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Daniel Dunaief

METRO photo

By Daniel Dunaief

Daniel Dunaief

This generation of college students have dealt with numerous shocks in their short lives. Most of them were born around the time of the terrorist attack on the World Trade Center. That event triggered several battles on foreign soil, led to the Department of Homeland Security, and created a world in which people took off their shoes at the airport and passed through metal detectors on the way in to concerts and sporting events.

As if that weren’t enough, this generation then had to deal with the 2008 financial crisis, when Lehman Brothers went bankrupt and when life, for many, became considerably more challenging amid a painful decline in the subprime housing market.

Through their upbringing, they also heard about mass shootings, some of which occurred at school. They practiced shelter-in-place and had nightmares about killers roaming the same hallways where artwork depicting students’ families and the alphabet adorned the walls.

The contentious 2016 presidential election brought two largely unpopular choices onto center stage. After a bitter election fight, the country didn’t have much time to heal, as the Democrats and Republicans transformed into the Montagues and Capulets.

Indeed, while each side dug in deeply, their respective media supporters expressed nonstop outrage and acted dumbfounded by the misdirection and apparent idiocy of the leaders and their minions across the aisle.

Then 2020 happened. The virus has killed over 120,000 Americans, crippled economies, led to mass layoffs and unemployment and turned the hug and the handshake into bygone gestures from six months ago that somehow seem even longer ago. With the killing of Minneapolis resident George Floyd, many protesters weathered the viral storm that had kept them inside for months to express outrage at a system where equal protection under the law seemed like a distant ideal.

Now, these same students face the possibility of returning to school. Some colleges have told their students to return earlier than normal, to forego visits to friend’s dorms, and to wear masks and social distance.

It seems likely that many of these colleges’ students, who have a familiar youth-inspired independent streak, will defy these new rules, much the same way many in the general public, including President Donald Trump (R), shun the idea of wearing masks.

If  I were running a college, and I’m glad I’m not because I’m struggling to provide sound  advice to two teenagers, I would triple and quadruple my medical staff. I would urge regular testing and I would make sure my college had the best possible treatments and plans ready.

Fortunately, the treatments for the virus have improved from the beginning, as the medical community has raced to provide relief to those battling draining and debilitating symptoms that have lasted for weeks or even months.

When people do contract the virus, as they inevitably will at some of these schools, I would urge students to rally around each other, their professors and anyone else who contracted COVID-19.

Unfortunately, this generation has had to grow up rapidly, to see ways each of them can play a role in helping each other. Students may not only become involved in the standard blood drives; they may urge their peers to check for antibodies and to donate convalescent plasma, which may help save lives and ameliorate the worst of the viral symptoms.

The modern college student doesn’t have to look to distant shores to find people overwhelmed and in need of their youthful energy and good intentions.

Many college students want to be relevant and contribute. They can and will have ample opportunities, with their antibodies, with their understanding and empathy, and with their ongoing resilience in the face of a lifetime of challenges.

Saket Navlakha. Photo from CSHL

By Daniel Dunaief

When people walk into their own home, they immediately ignore sensory cues around them. They may not notice the picture of their children on the wall, the lush leaves of the ficus plant, or the constant smell of soup that greets them when they return from work.

Similarly, animals and even flies become accustomed to cues in their environment, habituating to them so they can focus on more important signals, like the smell of nearby food or the appearance of a fly swatter.

Cold Spring Harbor Laboratory Associate Professor Saket Navlakha and his post doctoral researcher Yang Shen recently studied the way flies subtract smells from the environment, giving them the opportunity to focus instead on odors that might be more important to their lives.

In a paper last month in the Proceedings of the National Academy of Sciences, Navlakha and Shen converted the way flies use a signal filtering process to create a computer algorithm.

Navlakha explained that the tandem were using computer science to understand better a basic biological phenomenon of habituation and how it happens. “We’ve been studying background subtraction,” he said in a recent interview.

One of the applications for their work is in electronic noses. Hotels and even military departments may in the not too distant future use these systems to process odors to determine what’s in the environment.

These electronic noses detect faint signals within noisy backgrounds. Habituation enables them to remove from consideration those scents that would otherwise distract from the goal of scanning the environment for new information.

Navlakha suggested that humans, who are often a visually dominant species, are not always the best species at using a sense of smell to perceive the environment.

Saket Navlaka with his wife Sejal Morjaria, during a run in Port Washington in mid-May. Photo by Lawrence Lau

“Many other species rely on their noses as much as we rely on vision,” he said. “We don’t always have an intuitive sense of what is possible in the olfactory space. Sometimes, that limits our imagination.”

