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Stress may increase cold virus severity

By David Dunaief, M.D.

Dr. David Dunaief

September marks the beginning of the academic calendar and noticeably shorter daylight hours. The pace of life tends to become more hectic. Although some stress is valuable to help motivate us and keep our minds sharp, high levels of constant stress can have detrimental effects on the body.

It is very likely that there is a mind-body connection when it comes to stress. In other words, it may start in the mind, but it can lead to acute or chronic disease promotion. Stress can also play a role with your emotions, causing irritability and outbursts of anger and possibly leading to depression and anxiety.

Stress symptoms are hard to distinguish from other disorders, but they can include stiff neck, headaches, stomach upset and difficulty sleeping. Stress may also be associated with cardiovascular disease, with an increased susceptibility to infection from viruses causing the common cold and with cognitive decline and Alzheimer’s (1).

A stress steroid hormone called cortisol is released from the adrenal glands and can have beneficial effects in small bursts. We need cortisol in order to survive. Some of cortisol’s functions include raising glucose (sugar) levels when they are low and helping reduce inflammation and stress levels (2). However, when cortisol gets out of hand, higher chronic levels may cause inflammation, leading to disorders such as cardiovascular disease, as research suggests. Let’s look at the evidence.

Inflammation 

Inflammation may be a significant contributor to more than 80 percent of chronic diseases, so it should be no surprise that it is an important factor with stress. In a meta-analysis (a group of two observational studies), high levels of C-reactive protein (CRP), a biomarker for inflammation, were associated with increased psychological stress (3).

What is the importance of CRP? It may be related to heart disease and heart attacks. This study involved over 73,000 adults who had their CRP levels tested. The research went further to suggest that increased levels of CRP may result in more stress and also depression. With CRP higher than 3.0 there was a greater than twofold increase in depression risk. The researchers suggest that CRP may heighten stress and depression risk by increasing levels of different proinflammatory cytokines, inflammatory communicators among cells (4).

In another study, results suggested that stress may influence and increase the number of hematopoietic stem cells (those that develop all forms of blood cells), resulting specifically in an increase in inflammatory white blood cells (5). The researchers suggest that this may lead to these white blood cells accumulating in atherosclerotic plaques in the arteries, which ultimately could potentially increase the risk of heart attacks and strokes.

Chronic stress overactivates the sympathetic nervous system — our “fight or flight” response — which may alter the bone marrow where the stem cells are found. This research is preliminary and needs well-controlled trials to confirm these results.

Infection

Stress may increase the risk of colds and infection. Cortisol over the short term is important to help suppress the symptoms of colds, such as sneezing, cough and fever. These are visible signs of the immune system’s infection-fighting response.

However, the body may become resistant to the effects of cortisol, similar to how a type 2 diabetes patient becomes resistant to insulin. In one study of 296 healthy individuals, participants who had stressful events and were then exposed to viruses had a higher probability of catching a cold. It turns out that these individuals also had resistance to the effects of cortisol. This is important because those who were resistant to cortisol had more cold symptoms and more proinflammatory cytokines (6).

Diabetes and heart disease

When we measure cortisol levels, we tend to test the saliva or the blood. However, these laboratory findings only give one point in time. Thus, when trying to determine if raised cortisol may increase cardiovascular risk, the results are mixed. However, in a study measuring cortisol levels from scalp hair was far more effective (7). The reason for this is that scalp hair grows slowly, and therefore it may contain three months’ worth of cortisol levels. The study showed that those in the highest quartile of cortisol levels were at a three times increased risk of developing diabetes and/or heart disease compared to those in the lowest quartile. This study involved older patients between the ages of 65 and 85.

Lifestyle changes can reduce effects of stress

Lifestyle plays an important role in stress at the cellular level, specifically at the level of the telomere, which determines cell survival. The telomeres are to cells what the plastic tips are to shoelaces; they prevent them from falling apart. The longer the telomere, the slower the cell ages and the longer it survives. In a study, those women who followed a healthy lifestyle — one standard deviation over the average lifestyle — were able to withstand life stressors better since they had longer telomeres (8).

This healthy lifestyle included regular exercise, a healthy diet and a sufficient amount of sleep. On the other hand, the researchers indicated that those who had poor lifestyle habits lost substantially more telomere length than the healthy lifestyle group. The study followed women 50 to 65 years old over a one-year period.

