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Daniel Dunaief

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Partha Mitra at the Shanghai Natural History Museum in China where he was giving a talk to children on how birds learn to sing.

By Daniel Dunaief

Throw a giant, twisted multi-colored ball of yarn on the floor, each strand of which contains several different colored parts. Now, imagine that the yarn, instead of being easy to grasp, has small, thin, short intertwined strings. It would be somewhere between difficult and impossible to tease apart each string.

Instead of holding the strings and looking at each one, you might want to construct a computer program that sorted through the pile.

That’s what Partha Mitra, a professor at Cold Spring Harbor Laboratory, is doing, although he has constructed an artificial intelligence program to look for different parts of neurons, such as axons, dendrites and soma, in high resolution images.

Partha Mitra at the Owl Cafe in Tokyo

Working with two dimensional images which form a three dimensional stock, he and a team of scientists have performed a process called semantic segmentation, in which they delineated all the different neuronal compartments in an image.

Scientists who design machine learning programs generally take two approaches: they either train the machine to learn from data or they tailor them based on prior knowledge. “There is a larger debate going on in the machine learning community,” Mitra said.

His effort attempts to take this puzzle to the next step, which hybridizes the earlier efforts, attempting to learn from the data with some prior knowledge structure built in. “We are moving away from the purely data driven” approach, he explained.

Mitra and his colleagues recently published a paper about their artificial intelligence-driven neuroanatomy work in the journal Nature Machine Intelligence.

For postmortem human brains, one challenge is that few whole-brain light microscopic data sets exist. For those that do exist, the amount of data is large enough to tax available resources.

Indeed, the total amount of storage to study one brain at light microscope resolution is one petabyte of data, which amounts to a million megapixel images.

“We need an automated method,” Mitra said. “We are on the threshold of where we are getting data a cellular resolution of the human brain. You need these techniques” for that discovery. Researchers are on the verge of getting more whole-brain data sets more routinely.

Mitra is interested in the meso-scale architecture, or the way groups of neurons are laid out in the brain. This is the scale at which species-typical structures are visible. Individual cells would show strong variation from one individual to another. At the mesoscale, however, researchers expect the same architecture in brains of different neurotypical individuals of the same species.

Trained as a physicist, Mitra likes the concreteness of the data and the fact that neuroanatomical structure is not as contingent on subtle experimental protocol differences.

He said behavioral and neural activity measurements can depend on how researchers set up their study and appreciates the way anatomy provides physical and architectural maps of brain cells.

The amount of data neuroanatomists have collected exceeds the ability of these specialists to interpret it, in part because of the reduction in cost of storing the information. In 1989, a human brain worth of light microscope data would have cost approximately the entire budget for the National Institutes of Health based on the expense of hard disk storage at the time. Today, Mitra can buy that much data storage every year with a small fraction of his NIH grant.

“There has been a very big change in our ability to store and digitize data,” he said. “What we don’t have is a million neuroanatomists looking at this. The data has exploded in a systematic way. We can’t [interpret and understand] it unaided by the computer.”

Mitra described the work as a “small technical piece of a larger enterprise,” as the group tries to address whether it’s possible to automate what a neuroanatomist does. Through this work, he hopes computers might discover common principals of the anatomy and construction of neurons in the brain.

While the algorithms and artificial intelligence will aid in the process, Mitra doesn’t expect the research to lead to a fully automated process. Rather, this work has the potential to accelerate the process of studying neuroanatomy.

Down the road, this kind of understanding could enable researchers and ultimately health care professionals to compare the architecture and circuitry of brains from people with various diseases or conditions with those of people who aren’t battling any neurological or cognitive issues.

“There’s real potential to looking at” the brains of people who have various challenges, Mitra said.

The paper in Nature Machine Intelligence reflected a couple of years of work that Mitra and others did in parallel with other research pursuits.

A resident of Midtown, Mitra, his wife Tatiana and their seven-year-old daughter have done considerable walking around the city during the pandemic.

The couple created a virtual exhibit for the New York Hall of Science in the Children’s Science Museum in which they described amazing brains. A figurative sculptor, Tatiana provided the artwork for the exhibition.

Mitra, who has been at Cold Spring Harbor Laboratory since 2003, said neuroanatomy has become increasingly popular over the last several years. He would like to enhance the ability of the artificial intelligence program in this field.

“I would like to eliminate the human proofreading,” he said. “We are still actively working on the methodology.”

Using topological methods, Mitra has also traced single neurons. He has published that work through a preprint in bioRxiv.

METRO photo

By Daniel Dunaief

Daniel Dunaief

Jill has been cutting hair for 38 years. She has owned a few salons, but these days she has been scheduling hair cutting appointments at people’s homes.

She wears a mask, asks her customers to do the same and does her work outside or in the shelter of a garage, where the wind isn’t as strong.

An immigrant from Lebanon, Jill is completely professional, asking for extension cords through the garage, setting up a chair for her customers, and carrying her sterilized scissors, electronic clippers and comb.

Reflecting on the decades she’s spent chatting with customers while she works, she has an easy, purposeful manner about her efforts, while she rolls her “r’s,” sharing linguistic hints on her life.

