between siblings, they will figure out how to help build any tension in the moment. When challenged for their role as instigators, they will frequently play the victim card, claiming that making people angry at each other or at them wasn’t their intention and that everyone doesn’t understand how they were really only trying to help and to resolve the conflict.

Welcome to Narnia guests: No party is complete without at least one person who needs to bring everyone into their perspective or their world. These people often see everything through one perspective, whether it’s about saving stray dogs, the challenges of having difficult neighbors, or the difficulty of finding good Thai food in their neighborhood. The discussion could be about the challenges educators faced during the pandemic and, they will say, “Oh yeah? Well, that reminds me of the challenges of finding good Thai food.”

The revisionist historians: Often, some, or even many, of the people in a room spent considerable time with each other. Stories have a way of evolving over time, either because they sound better one way or because the storyteller’s memory has altered some of the facts to suit a better narrative. No, you didn’t invent the yo-yo, no, you didn’t predict the year the Cubs would finally win the World Series, and, no, you didn’t always use the phrase “just do it” before Nike added it to their ad campaign.

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Mehdi Damaghi. Photo from Stony Brook Hospital

By Daniel Dunaief

Do the birds on the Galapagos Islands, with their unique coloration, differently shaped beaks and specific nesting places, have anything to do with the cancer cells that alter the course of human lives?

For Mehdi Damaghi, Assistant Professor in the Department of Pathology at the Renaissance School of Medicine at Stony Brook University, the answer is a resounding, “Yes.”

Damaghi uses the same principles of evolutionary biology to understand how cancer, which resides within human genes, works to adapt, as it tries to win the battle to survive.

“What we try to understand is the Darwinian principals of cancer,” said Damaghi. Cancer “adapts and reprograms themselves” to their environment to survive.

Damaghi, who arrived at Stony Brook four months ago from Moffitt Cancer Center, plans to address numerous questions related to cancer. He recently received a $4 million grant from the Physical Science in Oncology program (PSON) through the National Institutes of Health/ National Cancer Institute. Working with cancer biologists, clinicians, and computational scientists, he plans to define and understand cancer’s fitness.

“We are trying to study the core evolution of cancer cells and the normal stroma around them,” said Damaghi. “We are looking at the evolution of the tumor and some of the host cells.”

Cancer biologists are trying to build mathematical and theoretical models to explore the playbook cancer uses when confronted with threats, either in the form of a body’s natural defenses against it or from therapies against which it can, and often does, develop resistance.

Treating cancer could involve using adaptive therapy, which could enable people to control and live with cancer longer, Damaghi suggested.

In studying cancer’s phenotype, or the way the disease is expressed and survives, he hopes to understand factors in the microenvironment. Many cancers, he reasons, become more problematic as people age. Indeed, centuries ago, cancer wasn’t as prevalent as it is today in part because life expectancy was shorter.

Damaghi also has an evolutionary model to explore metastasis, in which cancer spreads from one organ or system to other parts of the body. He is looking at the earliest stages of breast cancer, to see what factors some of these cancers need or take from the environment that enables them not only to develop into breast cancer, but also to spread to other systems.

Through the microenvironment, he is looking for biomarkers that might signal a potential tumor development and metastasis long before a person shows signs of an aggressive form of the disease.

“We look at the tumor as a part of a whole ecosystem that can have different niches and habitats,” he said. “Some can be hypoxic and oxidative, and others can be like a desert on Earth, where not much grows and then cancer evolves.”

Damaghi challenges cells in a culture or organoids, which are miniature, three-dimensional live models of human cells, with different microenvironmental conditions to see how they respond. He exposes them to hormones, immune cells, and hypoxic conditions.

“We try to understand what is the adaptation mechanism of cancer to this new microenvironment and how can we push them back to the normal phenotype,” he said.

Like other scientists, Damaghi has demonstrated that many of these cancer cells use sugar. Removing sugar caused some of the cancer to die.

Increasing the survival for patients could involve knowing what kinds of micro-environments cancer uses and in what order. Deprived of sugars, some cancers might turn to amino acids, dairy or other sources of food and energy.

Damaghi thinks researchers and, eventually, doctors, will have to approach cancer as a system, which might have a patient-specific fingerprint that can indicate the resources the disease is using and the progression through its various diseased stages.

