From left, Gary Gerard, lead interventional/cardiac catheterization technologist, Stony Brook Southampton Hospital; Dr. Travis Bench, director, Cardiac Catheterization Lab, Stony Brook Southampton Hospital; Helen VanDenessen, nurse manager, Imaging, Stony Brook Southampton Hospital; and Dr. Dhaval Patel, cardiologist, Stony Brook Medicine. Photo from SBU
By Javed Butler, MD
Dr. Javed Butler
Stony Brook Medicine has opened the new Cardiac Catheterization (Cath) Laboratory at Stony Brook Southampton Hospital to improve access to lifesaving heart care for residents of the East End of Long Island.
The lab provides emergency and elective treatments delivered by Stony Brook University Heart Institute specialists, for easier, faster access to the highest standards of cardiac care. The standard of care for a person experiencing a heart attack is that the blocked artery should be opened within 90 minutes of contact with medical care. That procedure can only be done in a cardiac catheterization lab by highly trained personnel.
For the rapidly increasing population of the East End, the nearest cath lab was previously located at Stony Brook University Hospital, up to 70 miles and a 60- to 90-minute drive. Even transportation by ambulance or helicopter could result in a life-threatening delay.
The new cath lab, led by interventional cardiologist Dr. Travis Bench, is currently the only facility in the East End capable of providing clinically complex care to critically ill heart patients. Bench and his partner, Dr. Dhaval Patel, have East End cardiology practices in Southampton and Center Moriches.
The lab will save lives by providing more immediate intervention for serious heart events such as myocardial infarctions (heart attacks). A delay in restoring blood flow through an artery increases the likelihood for significant damage to the heart. By allowing physicians to open a blocked artery in Southampton, without having to first transport a patient to Stony Brook, damage to the heart can be minimized and total heart failure may be prevented.
At the Southampton cath lab, doctors will be able to perform percutaneous coronary intervention (PCI), a nonsurgical procedure in which a physician inserts catheters through the skin to reach affected structures. The PCI treatments at Stony Brook Southampton Hospital include emergency and elective procedures.
The Southampton lab is staffed every day, around the clock, by Stony Brook Heart Institute’s interventional cardiologists with the most up-to-date knowledge and skills to diagnose and treat patients with heart disease.
For patients who need emergency catheterization, Stony Brook’s “Code H” protocol has produced an average “door-to-perfusion” time of 56 minutes, almost 45 minutes below the New York State regulated treatment guidelines. That is the level of care we strive for at Stony Brook Southampton Hospital. The systems and processes are in place and we look forward to taking care of our patients out east with that same dedication to quality and excellence.
To view a video and learn more about the Cath Lab at Stony Brook Southampton Hospital, visit www.heart.stonybrookmedicine.edu.
Dr. Javed Butler is the co-director of the Heart Institute and chief of the Division of Cardiology at Stony Brook Medicine.
Japanese maple seedlings in a woodland setting have the best fall colors. Photo by Kyrnan Harvey
By Kyrnan Harvey
“It’s fall, right?” my 7-year-old just asked. And I was like, “Um, yeah?” Notwithstanding a few weeks of unseasonably balmy, if not muggy, days, it is October and the first noticeable autumnal tints are seen in the American dogwoods that grow along the margins of the Laurel Ridge-Setauket Woods Nature Preserve on Belle Mead Road.
You needn’t be a gardener — nor ferry up to New England — to enjoy the weeks of glorious colors in the maples and the oaks in random woods and suburban roads: the yellow Norway maple, the red-orange of sugar and red maples, the russet-reds of the oaks.
There are many kinds of shrubs too, of course, that present fall color. These typically color up best in sunnier locations, but the native spicebush (Lindera benzoin), ubiquitous in our woods because the deer leave them alone, are beginning to yellow even in heavy shade. Last Saturday I was driving on Mt. Grey and West Meadow roads in Old Field, where homes are nestled into our native oak woods. Naturalized in the understory are the native mountain laurel, Kalmia latifolia, and planted rhododendrons that had grown massive before the deer population exploded.
If you live under a high canopy of oak trees, but want some great fall color, Japanese maples are a superb understory tree: They prefer some shade and will color up well despite it. Japanese maples are not limited to the popular weeping lacy trees. They are primarily Acer palmatum, but they also refer to Acer japonicum and Acer shirasawanum.
Japanese maple seedlings flourish in a woodland setting. Photo by Kyrnan Harvey
The grafted cut-leaf Japanese maple is justifiably popular but not inexpensive. These are propagated vegetatively, i.e., not by seed; they are called cultivated varieties (cultivars, in the trade), meaning they have specific genes; and they are identical to one another in leaf shape, size and color and also in rate of growth and habit, by which is meant the shape of the crown, whether pyramidal, weeping or columnar.
