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Most thyroid nodules are found incidentally. METRO photo

By David Dunaief, M.D.

Dr. David Dunaief

Thyroid nodules are often diagnosed incidentally on radiologic exams, such as CT scans of the chest, MRI scans, PET scans and ultrasounds of the carotid arteries in the neck. It’s rarely because of symptoms. More than 50 percent of people have thyroid nodules detectable by high-resolution ultrasound. Fortunately, most are benign. Depending on the study, the percent that are malignant can range from 1.1 to 6.5 percent of nodules. 

This leaves us with the question of what to do with a thyroid nodule. What’s the short answer? It depends on the size. If it is over one centimeter, usually it is biopsied by fine needle aspiration (FNA). While most are asymptomatic, if there are symptoms, these might include difficulty swallowing, difficulty breathing, hoarseness, pain in the lower portion of the neck and a goiter.

FNA biopsy is becoming more common. In a study evaluating several databases, there was a greater than 100 percent increase in thyroid FNAs performed over a five-year period from 2006 to 2011. This resulted in a 31 percent increase in thyroidectomies, surgeries to remove the thyroid partially or completely.

However, the number of thyroid cancers diagnosed with surgery did not rise in this same period. Thyroid nodules in this study were least likely to be cancerous when the initial diagnosis was by incidental radiologic exam.

Addressing indeterminate FNA results

As much as 25 percent of FNA biopsies are indeterminate. We are going to look at two techniques to differentiate between benign and malignant thyroid nodules when FNA results are equivocal: a PET scan and a molecular genetics test.

A meta-analysis of six studies of PET scan results showed that it was least effective in resolving an unclear FNA biopsy. The PET scan was able to rule out patients who did not have malignancies, but it did not do a good job of identifying those who did have cancer.

On the other hand, a molecular-based test was able to potentially determine whether an indeterminate thyroid nodule by FNA was malignant or benign.

Unlike in the PET scan study above, the researchers were able to not only rule out the majority of malignancies but also to rule them in. It was not perfect, but the percent of negative predictive value (ruled out) was 94 percent, and the positive predictive value (ruled in) was 74 percent. The combination test improved the predictive results of previous molecular tests by 65 to 69 percent. This is important to help decide whether or not the patient needs surgery to remove at least part of the thyroid.

What is the significance of calcification?

Microcalcifications in the nodule can be detected with an ultrasound. The significance of this may be that patients with microcalcifications are more likely to have malignant thyroid nodules than those without them, according to a small prospective study involving 170 patients. This does not mean that a patient has malignancy with calcifications, but that there is a higher risk.

The ‘wait and follow-up’ approach

As I mentioned above, most thyroid nodules are benign. The results of one study go even further, showing that most asymptomatic benign nodules do not progress in size significantly after five years. The factors that did contribute to growth of about 11 percent of the nodules were age (<45 years old had more growth than >60 years old), the existence of multiple nodules, greater nodule volume at baseline, and being male.

The study authors’ suggestion is that, after the follow-up scan, the next ultrasound scan might be five years later instead of three. However, they did discover thyroid cancer in 0.3 percent after five years.

How does thyroid function affect outcomes?

In considering risk factors, it’s important to note that those who had normal thyroid stimulating hormone (TSH) were less likely to have a malignant thyroid nodule than those who had high TSH, implying hypothyroidism. There was an almost 30 percent prevalence of cancer in the nodule if the TSH was greater than >5.5 mU/L (13).

Fortunately, most nodules are benign and asymptomatic, but the number of cancerous nodules found is growing. Why the mortality rate remains the same, year over year for decades, may have to do with the slow rate at which most thyroid cancers progress, especially of the two most common forms, follicular and papillary.

References:

(1) uptodate.com. (2) AACE 2013 Abstract 1048. (3) Thyroid. 2005;15(7):708. (4) European Thyroid Journal. 2022 Jun 29;11(4) online. (5) AACE 2013 Abstract 1048. (6) thyroid.org. (7) AAES 2013 Annual Meeting. Abstract 36. (8) AACE 2013 Abstract 1048. (9) Cancer. 2011;117(20):4582-4594. (10) J Clin Endocrinol Metab. Online May 12, 2015. (11) Head Neck. 2008 Sep;30(9):1206-1210. (12) JAMA. 2015;313(9):926-935. (13) J Clin Endocrinol Metab. 2006;91(11):4295.

