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Betty Boop

MEET BETTY BOOP!

This week’s shelter pet is an eight-year-old female pit bull terrier mix named Betty Boop, currently waiting at the Smithtown Animal Shelter for a family to adopt her. Named after the iconic cartoon diva (who was originally designed as a dog), Miss Boop can’t get enough of people, and volunteers at the shelter can’t get enough of her! 

This ball of love was brought in to the shelter by a good samaritan who found her looking lost at a nearby train station. It was quickly discovered how attached she gets to everyone when she cried watching the good samaritan leave. She doesn’t like to see any of her new friends go!

Betty Boop is the perfect combination of calm, affectionate, and sweet all rolled into a 70 pound ball of love. Her eyes say it all; she oozes love and adoration for every new person she meets. While she’s great with children, she would prefer to be the only pet in her home.

*Due to the health risk presented by the COVID-19 pandemic, there will be limited public access to the shelter. If you are interested in meeting Betty Boop please fill out an adoption application online at www.townofsmithtownanimalshelter.com.

The Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. For more information, call 631-360-7575.

The Cerulean Warbler is on the New York State Special Concern list. Photo by Gary Robinette/National Audubon Society

By John L. Turner

For many years there has been a broad public perception that the primary effect of dumping excessive amounts of carbon dioxide (CO2) into the atmosphere, from the burning of fossil fuels (and the release of other gases such as methane from landfills, gas and oil wells, and other sources), was the warming of the atmosphere — a phenomenon that was first called “global warming” or the “greenhouse effect.” 

Higher average daily and annual temperatures in the atmosphere have, indeed, occurred, so that label is partially correct — 2019 was the second hottest year ever measured, only slightly behind 2016, and according to records of the National Oceanic and Atmospheric Administration, the past five years are the warmest years on record in the 140-year span the federal government has been measuring atmospheric temperatures; today’s earth is more than two degrees (Fahrenheit) warmer than it was in 1950.

But while the term “global warming” has become shorthand to describe the effect increasing concentrations of atmospheric CO2 have on climate, a wide number of scientists recognize that warming temperatures are but one of many adverse environmental effects caused by too much atmospheric CO2 and, in fact, in some places excess CO2 has caused cooling. 

Thus, the term “global warming” both is inaccurate and too restrictive to capture the full range of ecological/environmental impacts and resultantly has fallen into disfavor, replaced by the more accurate label of “climate change” or “climate disruption”. But even these more accurate, expansive labels don’t completely portray the full suite of environmental effects occurring around the world, effects that go far beyond climate, as concerning as that alone would make the climate crisis.

Below is a description of but a few of the many commonly recognized “faces” of climate change that have emerged over the past decade:

More extreme and destructive weather — A warmer atmosphere has more energy and holds more water vapor. This has resulted, in the past decade, of more intense weather events such as increased rainfall and associated flooding, hurricanes, and in some places just the opposite: droughts, often resulting in catastrophic wildfires. Poor Texas: in 2011 the state experienced day time temperatures of over 100 degrees for more than 100 straight days! and experienced a “500-year” storm (a storm of such intensity it is expected to occur once every 500 years) for three straight years (2015-2017).

Sea level rise — As temperatures rise so does the level of the ocean due to thermal expansion and the large volumes of meltwater running off of glaciers and ice caps; it is 2.6 inches higher than 1993 and is rising about one-eighth of an inch per year, a rate that some fear will increase and perhaps increase quickly. 

The NYS Department of Environmental Conservation has published sea level rise projections for Long Island; for the 2050s the low projection is an eight inch rise, the medium range projection is 16 inches and the high projection is 30 inches. If the medium to high projections occur, Long Island’s shoreline will be redrawn with marshes and beaches disappearing and thousands of homeowners having to relocate. Miami and many other coastal cities are already being inundated.

Ocean Warming & Acidification — The world’s oceans are warming too and also absorbing the significant majority of excess CO2. When CO2 combines with seawater a weak acid — carbonic acid — is formed. This is not good for shell making creatures like clams and corals. Due to ocean warming and the shifting of pH, coral and other shell making creatures are increasingly stressed. A 2008 study on the health of the planet’s coral reefs indicated that one-fifth are gone with another 15-20% under significant stress.

Impacts to Wildlife — Every other species on Spaceship Earth will potentially be affected by climate change; many have already. Birds, for example, run the risk of starving due to a timing mismatch between when they migrate and when their insect food emerges. A report from the National Audubon Society published in late 2019 finds that two-thirds of North American species are at heightened risk of extinction due to climate change.

Spreading of disease — A number of disease-causing pathogens are likely to get worse as the climate becomes warmer and wetter. Malaria is but one example and it is not a small example. According to the World Health Organization 405,000 people died from contracting malaria last year with 228 million contracting the disease. Closer to home, scientists think both West Nile Virus and Lyme disease will become more prevalent as the planet warms.