The spectacular cut-leaf Japanese maple (Acer palmatum var. dissectum), red-leafed or green, is better used singly, as a specimen. Mature tress will get to be 15 feet in diameter, so do not make the common mistake of planting it too close to your driveway or front path or up close to your house. It is always a shame to have to restrict with pruning the natural form of these.
If you have the opportunity to plant a grove of Japanese maples, maybe for screening or to start a woodland garden, then the most expedient way would be to find a source of random Acer palmatum seedlings. Young trees, cheap. Don’t overly favor the showy red-leaved ones; select if you can a mix of green and red. In Joe’s garden, a client, there were three or four mature Japanese maples. We had many dozens of seedlings, offspring from the mother trees, growing out of the compost of years of leaf-blowing.
Many years ago Joe and I potted up a few of the younger ones, from 3 to 7 years old, and on a sunny Saturday morning in late October loaded them into the 8-foot bed of my ’68 Chevy. We parked on 5th Avenue in Park Slope in Brooklyn and presented a sidewalk sale. They were gorgeous in their variety of fall reds, oranges and even yellows. Fifteen years later and there are many dozens more seedlings, I just can’t bring myself to pull them up and throw them in the compost pile.
True, the deer will nip them as long as they can reach the branches. It is worth the effort to spritz a little deer repellent, especially in April, May, and June, for the first couple years until the branches are up and out of their reach. There is a blight on them, a soil-borne fungus called Verticillium wilt, that causes branches to die. Cut them back to the trunk. Sometimes the whole tree dies. If you have a dozen or more trees, as I recommend, and they are seeding themselves around, then it’s easy-come-easy-go. You don’t have to mourn the loss of a tree if there are many more healthy ones about.
It’s okay to start with unnamed seedlings of Acer palmatum. They are always gorgeous, leafing out in spring with their iconic leaves, or changing color in fall, they are never out of scale in the garden and comport well with companion shrubs and perennials. You could order a dozen and supplement them with a few choice named cultivars that you gradually collect at the garden center or through mail-order sources; or you could start right off with the choice varieties.
It would be preferable to have some of these splendid cultivars because some of their offspring seedlings will carry their desirable traits. Japanese maples are prolific self-sowers, so you might want to plant two or three of the great, well-known varieties: Invest in a few large trees, sourced at a nursery. Have them planted in locations that establish the structure and articulate the paths of a new woodland garden, underplant them with perennials and start looking out for seedlings next year!
Kyrnan Harvey is a horticulturist and garden designer residing in East Setauket. For more information, visit www.boskygarden.com.
Heather Lynch at Spigot Peak in the Antarctic. Photo by Catherine Foley
By Daniel Dunaief
Counting penguins is like riding the highs and lows of Yankees rookie Aaron Judge’s home run streaks, followed by his series of strike outs. He’s not as bad as his strike outs suggest, although he’s also not a sure thing at the plate either.
Similarly, in local populations, the Adélie penguin, which waddles to and fro squawking on land and gliding gracefully through the water, isn’t as clear a barometer of changes in the environment. Also, like Judge, when populations rise and fall, people are eager to offer their explanations for exactly what’s happening, even if the sensational explanations — he’s not that good, no, wait, he’s the greatest ever — may overstate the reality.
Heather Lynch visits Cape Lookout in Antarctica during recent trip that included an NBC TV crew that produced a feature for ‘Sunday Night with Megan Kelly.’ Photo by Jeff Topham
“We have to be careful not to be overreactive,” said Heather Lynch, an associate professor of ecology and evolution at Stony Brook University. “The concern is that, when we see increases or decreases, the implication is that there’s a miraculous recovery or a catastrophic crash.”
That, however, is inconsistent with Lynch’s recent results, which were published in the journal Nature Communications. Examining penguin data from 1982 to 2015, Lynch, Christian Che-Castaldo, who is a postdoctoral researcher in Lynch’s lab, and nine other researchers looked to see if there’s a way to connect the size of the population to changes in the environment. The study involved two teams of researchers, one supported by NASA and the other backed by the National Science Foundation.
“It’s a noisy system,” Lynch concluded. Managers of the populations of krill, small crustaceans that are the mainstay of the Adélie diet, try to use time series of key indicator species to understand what’s going on in the marine realm. In this article, Lynch said, local Adélie penguin populations may not be a clear signal of the health of the krill stocks because penguin abundance fluctuates for reasons she and her team couldn’t pinpoint.
These penguins, which Lynch has counted during her field work in the Antarctic, exhibit changes in population that can run contrary to the health, or stressed condition, of the environment.
“You can’t have your finger on the pulse” with the available data, Lynch said. “Part of our inability to model year-to-year changes is because we can’t measure the right things in the environment.”
The drivers of abundance fluctuations likely involve other animals or aspects of the krill fisheries they couldn’t model, she suggested.
“There’s a lot we don’t know about what penguins do under water, where they spend a large portion of their time and where they feed,” Grant Humphries, who was in Lynch’s lab for a year and now runs his own data science company in Scotland called Black Bawks Data Science Ltd, explained in an email. “The signals that drive year to year changes might actually lie there.”