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

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Photo courtesy of SBU

By Daniel Dunaief

Predicting extreme heat events is at least as important as tracking the strength and duration of approaching hurricanes.

Ping Liu

Extreme heat waves, which have become increasingly common and prevalent in the western continental United States and in Europe, can have devastating impacts through wildfires, crop failures and human casualties.

Indeed, in 2003, extreme heat in Europe caused over 70,000 deaths, which was the largest number of deaths from heat in recent years.

Recently, a trio of scientists at Stony Brook University’s School of Marine and Atmospheric Sciences (SoMAS) received $500,000 from the National Oceanographic and Atmospheric Administration to study heat events by using and analyzing NOAA’s Seamless System for Prediction and EArth System Research, or SPEAR, to understand heat waves and predict future such events.

The first objective is to evaluate simulations in the SPEAR model, by looking at how effectively this program predicts the frequency and duration of heat events from previous decades, said Ping Liu, who is the Principal Investigator on the project and is an Associate Professor at SoMAS.

Liu was particularly pleased to receive this funding because of the “urgent need” for this research, he explained in an email.

The team will explore the impact of three scenarios for increases in overall average temperature from pre-Industrial Revolution levels, including increases of 1.5 degrees Celsius, 2 degrees Celsius and four degrees Celsius, which are the increases the IPCC Assessment Reports has adopted.

Answering questions related to predicting future heat waves requires high-resolution modeling products, preferably in a large ensemble of simulations from multiple models, for robustness and the estimation of uncertainties, the researchers explained in their proposal.

“Our evaluations and research will provide recommendations for improving the SPEAR to simulate the Earth system, supporting NOAA’s mission of ‘Science, Service and Stewardship,’” they explained.

Kevin Reed, Professor, and Levi Silvers, research scientist, are joining Liu in this effort.

Liu and Reed recently published a paper in the Journal of Climate and have conducted unfunded research on two other projects. Liu brought Silvers into the group after Reed recommended Silvers for his background in climate modeling and dynamics.

Reed, who is Interim Director of Academic, Research and Commercialization Programs for The New York Climate Exchange, suggested that the research the heat wave team does will help understand the limitations of the SPEAR system “so that we can better interpret how the modeling system will project [how] blocking events and heat will be impacted by climate change.”

An expert in hurricanes, Reed added that blocking events, which can cause high pressure systems to stall and lead to prolonged heat waves, can also lead to unique hurricane tracks, such as Hurricane Sandy in 2012.

“A longer term goal of many of my colleagues at Stony Brook University is to better understand these connections,” said Reed, who is Associate Provost for Climate and Sustainability Programming and was also recently appointed to the National Academies’ Board on Atmospheric Sciences and Climate.

Liu will use some of the NOAA funds to recruit and train a graduate student, who will work in his lab and will collaborate with Reed and Silvers.In the bigger picture, the Stony Brook researchers secured the NOAA backing in the same year that the university won the bidding to develop a climate solutions center on Governors Island.

Reed suggested that the “results of the work can be shared with our partners and can help to inform future societally relevant climate research projects.”

Focus on two regions

The systems that have caused an increase in heat waves in the United States and Europe are part of a trend that will continue amid an uneven distribution of extreme weather, Liu added.

Heat waves are becoming more frequent and severe, though the magnitude and impact area vary by year, Liu explained.

The high pressure systems look like ridges on weather maps, which travel from west to east.

Any slowing of the system, which can also occur over Long Island, can cause sustained and uncomfortable conditions.

Over the past several years, Liu developed computer algorithms to detect high pressure systems when they become stationary. He published those algorithms in two journal papers, which he will use in this project.

Personal history

Born and raised in Sichuan, China, Liu moved to Stony Brook from Hawaii, where he was a scientific computer programmer, in November of 2009.

He and his wife Suqiong Li live in East Setauket with their 16-year old daughter Mia, who is a student at Ward Melville High School and  a pianist who has received classical training at the Manhattan School of Music. Mia has been trained by award-winning teacher Miyoko Lotto.