These days, she lives with her daughter, son-in-law and her three grandchildren. She has her own space in the house, but is hoping, before too long, to rent or buy a small place where she can call the shots.

She shared a story with me that offers some perspective about life and our reactions in the moment to our wins and losses.

Back in February, Jill had decided it was time to own a salon again. She pooled all her savings and placed a bid on a property. She was excited about the prospect of serving more customers, hiring staff and growing a business that would help her make money and increase her savings towards retirement.

She knew she was close to winning the bidding and had started imagining how she’d reinvent the space and the people she’d hire. But, then, the people selling the property informed her that they had chosen another bidder, who had deeper pockets and was a part of a larger chain. She was incredibly disappointed and felt as if she’d lost out on a business she knew she could run. She spent several weeks irritated by the situation.

A month after she lost the property, she joined the rest of the world in the pandemic-triggered lockdown. Initially, she couldn’t get out much.

As the days stretched into weeks and the weeks into months, she realized how lucky her loss on that property had been. She would have had to carry a $4,000 monthly mortgage for a location that was producing no revenue for months.

She considers herself an incredibly lucky loser. Back in February, of course, a mere month before the virus changed the United States, she had no way of knowing that her loss would save her from a mountain of unmanageable debt.

She feels as if a force from up high was looking out for her, protecting her from a financial burden and responsibility that would have been hard to manage, even with whatever government program she might have turned to for help.

Down the road, when the world returns to something resembling the experiences of 2019, she may, once again, consider buying a salon. Until then, however, she’s perfectly happy without the debt and the uncertainty of managing through a difficult small business and economic environment.

In the meantime, she will continue to show up at people’s homes, brushes, clippers and scissors in hand, ready to provide on-site haircuts to people who prefer, or can’t, leave their properties.

The challenges and obstacles that disappoint also sometimes protect us, even if we can’t see that in the moment, particularly when we know how much we want something.

Many of us will confront those frustrations in the future over which we have no control. Sometimes, we may gain perspective on what, at first, appears to be an unfortunate outcome.

Suffolk County Legislator William "Doc" Spencer. File photo

*Updated to include information about actions by the Suffolk County legislature.*

Suffolk County Legislator William “Doc” Spencer (D-Centerport) was arrested Tuesday for allegedly attempting to trade oxycodone for sex.

Spencer, who is a legislator for the 18th district and was in a Suffolk County vehicle at the time of the arrest Oct. 20, allegedly planned to meet a prostitute in the parking lot of a Goodwill store in Elwood to trade sex for the pills, which were reportedly oxycodone, a legal form of an opioid. Authorities had arranged a sting operation.

Spencer, who had two oxycodone pills in his possession at the sting operation, is charged with criminal possession of a controlled substance in the third degree, a class B felony, and criminal sale of a controlled substance in the third degree, a class B felony.

Spencer, 53, was arraigned on Wednesday at the John P. Cohalan Jr. Courthouse in Central Islip. The man has been a legislator since 2012 and serves on the county’s opioid task force.

Spencer is due back in court on Feb. 26th. If convicted of the top count, he could face a maximum of up to nine years in prison.

Assistant District Attorneys Kevin Ward and Laura de Oliveira, of the Public Integrity Bureau, are prosecuting the case.

“The message here is that the Suffolk County District Attorney’s Office will continue to work in partnership with all of the law enforcement agencies operating here on Long Island, including the DEA and members of the Long Island Heroin task Force, to hold criminals accountable no matter who they are or what their walk of life is,” Suffolk DA Tim Sini (D) said in a statement.

“Law enforcement officers follow the evidence and this time, the evidence led to a prominent member of the community,” Suffolk County Police Commissioner Geraldine Hart said in a statement.

Spencer was the chief of otolaryngology at Huntington Hospital. In a statement, a Huntington Hospital spokeswoman said Spencer is “not an employed physician at Huntington Hospital but has privileges as a voluntary physician with his own private practice. His privileges at the hospital have been temporarily suspended pending further investigation.”

Spencer is also Associate Clinical Professor at Stony Brook University Hospital. Spencer has not had medical privileges at Stony Brook University Hospital since 2014, a hospital official said.

Spencer runs a private practice, Long Island Otolaryngology & Pediatric Airway in Huntington.

Suffolk County Republican Committee Chairman Jesse Garcia was quick to jump on the news, calling in a release for Spencer to step down “immediately” as a county legislator.

In a statement, Garcia called Spencer’s alleged actions a violation of his oath as a doctor and elected official.

“This alleged act was an attempt to abuse his position of power and trust, prey on women, and take advantage of those he believed were prisoners of addiction,” Garcia said in a statement. “His legislative record of sponsoring dozens of resolutions focusing on health and drug abuse makes this alleged drug-for-sex trade all the more evil, because he clearly knew the consequences of his behavior on his intended victim.”

Suffolk County Legislature Presiding Officer Rob Calarco issued a statement in response to Spencer’s arrest, saying he has stepped down as Democrat majority leader.