Tom Hart, a researcher of the Department of Zoology at the University of Oxford who was not involved in this study, explores local scale variation in penguin populations. Locally, Hart said in an interview by Skype, “Things are incredibly noisy. When you aggregate, you get good signals, but with some error.” He suggested that this research drives him on further, showing that “local influences are important” because there’s so much variance left to explain. Lynch’s research is “a really good study and shows very well what’s happening on the regional scale, but leaves open what happens below that,” he said.
Indeed, Lynch suggested that by putting sites together, researchers can look at larger areas, which provide a clearer picture on shorter time scales.
Michael Polito, an assistant professor in the Department of Oceanography and Coastal Sciences at Louisiana State University who was not involved in the study, suggests that this extensive analysis indicates that “you can still look at the relationship between the abundance of penguins and the environment in a robust way. Even though any individual time series may not be the best way to understand these relationships, in the aggregate you can use them.”
Managers who set fishery policies in Antarctic waterways are often concerned about harvesting too much krill, leaving the penguins without enough food to survive and feed their chicks.
The challenge with this result, Lynch acknowledges, is that it makes setting krill boundaries more difficult.
A strategy that involves resetting conservation targets based on annual monitoring appears unrealistic given these results, Lynch said. “From a practical standpoint, we threw in everything we could and could explain only a tiny fraction of the variation,” she said.
Hart added that this is “not an argument to fish away,” he said. “We need to understand what’s going on at a local scale and we’re not there yet.”
To get people involved, Lynch and her team created a science competition, called Random Walk of the Penguins, to see who could predict the overall penguin populations for Adélie, gentoo and chinstrap penguins from the 2014 to 2017 seasons.
The competition, which was a collaborative effort with Oceanites, Black Bawks Data Science and Driven Data included $16,000 in prize money, which was donated by NASA. Entrants could use data from the 1982 through the 2013 seasons. The contest drew competitors from six continents. Of the five winners, all were from different countries.
Humphries, who was the lead on the data science computation, said the results were “somewhat humbling” because competitors were able to make “decent predictions” using only the time series. “With long-term predictions and for determining the tipping points, there is still a lot of work to be done.”
Lynch is relieved that her co-authors supported the direction the article took. “I’m a skeptic by nature and more than happy to throw orthodoxy (or even my own previous work) under the bus,” she wrote in an email. “I do hope that others will use our model as a starting point and we’ll never go back to the old days where everyone looked only at ‘their sites.’”
Eden. A garden. Adam and Eve. That apple. Not a pear or a persimmon or a pineapple, mind you. An apple whose invitational impact launched one of the biggest, if not the biggest, succession of events ever. I don’t know what variety that first apple was, but we descendants have more varieties to choose from that you can shake a candy apple on a stick at, and many of them are grown right here in our own state. So here we are eons later still tempted by that apple and turning it into everything from sauce to pie to chutney to cake to cider and that’s the short list. If you think it was easy deciding what apple recipes to share, guess again. Anyway, here’s how I’ve narrowed that selection.
Apple Coffee Cake
Apple Coffee Cake
YIELD: Makes 8 to 10 servings
INGREDIENTS:
3 cups peeled, cored and sliced
Granny Smith apples (about 6)
5 tablespoons + 2 cups sugar
4 teaspoons cinnamon
3 cups flour
3 teaspoons baking powder
Scant teaspoon salt
1 cup vegetable or corn oil
4 eggs
¼ cup apple juice
1 tablespoon vanilla extract
DIRECTIONS: Preheat oven to 375 F. Grease a 9- or 10-inch tube pan. In a medium bowl combine the apple slices, five tablespoons sugar and cinnamon. Set aside. Sift the flour, baking powder, salt and remaining 2 cups sugar into a medium bowl. Make a well in the center and pour in oil, eggs, apple juice and vanilla. Beat with a wooden spoon until well blended. Drain the reserved apple mixture of excess liquid. Spoon one-third of the batter into prepared pan. Arrange half the apple mixture in a circle on top of the batter. (Make sure no apples touch the side of the pan.)
Repeat procedure with another third of the batter, then the remaining apple mixture and finally the last third of the batter. Bake for 1 to 1¹/₄ hours, until cake tester inserted in middle of circle comes out clean. If top browns too much before inside is done, cover with aluminum foil. Cool to lukewarm; invert onto serving plate. Serve with whipped cream and steaming mugs of coffee or tea.
Deep Dish Apple Pie
Deep Dish Apple Pie
YIELD: Makes 6 to 8 servings
INGREDIENTS:
6 to 8 slightly tart apples
1 cup sugar
½ teaspoon salt
½ teaspoon cinnamon
1/8 teaspoon nutmeg
2 tablespoons flour
2 tablespoons butter
1 pie crust (10 inches or more)
2 to 3 tablespoons milk
DIRECTIONS: Preheat oven to 425 F. Peel, core and cut apples into thin slices; place in baking dish or deep pie dish. In a small bowl combine sugar, salt, spices and flour; sprinkle mixture evenly over apples. Dot with butter. Gently place pastry on top, fold edges under and press them against rim of dish with fingers or fork tines. Brush crust with milk. Bake 40 minutes or until crust is golden and apples are tender. Serve with vanilla ice cream or cheddar cheese.