Outside of the lab, Liu, who is five-feet, seven-inches tall, enjoys playing basketball on Thursday nights with a senior basketball team.

Growing up in China, Liu was always interested in weather phenomenon. When he was earning his PhD in China at the Institute for Atmospheric Physics at the Chinese Academy of Sciences in Beijing, he had limited computer resources, working in groups with IBM and, at times, Dell computer. He built several servers out of PC parts.

With air trapped inside the basin surrounded by tall mountains, Sichuan is particularly hot in the summer, which motivated him to pursue the study of heat waves.

Liu appreciated how Stony Brook and Brookhaven National Laboratory had created BlueGene, which he used when he arrived.

As for the future of his work, Liu believes predicting extreme heat waves is increasingly important “to help planners from local to federal levels cope with a climate that is changing rapidly and fostering more frequent and more severe heat events,” he explained.

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Shohei Ohtani. Photo by Mogami Kariya/Wikimedia Commons

By Daniel Dunaief

Daniel Dunaief

You know when you were younger and your parents, grandparents, teachers and adults in general urged you to “make every second count.”

“A second,” you’d scoff incredulously. “How much could I do in a second? It took me longer than a second just to say those words, and those, and those, and they don’t seem to count for much.”

While that may be true most of the time for most of us, it’s certainly not the case for sport’s best paid athlete, the baseball sensation Shohei Ohtani, who signed a $700 million contract to play for the Los Angeles Dodgers over the next decade.

To borrow from the Tom Cruise movie “Jerry Maguire,” the Dodgers showed him the money!

Wait, don’t go if you’re not a sports fan. This isn’t about baseball. It’s about money!

Just for fun, let’s take a closer look at the approximately $33.5 million Sports Insider Andrew Petcash estimates Ohtani will earn per year after taxes and fees.

Assuming he’s paid for every second of each year, that means, he earns $1.06 each second. That’s what he’ll earn each second he sleeps, eats, sits in traffic, brushes his teeth or waits for an announcer to say his name so he can run on the field.

Assuming he has a healthy 60 beats per minute heart rate, that means each time his heart goes “lub-dub,” he earns about a dollar.

According to a website called covers.com, the average time to sing “The National Anthem” is 115.4 seconds, which means Ohtani makes $122.32 each time he listens to the national anthem of a country where he’s earning much more than a living.

Extending the math a bit, Ohtani clears $3,824.74 per hour.

As for each day, he’ll make $91,780.82. At that rate, it will take the star pitcher and home run hitter (yes, he can do both) 11 days to make a million dollars.

Each month, his after tax take home pay will be $2.79 million. Assuming Ohtani, who is single, follows the General Rule for engagement rings, namely, that he should spend at least two months of salary on the ring, some lucky future partner may be in line for a ring that costs $5.58 million. That assumes the value of the ring comes from what he’s taking home and not his overall salary. If he chose a ring based on his gross pay, he’d spend a whopping $11.7 million, which is the equivalent of 16 average priced homes in Setauket.

So, speaking of cash, what does $33.5 million look like? If you stacked dollar bills, which are 0.0043 inches wide, one on top of the other without any extra space between the bills, the pile of money would reach 12,004 feet. That would stretch 2.3 miles into the sky. 

Now, if he were to try to hold that money — and no one uses cash anymore, so why would he – he would need more than a few teammates. There are $454 dollar bills in a pound, which means that $33.5 million weighs 73,788 pounds. 

Realistically, dollar bills aren’t the most likely currency for someone who earns over $1 for every second. Maybe you’d prefer to stack $1,000 bills? That would still present a pile of money that’s about 12 feet tall. Imagine how much money you’d make if you were standing downwind of that pile during a sudden gust? That sounds like the winner’s circle for a future game show. 

Of course, you say, the first player since Babe Ruth to demonstrate proficiency as a pitcher and a home run hitter is not getting paid for every second, but, rather, for the magic he works on the field.

If we want to break it down just to the time he’s paid during games, the average time for a baseball game in 2023 was two hours and 42 minutes. The season has 162 games. Let’s throw in 19 additional games, assuming his Dodgers win each series in the maximum number of games and become World Series champions. That means, he’s a part of 29,322 minutes of baseball or 1.8 million seconds. Assuming his paycheck covers games and not all the practice time and spring training, he clears $38.88 per second. So, depending on how you look at it, he earns somewhere between $1.06 for every second of each year and $38.88 for each second he plays. 