Calarco said, “Legislator Spencer has stepped down from his position as Majority Leader of the Legislature’s Democratic caucus. He is also being removed from his post as chair of the Legislature’s Health Committee which subsequently removes him from any assignments linked to that chairmanship, including serving on the Legislature’s Heroin and Opiate Epidemic Advisory Panel.”

“There is nothing in the law that requires a legislator to resign while charges are pending, and while the allegations against Legislator Spencer are serious, he is entitled to his day in court,” Calarco continued. “My colleagues and I remain focused on continuing the business of the people. The Democratic caucus will convene in the future to select a new Majority Leader, and a new health committee chair will be chosen in due time.”

Spencer is married and has three children.

Prior to his arrest, Spencer had been involved in several legislative efforts, including to combat the effects of the opioid epidemic. Spencer proposed a resolution that passed unanimously to make Narcan, which reverses the effects of narcotics, available to policy emergency responders in the Second Precinct.

Spencer had sponsored 35 resolutions, with close to 1/3 of them related to health and safety, including prohibiting smoking at county beaches and county parks. Spencer’s bills include a 5-cent fee for single use plastic bags, which stores started charging in January, 2018.

During his time in office, Spencer had worked to ban the sale of powdered caffeine to minors, raise the age of selling tobacco products, helped pass a measure to stop companies from manufacturing energy drinks to youth and led a ban on flavored e-cigarettes.

Last fall during the run up to his reelection, Spencer told the Times Beacon Record Newspapers he was committed to finding treatment and addiction solutions for people affected by the opioid crisis.

Spencer won reelection in 2019, defeating Republican Garrett Chelius and Independent Daniel West for a seat in a district representing Huntington, Halesite, Centerport, Northport, East Northport, Cold Spring Harbor, Lloyd Harbor among other towns.

An ordained minister, Spencer serves as the Pastor of Willow Manor Fellowship in Centerport.

Spencer was released on his own recognizance. He has to hand over his passport and a legal firearm.

This story was updated to include details about the number of pills Spencer had in his possession, the specific charges, the potential prison sentence if convicted, the names of the attorneys prosecuting the case, and comments from DA Sini and SCPD Commissioner Hart. The update also indicates that Spencer was released on his own recognizance and that Spencer is no longer the chief of otolaryngology at Huntington Hospital.

This story was updated Oct. 22 to update the statement by Rob Calarco.

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Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, raised a red flag about the safety of annual family gatherings during Thanksgiving last week on an interview on CBS.

People may have to “bite the bullet and sacrifice that social gathering unless you’re pretty certain that the people that you’re dealing with are not infected,” Fauci told CBS.

Richard Gatteau, SBU Dean of Students. Photo from SBU Website

Doctors at area hospitals and officials at Stony Brook University are offering guidance to residents and students over a month before an annual holiday that often brings people from several generations, cities and states together.

Before they send some of the 4,200 on campus students at SBU home, the university plans to test them for the presence of the virus that causes COVID-19.

The week of Nov. 16, “every resident will be tested,” said Dean of Students Richard Gatteau. “Any positive cases would remain on campus” until the university knew they were negative.

Students remaining on campus would receive meals and would get the same level of care through the holidays that students would normally get if they tested positive during the semester.

Stony Brook expects the student population to decline after Thanksgiving, when all classes and final exams will be remote through the end of the semester.

For the students who plan to return to campus, Stony Brook realizes the logistical challenges of requiring viral tests during the short holiday and will provide tests in the first two days after these students return to their dormitories.

Even before the holiday, Stony Brook expects to increase the frequency of viral testing from bi-weekly to weekly.

Gatteau said the student government plans to educate students who plan to join family during the holiday about procedures to keep everyone safe. This guidance mirrors school policies, such as wearing masks inside when near other family members, keeping a distance of six feet inside and washing hands regularly.

The dean of students recently spoke with Dr. Deborah Birx, head of the White House’s coronavirus task force who visited Stony Brook to speak with officials about the school’s COVID response. Though Birx was pleased with the measures the university took, she was reportedly more worried about the behavior of extended family than with students during Thanksgiving.

“Her concern is with the older generation not following the rules,” Gatteau said. She wanted students to encourage their grandparents to follow the same procedures because “grandparents will listen to their grandkids.”

Types of Tests

Dr. Michael Grosso, Chief Medical Officer at Huntington Hospital, urged everyone to plan to get tested before coming together for Thanksgiving.

Dr. Grosso said two types of tests are available for students and parents. The first is an antigen test and the second is a PCR, for polymerase chain reaction, test. Grosso suggests that the PCR test is more reliable as the antigen test “misses more cases.”

The test technique is critical to its success. Some false negatives may result from inadequate specimen collection, Grosso said. The deep nasopharyngeal specimen “requires a little skill on the part of the person doing the test.”

Additionally, people getting tested before a family gathering need to consider the timing of the test. They may receive a negative test during a period of time in which the virus is developing in their bodies.

Active testing may have helped reduce the severity of the disease for people who contract it. People are coming to the hospital in some cases before the disease causes as much damage.

In addition to getting tested and monitoring possible symptoms, Grosso urged residents to continue to practice the new, healthier etiquette, even when they are with relatives during the holidays.

