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Arline Goldstein. Photo from Leg. Trotta's office

Suffolk County Legislator Robert Trotta (Fort Salonga) has invited Arline Goldstein of St. James to serve as his appointee to the Suffolk County Citizens Advisory Board for the Arts. Established in 1978, the board suggests, reviews and recommends policies and programs for the arts. A major function of the board is the allocation of grants to various artistic and cultural organizations. The position is voluntary.

“Ms. Goldstein brings an incredible wealth of talent to the board as she is an artist who has had her work exhibited throughout Long Island and Manhattan. She is a past president of the Smithtown Arts Council and a retired teacher of Art and Gifted Children at the Longwood School District. In her studio on Lake Avenue, she teaches drawing and painting to adults, and in this pandemic holds classes on Zoom,” said Legislator Trotta.

In addition to her artwork, Ms. Goldstein is a founding member of “Celebrate St. James,” a non-profit organization whose mission is to preserve and promote the culture and arts of St. James. As vice president of the organization, she initiated “Art Walk” on Lake Avenue in St. James.

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Focus on improving your health by making lifestyle modifications. METRO photo
The right motivators might be as important as dietary changes

By David Dunaief, M.D.

Excess weight has consequences, including chronic diseases such as cardiovascular disease, diabetes, osteoarthritis, autoimmune diseases and a host of others. Weight also has an impact on all-cause mortality and longevity.

In theory, losing weight should be simple: if we burn more kilocalories (energy) than we take in, we should lose weight. However, it is much more complicated.

Among factors that result in weight loss (or not) are stress levels. High stress levels can contribute to metabolic risk factors such as central obesity with the release of cortisol, the stress hormone (1). In this case, hormones contribute to weight gain.

It is hotly debated as to which approach is best for weight loss. Is it lifestyle changes with diet and exercise, medical management with weight loss drugs, surgical procedures or even supplements? The data show that, while medication and surgery may have their places, they are not replacements for lifestyle modifications; these modifications are needed no matter what route you follow.

But the debate continues as to which diet is best – for both weight loss and overall health. Let’s look at the evidence.

Low-carbohydrate vs. low-fat diets

Is a low-carbohydrate, high-fat diet a fad? In the publication of a 12-month randomized controlled trial (RCT), results showed that a low-carbohydrate diet was significantly better at reducing weight than low-fat diet, by a mean difference of 3.5 kg lost (7.7 lb), even though calories were similar and exercise did not change (2).

The authors also note that the low-carbohydrate diet reduced cardiovascular disease risk factors in the lipid (cholesterol) profile, such as decreasing triglycerides (mean difference 14.1 mg/dl) and increasing HDL (good cholesterol). Patients lost 1.5 percent more body fat on the low-carbohydrate diet, and there was a significant reduction in the inflammation biomarker C-reactive protein (CRP). There was also a reduction in the 10-year Framingham risk score, which estimates cardiovascular risk. However, there was no change in LDL (bad cholesterol) levels or in truncal obesity in either group.

There were 148 participants, predominantly women with a mean age of 47, none of whom had cardiovascular disease or diabetes, but all of whom were obese or morbidly obese (BMI 30-45 kg/m²). Although there were changes in biomarkers, there was a dearth of cardiovascular disease clinical end points, which were not investigated.

Digging deeper into the diets used, it’s interesting to note that the low-fat diet was remarkably similar to the standard American diet; it allowed 30 percent fat, only 5 percent less than the 35 percent baseline for the same group. In addition, it replaced the fat with mostly refined carbohydrates, including only 15 to 16 g/day of fiber.

The low-carbohydrate diet participants took in an average of 100 fewer calories per day than participants on the low-fat diet, so it’s no surprise that they lost a few more pounds over a year’s time.

As David Katz, M.D., founding director of Yale University’s Prevention Research Center, noted, this study was more of a comparison of low-carbohydrate diet to a high-carbohydrate diet than a comparison of a low-carbohydrate diet to a low-fat diet (3).

Diet comparisons

Interestingly, in a meta-analysis (group of 48 RCTs), results showed that whether a low-carbohydrate diet (including the Atkins diet) or a low-fat diet (including the Ornish plant-based diet) was followed, there was a similar amount of weight loss compared to no intervention at all (4). Both diet types resulted in about 8 kg (17.6 lb) of weight loss at six months versus no change in diet.