In another study, chronic stress and poor diet (high sugar and high fat) together increased metabolic risks, such as insulin resistance, oxidative stress and central obesity, more than a low-stress group eating a similar diet (9). The high-stress group members were caregivers, specifically those caring for a spouse or parent with dementia. Thus, it is especially important to eat a healthy diet when under stress.

Interestingly, in terms of sleep, the Evolution of Pathways to Insomnia Cohort (EPIC) study shows that those who deal with stressful events directly are more likely to have good sleep quality. Using medication, alcohol or, most surprisingly, distractors to deal with stress all resulted in insomnia after being followed for one year (10). Cognitive intrusions or repeat thoughts about the stressor also resulted in insomnia.

Psychologists and other health care providers sometimes suggest distraction from a stressful event, such as television watching or other activities, according to the researchers. However, this study suggests that this may not help avert chronic insomnia induced by a stressful event. The most important message from this study is that how a person reacts to and deals with stressors may determine whether they suffer from insomnia.

Constant stress is something that needs to be recognized. If it’s not addressed, it can lead to suppressed immune response or increased levels of inflammation. CRP is an example of an inflammatory biomarker that may actually increase stress. In order to address chronic stress and lower CRP, it is important to adopt a healthy lifestyle that includes sleep, exercise and diet modifications. Good lifestyle habits may also be protective against the effects of stress on cell aging.

References: (1) Curr Top Behav Neurosci. 2014 Aug. 29. (2) Am J Physiol. 1991;260(6 Part 1):E927-E932. (3) JAMA Psychiatry. 2013;70:176-184. (4) Chest. 2000;118:503-508. (5) Nat Med. 2014;20:754-758. (6) Proc Natl Acad Sci U S A. 2012;109:5995-5999. (7) J Clin Endocrinol Metab. 2013;98:2078-2083. (8) Mol Psychiatry Online. 2014 July 29. (9) Psychoneuroendocrinol Online. 2014 April 12. (10) Sleep. 2014;37:1199-1208.

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.

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'Johnston Canyon' by Ross Barbera

By Irene Ruddock

Ross Barbera, a graduate of Pratt Institute, is known for his representational acrylic paintings on canvas, watercolors on paper, original jewelry and digital and abstract art. Presently teaching at St. John’s University in the Art and Design Department in Queens where he was chairman for three years, Ross continues to win many juried awards and prestigious grants to pursue his prolific art career.

You were born and raised in Brooklyn, yet all of your paintings, and even much of your jewelry, are depictions of some aspect of the rural landscape. How did that come about?

I spent my summers at my family’s homes in Smithtown and Peakville, New York, and it was during these summers away from the city that I discovered the world of the natural landscape. They were welcome retreats from the city where everything was different: night times were cool, the air smelled clean. I was surrounded by deep forests, ponds and running streams. I was particularly attracted to the interplay of sunlight on flowing water. Nature became the primary inspiration for my paintings ever since then.

Much of your work is representational, yet you also paint in the abstract. What is your inspiration for your abstract work?

Although representational landscape painting has dominated my artistic direction, I discovered abstract, luminous worlds by observing pond surfaces and ice formations “close-up.” For me, this was the hidden world beyond the visible world that has provided the inspiration for my abstract paintings.

Water Lily Watercolor Pendant by Ross Barbera

You have an interesting process in watercolor painting that you teach in your classes and workshops. Can you tell us about this?

I have been experimenting with methods that enable me to retain the look of watercolor painting while achieving painted surfaces comparable in strength to acrylic on canvas; this eliminates the need to protect the painting by framing it behind glass. The first step in this process is to bind the watercolor paper to stretched canvas with a thick polymer gel medium. The finished watercolor painting is then protected with multiple layers of acrylic varnish, and for the top layer I apply a few coats of a removable UV protecting varnish.

Some of the background of your paintings have a stained glass effect — clean, clear, translucent and filled with saturated color. How do you achieve that?

I’ve always worked hard to give my paintings a quality of light, in the belief that good landscape painting needs to communicate a feeling of atmosphere; I never complete a painting until I feel it projects a strong quality of sunlight. Regarding my watercolor paintings, I believe the natural transparency of the watercolor medium contributes to a clean, translucent image. I do not apply watercolor paint with sable paint brushes. I predampen the color shape to be painted with a paint brush and clean water. Next, using needle dispenser bottles that have been filled with premixed watercolor to the consistency that I require for painting, I apply multiple colors into the predampened area, and I permit the colors to freely intermix and blend without working into them with a brush. This method of paint application results in clean, clear and beautifully translucent color shapes, and I believe the effect is further enhanced by the application of the final, protective layers of varnish.