“Families need to have conversations” about how close they are prepared to get before they see each other, Grosso said. People need to “decide together what rules [they] are going to follow, and make sure everybody is comfortable with those.”

As for Thanksgiving in the Grosso home, the Chief Medical Officer said he and his wife have five children between them, two of whom will be coming for the annual November holiday. The others will participate, as has become the modern reality, at the other end of a zoom call. Typically, the entire family would come together.

Stony Brook’s Gatteau said he and his partner typically have 20 to 25 people over for Thanksgiving. This year, they are limited the guests to seven people. They plan to keep masks on in their house and will crack a window open so there is air flow.

The Monti and Saladino families, above, continue the work of The Don Monti Memorial Research Foundation. Photo from Jim Kennedy

Even amid the COVID-19 pandemic, The Don Monti Memorial Research Foundation continues to raise money to support cancer care and research on Long Island.

Caroline Monti Saladino speaks at last year’s Cancer Survivors Day. Photo from Mel Saladino

The foundation, named for Don Monti, who died at 16 in 1972 from acute myeloblastic leukemia, has changed some of the events this year, but not the mission.

Instead of the annual ball at the Woodbury-based Crest Hollow Country Club, which the Montis own, the foundation started its Capital Giving Campaign and hopes to raise $1 million this year. All of the proceeds support the mission, since the foundation’s senior staff, including Caroline Monti Saladino, president, work for free.

“Today with COVID, nothing has changed with the journey,” she said.

The foundation has mailed out a capital campaign brochure that includes letters from Michael Dowling, president and CEO of Northwell Health; Richard Barakat, director of Northwell Health Cancer Institute; and Bruce Stillman, president of Cold Spring Harbor Laboratory.

“Your investment in cancer clinical care, research, wellness and survivorship enhances our ability to provide comprehensive, multidisciplinary care for our patients and enables us to provide support services for their families and loved ones,” Barakat wrote in his letter.

Monti Saladino, who has helped cancer patients for close to five decades, said the needs of cancer patients haven’t changed.

The Monti foundation has become a multigenerational family cause, which Tita and Joseph started months after their son died. The foundation has raised more than $47 million to support research, education and patient care in oncology and hematology. It has donated money to Northwell Health, Huntington Hospital, Long Island Jewish and Cold Spring Harbor Laboratory for everything from patient care and treatment to genetic counseling to basic research.

The foundation recently donated $50,000 to Huntington Hospital to help fund its developing cancer center.

Numerous members of the Monti and Saladino families have dedicated time and effort to improving the lives of people with cancer and to offering support to the families of patients. Monti Saladino said her children are involved, as are some of her 12 grandchildren, who have continued the family tradition by raising money to support the foundation.

The foundation has an office at CSHL, where Stillman said he often sees “family members working there, helping to raise support — it’s an amazing dedication.”

In addition to the visible connection through laboratories at CSHL, the foundation has supported four Don Monti cancer centers in Nassau and Suffolk, at North Shore University Hospital, also Huntington, Glen Cove and Plainview hospitals.

The members of the Monti and Saladino families have also played instrumental roles by visiting patients, hosting Don Monti Cancer Survivors Day events and forging new relationships with recipients of their support.

When Northwell and CSHL were looking for a link between the basic research at the Lab where new ideas and methods are developed, and the clinic where medical teams worked to provide personalized care, the Monti foundation helped facilitate a partnership.

“We were very familiar with what was going on” at Northwell partly “through the Monti foundation,” Stillman said. “They were helpful. It was good that people on both sides knew each other.”

Cold Spring Harbor Lab Connection

CSHL has received between $300,000 to $500,000 each year for over a decade from the foundation, which supports innovative research and supplements the funds the scientists receive from government agencies like the National Cancer Institute.

Receiving national grants is difficult and competitive, which increases the value of philanthropic funding that is the “driver of innovation and one of the reasons the United States is so prominent in research,” Stillman said.

He appreciates how the foundation offers a direct connection between the scientists working to cure a disease and the patients and their families who are, and have been, battling cancer.

Principal investigators, postdoctoral researchers and graduate students attend Cancer Survivors Day, during which they see people who might benefit from their research efforts.

“When you see patients, it does change the way you think about how you do the research,” Stillman said.

The funds from the foundation have supported numerous research initiatives at CSHL, including the work of Nicholas Tonks and Christopher Vakoc.

Working with chemists, Tonks developed molecules that inhibit enzymes called protein tyrosine phosphatases, which could be used to treat breast cancer.

Vakoc, meanwhile, has found subtypes of cancer that require critical proteins to grow. He is working on a program to identify how to target what Stillman described as the “Achilles heel” of some cancers.

“Our reputation through the years as a patient-oriented organization and a research-oriented organization has really sustained us. A lot of the people we have healed through our organization are very generous.”

— Caroline Monti Saladino

Northwell Health Connection

The Monti foundation works closely with Dr. Ruthee-Lu Bayer, who is the chief of stem cell transplantation at Northwell Health.

“She and her team are amazing,” Monti Saladino said.