Crispy Baked Apples
YIELD: Makes 6 servings
INGREDIENTS:
6 tart apples, cored, then peeled halfway down
3 tablespoons melted butter
2 tablespoons flour
½ cup brown sugar
DIRECTIONS: Preheat oven to 425 F. Place apples, peeled side up, in a baking dish. Combine the butter, flour and sugar and pat it onto tops of apples. Bake at 425 F until crust is set; lower oven to 350 F and continue to bake until apples are tender (about 30 minutes). Serve with unwhipped heavy cream.
Now in its 37th year, the Setauket Artists’ Exhibition, featuring the works of over 40 local artists and artists from all over Long Island, will return to the Setauket Neighborhood House, 95 Main St., Setauket from Oct. 22 to Nov. 20 with viewing daily from 10 a.m. to 5 p.m. An opening reception will be held on Sunday, Oct. 22 from 1 to 4 p.m.
‘Long Island Sunset’ by Eileen Sanger
Participating artists this year include Lana Ballot, Ross Barbara, Eleanor Berger, Robert Berson, Rina Betro, Sheila Breck, Renee Caine, Al Candia, Gail Chase, Anthony Davis, Julie Doczi, Jeanette Dick, W.A. Dodge, Paul Edelson, Stu Gottfried, Donna Grossman, Peter Hahn, Melissa Imossi, Laurence Johnston, Anne Katz, Flo Kemp, Karen Kemp, Michael R. Kutzing, John Mansueto, Jane McGraw Teubner, Terry McManus, Eleanor Meier, Fred Mendelsohn, Muriel Musarra, Genia Neuschatz, Iacopo Pasquinelli, Paula Pelletier, Denis Ponsot, Joe Reboli, Joan Rockwell, Robert Roehrig, Irene Ruddock, Eileen Sanger, Carole Link Scinta, Sungsook Setton, Barbara Siegel, Patricia Sloan, Angela Stratton, Marlene Weinstein, Laura Westlake and Patricia Yantz.
‘From Here You Can Almost See the Sea” by Iacapo Pasquinelli
The distinguished judge this year is David Peikon, a “contemporary realism” oil painter who is an instructor at the Art League of Long Island. Peikon has had over 18 solo shows and his work is in corporate and private collections throughout the world.
Each year, the Setauket Artists honor a special artist who’s work is admired and who has contributed greatly to the show. It is an award especially appreciated since it is chosen by one’s peers. Muriel Musarra, a watercolorist and oil painter and a member of the Setauket Artists for 37 years, is this year’s choice. Her work is in many collections and exudes a certain quiet peacefulness that has charmed the community for years.
The three paintings being offered for the raffle this year are the following: “Giclee of Giverny #1” by Renee Caine, a recent Artist of the Month recipient for LIMarts; “An Afternoon in Tuscany,” an original pastel by Donna Grossman, instructor of drawing and oil painting at The Atelier in Saint James; and “Nissequogue Overlook,” an original acrylic by John Mansueto, a well-known painter from the South Shore.
Fred Bryant of Bryant Funeral Home has generously offered to be the Setauket Artists sponsor again. The artists applaud Bryant’s loyalty by providing funds that have made the exhibit more professional.
‘One Daisy’ by Angela Stratton
This year, the Setauket Artists introduce their new website, www.setauketartists.com. We invite you to take a look and sign up to join our mailing list. The website will tell you about the 37-year-old organization called Setauket Artists: its history, artists, paintings, Children’s Scholarship Fund, and our newest feature, art consultation.
Art consultation is designed to create a personal relationship with buyers who may want to purchase a piece of art but are unsure of where to begin to obtain art that best suits their surroundings. After suggesting many paintings, we will bring the actual paintings to your home or office where you will see the artwork in its environment, with no obligation to purchase. Art consultation is available all year long; we look forward to providing you with affordable paintings that truly fit your needs and our motto: Art for a Lifetime.
‘Setauket Bridge’ by Muriel Musarra
The Setauket Artists will continue their art scholarship fund for children in the Setauket schools, presenting these awards at the reception opening. This year’s recipients of the awards for drawing and painting are Will Boonin in memory of Setauket Drawing Group member Andrew Schmitt, Jaden Chimelis in memory of Setauket Artist Burt Woods and Paloma Papageorge in memory of artist JoAnn Coane, given by her husband Jim Coane.
If you miss the first reception, join the Setauket Artists for a free wine and cheese reception on Friday, Nov. 10 from 5 to 7 p.m. where music will be provided once again by singer Caterina Dee.