Yeah, and you thought your lawyer was charging you a pretty penny!

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METRO photo

By Leah S. Dunaief

Leah Dunaief

Tuesday we went to the funeral of another longtime friend. The chapel was overflowing with well wishers and mourners, and he deserved nothing less. He was a good man in every sense of the word: a good husband, a good father, a good grandfather, an inquisitive and caring person and a fun companion. He was a highly ethical man, never speaking against anyone who was not a government official, and it seems he enjoyed his life. 

He will be deeply missed.

Funny how life has a stark clarity during a funeral that then fades away when we are dealing with the chores of daily living. As the eulogies were read by his family, some stories making us laugh, others making us tear, we could see the tapestry of his life unfold. As we listened, we could not help but think of the unfinished paths of our own lives. How precious is each day with our loved ones, for they give the deepest meaning to our existence. What a miracle life is, and not to be wasted on some petty grievance or unnecessary anger. In fact, not to be wasted at all but to be lived to the fullest, with purpose and kindness: to be enjoyed even as we try to make our small world better regularly by doing the laundry.

Some day, each of us in that crowded room will die. What will be said of us, what amusing stories will be told, what terrible flaws did we have? How did we spend our so short lives on earth?

A poem was read at the funeral that spoke to this message, and as it was being read, almost every mourner’s head nodded in agreement. I share it with you here. It was called, “Dash,” by Linda Ellis.

I read of a man who stood to speak at a funeral of a friend. He referred to the dates on the tombstone from the beginning…to the end.

He noted that first came the date of birth and spoke of the following date with tears but said what mattered most of all was the dash between those years.

For that dash represents all the time they spent alive on earth and now only those who loved them know what that little line is worth.

For it matters not how much we own, the cars…the house…the cash. What matters is how we lived and loved and how we spend our dash.

So, think about this long and hard; are there things you’d like to change? For you never know how much time is left that still can be rearranged.

To be less quick to anger and show appreciation more and love the people in our lives like we’ve never loved before.

If we treat each other with respect and more often wear a smile…

Remembering that this special dash might only last a little while.

So when your eulogy is being read, with your life’s actions to rehash, would you be proud of the things they say about how you lived your dash?

As I sat listening to the eulogies, I recalled that I first learned of death shortly after I learned to read. I loved reading fairy tales, about princes and princesses and dragons and castles, and one of the stories ended with the death of a hero. I remember rushing into the kitchen in great distress and asking my mother and father, who, poor souls, were just eating what they expected to be a peaceful dinner, if there was such a thing as death? Further to the point, would they die? And why? They tried to calm me down, telling me soothing words, but clearly it was such an anguishing moment that I recall it to this day.

I’m supposed to be grown up now, and I accept the loss of loved ones with a broken heart. While death is a mystery, life remains a miracle.

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METRO photo

By Michael Christodoulou

Michael Christodoulou

It’s been a bumpy year for the financial markets — which means that some of your investments may have underperformed or lost value. Can you use these losses to your advantage?

It’s possible. If you have some investments that have lost value, you could sell them to offset taxable capital gains from other investments. If your losses exceed gains for the year, you could use the remaining losses to offset up to $3,000 of ordinary income. And any amount over $3,000 can be carried forward to offset gains in future years. 

This “tax-loss harvesting” can be advantageous if you plan to sell investments that you’ve held in taxable accounts for years and that have grown significantly in value. And you might receive some gains even if you take no action yourself. For example, when you own mutual funds, the fund manager can decide to sell stocks or other investments within the fund’s portfolio and then pay you a portion of the proceeds. These payments, known as capital gains distributions, are taxable to you whether you take them as cash or reinvest them back into the fund. 

Still, despite the possible tax benefits of selling investments whose price has fallen, you need to consider carefully whether such a move is in your best interest. If an investment has a clear place in your holdings, and it offers good business fundamentals and favorable prospects, you might not want to sell it just because its value has dropped. 

On the other hand, if the investments you’re thinking of selling are quite similar to others you own, it might make sense to sell, take the tax loss and then use the proceeds of the sale to purchase new investments that can help fill any gaps in your portfolio. 