A popular slogan seen at climate change rallies is “There is no Planet B.” We can continue to sleepwalk through the issue by electing leaders who “deny” climate change, and pretend there’s a Planet B awaiting us once we finish befouling Planet A. Collectively, we have a fundamental choice to make — we can recognize the madness of this idea, or recognize there is, of course, only one hospitable planet — Planet A — and as occupants of it, we are in a great position to do something about it.

The “faces” of climate change are profound and the magnitude of what needs to be done may seem intractable and overwhelming, leading us to throw up our collective hands in despair. 

A much better response is to use those same hands to reduce our carbon footprints by: holding a pen to check the box on the election ballot for candidates who recognize the serious threat climate change poses to nature and humanity, use another pen to write a check to a solar company if you can afford to install roof-top solar panels, twist some new LED light-bulbs into ceiling and lamp sockets, grab a screwdriver and install a dryer vent deflector to have the moist and warm heat from your dryer warm your house in the winter rather than be vented (and wasted) outdoors, lift the lid of your compost bin to compost organic waste, and drop recyclable materials, especially aluminum cans, into your recycling can.

And by completing these actions, and others, you’re acknowledging there is no Planet B, and further, that Planet A, this one small and fragile blue marble floating in a vacuum void, is all we have and all we will ever have. Taking these concrete steps to address the many faces of climate change is bound to put a smile on your face.

A resident of Setauket, John Turner is conservation chair of the Four Harbors Audubon Society, author of “Exploring the Other Island: A Seasonal Nature Guide to Long Island” and president of Alula Birding & Natural History Tours.

By Daniel Dunaief

It’s not exactly a Rembrandt hidden in the basement until someone discovers it in a garage sale, but it’s pretty close.

More than two decades ago, a Malagasy graduate student named Augustin Rabarison spotted crocodile bones in northwestern Madagascar, so he and a colleague encased them in a plaster jacket for further study.

David Krause, who was then a Professor at Stony Brook University and is now the Senior Curator of Vertebrate Paleontology at the Denver Museum of Nature & Science, didn’t think the crocodile was particularly significant, so he didn’t open the jacket until three years later, in 2002.

When he unwrapped it, however, he immediately recognized a mammalian elbow joint further down in the encased block of rock. That elbow bone, as it turned out, was connected to a new species that is a singular evolutionary masterpiece that has taken close to 18 years to explore. 

Recently, Krause, James Rossie (an Associate Professor in the Department of Anthropology at Stony Brook University) and 11 other scientists published the results of their extensive analysis in the journal Nature.

The creature, which they have named Adalatherium hui, has numerous distinctive features, including an inexplicable and unique hole on the top of its snout, and an unusually large body for a mammal of its era. The fossil is the most complete for any Mesozoic mammal discovered in the southern hemisphere.

“The fossil record from the northern continents, called Laurasia, is about an order of magnitude better than that from Gondwana,” which is an ancient supercontinent in the south that included Africa, South America, Australia and Antarctica, Krause explained in an email. “We know precious little about the evolution of early mammals in the southern hemisphere.”

This finding provides a missing piece to the puzzle of mammalian evolution in southern continents during the Mesozoic Era, Krause wrote.

The Adalatherium, whose name means “crazy beast” from a combination of words in Malagasy and Greek, helps to broaden the understanding of early mammals called gondwanatherians, which had been known from isolated teeth and lower jaws and from the cranium of a new genus and species, Vintana sertichi, that Krause also described in 2014.

The closest living relatives of gondwanatherians were a group that is well known from the northern hemisphere, called multituberculates, Krause explained.

The body of Adalatherium resembled a badger, although its trunk was likely longer, suggested Krause, who is a Distinguished Service Professor Emeritus at Stony Brook. 

Krause called its teeth “bizarre,” as the molars are constructed differently from any other known mammal, living or extinct. The front teeth were likely used for gnawing, while the back teeth likely sliced up vegetation, which made probably made this unique species a herbivore.

The fossil, which probably died before it became an adult, had powerful hind limbs and a short, stubby tail, which meant it was probably a digger and might have made burrows.

Rossie, who is an expert in studying the inside of the face of fossils with the help of CT scans, explored this unusually large hole in the snout. “We didn’t know what to make of it,” he said. “We can’t find any living mammal that has one.”

Indeed, the interpretation of fossils involves the search for structural and functional analogs that might suggest more about how it functions in a living system. The challenge with this hole, however, is that no living mammal has it.

Gathering together with other cranial fossil experts, Rossie said they agreed that the presence of the hole doesn’t necessarily indicate that there was an opening between the inside of the nose and the outside world. It was likely plugged up by cartilage or other soft tissue or skin.

“If we had to guess conservatively, it would probably be an enlarged hole that allowed the passage of a cluster of nerves and blood vessels,” Rossie said. 

That begs the question: why would the animal need that?

Rossie suggests that there might have been a soft tissue structure on the outside of the nose but, at this point, it’s impossible to say the nature of that structure.