Choosing Stony Brook

Damaghi appreciates the depth of talent in cancer sciences at Stony Brook University. He cited the work of Laufer Center Director Ken Dill and Cancer Center Director Yusuf Hannun. He also suggested that the Pathology Department, headed by Ken Shroyer, was “very strong.”

For their part, leaders at Stony Brook were pleased to welcome, and collaborate with, Damaghi. Hannun suggested Stony Brook recruited Damaghi because his research “bridges what we do in breast cancer and informatics.”

Shroyer, meanwhile, has already started collaborating with Damaghi and wrote that his new colleague’s focus on breast cancer “overlaps with my focus on pancreatic cancer.”

To conduct his research, Damaghi plans to look at cells in combination by using digital pathology, which can help reveal tumor ecosystems and niches.

He also appreciated the work of Joel Saltz, the Founding Chair in the Department of Biomedical Informatics. “In the fight against cancer, we all need to unite against this nasty disease,” Damaghi said. “From looking at it at different angles, we can understand it first and then design a plan to defeat it.”

Originally from Tehran, Iran, Damaghi is the oldest of five brothers. He said his parents encouraged them to explore their curiosity.

Damaghi, whose wife Narges and two daughters Elissa and Emilia are still in Tampa and hope to join him before long, has hit the ground running at Stony Brook, where he has hired three postdoctoral researchers, a lab manager, four PhD students, two master’s candidates, and three undergraduates.

Damaghi is inspired to conduct cancer research in part because of losses in his family. Two grandparents died from cancer, his aunt has breast cancer, and his cousin, who had cancer when he was 16, fought through the disease and is a survivor for 20 years.

Damaghi bicycles and plays sports including soccer. He also enjoys cooking and said his guests appreciate his Persian kebobs.

As for his arrival in Stony Brook, he said it was “the best option for me. It’s a great package and has everything I need.”

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Commack resident Theodore Wawryk, above, recently received shockwave intravenous lithotripsy at Huntington Hospital. Photo from Wawryk

Theodore Wawryk, a resident of Commack who performs maintenance work at the Bronx Gardens nursing home, had six stents placed in his heart in 2005.

One of the doctors performing the procedure was Dr. Gaurav Rao. Photo from Rao

This past February, Wawryk, 52, had a buildup of calcium behind some stents at their edges, which could lead to restenosis, or a narrowing of the arteries again.

The patient came to Huntington Hospital, where his cardiologist, Dr. Raj Patcha, director of the Cardiac Catheterization Laboratory, couldn’t initially get through the blockage.

Patcha reached out to Dr. Gaurav Rao, director of Interventional Cardiology at Huntington Hospital, to see if Wawryk might be a candidate to become the first Huntington Hospital patient to receive shockwave intravascular lithotripsy, also known as IVL.

Rao had used the shockwave treatment, which uses pressure waves to create fractures in the calcium, for over a year at other hospitals and was prepared to introduce the procedure at Huntington Hospital.

Other options for breaking through the calcium, such as orbital or rotational atherectomies, which act more like miniature jackhammers breaking up the calcium in the arteries, are off label when a stent is nearby because it can shave off the metal in the stent, leading to other complications, Rao said.

Additionally, placing another stent in the area without modifying the calcium leads to stent failure.

Rao and Patcha performed the procedure in early February.

“This is a much safer” approach, Rao said. “It’s revolutionary in the way we deliver classic cardiac care.”

Shockwave IVL enables the placement of stents by creating fractures in the calcium that allow doctors to put in functional and durable stents, Rao explained.

Other area hospitals have used shockwave IVL for circulatory issues as well. Stony Brook Hospital, for example, uses shockwaves for peripheral arteries. Huntington Hospital also uses shockwaves to treat peripheral vascular disease.

While every surgical procedure includes risks, Rao cited studies that indicate that the possibility of a dissection, or a tear in the wall of the aorta, for heart-focused IVL is 0.3% for shockwave IVL, which is substantially lower than the 3.4% rate for orbital atherectomy and 3% for rotational atherectomy.

Rao said about 70% of patients who are coming in for stents are eligible for IVL, while the remainder are still candidates for atherectomy.

Extremely long lesions or lesions where the entry point is small so that doctors can’t deliver an IVL balloon make atherectomies, with their front cutting abilities, the preferred approach, he said.

So far at Huntington Hospital, the growing number of patients eligible for shockwave IVL have chosen to have this approach.

“No one has shied away from shockwave therapy,” Rao said.

Patient experience

As for the patient experience, Wawryk recalled how the operation, felt “a little weird.”