If you do sell an investment and reinvest the funds, you’ll want to be sure your new investment is different in nature from the one you sold. Otherwise, you could risk triggering the “wash sale” rule, which states that if you sell an investment at a loss and buy the same or a “substantially identical” investment within 30 days before or after the sale, the loss is generally disallowed for income tax purposes.

Here’s one more point to keep in mind about tax-loss harvesting: You’ll need to take into account just how long you’ve held the investments you’re considering selling. That’s because long-term losses are first applied against long-term gains, while short-term losses are first applied against short-term gains. (Long-term is defined as more than a year; short-term is one year or less.) 

If you have excess losses in one category, you can then apply them to gains of either type. Long-term capital gains are taxed at 0%, 15% or 20%, depending on your income, while short-term gains are taxed at your ordinary income tax rate. So, from a tax perspective, taking short-term losses could provide greater benefits if your tax rate is higher than the highest capital gains rate.

You’ll want to contact your tax advisor to determine whether tax-loss harvesting is appropriate for your situation — and you’ll need to do it soon because the deadline is Dec. 31. But whether you pursue this technique this year or not, you may want to keep it in mind for the future — because you’ll always have investment tax issues to consider.  

Michael Christodoulou, ChFC®, AAMS®, CRPC®, CRPS® is a Financial Advisor for Edward Jones in Stony Brook. Member SIPC.

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METRO photo

By David Dunaief, M.D.

Dr. David Dunaief

Erectile dysfunction (ED) is a very common problem with a stigma. In fact, I have had several patients who resisted telling me they suffered from this malady. Because it can be a symptom of other diseases, it is crucial that you share this information with your doctor.

ED affects approximately 1 in 10 men on a chronic basis. If it occurs less than 20 percent of the time, it is normal; whereas if it occurs more than 50 percent of the time, there is a problem that requires therapy, according to the Cleveland Clinic (1). 

There are oral medications for ED. You’ve probably seen ads for them everywhere. Its prevalence has led pharmaceutical companies to saturate the airwaves, especially during sporting events. Approved medications include sildenafil (Viagra, or the “little blue pill”), tadalafil (Cialis), vardenafil (Levitra, Staxyn), and avanafil (Stendra). These drugs work by affecting the endothelium, or inner layer, of blood vessels and causing vasodilation, or enlargement of blood vessels, which increases blood flow to the penis. Unfortunately, this does not solve the medical problem, but it does provide a short-term fix for those who are good candidates for treatment.

ED’s prevalence increases with age. In a multinational MALES study, ED affected 8 percent of those aged 20-30 and 37 percent of 70-75-year-olds (2). What was surprising was that advanced age had the least association with ED, increasing the odds by only five percent. So, what contributes to the rest of the increase as we age? Disease processes and drug therapies.

What is the relationship between medical conditions and ED?

Chronic diseases significantly contribute to ED. The opposite may also be true; ED may be a harbinger of disease. Typical contributors include metabolic syndrome, diabetes, high blood pressure, cardiovascular disease and obesity. In the Look AHEAD trial, ED had a greater than two-fold association with hypertension and a three-fold association with metabolic syndrome (3). In another study, ED was associated with a 2.5-times increase in cardiovascular disease (4).

A randomized clinical trial (RCT) showed that patients with ED had significantly more calcification, or atherosclerosis, in the arteries when compared to a control group (5). They were more than three times as likely to have severe levels of calcification. They also had more inflammation, measured by C-reactive protein. 

How do medications contribute to ED?

About 25 percent of ED cases are thought to be associated with medications, such antidepressants; NSAIDs, such as ibuprofen and naproxen sodium; and hypertension medications. Unfortunately, the most common antidepressant medications, SSRIs, have the greatest impact on ED of all antidepressants. 

The California Men’s Health Study, with over 80,000 participants, showed that there was an association between NSAIDs and ED, with a 38 percent increase in ED in patients who use NSAIDs on a regular basis (6). The authors warn that patients should not stop taking NSAIDS without consulting their physicians.

Also, high blood pressure drugs have a reputation for causing ED. Beta blockers were thought to be the main culprit. A meta-analysis of 42 studies showed that beta blockers have a small effect, but thiazide diuretics (water pills) more than doubled ED, compared to placebo (7).