In an accompanying editorial, the author points out that it is unclear whether a low-carbohydrate/high-animal protein diet might result in adverse effects on the kidneys, loss of calcium from the bones, or other potential health risks. The author goes on to say that, for overall health and longevity and not just weight loss, micronutrients found in nutrient-dense foods may be the most important factor.

A Seventh-Day Adventist trial would attest to the benefits of emphasizing a micronutrient-rich, plant-based diet with limited animal protein. It resulted in significantly greater longevity compared to a macronutrient-rich animal protein diet (5).

Psyche

Finally, the type of motivator is important, whatever our endeavors. Weight loss goals are no exception. A published study followed West Point cadets from school to many years after graduation and noted who reached their goals (6). The researchers found that internal motivators and instrumental (external) motivators were very important.

The soldiers who had an internal motivator, such as wanting to be a good soldier, were more successful than those who focused on instrumental motivators, such as wanting to become a general. Those who had both internal and instrumental motivators were not as successful as those with internal motivators alone. In other words, having internal motivators led to an instrumental consequence of advancing their careers.

When it comes to health, focusing on an internal motivator, such as increasing energy or decreasing pain, could ultimately lead to an instrumental consequence of weight loss.

There is no question that dietary changes are most important to achieving sustained weight loss. However, we need to get our psyches in line for change. Hopefully, when we choose to improve our health, we don’t just focus on weight as a measure of success. Focus on improving your health by making lifestyle modifications. This tends to result in a successful instrumental consequence.

References:

(1) Psychoneuroendocrinol. online 2014 April 12. (2) Ann Intern Med. 2014;161(5):309-318. (3) Huffington Post. Sept 2, 2014. (4) JAMA. 2014;312(9):923-933. (5) JAMA Intern Med. 2013;173:1230-1238. (6) Proc Natl Acad Sci U S A. 2014;111(30):10990-10995.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.

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John Inglis. Photo courtesy of CSHL

By Daniel Dunaief

In the post COVID-19 world, the pace of science and, in particular, scientific publishing has changed, giving researchers a sense of urgency to share information that might lead to preventions, treatments and cures.

Cold Spring Harbor Laboratory has produced two preprint research services, bioRxiv and MedRxiv, that complement the longer peer-reviewed path to publication.

After numerous scientists restructured their labs to contribute to the growing body of knowledge and information about COVID-19, these researchers turned to preprint services to share the results of their work and the evolution of their thoughts on how to defeat the virus.

“It’s absolutely unprecedented for scientists to drop what they are doing and switch their focus to something completely new to aid society and mankind in general,” said John Inglis, the co-founder of bioRxiv and one of the members of joint management group for medRxiv.

MedRxiv, which started in June of 2019, helped provide the scientific community with an outlet for their health science research, with the caveat that the results haven’t received a thorough peer review, as they might in the New England Journal of Medicine, Cell, or other periodicals.

The number of preprint research papers has climbed dramatically this year, as scientists race to get their results from the bench to the server. The number of papers in bioRxiv increased to 88,268 in June from 71,458 in January. The increase at the newer medRxiv is much more dramatic, climbing from 953 in January to 7,541 in June.

The number of pandemic related papers on medRxiv and bioRxiv in total is 6,458, with 5,133 on medRxiv and 1,325 on bioRxiv.

Pandemic-related papers account for close to 70 percent of the new research published on medRxiv since January 1st, while the percentage of virus-related papers on bioRxiv is 6.2%, in large part because bioRxiv includes numerous other subject areas, including ecology, bioinformatics, plant biology and zoology.

The world has taken notice of all these papers, with page views peaking in April for medRxiv to almost 11 million for the month.

While the papers aren’t peer reviewed, the managers of these sites urge readers to remain cautious in their interpretation and use of these findings, while the scientific community continues to duplicate any encouraging or compelling results.

“We remind people all the time that these are preprints,” Inglis said, as the site has numerous reminders about the early nature of the findings. “They are preliminary reports and should not guide clinical practice or be reported as established information. That’s a battle we’re still fighting.”