She recalled that Bayer was doing clerical work she didn’t have time to do in the midst of her life-saving and life-extending efforts.

The foundation’s president suggested that the hospital should hire an administrator so Bayer’s team could see more patients. Monti Saladino spoke to the hospital administrator and said she would contribute $100,000 a year for five years, if the hospital contributed the remaining cost. The hospital agreed, providing some relief for Bayer’s efforts.

Monti Saladino said contributors appreciate the history of the Monti foundation and its ongoing focus.

“Our reputation through the years as a patient-oriented organization and a research-oriented organization has really sustained us,” she said. “A lot of the people we have healed through our organization are very generous.”

Stuart Hayim, who is a dealer of Ferraris and Maseratis on Long Island, recovered from lymphoma in 1979 while receiving medical treatment and personalized attention from Tita Monti, at the Don Monti Division of Oncology at North Shore University Hospital in Manhasset. Since then, he has won boat races and raised money each year for the foundation.

Monti Saladino said the foundation helps patients wherever and however it can.

When her young brother Don was diagnosed with leukemia in 1972, oncology and chemotherapy were “primitive,” she said. In terms of patient care, the medical experience “didn’t make people very comfortable.”

The Foundation’s Goal

Through the money the Don Monti foundation raised, the goal was to make the challenging experience of dealing with treating cancer more bearable for people and the families who go through it, she said.

The foundation built the first bone-marrow transplant unit in the 1990s, added a patient lounge and funded Cancer Survivors Day.

Monti Saladino said she “lives and breathes” her brother every day. Don died in June 1972, and her parents, Tita and Joseph Monti, had their first fundraiser that December.

Tita Monti, who died in 2006, said she didn’t want what happened to Don to happen to other people.

“We need to make a purpose out of his short 16 years of life, from the joy he gave us,” Monti Saladino recalled her mother saying.

Her brother’s story is a credit to his determination and to his mother’s perseverance, Monti Saladino said. Doctors had given him six weeks to live. His mother combined beetroot powder with natural and other healthy treatments that extended his life by 16 months.

Stillman said the legacy of the Monti family is evident throughout Long Island.

“It’s quite impressive, all of the number of people they’ve touched,” he said. “They’ve improved the treatment environment, the cancer environment, the clinicians and researchers.”

Monti Saladino said she and the family are far from perfect.

“We’ve got our issues,” she said. “They don’t affect this. This is a real focus that never changes.”

For more information, visit www.donmontifoundation.org.

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Residents on Long Island and elsewhere can’t call their doctor’s offices and ask to receive all of the same treatment that sent President Donald Trump (R) from the Walter Reed National Military Medical Center back to the White House and the campaign trail.

Dr. Luis Marcos said SBU was planning to participate in the second Regeneron trial, but a general lack of COVID patients scrapped that idea. Photo from SBU

After officials said he tested positive for COVID-19 Oct. 2, the president received a combination of the antiviral drug Remdesivir, an antibody cocktail from Regeneron, and the steroid dexamethasone.

Remdesivir has become more widely used in hospitals on Long Island.

The last two months, “all patients admitted to the hospital may qualify for Remdesivir according to the clinical judgment of your doctor,” said Dr. Luis Marcos, Associate Professor of Clinical Medicine at Renaissance School of Medicine at Stony Brook University.

The patient population that is most likely to benefit from Remdesivir includes residents who are over 60, have diabetes with hypertension and have been admitted to the hospital with mild pneumonia.

Patients who have liver disease or kidney failure may not be prescribed the intravenous drug.

Typically, Remdesivir, like other antiviral drugs, benefits patients who have contracted COVID-19 within a week, because the medicine stops the replication of the virus.

Patients who received Remdesivir after an infection that lasted more than 10 days may not benefit as much because the drug won’t reverse damage done to the lungs.

The side effects of antivirals typically last one to two days.

Dexamethasone is also available and used in hospitals including Huntington Hospitals and Stony Brook.

As a steroid, dexamethasone has “multiple side effects,” said Dr. Michael Grosso, Chief Medical Officer at Huntington Hospital. “It is only given when the benefit is expected to significantly outweigh the risk and so there’s going to be that assessment in every case,” Dr. Grosso said.

Patients with diabetes are likely to experience “more trouble with their blood sugar control if they’re receiving dexamethasone,” Grosso added.

Dexamethasone can also produce sleeplessness and, in some cases, psychiatric disturbances, doctors added.

The monoclonal antibody cocktail from Regeneron the president received has had limited use, mostly through clinical trials and in compassionate care cases. It has not received approval from the Food and Drug Administration, although it has applied for emergency use authorization.

Stony Brook was planning to participate in the second trial of Regeneron, with Dr. Bettina Fries, Chief of the Division of Infectious Diseases, as the principal investigator and Dr. Marcos as the co-principal investigator. The hospital did not participate because it didn’t have enough cases.

Marcos said the cocktail of antibodies block the virus actively causing inflammation.

The good news with the Regeneron treatment is that the side effects appear minimal, Marcos said.

Regeneron is unlikely to reverse the damage in the lungs caused by the virus. In managing patient care, doctors try to slow or stop the progression of pneumonia from the virus.