How does diet affect ED?

The Mediterranean-type diet has been shown to treat and prevent ED, improving one’s health and sex life at the same time. It’s the green leafy alternative to the little blue pill. The foods are rich in omega-3 fatty acids and high in monounsaturated fats and polyunsaturated fats, as well as in fiber. Components include whole grains, fruits, vegetables, legumes, walnuts, and olive oil. 

In two RCTs lasting two years, those who followed a Mediterranean-type diet saw improvements in their endothelial functioning (8, 9). They also had reduced inflammation and decreased insulin resistance.

In another study, men who had the greatest compliance with the Mediterranean-type diet were significantly less likely to have ED, compared to those with the lowest compliance (10). Even more impressive was that the group with the highest compliance had a 37 percent reduction in severe ED versus the low compliance group.

A study of participants in the Health Professionals Follow-up Study looked more closely at both the Mediterranean-type diet and an Alternative Healthy Eating Index 2010 diet, which emphasized consuming vegetables, fruits, nuts, legumes, and fish or other sources of long-chain fats, as well as avoiding red and processed meats (11). At this point, it probably won’t surprise you to hear that the greater participants’ compliance with either of these diets, the less likely they were to experience ED.

Therefore, it is important to bring ED to the attention of your physician. 

There are very effective lifestyle alternatives to oral medication that provide positive overall health effects and treat associated chronic diseases, while also helping patients eliminate medications that contribute to ED.

References:

(1) clevelandclinic.org. (2) Curr Med Res Opin. 2004;20(5):607. (3) J Sex Med. 2009;6(5):1414-22. (4) Int J Androl. 2010;33(6):853-60. (5) J Am Coll Cardiol. 2005;46(8):1503. (6) Medicine (Baltimore). 2018 Jul;97(28):e11367. (7) JAMA. 2002;288(3):351. (8) Int J Impot Res. 2006;18(4):405-10. (9) JAMA. 2004;292(12):1440-6. (10) J Sex Med. 2010 May;7(5):1911-7. (11) JAMA Netw Open. 2020 Nov 2;3(11):e2021701.

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

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Photo by David Ackerman

Local news is making news lately.

Last week, tech giant Google reached an agreement with the Canadian government that will allow the search engine to continue publishing links to local news outlets under select conditions. As part of the bargain, Google will pay out roughly U.S. $73.5 million annually to Canadian news companies.

We regard this development as a significant victory for local journalism, setting a powerful precedent we can follow here in the United States.

The local press is a vital institution for sustaining democracy. We know that in news deserts — or places not served by a local newspaper — communities generally have less civic engagement and more governmental mismanagement.

Without local news, we become alienated from the democratic process. Distant bureaucracies in Washington and Albany — over which we have little influence as private citizens — dominate our mental space and shape our worldviews.

Without local news, we can consume only the most polarizing, partisan content from mainstream media outlets that prosper and profit from a national culture of division.

At TBR, we are committed to a ground-up style of democracy. A stable federalist system requires a solid foundation. Like the food chain, community journalism is the primary producer, giving life to all other levels of democracy. Without the local press, our entire democratic ecosystem could collapse.

Local journalists reporting on civic matters and informed citizens engaging in the political process are the pillars of a thriving democracy. But how our industry is changing.

Today, local outlets fight just to survive — much less thrive and expand. Local newspapers have simply struggled to adapt in this digital age. Meanwhile, tech conglomerates are cannibalizing the local media landscape, circulating and monetizing our content without equitable compensation while siphoning away precious advertising dollars from small businesses — the lifeblood of the local press.

We find this dynamic deeply problematic. Fortunately, we have recourse.

Right now, the state Legislature is considering the Local Journalism Sustainability Act. This measure would create tax credits for local journalists and monetarily reward local news subscribers.

We regard this legislation as a positive first step toward attracting and retaining talent in our industry while counteracting the declines faced by many of our shuttering peers. We ask each of our state legislators to support this measure and invite readers to lobby them on our behalf.

But the work doesn’t end in Albany. Local news outlets in the U.S. deserve compensation from Big Tech, similar to our Canadian counterparts. If Canada can defend its local press, our federal government can, too.