For additional information, visit www.setauketneighborhoodhouse.com, Setauket Artists on Facebook or call 631-365-1312.
Irene Ruddock is the coordinator of the Setauket Artists.
The Long Island Museum, 1200 Route 25A, Stony Brook will welcome Austin-based Slaid Cleaves in concert this Saturday, Oct. 21 at 7 p.m.
Cleaves’ self-penned biography simply says: “Grew up in Maine. Lives in Texas. Writes songs. Makes Records. Travels around. Tries to be good.” A busy tour schedule, fueled by an engaging stage personality, have won Cleaves a devoted fan base which includes novelist Stephen King, who wrote the liner notes to Cleaves’ album, Everything You Love Will Be Taken Away.
Slaid gained national attention with his 1997 recording, No Angel Knows, produced by the legendary Gurf Morlix. Cleaves’ follow up album, Broke Down, brought him national airplay with the title song (a co-write with Rod Picott) and “One Good Year,” a Cleaves/Steve Brooks co-write. Six albums later, Slaid Cleaves continues to write powerful songs as evidenced by his brand new album, Ghost On The Car Radio. (www.slaidcleaves.com)
This is Slaid’s only area appearance on his current U.S. tour. He’ll be accompanied by mandolin and fiddle player, Chojo Jacques.
Advance sale tickets: $25 at www.sundaystreet.org through Friday, October 20th. Tickets at the door on the day of the show are $30 (cash only). For more information, call 631-751-0066.
Alex Bertolini and Michael Locissano star in SPAC’s Disney’s ‘Beauty and the Beast JR’.
A tale as old as time opens at the Smithtown Center for the Performing Arts
By Heidi Sutton
The French fairy tale, “Beauty and the Beast,” was written by Gabrielle-Suzanne Barbot de Villeneuve in 1740 and then revised and popularized by Jeanne-Marie Leprince de Beaumont in 1756. Translated into many different languages over the years, it has become a tale as old as time. Most children, however, are familiar with the Disney film versions — the 1991 award-winning animated musical and the live-action musical starring Emma Watson released earlier this year.
Now the beloved fairy tale comes to life on the grand stage of the Smithtown Center for the Performing Arts as Disney’s “Beauty and the Beast JR” and does not disappoint.
Gaston (Zak Ketcham) and his admirers
Expecting a shortened version of the story to appease the young children in the audience, many who came dressed as Belle, imagine my surprise and certainly others in the theater when the curtain goes up last Saturday afternoon and for the next 2 hours and 20 minutes, the audience is transported to a small provincial town in France in what feels like a full-blown Broadway production with an amazing set, incredible costumes, wonderful singing, stupendous dancing and terrific acting — all followed by a well-deserved standing ovation.
If that isn’t enough, you’ll get to experience all the wonderful songs by Alan Menken and Howard Ashman again including “Belle,” “Gaston,” “Be Our Guest,” “The Mob Song,” and everyone’s favorite, “Beauty and the Beast” sung by Mrs. Potts.
The classic story of love and sacrifice, a girl by the name of Belle searches to find her place among the townspeople in her village, all while dodging the advances of a self-loving brute named Gaston. When her father is taken prisoner by a monstrous beast in an enchanted castle, Belle chooses to take his place. The Beast is really a young selfish prince who is cursed to live forever as a hideous creature unless he can learn to love and in return find someone who will love him before all the petals on an enchanted rose wither. But time is running out. If the Beast does not learn his lesson soon, he and his staff will be doomed for all eternity. Will Belle be the one to break the spell?
Jordan Hue skillfully directs a cast of 33 talented teens, who all seem to be having the time of their life. Alex Bertolini is perfectly cast as the beautiful Belle. With her sweet voice and mannerisms, she instantly steals the audience’s hearts. Michael Locissano gives a magnificent performance as the Beast, switching effortlessly from losing his temper to a sad and broken man. Zak Ketcham takes the juicy role of the arrogant Gaston, pompadour and all, and runs with it; and Kyle Westgate-Addessi, as Gaston’s dim-witted sidekick, Lefou, is equally impressive.
Lumiere (Luke Ferrari) and Babette (Brooke Miranda)
Although the entire supporting cast is superb, special mention should be made of the castle staff (humans who have been magically transformed into household objects under the curse) — the enchanted candelabra Lumiere (Luke Ferrari), Cogsworth the talking clock (Logan O’Leary), Mrs. Potts the teapot (Aubrey Alvino), Babette the feather duster (Brooke Miranda) and Mme. De La Grand Bouche the wardrobe (Nikki Sponaugle). And last, but certainly not least, the sweet and adorable teacup Chip (played by Raquel Sciacca during last Saturday’s performance).
Costumes by Ronald Green III are rich and colorful and look as if they stepped straight out of the Disney film, especially during “Be Our Guest,” where the stage is consumed with dancing flatware, napkins, plates and a floor rug. The Beast’s costume has both the royal appearance of a prince and the ragged edges of a cursed monster, and Belle’s dinner gown in signature yellow is breathtaking. However, without giving too much away, it is the castle staff costumes that take it over the top. M.E. Jung’s choreography, highlighted during the musical numbers “Gaston” and “Be Our Guest,” pulls it all together brilliantly.