Marcos said patients who are asymptomatic or have minor symptoms shouldn’t race to take the more widely available Remdesivir or Dexamethasone because 99% of patients with COVID infection do not have pneumonia. Those patients with a mild upper respiratory infection may not need anything but Tylenol.

Patients who are developing more severe symptoms can come to the hospital to determine the best medical response.

“If you have fever or you don’t feel that great, of course, come to the Emergency Room, we can evaluate you, and decide what to do next. For mild, mild cases, I don’t think we should be using Remdesivir,” Grosso said.

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With the approaching emotions of the holidays, Suffolk County residents may face persistent and unwanted changes in their lives, from not seeing a cherished family member to remaining confined to the same house where they work, live, eat and study. Between now and the end of the year, TBR News Media will feature stories about the impact of the ongoing pandemic on mental health. The articles will explore how to recognize signs of mental health strain and will provide advice to help get through these difficult times. This week, the article focuses on youth.

In a normal year, when school is out, the number of referrals Dr. Sharon Skariah, Director of Child Adolescent Psychiatry at South Oaks Hospital in Amityville, declines during the summer.

Dr. Sharon Skariah says parents should recognize their own issues in order to help their children. Photo by Sharon Skariah

That’s not the case this year, as children continued to seek help for mental health challenges caused by the loss of a parent, the loss of financial or health security and the decline in social contact amid social distancing.

“We’ve been seeing significant anxiety and depression,” Skariah said. “Part of that is the prolonged time that [children] have been out of school.”

Skariah expects that the ongoing pandemic losses and restrictions will likely continue to cause those figures to increase.

Several mental health professionals shared their dos and don’ts for parents with grieving children.

Grieving Dos

For starters, Skariah suggests that parents should recognize their own anxiety and depression.

“If they find that they are themselves overwhelmed with the chaos of the pandemic, they should be aware that their own anxiety and mood can play a role in their children’s behavior,” she said.

Dr. Meghan Downey, clinical psychologist and Director of Northwell Health’s OnTrackNY, urged people to maintain a routine.

“Often, a holiday can exacerbate our stress levels,” Downey said. “Changes to our routine can increase stress. Continuing with the same sleep wake routine, normal eating and [finding time] for joy and relaxation provide a good foundation for managing grief.”

Based on prior group traumatic events, like the 9/11 terrorist attacks and the SARS virus, Skariah said the restoration of order happens over time and depends on personal and predisposing factors.

She urged families to be genuine and open and actively listen to what children say. Downey suggests children need to feel that they are allowed to mourn.

A support network can and should consider showing empathy, care and concern. Approaching people when they are calm, rather than in a distressed state, can provide some mental health relief.

People who are experiencing grief also can benefit from staying connected, even through holiday letters, phone calls, or a card, Downey said.

When Downey gives presentations to children and educators in school, she advises people working with young children to allow them to play death, to display their emotions through play.

Grieving Don’ts

Telling children platitudes like “time heals all wounds” may not be helpful for someone who is “acutely grieving,” Skariah said.

Downey added that telling children that a loved one is “sleeping” or that they should “stop crying, other people might get upset” provides mixed and confusing messages.

Telling children that “at least [the person who died is] not in pain anymore, they are in a better place” often doesn’t help and distracts people from feeling their emotional intensity, Downey said.

Downey cautioned youths, and their adult guardians, to manage over-indulgent behavior, such as with food or with excess spending.

While those indulgences provide temporary relief, they can also contribute to feelings of guilt, which can exacerbate grief, Downey cautioned.

Bradley Lewis, Administrative Manager for School Based Mental Health Services for South Oaks Hospital, said he has received numerous requests during the pandemic for support related to COVID-19.

Lewis said Downey’s presentations to some of the 11 school districts went beyond the thought of death, but include losses in other areas, like access to friends, senior awards dinners, and graduations.

“A lot of families appreciated the opportunity to learn more about grief and loss, to understand the different types of grief their children might be going through,” Lewis said.

With parents, Lewis urges parents to “end the stigma of mental health,” he said.

File photo

By Daniel Dunaief

Daniel Dunaief

Three years and a different world ago, I attended a scientific conference at Cold Spring Harbor Laboratory on a gene editing technique called CRISPR, or more technically CRISPR-cas9.

I rubbed elbows with some of the many talented scientists at an internationally renowned institution. In a casual atmosphere filled with high-powered talks from people who speak the language of science with accents from all over the world, the grounds at CSHL, with its winding roads and personalized parking spaces, offers a tree-lined backdrop for new collaborations and discoveries.

Back then, I invited one of the conference organizers, Jennifer Doudna (pronounced Dowd nuh), who is a Professor of Chemistry and Molecular and Cell Biology at the University of California, to lunch.

After a talk she gave to a packed Grace Auditorium, she and I strolled to the cafeteria to discuss a gene editing tool that has the potential to change the world.

Indeed, even today, labs around the world are using a technique based on the way bacteria recognize and fight off viruses to combat the effect of SARS-CoV-2, or the virus that causes COVID-19.