The Associate Professor, who has been a part of the research team exploring this particular fossil since 2012, described the excitement as being akin to opening up a Christmas present.

“You’re excited to see what’s in there,” he said. “Sometimes, you open up the box and see what you were hoping for. Other times, you open the box and say, ‘Oh, I don’t know what to say about this [or] I don’t know what I’m looking at.’”

For Rossie, one of the biggest surprises from exploring this fossil was seeing the position of the maxillary sinus, which is in a space that is similar across all mammals except this one. When he first saw the maxillary sinus, he believed he was looking at a certain part of the nasal cavity, where it usually resides. When he studied it more carefully, he realized it was in a different place.

“All cars have some things in common,” said Rossie, who is interested in old cars and likes to fix them. The common structural elements of cars include front and back seats, a steering wheel, and dashboard. With the maxillary sinus “what we found is that the steering wheel was in the back seat instead of the front.” 

A native of upstate Canton, which is on the border with Canada, Rossie enjoyed camping growing up, which was one of the initial appeals of paleontology. Another was that he saw an overlap between the structures nature had included in anatomy with the ones people put together in cars.

A resident of Centerport, Rossie lives with his wife Helen Cullyer, who is the Executive Director of the Society for Classical Studies, and their seven-year-old son.

As for the Adalatherium, it would have had to avoid a wide range of predators, Krause explained, which would have included two meat-eating theropod dinosaurs, two or three large crocodiles and a 20-foot-long constrictor snake.

To reduce binge eating, take the dog for a walk while social distancing. METRO photo

By David Dunaief, M.D.

Dr. David Dunaief

Obesity is an ongoing struggle for many in the United States. The latest statistics suggest that 40 percent of the population is obese. Obesity is a disease unto itself and is defined by a BMI (body mass index) of >30 kg/m2, but obesity can also be defined by excess body fat, which is more important than BMI.

Obesity has been associated with COVID-19, especially in the U.S. In a study involving 5700 hospitalized COVID-19 patients in the NYC area, the most common comorbidities were obesity, high blood pressure and diabetes (1). Of those who were hospitalized, 41.7 percent were obese.

In a study in China, results showed that those who were overweight were 86 percent more likely to have severe COVID-19 pneumonia, and that percentage increased to 142 percent when obesity is reached (2). The study has yet to be peer-reviewed, but it complements other studies.

Another study from France indicates that those with a BMI >35 (severely obese), were more likely to be put on ventilators (3).

In fact, one study’s authors suggested quarantining should be longer in obese patients because of the potential for prolonged viral shedding compared to those in the normal range for weight (4). And though age is a risk factor for COVID-19, among those younger than 60 and obese, there is a two-times increased risk of being admitted to the hospital, according to a 3,615-patient study at NYU Langone Health (5).

Why are you at higher risk for severe COVID-19 with obesity? 

According to the prevailing theory, obesity may interfere with mechanical aspects of breathing, thus increasing airway resistance and make gas in exchange more difficult in the lung. It may also impede on lung volume by exerting pressure on the lungs and may involve weaker muscles necessary for respiration (6).

Why is excess fat more important than BMI? 

First, some who have elevated BMI may not have a significant amount of fat; they may actually have more innate muscle. More than 25 percent of my patient population is “solidly built,” which means they have greater muscle mass as well as too much excess fat. (I have a body analysis scale that detects muscle mass and fat through two different currents of ohms.) Visceral fat is the most important, since it’s the fat that lines the organs, including the lungs.

For another, fat cells have adipokines, specific cell communicators found in fat cells that communicate with other fat cells but also other systems such as the brain, immune system, muscles, and liver. Adipokines can be mediators of both inflammation and insulin resistance, according to an en-docrinology study (7). In a study of over 4,000 patients with COVID-19, the author suggests that inflammation among obese patients may be an exacerbating factor for hospitalizations and severe illness (8). 

If we defined obesity as being outside the normal fat range – normal ranges are roughly 11-22 per-cent for men and 22-34 percent for women – then close to 70 percent of Americans are “obese.”

Inflammation reduction and weight-loss combined

In a randomized controlled trial with 75 participants comparing a plant-based diet to a control diet, there was a greater than 14 lbs. weight reduction and roughly 10 lbs. fat reduction over a 14-week period (9). Of the weight lost, about 70 percent was excess fat. Remember, excess body fat, through adipokines, may be inflammatory and increase the risk of severe COVID-19. 

The weight reduction with a plant-based approach may involve the increase in fiber, reduction in dietary fat and increased burning of calories after the meal, according to Physician’s Committee for Responsible Medicine (PCRM) (10).

You also want a diet that has been shown to reduce inflammation.

We are currently submitting a small study for publication involving 16 patients from my clinical practice. It shows that those who ate a whole food plant-based LIFE (low inflammatory foods every-day) diet over a seven-day period had a significant decrease in inflammation measured by hsCRP (high sensitivity c-reactive protein). This occurred in those who completely changed their diets to the LIFE diet, but also occurred in those who simply added a greens and fruit-based smoothie daily to their existing diet.