‘Glacier’ by Ross Barbera

How does your digital work influence your art?

My wife Bonnie bought me my first tablet where I downloaded a drawing app. I was instantly addicted! I eventually downloaded a painting app and loved the convenience of digital plein air painting. Next, I began to export my digital paintings to my computer so I could continue to develop them in Photoshop. I restrict myself to basic brushes that come close to what I use in my acrylic on canvas paintings, and I do not use any effects or filters. I intend my digital paintings to be characterized by the same painterly quality that you would see in my paintings on canvas.

How did you become interested in creating jewelry? Can you describe how you incorporate your watercolors into your jewelry?

I started making jewelry when I was a graduate student at Pratt Institute. My early jewelry was created mostly in sterling, and I often incorporated enamels to add color. I am now using a wide range of different types of paper and wood and eventually discovered the limitless possibilities of building pendants, earrings, bracelets and hair pieces with layers of watercolor paper. I like building up layers on 140-pound Arches watercolor paper, and painting directly onto the surface with watercolor and acrylic paints. I coat the jewelry with multiple layers of acrylic varnish, and the final process involves heating the finished piece in an oven at 150°F, which hardens the varnish process.

What is the focus of your recent work?

I visited the Canadian Rockies with the intent of photographing the mountain glaciers and rivers for a new series of acrylic paintings that would be dedicated to the disappearing glaciers. I plan to continue in my effort to capture the diversity of the North American landscape in painting and will visit national parks throughout the United States and Canada for this purpose.

Where can we see your artwork?

I currently have an exhibit featuring my paintings and jewelry at the Comsewogue Public Library in Port Jefferson Station through the month of September. I also currently have a painting on exhibit in the juried show Colors of the Night at the Mills Pond House Gallery in St. James until Sept. 30. My paintings and jewelry can be viewed at any time by visiting www.rossbarbera.com, and my instructional videos can be found on my YouTube channel Realisticart. My jewelry can be purchased directly from my website, www.paperpendants.com.

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By Matthew Kearns, DVM

Dr. Matthew Kearns

Harvey, Irma, and now Jose still pose a threat. I recently read an article that referred to a study that documented 16 percent (mostly low income and elderly) of people interviewed would not evacuate without their pets, and 44 percent of those who refused to evacuate during Hurricane Katrina did so in part because they did not want to leave their pets behind.

I started thinking of what I would do with my own animals should there be a disaster or simple emergency at home. Although we haven’t had devastation on Long Island since Hurricane Irene or Hurricane Sandy, I think a checklist to be adequately prepared for emergencies or evacuations (especially on short notice) for our pets should be a priority.

Have an evacuation plan. This includes a “safe haven.” Find out ahead of time if there are any shelters that take animals during a disaster, pet-friendly hotels to go to or an out-of -own relative or friend that will take both you and your pet during a disaster.

Find out ahead of time if there are any shelters that take animals during a disaster.

Put together a first aid kit. A basic first aid kit for your pet should include: blanket, thermometer, penlight, sterile 4×4 gauze pads, sterile dressing (small, medium, large), roll gauze, 1- and 2-inch white tape, nonstick (Telfa) bandages, triangular bandage and safety pin, cloth strips, Betadine or triple antibiotics, scissors, tweezers, instant cold pack, hydrogen peroxide, splint, veterinarian’s phone number, local emergency clinic’s number, poison control telephone number, glucose concentrate (e.g., Karo Syrup or other syrup), canned dog or cat food and bottled water.

Once you have your first aid kit prepared, you will be ready for most emergencies. Here are some tips on handling most general emergencies:

• If an animal is frightened or in pain, it may bite (even friendly dogs or cats). If you find an injured animal, consider using something to muzzle (small piece of rope, a tie, etc.) or throw a large thick blanket over the pet to pick it up. Please do not get yourself hurt trying to help a scared, injured, potentially dangerous animal.

• Anything makes a good stretcher (flat piece of board, old door, etc.). If your pet has a bite wound or penetrating wound, try to keep the wound clean and moist until your pet can be transported to your regular veterinarian or an emergency veterinary hospital. Moistened clean cloths, gauze, etc. can be used. If there is excessive bleeding, direct pressure should be applied (consider an ACE bandage, other). Do not try to remove anything that is impaled into the pet.