During that sunny July day in 2017, however, we were blissfully unaware of the challenges to come in 2020. We sat down at a central table outside, with people passing, nodding and acknowledging my tall and talented lunch guest.

While she responded to an appreciative crowd of casually dressed researchers, she was present and focused on the many questions I’d prepared for an upcoming Power of 3 column (see page B9 for another look at that column).

Like many revolutionary technologies and inventions such as splitting the atom, CRISPR is neither all good nor all bad. Editing genes creates opportunities to cure or prevent diseases and to disarm a range of miniature invaders.

At the same time, gene editing puts the power of Mary Shelley’s Frankenstein into the hands of scientists or doctors, offering the kind of tool that requires careful ethical considerations.

Indeed, just last year, a Chinese court sentenced a researcher to three years in prison for using gene editing in unborn babies.

Doudna, who moved to Hawaii when she was seven and is a passionate gardener, is in the third year of a four-year $65 million grant from the Defense Advanced Research Projects Agency, which monitors security concerns for the intentional or accidental misuse of the technology.

Eating with Doudna on a breezy, bright summer day, I appreciated how ready she was to tailor the conversation to my level of understanding of this technology, offering details about gene editing and making sure I understood her.

While she was impressive and articulate, she certainly didn’t seem as if she were speaking to me from on high. She shared a deliberate and directed intelligence, blending a combination of an explanation of what she’d done and thoughts on the next scientific steps.

Doudna, who lives with her husband Jamie Cate, who is also a Berkeley scientist, and their high school senior son Andrew, shared an appreciation for the history of Cold Spring Harbor Laboratory, where she’d visited at different points in her career.

Back in 1987, she spotted a woman walking towards her. Nobel prize winner Barbara McClintock, whose name still comes up regularly in conversations with scientists at the site, strolled by, giving Doudna a thrill.

The next time someone spots or interacts with the Berkeley Professor at CSHL, they will likely feel the same excitement, as Doudna was recently named a recipient of the Nobel Prize.

Then again, it was clear from the way the attendees at the conference reacted to Doudna three years ago that, Nobel prize or not, she was already a rock star in the scientific community whose foundational work may, one day, lead to the kind of breakthroughs that extend and improve life.

Christina Joselevitch

By Daniel Dunaief

Children knock on the door of 1313 Gluto Lane, a favorite house for Halloween. The resident, known for providing coveted confections at a rapid rate, immediately comes to the door, asks no questions about the Halloween costumes that might slow the process down and, with almost super-human speed, dumps candy into open bags and closes the door.

Word spreads about the house on Gluto Lane. Soon, the doorbell rings at a furious pace, with children eager to get the best candy of this difficult year and move on to the next house.

At first, with Trick or Treaters coming at a regular pace, the process works, but then, something goes awry, creepy music begins and the door doesn’t open.

That’s what’s happening in bipolar retinal cells in the goldfish Christina Joselevitch, a Postdoctoral Associate in the Neurobiology and Behavior Department at Stony Brook University’s Renaissance School of Medicine, is studying.

Known for their incredible speed at releasing neurotransmitters stored in circular vesicles, these bipolar retinal cells go through a depression in which they can’t release the neurotransmitter glutamate despite repeated signals for the release of the neurotransmitter.

“When you stimulate those cells very strongly, with two stimuli close apart, they suffer depression,” Joselevitch said. “Nobody knew why, if they’re able to signal constantly, they should suffer from depression.

To be sure, Joselevitch was working with extreme stimulation to probe the limits of the system and understand its underpinnings. This is not necessarily how these cells work. She said the researchers don’t know if retinal neurons experience synaptic depression under normal conditions and what function depression would have in bipolar cell physiology, in vision or in signaling processing in general.

In a recent publication in the Journal of Neuroscience, Joselevitch described at least two processes that contribute to this slowdown, which she describes as the rate limiting steps. The vesicles need to get to the membrane and they need to get ready to mature before they are release. Once vesicles move towards the cell membrane, they don’t immediately fuse and send their neurotransmitter into the synapse between cells. In some cells, such as the retinal photoreceptors and bipolar cells and in hair cells of the ear and lateral line in fish and in cells of the pineal gland, they gather in a ribbon close to calcium entry points.

Scientists have two theories of the ribbon function. The first is that it could act as a conveyor belt and speed up vesicle priming and delivery to the membrane and the second is that it could set a constant pace for vesicle delivery.

Joselevitch’s results suggest that the vesicles attach to the ribbon, where they go through a maturation process. These paired-pulse depressions don’t just occur in fish: they also affect the ability of mammalian cells to respond to a second stimulus.

These cellular phenomena show the limits of the system. Indeed, Joselevitch likened the process to a car that has reached its maximum speed. Pushing down harder or more on the accelerator won’t enable further acceleration.

The impact of this work is “broad,” she said. Studying this process could enable a stronger awareness of the steps in fast-acting processes in the nervous system. Such research could also provide an understanding about processes that go awry in various neurological diseases.

In an email, Professor Lonnie Wollmuth, who is the principal investigator for the Stony Brook lab in which Joselevitch works, described Joselevitch as “invaluable to our on-going efforts to study presynaptic mechanisms in the retina.” He wrote that she was an “outstanding and very careful scientist” who is “passionate” about her research and has served as a mentor for others in the lab.  Joselevitch has been working in Wollmuth’s lab for about 16 months.