Light-up roses may be purchased before the show and children can meet Belle and the Prince in the lobby after the show for photos. Costumes are encouraged and booster seats are available.
The main cast of Disney’s ‘Beauty and the Beast JR’
The Smithtown Center for the Performing Arts, 2 E. Main St., Smithtown will present Disney’s “Beauty and the Beast JR” through Oct. 29. All seats are $15. To order, call 631-724-3700 or visit www.smithtownpac.org.
More than four days after lift off, pioneering astronauts Neil Armstrong and Buzz Aldrin had landed in the Sea of Tranquility on the surface of the moon. The NASA schedule, which included preparing the vehicle for an emergency abort of the mission in the event of a problem, called for a nap of four hours. Once they were there, however, Armstrong and Aldrin couldn’t imagine taking a four-hour respite.
“Both Armstrong and Aldrin were, understandably, excited about where they were and decided to forgo the sleeping and changed history,” Thomas Williams, element scientist in Human Factors and Behavioral Performance at NASA, described in an email.
A future trip to Mars, however, would involve considerably longer delayed gratification, with the round trip estimated to take over 400 days. The stresses and strains, the anxiety about an uncertain future and the increasing distance from family and friends, not to mention the smell of cut grass and the appearance of holiday decorations, could weigh on even the most eager of astronauts.
Determined to prepare for contingencies, NASA is funding research to understand ways to combat the mental health strains that might affect future astronauts who dare to go further than anyone has ever gone.
‘Being in long-duration space missions with other people, we expect the mental health risk will be much more elevated’. — Adam Gonzalez
Gonzalez, an assistant professor of psychiatry at Stony Brook University, received over $1 million in funding from NASA to explore ways to help these future astronauts who might be anxious or depressed when they’re on the way to the red planet.
In a highly competitive process, Gonzalez received the financial support to provide guidance on what NASA considers a low-probability, high-consequence mental health event, according to Williams.
Gonzalez “was funded because of the soundness of his research proposal and the clinical and technological expertise of the research team he assembled to help NASA address this research gap,” Williams explained.
Gonzalez started providing three different types of psychological assistance to 135 people in the middle of September. He is testing ways to provide mental health assistance with a delay that could require over 40 minutes to travel back and forth.
One group of test subjects will use a system called myCompass, which is a mental health self-help program. Another group will use myCompass coupled with a delayed text messaging response from a therapist, and a third will have a myCompass system along with delayed video messaging from a therapist.
“Being in long-duration space missions with other people — in this case, months and potentially years — stuck in extremely close quarters with others, we expect the mental health risk will be much more elevated relative to what they are going to have on the International Space Station,” Gonzalez said.
Williams said astronauts to date have not had any diagnosable disorders, but NASA has seen fluctuations in their mood, which appears linked to workload demands and the phase of the mission, Williams said. For astronauts, NASA does not want a continuing negative trend that, over a longer term, could turn into a problem.
“Part of what we hope to achieve with [Gonzalez’s] research is a validated approach to address any of these concerns,” Williams said, adding that astronauts typically understand that their contributions involve work in “high-demand, extreme environments,” Williams said.
Still, like explorers in earlier centuries, astronauts on a trip to Mars will journey farther and for a longer period of time than anyone up to that point. MyCompass is a “good, efficacious program” that takes a “trans-diagnostic cognitive behavioral therapy approach,” Gonzalez said. He suggested that the program is broad enough to help individuals manage their emotions more generally, as opposed to targeting specific types of health disorders.
Gonzalez emphasized that the choice of using myCompass as a part of this experiment was his and might not be NASA’s. The purpose of this study is to investigate different methods for communicating for mental health purposes when real-time communication isn’t possible.
William suggested that Gonzalez’s work, among others, could lead to individualized procedures for each astronaut. In addition to his work with NASA, Gonzalez also assists people at the front lines after man-made or natural disasters. He has worked with Benjamin Luft, the director of Stony Brook University’s WTC Wellness Program, on a program that offers assistance to first responders after the 9/11 attacks.
Gonzalez’s father, Peter, was a police officer who worked on the World Trade Center cleanup and recovery efforts. The elder Gonzalez has since had 9/11-related health conditions.
Gonzalez and associate professor Anka Vujanovic, the co-director of the Trauma and Anxiety Clinic at the University of Houston, are putting together a research project for the Houston area. Vujanovic did a mental health survey on Houston area firefighters earlier this year. They are inviting these firefighters to complete an online survey and telephone assessment to determine their mental health after Hurricane Harvey.