The peer review process has also picked up some speed, as journals, inundated with potential game-changing material, have been accelerating the process of reading and reviewing papers. The median time between posting an article on bioRxiv and publication in a journal before the pandemic was nine months. Some papers in medRxiv have been published in journal in as few as 35 days.

For medRxiv, the screening process requires an ethics statement, a funding statement, and any potential conflicts of interest. These requirements are “all far more familiar in medical publishing than in scientific publishing,” said Inglis.

At bioRxiv, which recently introduced a competing interest statement as well for authors, freelancers and a group of Principal Investigators look at everything before it posts, to make sure it’s science and that it’s not dangerous. The screeners turn the manuscripts back to the team if they have any concerns.

“We felt, early in the pandemic, that it was necessary to make sure we have people with expertise in outbreak science,” Inglis explained. “We brought on volunteers.”

According to Inglis, the percentage of manuscripts that scientists submit, but that bioRxiv doesn’t publish, is between 5 and 10 percent, while that figure is closer to 20 to 25 percent for medRxiv.

Inglis said numerous scientists have done some modeling based on public data, but that the preprints don’t accept those papers unless they contain additional research.

The preprint management team was “worried about the indiscriminate use of these models to guide public policy,” he said.

Additionally, the team excluded manuscripts that might be dangerous to human health or human-health related behavior. They didn’t want people to rush out and take something that, theoretically, might help, but that hasn’t received sufficient testing. A treatment might block a receptor, but also have significant side effects.

Inglis said the team of people who work at the preprints, which includes five full-time preprint-platform dedicated staff members and seven other CSHL staff with other responsibilities, including the founders, tech developers and production staff, worked seven days a week, with long working days to meet the increased need and demand.

People working on this effort “are not doing it because they are getting rich or handsomely acknowledged.” An arduous job with thousands of papers, the staff are working out of a “sense of purpose and mission,” Inglis explained.

The Chan Zuckerberg Initiative and CSHL provide financial support for these preprints. The research community has shared their appreciation for these preprints and CSHL generously acknowledges the work of the staff.

Inglis and Richard Sever co-founded bioRxiv. MedRxiv is managed by Sever and Inglis in collaboration with Professors Harlan Krumholz and Joe Ross from Yale and Dr. Theo Bloom and Claire Rawlinson from BMJ, which was originally called the British Medical Journal.

Inglis said numerous papers have become game-changers in the battle against the virus, including a study from two weeks ago in the United Kingdom on dexamethasone, a steroid that was proven effective in severe cases of COVID-19. Indeed, just recently, a Bethesda hospital became the first in the nation to use the steroid to combat the virus.

The team working in preprints at CSHL appreciates the opportunity to contribute to the public health crisis.

Inglis is pleased with how the community trusted the preprints with their work, while numerous members of the community helped screen manuscripts and provide advice about how to react to the needs of the pandemic.

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Dogs die in hot cars! Stock photo

Dogs and cats can suffer from the same problems that humans do in hot weather. These health concerns include overheating, dehydration and even sunburn. By taking some simple precautions, you can keep your companions healthy and happy in higher temperatures.

▶ Never leave your animal alone in a vehicle. Even with the windows open, a parked automobile can quickly become a furnace.

▶ Limit exercise. Your pet may slow down when the weather heats up, so the best time for exercise is in the early morning or evening, but never when it’s especially hot or humid. 

▶ Take care not to let your dog stand on hot asphalt, his body can heat up quickly and his sensitive paw pads can easily burn.

▶ Never trim your pet’s coat to the skin, which can rob your dog of his protection from the sun. 

▶ Always provide plenty of shade and cool, clean water for animals when outdoors.

▶ Bring your cat or dog inside during the hottest part of the day.

▶ Make sure your pet always wears a collar and identification tag.

▶ In Suffolk County tethering a dog outside in temperatures over 90° is against the law.

If you see a dog in a hot car, record the information about the vehicle (make, model, color, license plate number), alert the management of the business and call 911 or the Suffolk County SPCA at 631-382-7722.

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Stock photo

By Matthew Kearns, DVM

My last article focused on some general potty-training techniques. This article will focus on crate training.