While Navlakha is not crafting sensors that can detect compounds, he is working on the computer science analogs to odor recognition and discrimination. He is exploring the kind of data analysis that would have applications in a range of fields. 

In one example, he said a sensor in an airport might be surrounded by a symphony of smells, including new pungent or even subtle toppings on pizza or even a new cologne from someone working in a watch repair store. 

The sensor might need to sift through all that data to find someone who is transferring a toxic chemical through an airport, the scent of which might be faint and almost insignificant compared with the other odors spreading through the terminal.

In a more everyday example, a sensor in the refrigerator might detect the subtle changes in odors emitted by foods that are starting to become inedible, such as an onion or cream cheese.

“You want to detect” when food is starting to turn so you can “eat it and use it” before it becomes inedible, Navlakha said. “These are the kind of problems we are exploring on the data analysis side.”

Navlakha specifically looked at the activity of Kenyon cells, which are special odor neurons. When a fly receives a new scent, about five percent of these cells turn on, developing a unique activity tag.

Once the fly becomes habituated to a smell that isn’t relevant for its survival — either to indicate the presence of food or to announce the arrival of a predator — Navlakha believes the number of Kenyon cells that make up the tag for the odor declines. While this is his theory, he said more work needs to be done to confirm these predictions.

A new odor repeats the process, bringing the fly’s attention to a new smell. The fly brain in principal can reverse the subtraction process for habituated odors if the odor becomes more rare or important for the fly’s survival. Researchers need to conduct more work to confirm this as well.

Navlakha hopes to frame the fluid process of recognizing, habituating and bolstering the signal for odors to understand how the brain is functioning.

He said the fly brain responds to smells based on two mechanisms. In the first, the fly has an innate, evolutionary behavior. In the second, the fly learns through experience. Navlakha studied the learned behaviors.

The next steps involve pushing more on the experimental front, determining the limits of odor discrimination and looking at the role of habituation.

He hopes to extend an experiment that others have done with people. Experimenters took three odors that were all relatively similar that come from three flowers. Most people could not discriminate between two out of the three odors. In an experimental group, they allowed people to habituate to one of three smells and then they had to discriminate between the other two. By subtracting out the common part of all three smells, they were more successful at decoding the difference between the others.

“We want to see if we can do this in fruit flies” while recording from a region of the fly brain called the mushroom body.

Navlakha also bought an electronic nose. Using this artificial system, he wants to test odor discrimination algorithms.

“One thing this would allow us to do is to test and validate these algorithms to see how well they perform,” he explained. “There are all kinds of tests to see what kind of power these sensors have.”

In the PNAS paper, Navlakha mostly used the literature for their biological inspiration. They discussed numerous parts of the paper with biological collaborators and including biological experiments. They did not introduce any new biological data.

He came across this literature about 18 months ago.

“We thought it was interesting because we could understand the whole series of transformations when a fly smells,” he said. He worked on how to understand the process from input to output.

During the COVID-19 lockdown, he has been spending considerably more time doing theoretical work and modeling. He and his wife Sejal Morjaria have also gotten out of the house to do some running.

As for his work, Navlakha is hoping to build on what he’s done so far and expects he will, if you’ll pardon the pun, follow his nose as the research progresses.

 

METRO photo

By Daniel Dunaief

Daniel Dunaief

As we approach Father’s Day, I can’t help thinking that the creators of the alphabet hid important lessons in plain sight when they put the letters “n” and “o” between the letters “m” and “p.”

The letter “m” starts the Latin word “mater,” which means mother. The letter “p” starts the word
“pater,” which, also in Latin, means father.

Between mom and dad, then, resides the simple,
effective and important word “no.”

Parents who aren’t on the same page about decisions will find children who don’t believe a “no” ever means anything because they will run to the other parent to find someone who will render a “no” from the former parent meaningless.

Parents need the word “no” to unite them, bringing together the “m” and “p” that makes it possible to provide consistent parenting advice. When a “no” from dad is also a “no” from mom, children can’t divide and conquer with their parents.

Now, valuing and appreciating the word “no” doesn’t necessarily mean parents should say “no” to everything. In fact, when mom and dad agree on something for their children, they can and should celebrate the opportunities they urge their progeny to pursue.

When our children were young, we found ourselves falling into the repeated “no” pattern, mostly to protect our children. “Don’t go in the street, don’t put that toy in your mouth, don’t grab that dog’s tail, etc.” While all of those rules are valid and valuable, they also can create a culture of “no” that constantly reminds children of their limitations, giving them the equivalent of a Greek chorus of “no” that follows them around, preventing them from exploring the world or from considering opportunities and risks worth taking because they expect a giant “NO!” sign to appear in their closet, under their bed, at the entrance to their classroom or in the backyard.