• Bone fractures can be immobilized with a splint. A splint can be made up of rolled up magazines or newspapers, cardboard, a metal hanger or wood. If it is an open/compound fracture, cover it with a clean moistened dressing. If the animal cannot or will not allow a splint, just try to keep it confined until you can transport it to either your regular veterinarian’s office or an emergency veterinary hospital. Hopefully none of this will be necessary. However, in order to reduce stress and trauma to both you and your pet both during and after a disaster, it is important to plan ahead.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. 

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If we stepped outside tomorrow to a 52 degree day, we’d race back inside and put on a coat.

If we opened the door in January to the same temperature, we might race back into the house to shed that same coat.

It’s all about expectations.

Our daughter figured that out several years ago. Gone are the days when she tells us she thinks she did well on a test. She doesn’t want us to ask, “What happened?” or hear us say, “Oh, but you thought you did well on that test.”

Instead, she often tamps down our expectations, indicating that we’d better brace for the equivalent of the academic cold. If she does better than expected, she won’t have to contend with questions. If she met the lowered expectations, she can say that, even if she didn’t do well, she can take consolation in knowing how she performed.

Yes, relationships are all about managing those expectations.

Let’s take a quick look at President Trump. He’s a shoot-from-the-tweet president. He frequently misspells words, gets facts wrong here and there, and attacks his opponents, his allies and anyone in between according to his mood.

Has he done the same thing as our daughter? Is he resetting our expectations? Is he pleased to redefine the notion of a modern-day president?

If, and when, he seems levelheaded, deliberate and considerate, is he climbing over a bar he reset for himself, giving us a chance to applaud the manner in which he interacted with a public prepared for a stream of anger and disdain?

Relationships, as Harry from the movie “When Harry Met Sally” knew all too well, are also about setting expectations. When Harry (played by Billy Crystal) is sharing one of his many philosophies of life with Sally (Meg Ryan), he suggests that he never takes a girlfriend to the airport early in a relationship because he doesn’t want her to ask why, later in the relationship, he doesn’t take her to the airport anymore.

Some people’s jobs, like stock market analysts, meteorologists and oddsmakers, involve setting expectations.

Built into their forecasts, meteorologists often leave the back door open, in case they’re wrong. As in, “It probably won’t rain, but there’s a 15 percent chance of precipitation today.”

While that forecast is innocuous enough, it leaves a small measure of flexibility in case the weather people missed a heavy band of rain clouds from their Doppler models, which happened recently, leaving my wife disappointed and dripping wet at her office after trudging through an unexpected shower.

Of course, a meteorologist who predicted rain every day in anywhere but Ketchikan, Alaska, where the locals say it rains 400 days a year, wouldn’t last long, as people would bristle at carrying unnecessary umbrellas through the brilliant sunshine

Many years ago, my wife and I went to see a movie. When we got to the theater, the film was sold out.

Instead of turning around, we bought tickets to a film on which we hadn’t read any reviews and knew nothing. We wound up watching “Shakespeare in Love.” We thoroughly enjoyed it, in part because we had no expectations.

Perhaps the most difficult expectations to meet, or exceed, are our own. Raising the bar for anything — the taste of the food we cook, our performance during a presentation or our ability to stay calm in a crisis — involves risk. Then again, once we clear our new expectations often enough, we know what we can expect of ourselves and can move on to bigger challenges. The rewards, even if we never tell anyone how much more we accomplished than we expected, seem well worth the risk.

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This past week, we went “shufflin’ off to Buffalo.” Bet you don’t know where that expression came from. I certainly didn’t know that “Shuffle Off to Buffalo” is a song from Act II of the 1933 movie, “42nd Street,” and that it was a railroad saying even earlier. All I had to say was that I was going to Buffalo, and the response was immediate: “Shufflin’ off?” I was asked.

The second reaction was also the same. “Better bring your long underwear,” I was urged. “And a shovel. Is it snowing there yet?” Well, I’m going to tell you that Buffalo gets a bum rap. First of all, it was 82 degrees in the afternoon when it was only 80 degrees on Long Island. Fortunately I had passed on the suggested long underwear. I did bring a pair of shorts, but I did not wear them because I didn’t see anyone wearing shorts in the city. When I am traveling, I’m a big believer in the “When in Rome” adage.