They are also conducting a three- to four-hour resilience training workshop for Houston area firefighters engaged in Harvey disaster relief efforts. “This resilience program, developed by [Gonzalez] and his colleagues, has shown promising results in reducing various mental health symptoms when tested among first responders in the aftermath of Hurricane Sandy,” Vujanovic explained in an email.
Vujanovic has known Gonzalez for over 10 years and suggested his questions were focused on “how can we better serve others, how can we improve existing interventions and how can we develop culturally sensitive approaches for vulnerable, understudied populations.” Gonzalez, who grew up in Bensonhurst, Brooklyn, and came to Stony Brook in 2012, said he was always interested in helping others.
Williams suggested that this kind of research can help people outside the space program. “We openly share and encourage the sharing of any of our relevant research findings to help address societal needs,” he added. Gonzalez’s research is “a great example of how a NASA focus on delivering personalized interventions in support of long-duration spaceflight could potentially be generalized to more rural settings where mental health providers may be scarce.”
Lower triglycerides may reduce cardiovascular risk
By David Dunaief, M.D.
Dr. David Dunaief
The lipid, or cholesterol, profile is one of the most common batteries of blood tests. Why? Abnormal cholesterol levels may have an integral role in exacerbating a number of chronic diseases. These diseases are some of the most common, including atherosclerosis (hardening of the arteries), cardiovascular disease (heart disease and stroke) and vascular dementia. It’s even thought to be a component of age-related macular degeneration, the number one cause of vision loss in those who are at least age 60 in industrialized countries (1).
Let’s delve into the components that make up the cholesterol profile. The lipid panel is made up of several components. These include total cholesterol, HDL or “good cholesterol,” LDL or “bad cholesterol” and triglycerides. Many people focus more on total cholesterol, HDL, and LDL and less on triglycerides. We worry about whether the levels are high enough for HDL and are low enough for total cholesterol and LDL. Is this the proper focus? With total cholesterol and LDL, this seems to be appropriate.
However, with HDL it is becoming more complicated; it is less about how high the levels are and more about the functionality of HDL. There are drugs that increase HDL levels, such as niacin and the fibrates, without significantly reducing cardiovascular events. This was demonstrated in the AIM-HIGH trial (2). In this trial, niacin added to a statin drug increased HDL levels and decreased triglyceride levels without a change in the primary end point of cardiovascular outcomes. Thus, they were deemed less than satisfactory and the trial was abruptly ended. However, triglycerides get the short end of the stick. Just look at the lack of coverage in the mainstream media. In this article, we will explore the different components of the lipid panel and the supposed roles they play in our health. Let’s look at the research.
HDL — the good cholesterol that may not be so good
Eating one-and-a-half cups of oatmeal each day can lower your cholesterol by 5 to 8 percent.
For years, when patients were told their total cholesterol and LDL are high, they asked if their HDL levels compensated for this. Of course, we in the medical community are partially to blame for fueling this thinking. More and more studies point to the importance of HDL functionality rather than the level.
In a study investigating a specific gene variant, or mutation, those who had very high levels of HDL, a mean of 106 mg/dL, and two copies of a P376L mutation, had an increased risk of heart disease (3). In a population of 300 participants with this very high level of HDL, only one had this mutation.
When the investigators broadened the number to 1,282 participants, the results were the same. Results were consistent when they looked at a meta-analysis of 300,000 participants with high HDL.
Carriers of the gene mutation, meaning they had one copy instead of two, were at a 79 percent increased risk of heart disease. Those who had this gene mutation were mostly Ashkenazi Jews of European descent. The good news is that this gene mutation is rare. However, it does show that in certain circumstances, HDL is not always good.
Lest you become too relaxed about this study, since the occurrence was uncommon, another study’s results showed that there is a U-shaped curve when it comes to HDL levels (4). In other words, those on the lowest and the highest ends of HDL levels had higher risk of death from both cardiovascular and noncardiovascular death. There were associations among HDL and other factors, like vegetable and fruit consumption, high blood pressure, diabetes, age and sex. Thus, HDL may not by itself be an indicator of heart disease death risk as suggested by the investigators in the trial. This was a large population-based study with over 600,000 participants.
In a third study, results showed that functionality is more important than HDL level (5). What is called the cholesterol-efflux capacity may be central to HDL functionality. This technique calibrates the reverse transport of cholesterol. Cholesterol is removed from a type of white blood cell in the wall of the artery, put back into the bloodstream and removed by the liver. The importance of the functionality is that a higher cholesterol-efflux capacity results in a lower risk of cardiovascular disease. In other words, you may not be able to rely on HDL levels to determine cardioprotective effects.
Triglycerides should get their due
Triglycerides need their 15 minutes of fame, just like the rest of the cholesterol profile. Triglycerides may be an independent risk factor for cardiovascular disease. In a study, results showed that triglycerides are an independent risk factor for all-cause mortality in those with heart disease (6). But even more interesting is that those with high normal levels, those between 100 and 150 mg/dL, have a significantly increased risk of cardiovascular death. In other words, those who are still within normal limits, but at the upper end, should consider reducing their levels.