My wife and I put considerable energy into redirecting our children, rather than giving them a negative answer. We suggested alternatives to their suggestion or even, at times, a compromise answer that wasn’t a negative so much as it was a reshaping of an impulse.

On an elemental level, the letters “n” and “o” also seem so apt for the world between mom and dad. After all, N for nitrogen represents 78 percent of the atmosphere while O for oxygen represents 21 percent, which means that, between the letter placeholder for mom and dad resides the letters for 99 percent of the atmosphere of the earth.

The elements nitrogen and oxygen also, like some families, exist in paired form as molecules instead of single elements. These molecules float around in the atmosphere as a duo, with a strong covalent bond keeping the orbiting electron shells full.

For children, saying “no” to their parents starts early as a way to fight back against the world of “no” while they drift into the world of the terrible twos or, in our children’s case, the threadbare threes. When these children are caught between their mother and father, they may find that their only defense against a disagreeable world is to hold up their own “no” shield.

That small word, however, is important to change the world as well, because children who can defend their “no” answer to parents can also refuse to accept problems they see in the world. Instead, they can defy policies or ideas that rankle them. Saying “no” to anything aids cognitive development and, as it turns out, is good preparation for parenting. It has to be true because it’s right there, hidden in place sight, in the alphabet.

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Angie Tempio with her boyfriend James O'Brien

By Daniel Dunaief

New York may have started Phase One of its reopening and other states may have reopened shops and businesses, but life won’t change much for Angie Tempio.

A native of Commack who had been working at the front desk at Funt Orthodontics in Setauket since 2017, Tempio received a heart transplant last summer and plans to do everything she can to protect herself amid threats from the pandemic.

Tempio, who was preparing to rebuild her life outside of an apartment she shares in Yaphank with her boyfriend James O’Brien, plans to remain as isolated as possible, lowering the chance of contracting COVID-19.

Angie Tempio with her boyfriend James O’Brien

 

“The world is opening back up,” Tempio said. “For me, it’s not. Nothing will change for a few months. I’m used to being left behind.”

Tempio, however, doesn’t feel sorry for herself or rue her situation. She now focuses on new possibilities. 

Diagnosed with restrictive cardiomyopathy when she was 11, she slowly went into heart failure. She struggled for a few years before her transplant, but the last year was the toughest. She said her pacemaker kept her alive.

Tempio, who recently turned 26, had made her peace with death, particularly when she struggled to walk two steps at a time and when her failing heart beat only 30 times per minute. “I was lucky,” she said. Two months after she went on the transplant list, she “got the call, which is a miracle in itself.”

While Tempio feels overwhelmingly blessed that she can consider having children, she said she is also sensitive to the over 1,870 residents who died from COVID-19 in Suffolk County.

Tempio had a rare heart condition that caused her to be a small statistic. Even with the overall mortality rate for COVID-19 below one percent, she empathizes with people and their family who are on the other side of those small numbers.

“Experiencing being a small statistic has definitely made me look at things differently,” she said. “In my head, anyone can [be such a statistic] and most people aren’t realizing that and that’s what’s making me overly cautious.”

Tempio said she was a gymnast and was seemingly healthy before she developed the rare heart disease.

“Although I haven’t experienced the virus itself, I’ve been through the same obstacles,” she explained in an email.

Even when the coronavirus first started infecting people on Long Island, Tempio wore masks to the classes she is taking at Suffolk County Community College, where she hopes to study to become a transplant coordinator. She said she felt judgment from people who thought she was being overly concerned about the virus.

“Most people didn’t realize” how much more vulnerable she was to the virus than the typical person walking around Long Island, she said. 

While she’s waiting for the moment when she can emerge from a home cocoon, Tempio has been connecting with a network of friends and a close-knit heart transplant support group. She and 13 others are a part of a group that shares a profound and unique experience that brings them together and helps them connect with, and support.

“They have been my outlet during one of the hardest times in my life and I am so grateful to have them,” she said.

Tempio said she feels a responsibility to live her best and healthiest life. She believes she is “now living for my donor,” she said, and plans to “take the best care of this heart that I can.”

Dr. Frank Darras. Photo from SBU

By Daniel Dunaief

Dr. Frank Darras, Clinical Professor of Urology and Clinical/ Medical Director of the Renal Transplantation Program at Stony Brook University Renaissance School of Medicine Hospital, has performed over 1,700 kidney transplants since 1990. 

This year has been especially challenging for the surgeon, as he has had to enhance safety procedures to protect patients who are on immunosuppressants during the COVID-19 pandemic.