Actually the city looked quite pleasant to me, larger than I had imagined, clean and with a fair share of tall buildings. The population of more than 250,000 residents makes it the second largest city in the state. I understand that Buffalo, like a number of rust-belt cities, has undergone quite a face-lift.

Admittedly I did not see much of it since I was there for the fall meeting of the New York Press Association, and that meant I was locked into the hotel site where the workshops were held. But we did have a chance to look around a bit when we went out to the Anchor Bar, where Buffalo chicken wings were allegedly invented. It’s a pleasant and good-sized sports bar, and most people at the tables were, sure enough, having chicken wings with blue-cheese dip and cut-up celery sticks on the side, although one lady was eating a good-looking dish of shrimp scampi. She must have been a native.

In the way of cultural attractions, the city has an art museum, a science museum, a theater district, multiple art galleries, and the historic Martin House that was recommended for viewing. Buffalo was once the scene of considerable wealth from the auto industry, where Pierce-Arrow automobiles were manufactured, also the railroads and the Erie Canal. As a result there are a number of urban mansions. It also has a river walk on Lake Erie that houses several eateries. Food, in fact, is big. And people we met, in restaurants, the hotel and on the streets were friendly and unhurried — such a change of pace for a native New Yorker like me or even someone born and bred on Long Island. It always helps when the weather is beautiful, which it was for our entire stay.

The Buffalo Transportation Pierce-Arrow Museum was enough to make lovers of antique automobiles cry for joy. The museum, which is large and planning to get larger, also has antique bikes and motorcycles, all in seemingly shiny new condition. And it even houses a filling station designed by Frank Lloyd Wright. It’s a remarkable piece of architecture.

It was an eight-hour drive from Bridgeport, where the ferry docked, to Buffalo, and that does not count the stops. The roads are excellent, the roadside trees just beginning to suggest autumnal colors, and we spent one night on the way up in Canandaigua, about an hour and a half from Buffalo.

In the heart of the beautiful Finger Lakes region, the area is deservedly famous for its Riesling wines, which I confess to having tasted. The village, its name derived from the Seneca tribe, was the scene of the Susan B. Anthony trial in which she was accused of voting illegally in 1873, since women were not then allowed to vote. She was found guilty and fined $100 with costs, which she did not pay.

Colleagues were surprised that we drove to Buffalo rather than just flying there, but I remembered from a previous trip many years ago, when I was a high school student, that the Mohawk Valley and upper New York state are truly lovely destinations. This trip confirmed that memory.

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Photo courtesy of Kent Animal Shelter

MEET ZAP! Zap is a 1-year-old terrier mix who recently came from the Bahamas where dogs (known as potcakes) don’t have a very good life. That’s all behind him now, and he’s ready to settle in with a forever family! A smart, well-behaved guy, he walks nicely on a leash and sits on command for treats. You’re sure to love him! Zap comes neutered, microchipped and up to date on all his vaccines. Kent Animal Shelter is located at 2259 River Road in Calverton. For more information on Zap and other adoptable pets at Kent, please call 631-727-5731 or visit www.kentanimalshelter.com.

Update: Zap has been adopted!

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When we went to a Japanese tea ceremony, known as chado, it was an immersion in Japanese culture. We had an enjoyable and instructive time at the Charles B. Wang Center at Stony Brook University even if it was for only 30 minutes this past Sunday afternoon. By reservation, the center offers an authentic experience in a charming bamboo teahouse on the first floor, hosted by a kimono-clad lady who holds such sessions for a maximum of four people at a time.

We arrived early, signed in and waited until the session before ours ended. The hostess then welcomed us with a bow, which we returned, and she explained that the design of two doors, a low one and a higher one, in the teahouse was deliberate. The guests, by bending to enter through the lower or “crawling in” door, were assured that all were of equal importance. None was to be considered more worthy. She then pointed out that because the sliding door was open slightly, it meant that the guests should enter. Had it been closed, we were to wait.

We left our shoes outside the little house and sat on one of the four low stools placed inside for us on the tatami mats. The hostess then entered through the higher door and began preparations. Her movements were deliberate and scripted into a traditional procedure, called temae. She was following a centuries-old ritual of making and serving the powdered green tea called matcha.