In my practice, I have seen a number of patients lose a substantial amount of weight, but also excess body fat, over a short period. For instance, a 70-year-old male lost 19 lbs. of weight and 12 lbs. of excess body fat over a six-week period. His inflammation, which was very high to start, dropped substantially to the border of optimal levels, using hsCRP as the inflammation measurement. This patient and many others have seen tandem reductions in both weight and inflammation. To boot, this was a cardiac patient whose cardiologist had considered a stent, but later said he did not need it after reducing his inflammation.

Exercise to reduce binge eating

While sheltering in place with fewer physical activities available, it is very tempting to binge eat or use food as a leisure activity. But there is a way around this. 

In patients who are overweight and obese, those who exercised compared to those who were sedentary, showed a significant reduction in binge eating over a 12-week intervention (11). The participants at baseline had a mean BMI of 30.6 kg/m2 and a mean age of 43 years. Of the 46 participants, almost two-thirds were women. Exercise can be as easy as walking or running outside while social distancing; doing exercises with your own body weight, such as calisthenics; taking online exercise classes (of which there are plenty); or using exercise equipment you have at home, might help allay binge eating.

If COVID-19 does not convince you that losing excess body fat is important, then consider that obesity contributes to, or is associated with, many other chronic diseases like cardiovascular disease, high blood pressure, and high cholesterol, which also contribute to severe COVID-19. Thus, there is an imperative to lose excess body fat. Now, while we’re sheltering in place, is the time to work on it.

References:

(1) JAMA. online April 22, 2020. (2) https://doi.org/10.2139/ssrn.3556658 (2020). (3) Obesity. online April 9, 2020. (4) Acta Diabetol. 2020 Apr 5: 1–6. (5) Clin Infect Dis. Online April 9, 2020. (6) Chron. Respir. Dis. 5, 233–242 (2008). (7) Front Endocrinol (Lausanne). 2013; 4:71. (8) MedRxiv.com. (9) Nutr Diabetes. 2018; 8: 58. (10) Inter Journal of Disease Reversal and Prevention 2019;1:1. (11) Med Sci Sports Exerc. 2020;52(4):900-908.

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. 

Photo by Kyle Barr

Small businesses are the Atlas of the economy. Too often attention is paid to the huge corporations, whose employment numbers are cited for why they need stimulus in times of crisis. However, when money circulates at the ground level, it tracks among the small businesses, our friends, our neighbors. 

That’s why it’s so disheartening to see a program meant to support those same small businesses first be shuttled through banks who simply weren’t prepared for it, then being abused by large companies it wasn’t made for, and now is seeing constant changes which may make using the loan a kind of poisoned chalice, one that looks appetizing but may just be a death blow to any who drinks from it.

The fact the Payment Protection Program was shunted through banks in the first place was a misstep. Many small business owners complained clients of the banks were given preference (and even among those, larger companies were prioritized). Smaller-sized banks themselves found they had to establish a whole new infrastructure for handling and dealing out these loans.

And then, companies with many more employees nationwide than the requisite 500 or under had received such loans because of loopholes in the lending requirements. Approximately 94 loans were made to publicly traded companies, totaling around $365 million. Reuters reported that well over 70 of these companies which received aid had months of emergency cash on hand to get them over the hump. The loans of up to $10 million were designed to tide over small businesses for eight weeks, rehiring staff in the process. 

A program that started with $349 billion has grown to $669 billion after thousands were left high and dry after the first round of loans. This program that was meant to support small businesses has contorted into a mess of paperwork that has many concerned it will saddle them with debt long term.

Some owners find they have no reason to take on their furloughed labor if none of them wish to return to work anyway. With many fearing the economic impact could last much longer than eight weeks, even more are concerned they may have to lay off employees once again just a short time after spending the funds.

Some businesses have reported anxiety at using the funds at all, fearing that they will somehow make themselves ineligible for the loan turning into a grant. Many businesses rely on independent contractors, but according to loan rules, none of the money received can be used for contract labor.

Politico wrote May 8 that the watchdog agency of the Small Business Administration (the SBA administers the PPP loans) reported the federal agency has strayed away from the original language of the law in creating new restrictions. PPP requires businesses to spend 75 percent of the loan on payroll to get forgiveness and that the balance must be paid back in two years. Both of these bylaws were absent from the original bill.

But questions still weigh heavily on the minds of business owners. Everything most people understand about the loans can still change. 

All this goes to show PPP was unleashed too hastily and clarifications have been much too slow to roll out. Small business owners need specifics and they need guarantees. Guidelines need to be strict enough to avoid scams while keeping in mind the reality of modern day small businesses. 