Crate training is a wonderful way to give your puppy the guidance it needs. Crate training originates from a “den theory” observed in wild dogs. Wild dogs are nomadic by nature, but they do settle down for part of the season to mate and raise pups. Males hunt and females search out a den. This den is a safe haven away from other predators and the elements. Wild dogs also instinctively go to the bathroom outside the den. If the crate is treated the same way it can be a nice, safe area for the puppy.

The primary goal is always, ALWAYS make the crate a “safe area” for your puppy. Do not isolate the crate and never use the crate as a form of punishment. When you (or other family members) are home the door to the crate should be left open to allow your puppy to go in and out as they please.

A favorite toy or a treat before you put your puppy in the crate is a great distractor/reward. A crate is most effective, but a crate does not always have to be a crate. You can baby gate off a portion of the kitchen, give a room, etc.

Avoid leaving your puppy in the crate too long. This could lead to them soiling the crate (if left with no choice). Remember from our last article that puppies can only physically “hold it” for so long. A good rule of thumb is to count the number of months old the puppy is and add one to come up with the number of hours the puppy can hold it. For example, an 8 week (2 month) old puppy can hold it for 2 + 1, or 3 hours.

Puppies can usually hold it longer at night. However, when you first get a puppy, it would be a good idea to get out of bed to let them out (or even set an alarm clock) to take them outside (SUPERVISED) to go to the bathroom and praise them when they do. Remember that eating and drinking will stimulate the puppy to go to the bathroom, so allow extra time to bring them back outside after they eat and drink. If the puppy soils the crate just clean it up. We want the crate to be a safe area away from punishment if it is to be effective. 

Do not try to force an older dog into a crate or you may be at your veterinarian’s office for broken nails and teeth (as they do anything to get out of the crate). That is not to say that you cannot crate train an adult dog but it takes time, patience, and the guidance of a behaviorist or trainer. It is much easier (and less expensive) to start at a younger age, remain patient, and consistent. I hope this helps and good luck. 

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. Have a question for the vet? Email it to [email protected] and see his answer in an upcoming column.

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'Us' by William King, 1996, brushed stainless steel. Image courtesy of Heckscher Museum

Some good news: The Heckscher Museum of Art will reopen on Aug. 1.

Visitors will finally be able to see the incredible artwork from Long Island’s Best: Young Artists at the Heckscher Museum and Amanda Valdez: Piecework in person (through Heckscher at Home, the museum had presented these exhibitions virtually) as well as a new installation titled Balancing Act: Three Sculptures by William King. The mini-exhibition features whimsical works by Long Island sculptor William King who was known for his ability to breathe life into static sculptures, especially these stainless steel pieces that at first glance look precariously balanced.

“This is the first time that all three of King’s sculptures from the museum collection are on view together,” noted curator Karli Wurzelbacher. “The themes they address are central to our shared human experience and strike me as especially timely. The need for social distancing means that the gatherings and activities that usually take place in the museum’s lobby are on pause. I’m thrilled that King’s freewheeling figures can populate the space and greet our visitors as they return!”

To ensure all visitors’ safety, admission will be by advance reservation and timed ticketing only. Frequent cleaning schedules are in place and the museum will be a touch-free experience. New modified hours, updated admission policies, and complete health and safety guidelines can be found at www.heckscher.org/reopening. For the time being, admission will be free. To reserve your ticket, visit www.heckscher.org or call 631-380-3230.

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Easy Plum-Almond Galette

By Barbara Beltrami

In the heart of summer when fresh stone fruit and all kinds of berries beckon to us, it’s the season for putting them in galettes, pies and tarts and letting their sweet and slightly tannic juices tease and please our palates. It really doesn’t matter whether you turn them into a beautifully domed two crust pie or arrange them over a pate brisee in a tart pan or scatter them over a free form galette crust. You’ll still have that incomparable combination of flaky pastry crust and jewel-hued fresh fruit. And of course, in the following recipes the fruits and preparations are interchangeable as long as you adhere to the measurements, so go ahead and do it your way.