As the tea ceremony developed in Japan and was practiced by the monks, it was influenced by Zen Buddhism and embraced by the samurai or warrior class. The quiet ambience, the spare furnishings inside the teahouse, the unhurried and predictable movements of the hostess, the decorative scrolls emphasizing virtues like harmony, respect, purity and tranquility, helped calm the mind and push away fear before battle. Even the sound of water slowly boiling for the tea was soothing. The little bamboo teahouse was constructed in the midst of the modern Wang Center, yet we could leave behind our busy thoughts and worldly concerns with our shoes and purses as we entered this special space.

Speaking quietly to us, the hostess explained the equipment to make the tea: bowls, the green tea powder that was not artificially colored but naturally bright green, the delicate whisk carved from bamboo to mix the powder with the hot water in the bowls, the tea caddy, the scoops — the smaller one to measure out the powder, the larger to bring the water to the pot.

Each tool was beautifully and simply crafted from the unadorned wood. She gave us a fruit candy first, then handed each of us a bowl with tea, pointing out that the sweet was intended to offset the bitterness of the tea or perhaps emphasize them both.

There was a simple mindfulness to the whole process. We were there with her, in the moment, watching her mix the tea, wipe clean each bowl before we drank, then again afterward, with the hot water and special cloth she kept in the belt of her kimono for that purpose. Nothing else intruded. The effect was almost hypnotic.

And then it was over. We left the bamboo teahouse, put on our shoes, shouldered our purses and re-entered the outside world. It was a quiet interlude in an otherwise busy and hectic day. A nice cup of tea will always call me back.

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I didn’t see a horrifying and preventable accident this morning. I didn’t see a little girl, let’s call her Erica, on her way to her first week of school.

Erica, who, in our story, is 10 years old, wants to be a veterinarian, and has pictures of animals all over her room. She begged her parents so long for a kitten that they relented. They saw how well she took care of the kitten, putting drops in her eyes when she needed them, making sure she got the correct shots and even holding her kitten in the office when they had to draw blood to test for feline leukemia, which, fortunately, her kitten didn’t have.

Two years after she got her kitten, Erica continued to ask for additional animals, adding a fish, a rabbit and a hamster to her collection. Each morning, Erica wakes up and checks on all the animals in her little zoo, well, that’s what her father calls it, to see how they’re doing.

Her mother is convinced that the animals respond to her voice, moving closer to the edge of the cage or to the door when they hear her coming. When mother leaves to pick up Erica from school, the animals become restless.

I didn’t see Erica walking with her best friend Jenna. Like Erica, Jenna has a dream. She wants to pitch for the United States in softball in the Olympics. Jenna is much taller than her best friend and has an incredible arm. Jenna hopes the Olympics decides to have softball when she’s old enough and strong enough to play. Jenna thinks bringing a gold medal to her father, who is in the Marines and has traveled the world protecting other people, would be the greatest accomplishment she could ever achieve.

I didn’t see a man, whom I’ll call Bob and who lives only four blocks from Erica and Jenna, put on his carefully pressed light-blue shirt with the matching tie that morning. I didn’t witness him kissing his wife Alicia, the way he does every morning before he rushes off to his important job. I didn’t see him climb into his sleek SUV and back quickly out of his driveway on the dead-end block he and Alicia chose more than a dozen years earlier.

I didn’t see Bob get the first indication from his iPhone 7 that he had several messages. I didn’t witness Bob rolling his eyes at the first few messages. I didn’t see him drive quickly toward the crosswalk where Erica and Jenna were walking. The girls had slowed down in the crosswalk because Jenna pointed out a deer she could see across the street in a backyard. Jenna knew Erica kept an animal diary and she was always on the lookout for anything her friend could include in her cherished book.

I didn’t see Bob — his attention diverted by a phone he had to extend to see clearly — roll too quickly into the crosswalk, sending both girls flying. I didn’t see the ambulances racing to the scene, the parents with heavy hearts getting the unimaginable phone calls, and the doctors doing everything they could to fix Jenna’s battered right arm — her pitching arm.

I didn’t see it because it didn’t happen. What I did see, however, was a man in an SUV, driving way too quickly through a crosswalk, staring at his phone instead of looking out for Erica, Jenna and everyone else’s children on his way to work.

It’s an old message that we should repeat every year: “School is open, drive carefully.”