The results also showed a dose-dependent curve; the higher the levels of triglycerides, the higher the risk of death from cardiovascular disease. Measurements used included borderline high of 150-199 mg/dL, moderately high of 200-499 mg/dL and very high of >500 mg/dL. This was a secondary prevention trial, meaning the patients already had heart disease. Unfortunately, a disproportionate number of patients were men, 81 percent. However, this study had a strong duration of 22 years with data based on 15,000 patients. The weakness of this trial was its inability to control for confounders such as sickness, treatments and cause of death. Still, this signifies that triglycerides have an important role in our health.
Triglycerides are affected by diet. The elements in the diet that raise levels include sugars, grains — for some even whole grains — and starchy vegetables as well as saturated fats and trans fats.
What about whole eggs? Good, bad or neutral?
Today, the debates in the medical community over eggs’ merits, detriments or neutrality continue. In an observational trial from Finland, results show that one egg a day did not increase the risk of heart disease (7). Whew, now we can put that debate behind us and eat eggs, right? NOT SO FAST!
While the strength of the trial was its very impressive duration of 21 years, the weaknesses of the trial were huge. First, participants were asked for a four-day dietary history at the start of the trial and then never again. It was assumed that they were eating the same foods over this long time period. Second, there were no blood tests taken specifically for the study. In other words, there are no cholesterol levels for the trial. So we don’t know if one egg a day — and remember we’re making a gigantic assumption that they did eat one egg a day — had any negative impact on cholesterol levels. Third, this study population did not include women. There were 1,032 men involved. Having said all this, you could try an egg a day. However, I would highly recommend a physician’s supervision.
In my practice, I had several patients eat two eggs a day, and their total cholesterol levels went up by approximately 100 mg/dL in one month. But this is anecdotal data from my clinical experience.
In conclusion, don’t think you’re safe if you have a high HDL level. It is best to lower your triglycerides to below 100 mg/dL, and an effective way to do this is by reducing sugars, grains, starchy vegetables and saturated fat in your diet. However, there is subset data suggesting that the fibrate class of drugs may have benefit in those who have triglycerides of at least 500 mg/dL (6).
References: (1) www.nlm.nih.gov. (2) N Engl J Med 2011; 365:2255-2267. (3) Science 2016; 351:1166-1171. (4) AHA 2015 Scientific Sessions; Nov. 10, 2015. (5) N Engl J Med. 2014;371(25):2383-2393. (6) Circ Cardiovasc Qual Outcomes 2016;9:100-108. (7) Am J Clin Nutr. 2016;103(3):895-901.
Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.
Kenyer Natural Bakery will return to the event this year.
Save the date! The Greater Port Jefferson Chamber of Commerce, in partnership with Dan’s Papers, will host its 10th annual The Taste @ Port Jefferson at the Village Center, 101-A E. Broadway, Port Jefferson overlooking the Harborfront Park and harbor on Saturday, Oct. 21 from 6 to 8 p.m.
In celebrating this landmark anniversary, the chamber has reached out to the greater Port Jefferson restaurant community and will highlight over 30 restaurants and purveyors offering top-quality food tastings and desserts as well as samples of premium liquors, wines and beers. The event, for ages 21 and over, has been changed to a night venue, which creates new energy and features musical entertainment by the rock band New Life Crisis. In addition to the usual indoor setting, the event will spill outside under a 50- by 100-foot tent.
Try some delicious crepes from Crazy Crepe Café.
Participating food purveyors will include Amazing Olive, Bagel Express-Setauket, Bliss, Chick-fil-A at Port Jefferson, Crazy Crepe Café–Mount Sinai, Crazy Fish Bar & Gill, Curry Club, Danfords Wave Seafood Kitchen, Don Quijote, Dos Mexi Cuban Cantina, Kenyer Natural Bakery, Flying Pig Café, Land & Sea Seafood & Restaurant, Messina Market & Catering, Penntora Lao-Thai Catering, Port Jeff Lobster House, Slurp Ramen, Spiros Restaurant & Lounge, St. Charles Hospital, The Meadow Club and Tuscany of Miller Place.
Dessert samplings from A Cake in Time, East Main & Main, Kilwins of Port Jefferson and LaBonne Boulangerie Bakery will be offered along with beverage tastings from Starbucks, Port Jeff Brewing Company and Manhattan Beer.
Presenting sponsor this year will be New York Cancer & Blood Specialists, and chamber partner St. Charles Hospital will be highlighted as a silver sponsor. Other sponsors include BNB Bank, Farrell Storage and O’Brien Group, LLC, and the media sponsor is Dan’s Papers.
Tickets, which may be purchased online at www.tasteatportjeff.com, are $65 per person for general admission starting at 7 p.m. and $95 for VIP guests at 6 p.m., which includes early access by one hour, a special VIP lounge with tables and chairs, premium pours and desserts, VIP gift bag and special entertainment. For further details, call 631-473-1414.
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