U.S. Sen. Chuck Schumer (D) has already called for easing restrictions. Our other local federal representatives must hear owners’ concerns, and then relay those fears to the U.S. Treasury Department and SBA.

These small businesses need that help, because if we lose them, some of the best parts of our communities go with them.

Stock photo

By Daniel Dunaief

Daniel Dunaief

I love my neighbors. I never knew who most of them were, but I do now. I see them almost every day and they are friendlier than most of the people I’ve ever worked with. Then again, they haven’t been sitting at their desks, waiting for me to file a story, to fix some error, or to explain how I could have ended the previous sentence with a preposition.

I don’t just love my neighbors. I love the trees that reflect the different types of spring lighting that falls on them throughout the day, as I take my exhausted dog for yet another long walk. The singing of the birds? I can’t get enough of it. In fact, the other day, I heard three birds, all singing their repetitive songs. Meanwhile, a woodpecker was banging his head against a tree, searching for his insect prey while providing a percussion background to the sounds of the other birds chirping. Incidentally, why haven’t clever scientists studied woodpeckers to see how they recover from nonstop concussions? How can they fly straight after all that pounding?

So, my neighbors can’t always update me on their lives, because A. they don’t always have time to chat with the guy who walks his big, white dog too many times a day, and B. they want to make sure they stay at least six feet away from me, which isn’t so easy when said big white dog pulls me and him
towards them.

They do a fantastic job of updating me on their lives with the signs that grace their lawns. I’ve read about birthdays, new babies, graduations, among many other milestones and celebrations limited by our red light, green light, one-two-three game with a virus that doesn’t seem to have turned away long enough for us to do much moving.

Anyway, I was just thinking about the signs my neighbors don’t put on our lawns, but that might reflect their current reality. Here’s a list of a few:

— No one told us we’d be entertaining three kids under 5 years old indefinitely.

— Yes, I’m working on the lawn again.

— Don’t make fun of my makeup. Yours doesn’t exactly look great, either.

— Do you want to buy any knives from our cute and enterprising daughter who just finished college finals and needs something to do (okay, we might put that one on our lawn).

— I see you staring at my house, while you’re pretending to look at the trees.

— I’m celebrating nothing today. How about you?

— If you miss sports too, try to hit this sign with a ball and win a lollipop.

Lord of the Flies might have been fiction. This is real. Don’t, under any circumstances, knock on our door.

— This invisible fence isn’t for a dog. Keep off the lawn.

— Does anyone know what day it is?

— Hopefully, this sign will distract you from the peeling paint on our shutters.

— We’ve been binge watching Stranger Things and can’t come to the door right now because we’re in the Upside Down. Please leave a message.

— No, wrong house. The neighbor down the street and to the left is the happy one.

— We know it sounds weird, but it’s our version of modern music.

Finally, I’d like to share an actual, handwritten sign that from a neighbor who had clearly had enough of the rest of us, with our stupid dogs on stupid leashes every day.

— No poop zone (I can’t believe I have to say this).

Photo from METRO

By Leah Dunaief

Leah Dunaief

Zooming has become a verb in the same way xeroxing did many years ago. When a product assumes an important role in daily life, the manufacturer’s name sometimes becomes the name for the process. So it was for many years with photocopying. And now, I don’t know about you, but for those of us who are working remotely even part of the week, participating in calls over the Zoom platform is a regular occurrence.

Who ever heard of Zoom before sheltering in place began? Well, maybe I did, but only as a possible growth stock to invest in, and running at $100 a share, it struck me as too expensive to be interesting. When I googled (another such example) the name, it was described as “an American communications technology company headquartered in San Jose, California. It provides videotelephony and online chat services … and is used for teleconferencing, telecommuting, distance education and social relations.” Until I actually went through “joining a meeting,” it had no relevance to my life.

Enter the pandemic and sheltering in place, and we all discovered that unlike some other high tech stuff, Zoom was easy to use and helpful for work and play. We now have departmental meetings and community board meetings via Zoom, and I enjoy weekly rendezvouses with my children and grandchildren. For now, seeing everybody is free.

Like all technical marvels, however, there are positives and negatives in connection with Zoom. After three Zoom meetings, each for two hours, in one day, I found that I was exhausted and feeling out of sorts. The first such day, I just assumed it had little to do with zooming. The next time, with a similar schedule and the same result, made me realize there was a cause-and-effect taking place, but I didn’t understand why.

Then I read, “Why Zoom Is Terrible,” a column in The New York Times by journalist Kate Murphy, that made a lot of sense. Before I share the particulars, I want to rush to say that I don’t think Zoom is terrible. I think it is what it is, like all new inventions that change one’s life: a miracle. However difficult our lives are today, imagine if there were no video conferencing available to us. Even physicians have embraced telemedicine as a substitute for office visits for now, but surely as a way of communicating with remote patients who cannot get to the office in a life-or-death emergency in the future.