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Richard Moffitt, who joined Stony Brook University’s Biomedical Informatics and Pathology departments at the end of July, recently contributed to an extensive study of pancreatic cancer. Photo by Valerie Peterson

By Daniel Dunaief

It may take a village and then some to conquer pancreatic cancer, which is pretty close to what The Cancer Genome Atlas project assembled.

Pulling together over 200 researchers from facilities across the United States, the TCGA recently published an article in the journal Cancer Cell in which the scientists explored genetic, proteomic and clinical information from 150 pancreatic cancer patients.

Richard Moffitt, an assistant professor in the Departments of Biomedical Informatics and Pathology at Stony Brook University who joined the institution at the end of July, was the analysis coordinator for this extensive effort.

The results of this research, which worked with pancreatic ductal adenocarcinoma, the most common form of this cancer, offered a look at specific genetic changes involved in pancreatic cancer, which is the third leading cause of death from cancer.

“The study has several immediate clinical implications for patients facing the diagnosis of pancreatic cancer,” Ralph Hruban, one of the corresponding authors on the article and the director of the Sol Goldman Pancreatic Cancer Research Center at Johns Hopkins University School of Medicine, wrote in an email.

The work “provides hope for future clinical trials in that 42 percent of patients within this cohort had cancers with at least one genetic alteration that could potentially be therapeutically targetable, and 25 percent of the patients had cancers with two or more such events.”

These genetic findings suggest a potential basis for genetic change-driven therapy trials down the road, Hruban suggested. As the analysis coordinator, Moffitt “played a critical role” Hruban continued. “He brought hard work, amazing creativity and great scientific knowledge to the project.”

Moffitt joined this effort about four years ago, after the collaboration began. The assistant professor said he pulled together the various data sets and analysis results from different teams and helped turn that into a “coherent overall story.”

Moffitt was also in charge of the messenger RNA analysis. He had been at the University of North Carolina as a postdoctoral researcher in Vice Chair of Research Jen Jen Yeh’s lab for the last five years until his recent move to Stony Brook.

Benjamin Raphael, another corresponding author on the article and a professor in the Department of Computer Science at Princeton University, suggested Moffitt played a critical part in the recent work. “In any large-scale collaboration such as this one, there tend to be a smaller number of researchers who play an outsized role in the project,” Raphael explained in an email. Moffitt “played such an outsized role. Without his dedication to the project over the past few years, it is doubtful that our analysis” would have been as comprehensive.

Members of TCGA contacted Moffitt and Yeh because the tandem were working on a new approach to studying gene expression that would eventually be published in a 2015 Nature Genetics article.

Working with Yeh, Moffitt helped tease apart the genetic signature of pancreatic cancer cells from the different types of cells around it, which also includes healthy cells and a cluster of dense cells around the tumor called the stroma.

“The proportion of cancer cells in pancreatic cancer is low so if you imagine a mix of marbles of the same color on the outside but different on the inside and only having 10 in a bag of 100, figuring out what 10 [are] ‘tumor’ colors on the inside was very challenging,” Yeh explained in an email.

The TCGA study explains subtypes of cancer Moffitt didn’t know existed just a few years ago, while exploring the possible role that micro RNA and DNA methylation — the process of adding or taking away a methyl group from a genetic sequence to turn on and off genes — has in describing those subtypes.

Researchers “need projects like TCGA that are a really well-controlled way to study almost every molecule you want to study systematically for 150 cases to reveal these networks,” Moffitt said.

Moffitt has coupled his appreciation for algorithms and math with an interest in biology and engineering. His Ph.D. was done in a dry lab, which didn’t even have a sink. When he moved to UNC to conduct his postdoctoral work, he took a different approach and worked with surgical oncologists on tissue samples.

Moffitt plans to continue working with TCGA data and also to see how the subtypes can be used to predict responses to therapies. Some time in the future, researchers hope patients can get a diagnostic biopsy that will direct them to the specific therapy they receive, he said.

Moffitt grew up in Florida and earned his bachelor’s and doctoral degrees at Georgia Tech before completing his postdoctoral research at UNC. He has been gradually drifting north. Moffitt and his wife Andrea, who just started her postdoctoral work with Michael Wigler and Dan Levy at Cold Spring Harbor Laboratory, live in Stony Brook.