Easy Plum-Almond Galette

Easy Plum-Almond Galette

YIELD: Makes 8 servings

INGREDIENTS:

For the pastry:

1 1/2 cups flour

12 tablespoons (1 1/2 sticks) unsalted butter cut into pieces

1/4 teaspoon salt

1/3 cup ice water

For the filling:

1/4 cup + 1/3 cup sugar

1/4 cup ground almonds

3 tablespoons flour

2 1/2 pounds plums, washed, halved, pitted and cut into half-inch wedges

3 tbsp unsalted butter, cut into tiny pieces

1/2 cup currant jelly, melted

DIRECTIONS:

For the pastry:

Place flour, butter and salt in bowl of electric food processor; pulse a few times just to blend; add ice water and pulse another few times until dough pulls together and you can still see little pieces of butter. Remove dough from processor, shape into a ball and on a lightly floured surface roll into an oval or circle about 16 to 18″ across and one-eighth-inch thick. Gently transfer to baking sheet. Chill 30 minutes. Preheat oven to 350 F.

For the filling:

In medium bowl combine a 1/4 cup of sugar, almonds and flour and spread evenly over galette pastry. Arrange plum slices in pattern over flour mixture; dot with butter and sprinkle with remaining one-third cup sugar but leave a two-inch border around edges. Gently fold or roll edges of dough up to meet and form a little wall at edges of fruit. Bake until crust is a deep golden and fruit is tender and bubbling, about one hour. Gently slide knife or spatula under crust to release it from any juices that have caused it to stick. Brush top of fruit and edges of crust with currant jelly. Serve warm or at room temperature with vanilla ice cream or creme fraiche.

Basic Blueberry Tart

Basic Blueberry Tart

YIELD: Makes one 8-inch tart.

INGREDIENTS:

1 stick unsalted butter at room temperature

1 cup flour

Pinch salt

1 teaspoon sugar

1 tablespoon cider vinegar

1 quart blueberries, rinsed and picked over

1/3 cup sugar

1 tablespoon flour

Confectioners’ sugar (optional)

DIRECTIONS:

Preheat oven to 375 F. In bowl of food processor combine butter, the cup of flour, salt, sugar and vinegar. Pulse until dough comes together but is still pasty. Press evenly into eight-inch spring form tart pan.  Reserve two-thirds cup of berries, then in large bowl combine remaining berries, the one-third cup sugar and tablespoon flour. Pour evenly into tart crust. Bake until filling is bubbly and crust is golden, about 35 to 40 minutes. Remove from oven, let cool, remove from tart pan and sprinkle top with reserved fresh blueberries. Dust with confectioners’ sugar if desired. Serve at room temperature with whipped cream.

Jenny’s Peach Pie

Jenny’s Peach Pie

YIELD: Makes 6 to 8 servings

INGREDIENTS:

For the pastry:

2 1/2 cups flour

1 1/2 sticks unsalted butter, diced

1 teaspoon coarse salt

1 egg yolk, beaten

1 teaspoon white or cider vinegar

1/4 cup ice water

For the filling:

6 to 8 ripe peaches, sliced (do not peel)

2 tablespoons freshly squeezed lemon juice

1 cup sugar

1/4 cup flour

DIRECTIONS:

To prepare the crusts, in a food processor pulse together the flour, butter and salt until mixture resembles coarse meal. In a small bowl, combine the egg yolk, vinegar and ice water; sprinkle four tablespoons mixture over flour mixture and pulse; if dough does not hold together sprinkle remaining liquid and pulse again.

On a lightly floured surface gather the dough into a ball and knead a few times. Divide dough in half, enclose in plastic wrap and refrigerate at least one hour.

Meanwhile prepare the filling. In a large bowl combine the peaches, lemon juice,  sugar and flour. Preheat oven to 425 F. On a lightly floured surface shape one ball of chilled dough into a disc, then roll out and place in a 9-inch pie plate. Add filling; shape second ball of dough into a disc and roll out; gently center on top of filling. Trim pastry edges and crimp together.

Place in oven for 15 minutes at 425 F, then reduce heat to 375 F and continue to bake until crust is golden and filling is bubbly, about another 40 minutes. Serve hot, warm or at room temperature with peach ice cream.

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Stock photo

By Nancy Marr

The year 2020 in New York State began with excitement about voting access and modernization. Governor Cuomo had signed the bill for 9 days of early voting in November 2019 and New York voters embraced it.