Wawryk described how the doctors told him he’d feel a “little zap” inside his body.

Indeed, Rao said the procedure uses an electrical pulse that can cause the heart rate, particularly for someone with a resting pulse below 60 per minute, to accelerate for about 10 seconds.

Intravenous lithotripsy, which uses a low energy pressure wave of about 8 to 10 nanojoules and involves inserting a tube through the arm or leg, is generally “well-tolerated” Rao said. Many patients don’t feel the effect of the procedure.

Even with the slight shockwave, Wawryk said he would recommend the procedure to other patients considering it.

Wawryk, whose father died of a heart attack at the age of 46, is grateful for the cardiac care he received. He appreciates the time he gets to spend with his wife Nydia and his 19-year-old son Michael.

The Commack resident spent a day at the hospital, as the procedure started at 7 a.m. and he was heading home by 7 p.m. that night. He said he felt like the staff treated him as if he were at a “five-star resort.”

Rao is pleased to offer this interventional cardiac approach at Huntington Hospital, which makes it possible for residents nearby to receive the treatment and head home, without a longer ride back from a hospital further away.

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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

When our children were young, we tried the Ferber method to encourage them to put themselves to sleep.

No, we didn’t abandon them in their room and return six hours later with a smile and a wink. We walked out of the room, told them to go to bed, and slowly extended the time before we returned.

It worked, although the complaints sometimes frayed our nerves to the point where we would argue about who drank the last of the milk, and I can’t even drink milk.

When the children got sick, all bets were off. Walking out of the room when they couldn’t breathe, when they had toxic sludge coming out of one or both ends, and when they had a fever was not an option for us, no matter how little sleep we’d had the night, week, or month before.

Once they recovered from their illness, however, we had to go back to the gradual Ferber method again, as they seemed to have forgotten that they might not need anything from us and that they should just close their eyes and go to sleep.

Parenting in the wake of the pandemic is a little like trying to figure out what role to play after the world has been sick for a few years and when we had to adapt whatever parenting rules we had established.

Do we tell them to “suck it up,” to “fend for themselves,” and to “tough it out,” or do we continue to offer support after they, and we, endured a new set of rules designed to keep us safe in the long term, but that caused all kinds of frustration in the shorter term?

Parenting always seems to have more questions than answers, but the number of questions and the frequency with which we ask them seems to have increased.

Indeed, even as our children have reached the age when we no longer have to strain our backs to make sure they don’t walk too close to the edge of a pool or to a rough surf, we still wonder what role, and how aggressively and consistently, we should play after the pandemic.

How many times have we wanted to agree with them in the last few years when they complained that “this isn’t fair?” Offering the reply, “who said life was fair,” didn’t seem appropriate, sympathetic or understanding. That response would only reinforce the reality that a year without graduation, proms, or downtime that didn’t involve a phone or a Monopoly board was definitely not fair.

Recently, I chatted with a parent in my neighborhood whom I haven’t seen in months. Within seconds, she shared her son’s recent tale of woe. Returning to the soccer field, he injured his leg badly enough that he’ll likely be out of action for soccer and several other sports for the next six months.

That, she said, is heartbreaking on top of all the time he missed on the field.

Amid all the concern for his physical well-being, she shared her worry about his mental health. She reached out to psychiatrist and psychologist friends, hoping to find someone with whom he might talk about yet another interruption in his plans to enjoy participating in a team sport.

To her dismay, she found that the mental health care system is as overburdened as the physical one was during the worst of the pandemic. Concerned about the context for her son’s life, she has dialed back her urge to encourage him to return to school on crutches, standing at the ready to bring him home whenever he feels physically and emotionally overwhelmed.

I completely understand that. At the same time, I wonder if and when we might deploy a safe Ferber-style approach after all the disruption of the last few years.

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Above, from left, CSHL Associate Professor Steven Shea, Yunyao Xie, a former postdoctoral researcher in Shea’s lab, and Roman Dvorkin at work. Photo from CSHL

By Daniel Dunaief

The black box has a blue spot.

Often considered so mysterious that it has been called “the black box,” the brain has a small cluster of cells called the locus coeruleus (LC), or blue spot because it appears blue.

The LC is the predominant source of the neurotransmitter noradrenaline, which plays numerous roles, including triggering the “fight or flight” response, sleep/wake regulation and memory.