The Journalism Competition and Preservation Act, introduced in the U.S. Senate earlier this year by Sen. Amy Klobuchar (D-MN) with broad bipartisan support, would allow local outlets to jointly negotiate fair compensation for access to our content by Google, Facebook and other large corporations.

We urge our U.S. Congressman Nick LaLota (R-NY1) to pick up the measure, guiding the slim House majority toward enactment.

As local press members, we are staring down an extinction-level event. The monopolistic, plagiaristic, predatory tactics of Big Tech must end. We ask for a level playing field.

To our readers and public officials alike, we urge you to do what you can to stand up for local news.

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Zhe Qian

By Daniel Dunaief

Addition and subtraction aren’t just important during elementary school math class or to help prepare tax returns.

As it turns out, they are also important in the molecular biological world of healthy or diseased cells.

Some diseases add or subtract methyl groups, with a chemical formula of CH3, or phosphate groups, which has a phosphorous molecule attached to four oxygen molecules.

Nicholas Tonks. Photo courtesy of CSHL

Adding or taking away these groups can contribute to the progression of a disease that can mean the difference between sitting comfortably and watching a child’s performance of The Wizard of Oz or sitting in a hospital oncology unit, waiting for treatment for cancer.

Given the importance of these units, which can affect the function of cells, researchers have spent considerable time studying enzymes such as kinases, which add phosphates to proteins.

Protein tyrosine phosphatases, which Professor Nicholas Tonks at Cold Spring Harbor Laboratory purified when he was a postdoctoral researcher, removes these phosphate groups.

Recent PhD graduate Zhe Qian, who conducted research for six years in Tonks’s lab while a student at Stony Brook University, published a paper in the journal Genes & Development demonstrating how an antibody that interferes with a specific type of protein tyrosine phosphatase called PTPRD alters the way breast cancer spreads in cell cultures.

“The PTPs are important regulators of the process of signal transduction — the mechanisms by which cells respond to changes in their environment,” explained Tonks. “Disruption of these signal transduction mechanisms frequently underlies human disease.”

To be sure, Tonks cautioned that the study, which provides a proof of concept for the use of antibodies to manipulate signaling output in a cancer cell, is a long way from providing another tool to combat the development or spread of breast cancer.

The research, which formed the basis for Qian’s PhD project, offers an encouraging start on which to add more information.

Blocking the receptor

Qian, who goes by the name “Changer,” suggested that developing a compound or small molecule to inhibit or target the receptor for this enzyme was difficult, which is “why we chose to use an antibody-based method,” he said.

By tying up a receptor on the outside of the cell membrane, the antibody also doesn’t need to enter the cell to reach its target.

The Antibody Shared Resource, led by Research Associate Professor Johannes Yeh, created antibodies to this particular receptor. Yeh created an antibody is shaped like a Y, with two arms with specific attachments for the PTPD receptor.

Once the antibody attaches, it grabs two of these receptors at the same time, causing a dimerization of the protein. Binding to these proteins causes them to lose their functionality and, ultimately, destroys them.

Cell cultures of breast cancer treated with this antibody became less invasive.

Limited presence

One of the potential complications of finding a new target for any treatment is the side effects from such an approach.

If, for example, these receptors also had normal metabolic functions in a healthy cell, inhibiting or killing those receptors could create problematic side effect.

In this case, however,  the targeted receptor is expressed in the spine and the brain. Antibodies normally don’t cross the blood-brain barrier.

Qian and Tonks don’t know if the antibody would affect the normal function of the brain. Further research would help address this and other questions.

Additionally, as with any possible treatment, future research would also need to address whether cancer cells developed resistance to such an approach.

In the time frame Qian explored, the cells in culture didn’t become resistant.

If the potential therapeutic use of this antibody becomes viable, future researchers and clinicians might combine several treatments to develop ways to contain breast cancer.

Eureka moment

In his research, Qian studied the effect of these antibodies on fixed cell, which are dead but still have the biochemical features of a living cell He also studied living cells.

When the antibody attaches to the receptor, it becomes visible through a staining process. Most antibody candidates stain living cells. Only the successful one showed loss-of-signal in living staining.

The antibody Qian used not only limited the ability of the receptor to send a signal, but also killed the receptor. The important moment in his research occurred when he discovered the antibody suppressed cancer cell invasion in cell culture.