We synchronized federal, state and local primary elections to reduce costs and encourage greater turnout. Young people can pre-register at ages sixteen and seventeen with automatic registration when they turn eighteen. Voters who move within the state will have their registration go with them seamlessly. We also closed the LLC Loophole, meaning that an LLC’s political spending was limited to the same amount allowed to corporations, $5,000 annually. We expected to see the fruit of these efforts this year.

Then, starting in March, we saw the threat of the pandemic on voter safety. After declaring a state of emergency, Gov. Cuomo ordered the presidential primaries postponed from April 28 to June 23 (already the date of state and local primaries) and then ordered Boards of Elections to send Absentee Ballot (AB) applications to all voters in New York State eligible to vote in a primary.

There was great confusion since some voters had already mailed individual AB applications, and those were different from the mass-mailed applications. The NYS Board of Elections announced cancellation of the Democratic presidential primary due to pandemic fears. Then a court declared that cancellation invalid, and the primary was back on. This caused the absentee ballots to be on two pages (presidential on one, other offices on another page) resulting in some  eligible voters not receiving both ballot pages.

A huge number of people in Suffolk County applied for Absentee Ballots (more than double the in-person number of voters) and counting mailed in ballots could only begin on July 1 and was expected to end on July 9. Our media didn’t help either; readers were told which candidates were “leading” after the relatively small number of in-person votes were counted on election night (in CD1’s Democratic primary, about 15,000).

As if that amount of confusion couldn’t be any worse, due to the virus a very large number of poll workers chose not to work on election day, regular polling sites refused to be hosts and the Suffolk Board of Elections reduced the actual number of polling places on June 23 by almost two-thirds.

Letters were mailed to voters just before election day, but chaos resulted, including removing neighborhood polling places in communities where transportation was a challenge as well as communities of color. Signage was poor or non-existent in new locations and many places were hard to find. 

Voters in New York State have traditionally felt that although we had antiquated aspects to our elections (no early voting, no “no excuse” absentee ballots, no same-day voter registration, and terrible voter turnout) we were in pretty good shape compared to other states that were suppressing the vote. Our blinders have now been removed and much work needs to be done, quickly and thoughtfully, in order to assure a fair, secure, auditable, inclusive and clear process on Nov. 3.

Your voice counts as much as your vote. The New York State Legislature has already closed its session, but the Governor can bring them back. We need money allocated to the Boards of Elections to ensure the Nov. 3 elections are perceived by all voters as valid and reflective of all those who voted.

Study media writeups of the June 23 results during July, learn from them, and in the fall help spread nonpartisan communication about the process. The League of Women Voters’ voter information website, www.VOTE411.org. is a great starting point to see if a voter is registered, learn who is on their ballot, and understand election law and changes in their state.

Threats to the viability of the United State Postal Service will be an issue if the November election is deemed not safe enough for in-person voting. Congress must act immediately to fix the Postal Accountability and Enhancement Act (PAEA) which required the USPS to create a $72 billion fund to pay for the cost of its post-retirement health care costs, 75 years into the future. This burden applies to no other federal agency or private corporation.

Nancy Marr is first vice president of the League of Women Voters of Suffolk County, a nonprofit, nonpartisan organization that encourages the informed and active participation of citizens in government and influences public policy through education and advocacy. For more information, visit www.lwv-suffolkcounty.org or call 631-862-6860.

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MESSAGES OF HOPE

Fred Drewes of Mount Sinai came upon this colorful scene on July 10. He writes, ‘The pilings at Satterly Landing on Shore Road in Mt. Sinai Harbor have been decorated with interesting and pleasing art work. Each conveys a hopeful message and hope for the future.’

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Port Jefferson Station resident Gerard Romano spied this group of roses blooming by the Port Jefferson Village Center on June 15, a perfect accompaniment to the poem below.
Reopening

By Ellen Mason, Stony Brook

Civilization awakens.

The weather is warm.

We’re eager to mingle.

We’ve weathered the storm.

We’ve made such adjustments,

In the wish to resume.

Now it’s time for a haircut

And examining room.

We’re forever grateful

To workers out there,

Who stayed at their posts,

Through this horrible scare.

We welcome the changes

But with caution, at last

To face life in the future,

With somber thoughts of the

                                     past.

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