Recently, Cold Spring Harbor Laboratory Associate Professor Stephen Shea and his post doctoral researcher Roman Dvorkin demonstrated that the LC was involved in normal maternal social behavior. In the publication Journal of Neuroscience, they demonstrated that surrogate mothers had a spike in this neurotransmitter just at the time when they retrieved young pups that had rolled out of the nest.

“Most of the research on noradrenaline and the LC has been involved in non-social behavior,” said Shea. Researchers have recorded it extensively during “cognitive tasks and memory formation.”

The evidence for its involvement in social behaviors has been more indirect. With the exception of a study 35 years ago that made a few recordings in cats, the current research is the “first time anyone has recorded” the LC during a more normal social behavior, Shea said.

Research on this blue spot could prove valuable in connection with understanding and treating a wide range of diseases and disorders. Noradrenaline (NA) is “one of the systems that is disturbed in anxiety and depression,” Dvorkin said. It also may be involved in other diseases, like autism. Scientists have conducted research on the LC and ADHD, Parkinson’s disease and Alzheimer’s disease, Dvorkin explained.

Some studies have also linked Rett syndrome, for example, which is a rare inherited genetic disorder that affects mostly girls and can alter the ability to speak, walk and eat, to lower levels of noradrenaline.

“There’s evidence that the LC has pathology in Mecp2 mice,” said Shea, referring to a gene traced to Rett. “We are working on that directly.”

Researchers believe studying the structure of the LC could lead to diagnostics and therapeutics for some of these diseases. Dvorkin suggested that this kind of research is “important to see how it works under normal, awake conditions.”

Monitoring the release of this neurotransmitter during a typical social behavior among female mice provides a context-connected understanding of its potential role.

“When people are studying this, they often use investigator-contrived tasks,” Shea said. “This is the system that preexisted for mice to use for other purposes.”

Shea has done earlier work with the LC, particularly as the sense of smell is so prominent in social interactions for mice. He demonstrated that anesthetized mice exposed to the scent of an unfamiliar mouse react as if they have a familiarity with the mouse. 

She believes the LC initiates sensory plasticity or sensory learning. NA can affect the sensory responses in parts of the brain that carry information, creating a stored memory. While his extensive work offers some clues about the role of the LC in mice, all vertebrates have the LC in their brain stems, including humans.

Shea said other research has demonstrated the involvement of the LC in cognitive tasks and memory formation, including during periods of sleep and wakefulness.

Blocking the release of noradrenaline is challenging in part because it is compact and the cells in the brain interact with so many of their neighbors, which makes turning on or off a specific signal from one region especially challenging.

At the University of Washington, Richard D. Palmiter and S.A. Thomas published a visible and definitive paper in 1997 in the journal Cell that brought the LC to other researcher’s attention.

These researchers created complete knockout mice, where they found that rodents lacking noradrenaline were “really bad mothers,” according to Shea.

In their research, Dvorkin and Shea used optogenetics and chemogenetics to inactivate the LC and the release of noradrenaline.

Future experiments

Below, a mouse retrieving a pup that has rolled out of its nest. Photo by Roman Dvorkin

The next step in this research could involve understanding the relative importance of the signal from the LC and noradrenaline.

In typical life settings, mice and other vertebrates confront competing signals, in which a pup rolls out of the nest at the same time that one of their many predators, like a hawk or other bird is circling overhead.

“That could be a next step” in this research, said Dvorkin.

Dvorkin believes it is possible to increase or decrease the threat level for mice gradually, in part because mice learn quickly when the threat is not real or what to avoid if the threat is too risky.

Shea is also looking more closely at courtship behavior.

The LC could be involved in sexual selection and in dominance hierarchies, enhancing the aggressive behavior of alpha males towards less dominant males. 

“We see big signals associated with events in courtship, including when the female and male begin to mate,” said Shea.

A resident of East Northport, Dvorkin lives with his wife Paolina and their nine year-old son Adam, who is in third grade at Pulaski Road School.

Originally from Afula in northern Israel, Dvorkin has been working in Shea’s lab for over five years. Outside the lab, he enjoys spending time with his family, taking pictures, and swimming at the JCC.

Dvorkin has enjoyed his work at CSHL, which he described as a “great experience in a beautiful place,” where he can appreciate the quiet and where he has received considerable support.

In the future, he’d like to apply his expertise in working on neuronal cell cultures and behaving animals to address translative questions, such as neurodegeneration.

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