Outside of the lab, Qian enjoys swimming, which he does between four and five times per week. Indeed, he combined his athletic and professional pursuits when he recently raised funds for Swim Across America.

“I not only want to do research, but I also want to call more attention to cancer research in the public,” said Qian.

The Swim Across America slogan suggests that each stroke is for someone who “couldn’t be with us” because of cancer. In the lab, Qian thinks each time he pipettes liquids during one of his many experiments it is for someone who couldn’t make it as well.

Qian, who currently lives in Hicksville, grew up in Suchow City, which is a village west of Shanghai and where Cold Spring Harbor Asia is located. 

Qian has been living on Long Island since he arrived in the United States. Qian graduated from Stony Brook University in October and is currently looking for a job in industry.

Looking back, Qian is pleased with the work he’s done and the contribution he’s made to breast cancer research. He believes the antibody approach offers a viable alternative or complement to searching for small molecules that could target or inhibit proteins or enzymes important in the development of cancer.

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The USS Shaw explodes during the Japanese assault on Pearl Harbor Dec. 7, 1941. Public domain photo

By Rich Acritelli

“We thought they were U.S. planes until we saw the big red sun on the wings, and they began to bomb and strafe, and there was that big red sun on their wings, and it was war.”

 — William Harvey, USS Sacramento, 1941

Eighty-two years ago on Dec. 7, the Empire of Japan struck the United States Armed Forces stationed at Pearl Harbor, Hawaii.

In the early morning hours, a massive Japanese naval and air presence was just 200 miles off the coast of these islands as military personnel and civilians awaited a leisurely Sunday. In an attack that lasted a little over two hours, an American population was thrust into a global conflict.

The surprise attack stunned government and military officials alike. Many Americans were shocked by this news, deluded by the inaccurate perception that the Japanese were not capable of hitting Hawaii with any robust force.

Instead, airmen, army forces and naval ships were reeling from continual aerial assaults by the Japanese Zero fighter aircraft that openly strafed American targets. From Japanese aircraft carriers, 40 torpedo planes, 103 level bombers, 131 dive bombers and 79 fighters opened up the war against American targets.

Once the smoke cleared, 2,403 American service members were killed, more than 1,000 injured and 19 American ships were crippled or destroyed.

The United States was fortunate that its three aircraft carriers were at sea. Adm. Isoroku Yamamoto initially stressed caution against this attack. He openly believed that if the American carriers were not hit, he could “run wild” for a year before the “sleeping giant awoke.”

Yamamoto, who traveled extensively around the United States, fully understood America’s economic and military potential, worrying that Japan would lose any long war against this country. The next day, President Franklin D. Roosevelt (D) rallied a shaken nation, announcing that a “state of war” existed between the U.S. and Japan.

Americans from all walks of life entered the U.S. Armed Forces to avenge this national tragedy and oppose the rise of fascism. The Japanese and Germans faced limited military achievements, but they underestimated the American resolve to mobilize every facet of its government, economy and population. 

By 1945, America and its allies had achieved “complete” and “utter” victory first against Germany and then Japan.

A way to remember

Dec. 7, 1941, is a national day of remembrance of service for many past, present and future veterans. Recently, Thomas Semkow, a lifetime member of Rocky Point VFW Post 6249, died of cancer on Nov. 13, at 78. A soft-spoken man who was born in Manhattan and enjoyed every aspect of the Rocky Point VFW, Thomas was a Vietnam veteran. He was sent to Vietnam during the height of the fighting. Thomas had the unique experience of being a member of the Green Berets as a medic who worked closely with American and South Vietnamese forces who directly fought the Vietcong and the North Vietnamese Army.

Never one to speak about his experiences during the war, Thomas’ military achievements are on display at the VFW 6249 Suffolk County World War II and Military History Museum, opening Thursday, Dec. 7.

His death is a continual reminder of the older World War II, Korean and Vietnam war veterans who are dying on a daily basis. They sacrificed greatly to defend this nation. Let us remember now their valor during the Japanese attack.

Rich Acritelli is a history teacher at Rocky Point High School, adjunct professor at Suffolk County Community College and curator of the VFW 6249 Suffolk County World War II and Military History Museum.

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