Synaptic transmission is fundamental to all brain function, Wollmuth explained. “Changes in the strength of synaptic transmission underlie basic higher order brain functions like learning and memory,” the Stony Brook Professor wrote. Joselevitch’s experiments “reveal mechanisms of presynaptic vesicle release at all synapses and provide novel insights into the processing of vesicles at ribbon synapses.”

Based on Joselevitch’s work, Wollmuth’s lab has submitted a large National Institutes of Health grant to the National Eye Institute to study the molecular components of presynaptic release in the retina. She has also started to integrate her work with Alzheimer’s Disease, as proteins found in that disease disrupt the molecular machinery involved in presynaptic release.

A native of Brazil, Joselevitch has been at Stony Brook University since last July. She is on sabbatical with the University of São Paulo. She is hoping to participate in these studies in New York for a few more years.

She said she was “always a nerd,” and liked to study languages. With varying levels of proficiency, she speaks five languages: Portuguese, English, German, Dutch, and Spanish. At one point, she wanted to be an astronaut, but her mother Carmen dissuaded her from pursuing that interest.

Joselevitch had planned to return to Brazil to see her family in April, but had to cancel that plan because of a travel ban from the COVID-19 pandemic. She said her parents have been “good sports” and her father has bought a smartphone so he can talk through Skype or WhatsApp with his scientist daughter.

Joselevitch enjoys biking, hiking, singing and playing guitar and has been productive during the pandemic, writing papers and proposals. Stony Brook is nominating her work for consideration for the Warren Alpert Distinguished Scholar Award.

Wollmuth wrote that Joselevitch’s research forms “the foundation for future experiments to address the molecular components of vesicle dynamics.” Once they are identified, researchers can modulate and protect them in brain diseases.

Citing author James Joyce, Joselevitch explained her focus on neurons in the fish eye, which, she hopes, may lead to a broader understanding of neurology and disease. When asked why he wrote about Dublin when he could describe other places he’s visited, Joyce responded, “In the particular is contained the universal.”

METRO photo

By Daniel Dunaief

Daniel Dunaief

We are one of the loudest families on the block, and there are only four of us when we’re all home. Well, five, if you count the dog, and you should definitely count the dog.

Every so often, my dog gets on one of his benders where the entire neighborhood has to hear him. He races into the backyard and barks at shadows that my eyes, and the eyes of my son, who runs to the back door and turns on the light, can’t see either.

Every neighbor presents his or her unique challenges to a block where we continue to spend a large percentage of our time. There’s the guy who drives too fast. We all glare at him, but he doesn’t seem to notice. He probably can’t see us because he’s moving too quickly and exists in a different space-time continuum. Don’t you love a word like continuum that dares to have two “u’s” in a row?

Then there’s the neighbor whose house is under constant construction. No matter what season, time of the month, or time of day, construction people are always there, digging, pulling, pushing, installing, removing, re-laying, resurfacing, ripping up, putting back down.

Who needs all that continuous fixing? I don’t even live in their house and I’m exhausted by the constant change. Sure, it’d be nice if that bulb above my wife’s head in our bedroom actually worked, but my arms are too short on the ladder and the bed is in the wrong place. I put my son on my shoulders and he reached up and turned, but the bulb and the fixture kept spinning.

On the other side, we have a lovely neighbor who is so nice that even the people who frown at the bunnies and deer, which prance through our neighborhood as if they were responding to a cue from a Disney director, smile at her. Her smile and laughter seem like a starter’s gun, waiting for a small cue to explode to the surface.

Anyway, the rest of her family is friendly enough, but doesn’t share her ebullience. They do, however, love their cars. The louder the sound, the more impressive the car, or so it seems. Their driveway hosts regular revving contests. Okay, how many columns have words with two consecutive “u’s” and two consecutive “v’s” in them? Revving continuum, anyone?

Somehow, despite the constant cacophony from the driveway, their house attracts an abundance of magnificent birds, even when they use the leaf blower to keep their immaculate backyard free of the few leaves with the temerity to fall on their property.

Then there is the talker. She’s incredibly sweet, insightful and intelligent. The two challenges are that the polite banter doesn’t seem to have a natural end, and she is so soft spoken that I find myself nodding and raising my eyebrows, hoping I’m offering the proper response to questions I can’t hear. I can’t move closer to her because we react to people as if they were porcupines, with six foot quills.

Then there are the adorables. These are the families that have young children who giggle, laugh and play, blissfully unfocused on the pandemic and thrilled that they are out on a bike or that they can identify a bird that passed overhead. They race each other on tiny bikes, ask me why I’m wearing the same sweatshirt again, and skip to the sound of music I can’t hear. They also see the nonstop trucks delivering materials to the construction house as a source of entertainment. One of our young neighbors was on her way to school on a recent morning. Her mother stopped her car and rolled down the window so she could tell me about Mrs. Cathy and Ms. Mary. Those happy adorables are the block winners.