There are, however, some drawbacks, as Murphy’s article explains, and we should be aware of them. The way the video images are “digitally encoded and decoded, altered and adjusted, patched and synthesized introduces all kinds of artifacts: blocking, freezing, jerkiness and out-of-sync audio. These disruptions, some below our conscious awareness, confound perception and scramble certain social cues. Our brains strain to fill in the gaps and make sense of the disorder, which makes us feel vaguely disturbed, uneasy and tired without quite knowing why.”

This explains a lot to me. Just the audio delay alone tends to make me speak more loudly to the screen than I would normally in an unconscious attempt to get my words to the listeners faster and get their responses back more quickly. After six hours of yelling alone, I can feel pretty tired. And when I look at the others on the grid, in a manner reminiscent of the television show, Hollywood Squares, I am not looking them in the eye. There is no eye contact, and often people are actually looking at themselves — checking out their hair and whether their collar is covering their chicken neck.

We are, as the author points out, “exquisitely sensitive to one another’s facial expressions …and [that is] essential to our understanding of one another.” But such subtleties are frozen, smoothed over or delayed on the screen, however hard we might strain to see them, hence our fatigue and even a bit of alienation.

So now you know. And by the way, Zoom is now selling at $164.55 a share. I never bought it.

METRO photo

By Nancy Burner, Esq.

Nancy Burner, Esq.

Congratulations! You’re going to be graduating from high school very soon and are (fingers crossed) heading off to college in the fall. In preparation, you are shopping for school supplies, bedding, a new wardrobe, and researching the best classes to take. What you’re likely not thinking about is ensuring you have the proper estate planning documents in place before taking that next step in your life.

Drawing up a will or advanced directives for a college student may seem like an unnecessary task and expense, but once you turn 18, you are considered an adult under New York State law. Since you are no longer under your parents’ care, they do not have an automatic right to make decisions on your behalf. While this may seem like your long-awaited initiation into the freedom of adulthood, the reality is that situations may arise where a parent or other family member’s input is crucial.

Students are especially prone to getting sick or injured and, combined with living on their own, make it necessary to put certain legal directives in place. The three documents every college student needs are a health care proxy, HIPAA release form, and durable power of attorney.

A health care proxy allows you to appoint an agent to make medical decisions for you if you cannot do so for yourself. You can only name one agent but can nominate alternate agents in case your primary agent is unable or unwilling to act. The HIPAA release form further authorizes your agent to obtain your medical information. Without these documents, your parent (or whomever you designate to make such medical decisions) is going to face resistance when it comes to inquiring about the status of your health or providing care instructions to your doctor.

The power of attorney names an agent to make financial decisions on your behalf. The power of attorney does not strip you of your financial powers but rather duplicates them so that your agent can act in your stead if you are incapacitated or otherwise unable to act. A power of attorney can be beneficial if you need someone to pay a bill, apply for financial aid, or hire a professional on your behalf, such as an accountant or lawyer.

Beyond the aforementioned documents, you may also consider a last will and testament and a living will. Although they sound similar, they are very different documents. Depending on the extent of your assets, either saved or inherited, you may want to designate beneficiaries in a last will and testaments or trust. A “living will” documents end of life decisions, such as whether you want to be kept alive by artificial means if you have an incurable disease or are in a persistent vegetative state.

Although these are questions that you will hopefully not face for decades, planning for your future is an important way of taking control of your life. Any new graduate — or eighteen-year-old for that matter — should make time to seek the advice of an Estate Planning attorney to discuss what documents should be in place as you enter the world of adulthood.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office. 

Centre ValBio staff members distribute face masks to the Malagasy people.

By Daniel Dunaief

Long Islanders are pitching in to protect the people of Madagascar, called the Malagasy, from COVID-19. They are also trying to ensure the survival of the endangered lemurs that have become an important local attraction and a central driver of the economy around Ranomofana National Park.

Patricia Wright, a Distinguished Service Professor at Stony Brook University and founder and executive director of the research station Centre ValBio (CVB), is working with BeLocal to coordinate the creation and distribution of masks. They have also donated soap, created hand washing stations at the local market, and encouraged social distancing.

BeLocal, an organization founded by Laurel Hollow residents Mickie and Jeff Nagel, along with Jeff’s Carnegie Mellon roommate Eric Bergerson, is working with CVB to fund and support the creation of 200 to 250 masks per day. BeLocal also purchased over 1,800 bars of soap that they are distributing at hand washing stations.

Wildlife artist Jessie Jordan is volunteering her time to help the Malagasy people.

All administrators for regional government in the national park area near CVB, which is in the southeastern part of the island nation, have received masks. The groups have also given them to restaurant owners and anybody that handles food, including vendors in the market.

At the same time, CVB has received permission to become a testing site for people who might have contracted COVID-19. At this point, Wright is still hoping to raise enough money to buy a polymerase chain reaction machine, which would enable CVB to perform as many as 96 tests each day.