A competitive water skier during his youth in Florida, Richard Moffitt, dons two skis when he’s out with friends on Lake Oconee, Georgia in 2013. Photo by Andrea Moffitt

The water on Long Island is colder than it is in Florida, where Moffitt spent considerable time on a show skiing team. This was his version of a varsity sport, where he spent about six hours a day on Saturday and Sunday during the spring and about three hours a night before tournaments performing moving pyramids, among other tricks. When he was in high school, Moffitt wrote a computer program that automates the show skiing scoring process.

Moffitt processes the world through probabilities, which figured into the way he chose stocks in high school as a part of a stock picking competition and the way he approached his picks for March Madness. His basketball bracket won a competition for bragging rights among about a dozen entrants in 2016 and he was one game away from repeating in 2017 until UNC beat Gonzaga.

As for his Stony Brook effort, Moffitt plans to collaborate with members of the Cancer Center as well. “Being in demand is a good thing.”

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By Elof Axel Carlson

Elof Axel Carlson

Why is the term race rarely used by geneticists? The term race is not a scientific one. It is largely cultural when applied to humans. It is too ambiguous a term for describing a population of any one species.

For example, suppose I were a breeder of dachshunds and I specialized in two varieties — one that had a black coat of fur and the other that had a tan coat of fur. I would not call them black or tan races. I would call them varieties of a specific breed called dachshunds of dogs who are described by biologists as the species Canis vulgaris.

The term race is vague. Is it the varietal difference? Is it the collection of traits that we use for dogs, cats, horses, cattle and other domesticated animals? If it is applied to the color of dachshunds, does that mean humans are divided into thousands of races if I were to use McKusick’s online reference work on Mendelian inheritance in humans?

That work describes thousands of genetic traits caused by single gene malfunctions. Geneticists use the term breed for genetically manipulated traits or collections of traits by human selection or breeding. They use the term varieties or naturally occurring variations in a population or for new varieties arising by mutation in a sperm or egg.

Racism is used to describe a social application of race to designate rights and to assign attributes to other races by members of a specific race. There is far more genetic variation within a single race than there is between any two races. The criteria for classifying human races are often arbitrary and are based on skin color, facial appearance, hair texture and other visually distinctive traits. Many of these traits involve quantitative factors (like skin color), and thus racial mixture quickly obliterates the sharp racial traits initially used to describe a person of a specific race.

Quite a few people who have considered themselves and their immediate family as white are surprised when they send off DNA to be analyzed and discover they have percentages of African, Asian, Hispanic, Native American or Jewish ancestry along with their majority Caucasian Western European ancestry.

Racism is particularly destructive in assigning behavioral traits (personality, intelligence and social failure or inadequacy) to race. Most of those traits are determined by how we are raised and not by a roll of genes in forming our parents’ sperm or eggs. If they were to follow their own criteria, racists would find that white Catholics and Protestants are inferior to Jews and Orientals in intelligence measured by intelligence tests or IQs.

The revival of racist ideology among groups like the KKK, neo-Nazis and white supremacy groups is not based on biology or genetics. It is based on prejudice passed down by people who feel victimized if people different from them are treated with justice, fairness and equal opportunity.

The Civil War was fought over slavery. Thousands of abolitionists participated to hide escaped slaves, write books and pamphlets denouncing slavery and demanded the freedom of all slaves. The Confederacy seceded from the U.S. and fought to keep its slaves, many slave owners justifying slavery on biblical grounds — that it was a divine punishment for the descendants of a son who laughed at his drunken naked father.

Most ministers and priests in the North denounced that interpretation. We are not born with a knowledge of our past history. It has to be learned and it has to be taught. It is easier to avoid talking about our past errors than to ignore them.

Germany made a special effort after World War II to teach the racism of its Nazi past to all its school children so that error would never again be repeated. Let us hope that we teach our youth that we are one living species, Homo sapiens, and in the Judeo-Christian tradition we all have one ancestor in common.

In the scientific tradition we also have one human species in recorded history and enormous genetic variation that is constantly changing as humans migrate around the world, settle down or move on to new areas of the Earth. Most of that variation is in Africa where our species first arose.

It is ironic that whites who enslaved or colonized Africa diminished, in their minds, this genetic variation and reduced it to racist formulas of a handful of physical or behavioral traits. I hope this revived racism will recede and our focus will shift to problems that can and should be solved by our elected representatives. Those problems are overwhelmingly caused by our social and economic conditions and not by our genes.

Elof Axel Carlson is a distinguished teaching professor emeritus in the Department of Biochemistry and Cell Biology at Stony Brook University.

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