The non-governmental organization PIVOT, which was founded by Jim and Robin Hernstein, has also helped create screening stations to test residents for fever and other symptoms of the virus. As for the masks, BeLocal and CVB are supporting the efforts of seamstresses, who are working 7 days a week.

Jessie Jordan, a wildlife artist based in Madagascar who has been living at CVB for several weeks amid limited opportunities to return to the United States, has been “busy collaborating with local authorities and contributing masks, soap and hand washing stations to the community.”

At this point, Jordan said people were concerned about the economy, but not as afraid of the virus. “The local health centers are less busy right now because of confinement measures and people are scared of testing positive,” she explained in an email.

The Malagasy who benefit from the national park economically through tours and the sale of local artwork have suffered financially. Social distancing in the cities is “nearly impossible,” while Jordan said she has heard that some people in the countryside don’t have access to TV or radio and are not aware of the situation.

As of last week, Madagascar had 132 confirmed positive cases of the virus. Through contact tracing, the government determined that three people brought COVID-19 to the nation when they arrived on different planes. The country had 10 ventilators earlier this month for a population that is well over 23 million.

BeLocal researched the best material to create masks that would protect people who worked in the villages around Ranomafana. “We researched templates and materials and worked together with CVB to choose the best material that would be available,” Leila Esmailzada, the Executive Director of BeLocal, explained in an email.

BeLocal organized a team that reached out to Chris Coulter, who had started making soap several years ago. Coulter has worked with local officials to make soap.

“We knew Coulter from a few years ago” from an effort called the Madagascar Soap Initiative to get soap into every home and make it accessible, explained Mickie Nagel, the Executive Director of BeLocal. “We hope the people making it right now will consider turning this into a business.” Before Madagascar instituted restrictions on travel, BeLocal and CVB had purchased several sewing machines.

Representatives from BeLocal and CVB have been conducting hand washing and social distance education efforts to encourage practices that will limit the spread of COVID-19.  Government officials have also shared instructions on the radio and TV, Wright said. When the mayor of Ranomofana Victor Ramiandrisoa has meetings, everybody stands at least six feet apart.

CVB has produced picture drawings in Malagasy that are plastered on the sides of cars that describe hand washing procedures and social distancing. “We also have educational signs in the post offices, restaurants and in the mayor’s offices that we paid for,” Wright explained. She said the government, CVB and BeLocal are all educating people about practices that can limit the spread of the deadly virus.

“Organizations in Ranofamana are collaborating with the local government on efforts to prevent the spread of COVID-19,” Esmailzada wrote. “The local government recently began conducting PSA’s along the road and in main markets about hand washing, mask wearing and social distancing and CVB staff are leading by example.”

As for the lemurs Wright, whose work was the subject of the Imax film “Island of Lemurs: Madagascar,” said the country has taken critical steps to protect these primates.

“The government of Madagascar is assuming the worst and is not allowing anybody into the park,” Wright said. The president of Madagascar, Andry Rajoelina, has closed national parks to protect the lemurs, Wright said.

The lemurs have the support of conservation leader Jonah Ratsimbazafy, who earned his PhD while working with Wright at Stony Brook University. Ratsimbazafy is one of the founding members of the Groupe d’Etude et de Research sur les Primates, which is a community based conservation organization that protects lemurs. 

Wright and others are concerned the virus may spread to lemurs. Several lemurs species have the angiotensin converting enzyme, or ACE2, that forms the primary point of attachment for the virus in humans.

Indeed, scientists around the world are working to find those species which might be vulnerable to the virus. According to recent research preprinted in bioRxiv from a multi-national effort led by scientists at the University of California in Davis, several species of lemur have high overlap in their ACE2 inhibitors. This includes the endangered aye-aye lemur, which is the world’s largest nocturnal primate, and the critically endangered indri and sifaka.

“We are worried that lemurs might get the virus,” Wright said.

Photos courtesy of Jessie Jordan

Foods that comfort the mind and body protect you from chronic diseases in the long term. Stock photo
Focusing on real ‘comfort food’ will improve your outcomes

By David Dunaief, M.D.

Dr. David Dunaief

I think it’s fair to say that our world has been radically altered by the current COVID-19 pandemic. If you are at home weathering this storm, it can feel like you are in a literal silo. 

So naturally, we need to find things that make us feel “better.” Many of us reach for food to help comfort us. Guess which food item has had the largest sales increase in the U.S. from 2019. Here is a hint: it’s not broccoli. It’s frozen cookie dough, where sales are up 454 percent (1). 

But there is a difference between food that comforts just the mind and food that comforts both the mind and the body. What is the difference? Let’s look at two recent examples from my clinical practice. 

Food that comforts the mind and body 

Stock photo

First, let’s look at the results of a 71-year-old male who stopped eating out during COVID-19, like so many of us. Apparently, for this patient, eating out meant indiscretions with his diet. While at home, there was less temptation to stray from his dietary intentions. The results speak for themselves. 

In a month, his nutrient level improved, measured using serum beta carotene levels. His inflammation, measured by c-reactive protein (CRP), was reduced 40 percent. What is the importance of inflammation? It is the potential basis for many of the chronic diseases that are rampant in the U.S. (2). His kidney function increased by about 14 percent with an increase in his glomerular filtration rate (GFR), which helps remove waste from the kidney, from 51 to 58. This patient, who suffers from gout, also found his uric acid dropped. Finally, and most importantly, his symptoms improved, and he garnered more energy. He described himself as enjoying food more.

I am not suggesting you don’t order out, but do it wisely. Diametrically opposed is our second example. 

Food that comforts the mind only

Stock photo

This 72-year-old female decided to embrace ultra-processed foods, adding cookies, cakes and sour-dough breads to her diet. Her kidney function decreased by more than 15 percent, with the GFR shifting from 88 to 63. Her inflammation, measured by CRP, went up by 75 percent. Her LDL, “bad cholesterol,” increased by more than 20 percent. Her allergy symptoms worsened. She described herself as more sluggish and, to boot, she gained five pounds.

What makes these examples even more interesting is that both patients are deemed in the high-risk category for getting severe COVID-19 and being hospitalized. COVID-19 is associated with elevated CRP, which may increase the risk for more lung lesions and the risk of severe disease (3).

What is the moral of the story? Use this time to focus on foods that comfort both the mind and the body. Make food work for you and against the common enemies of COVID-19 and chronic diseases that are putting people at higher risk for viruses.

What about exercise? 

Just because we are cooped up indoors most of the time does not mean we can’t exercise. Time and again, exercise benefits have been shown. Yet, we are sitting more and, with social distancing, we have less incentive to go outside or opportunities to socialize, go to the gym or do many of our usual activities.

However, not to fret. There was a recent small study with eight volunteers equally split between men and women. Results showed that four-minute intervals of exercise throughout the day that interrupted continuous sitting led to a substantial improvement in triglycerides and metabolized more fat after high-fat meals the next day, compared to continuous sitting for eight hours uninterrupted and then eating a high fat meal the next day (4).  

The participants used a stationary bike, exercising intensely for four seconds and then resting for 45 seconds, repeating the sequence five times in a row. They completed this four-minute sequence once an hour for eight hours. Their daily intense exercise totaled 160 seconds. This bodes well for very short bursts of exercise rather than sitting for long periods without movement.

Not everyone has a stationary bike, but you can do jumping jacks, run in place, or even dance vigorously to your favorite tunes once an hour.

Ventilator vs. Incentive Spirometer

As I’m sure you’ve been reading, some with severe COVID-19 require ventilators. Unfortunately, the statistics with ventilators are dismal. According to a recent study of 5700 COVID-19 patients in the New York region, 88.1 percent of patients died (5). Hospitals are trying alternate approaches while using oxygen masks not ventilators, such as proning (turning patients on their stomach instead of lying on their backs in bed) and having them sit up in a chair in order to help with oxygenation in the lungs in those who have low oxygen saturation.

However, the ultimate exercise for the lung and the ability to improve oxygenation is an incentive spirometer. This device expands your lungs as you inhale. The more you do it, the better your lung functioning. One study, which I mentioned in previous articles on lung function, involved inhaling a total of 50 breaths a day which in two increments (6). 

The brand of spirometer used was a Teleflex Triflo II. This costs less than five dollars online at medicalvitality.com

What about incentive spirometer in sick patients? There was a small study with patients who had COPD exacerbations (7). Those who were given an incentive spirometer plus medical treatment saw a significant increase in the blood gases over a two-month period. Also, the quality of life improved for those using the incentive spirometer. 

Remember, one of the factors that may be a sign that someone is at high risk for severe COVID-19 is very low oxygen saturation. If you can improve oxygen saturation with incentive spirometer that is readily available, how can you pass this up? 

While it is tempting to gorge yourself with food that comforts the mind, DON’T! Foods that comfort the mind and the body protect you not only in the short term, but also the longer term from the consequences of chronic diseases.

Therefore, focus on DGLV (dark green leafy vegetables) that raise beta-carotene, which in turn lowers CRP. This can be achieved with diet by increasing consumption of beta-carotene-rich fruits and vegetables while limiting consumption of beta-carotene-poor ultra-processed and fatty foods. Interestingly, it is much easier right now to get DGLVs than it is to get certain ultra-processed foods. Add in exercise and an incentive spirometer and you will comfort your body plus your mind.

References:

(1) CNBC.com April 23,2020. (2) Front Immunol. 2018; 9: 1302. (3) Med Mal Infect. 2020 Mar 31;S0399-077X(20)30086-X. (4) Medicine & Science in Sports & Exercise. Online April 17, 2020. (5) JAMA. 2020 Apr 22;e206775. (6) Ann Rehabil Med. Jun 2015;39(3):360-365. (7) Respirology. 2005 Jun;10(3):349-53. 

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.