As part of the new normal for kidney transplants, Stony Brook takes time to test patients for coronavirus. In the first few weeks after the virus hit Suffolk County, the tests took all day. In recent weeks, the labs have produced test results within one to three hours.

Through late April, Darras said the hospital hasn’t had to send anyone home who had a positive COVID-19 test.

The long-term effects of COVID-19 on the function of normal kidneys is difficult to predict, he said. Many of the patients with the most severe symptoms from the virus not only needed ventilators, but also needed dialysis treatments. In the majority of cases where people recovered from the virus, their kidneys also recovered.

The hospital has also seen patients who received kidney transplants who have contracted the virus. “Several of these [transplanted patients] had diminished function, but all of them recovered their kidney function,” Darras said.

The longer-term effects of the virus are unknown. Some patients who were severely ill may have recovered, but have kidney problems that slowly escalate over time.

“I would not be surprised to see that happen, whether that’s months or years down the road,” Darras said.

Another unknown is how the virus would affect the transplant community in the longer term. “In the worst case, it’ll make our living donor pool smaller,” he said. About one out of three kidney transplants comes from a living donor. “On the other hand, in the best case scenario, [the virus will have] relatively little impact. It’s too early to tell,” he added.

According to Darras, people who need kidney transplants can extend their life expectancy by two to three times. He estimated that about five to six percent of the people waiting for a transplant died while on a kidney waiting list.

Darras explained that “time is of the essence” for many patients because the “longer patients are on dialysis, the more urgent [the need] to get them transplanted,” and added that finding donors is critically important, particularly during the pandemic.

“There is a concern about trying to make sure that we can get enough kidneys,” he said. “Our job and the job of LiveonNY is to raise awareness about organ donation.”

Bruce Stillman. Photo from CSHL

By Daniel Dunaief

Bruce Stillman, the CEO of Cold Spring Harbor Laboratory, last week won the Dr. H.P. Heineken Prize for Biochemistry and Biophysics, which is considered the most distinguished scientific prize from the Netherlands.

The prize, which has been awarded to 13 researchers who have gone on to win Nobel Prizes, includes a $200,000 award and a crystal trophy.

Stillman earned the award, which began in 1964 and is given every two years in categories including Medicine, Environmental Sciences and History, for his decades of work on mechanisms involved in the replication, or copying, of eukaryotic DNA.

The understated Stillman, who was born and raised in Australia, expects he’ll put the prize money into a foundation, although he hasn’t thought much about it given the other concerns that dominate his time, including not only running his own lab amid the COVID-19 pandemic but also overseeing a facility where he has been the Director since 1994 and its CEO since 2003.

Stillman said the lab has had “extensive discussions” among the faculty about whether to pursue additional research fields on an ongoing basis to combat the current virus as well as any future public health threats.

While CSHL is not an infectious disease center, the facility does have a historical precedent for contributing to public health efforts during a crisis. Indeed, during World War II, the laboratory helped create a mutated strain of fungus that increased its yield of the drug penicillin.

At this point, CSHL does not have a high containment facility like Stony Brook University where it can handle highly infectious agents.

“We may have to have one here,” Stillman said. “The reality is there are tons of infectious diseases” and the lab might need to repurpose its scientific skills towards coming up with answers to difficult questions.

Even without such a Biosafety Level 3 designation, CSHL researchers have tackled ways to understand and conquer COVID-19. Associate Professor Mikala Egeblad has been exploring whether neutrophil extracellular traps, which are ways bodies fight off bacterial infections, are playing a role in blood clotting and severe respiratory distress.

These NETS may be “promoting severe symptoms in COVID,” Stillman said. Egeblad is working on a case study with several other collaborators who have focused on these traps. Egeblad is also studying the effectiveness of NETS as a biomarker for the most severe patients, Stillman said.

CSHL is also investigating a small molecule compound to see if it inhibits viral infection. Researchers including Assistant Professor Tobias Janowitz are about to participate in a combined Northwell Health-CSHL double blind study to determine the effectiveness of famotidine, which is the active ingredient in the ulcer-treating medication Pepcid.

The coronavirus treatment, which will include patients who don’t require hospitalization, would require a higher dose than for heartburn.

As a part of this study, the scientists will use a patient tracking system that has been used for cancer to determine the effectiveness of the treatment through patient reporting, without requiring laboratory tests.

Stillman is pleased with how CSHL has “repurposed ourselves quickly, as have many institutions around the world.” He highlighted the constructive interactions among scientists.

The public health crisis has “generated a different kind of behavior in science, where there’s a lot of interaction and cooperation,” Stillman said. The preprint journal BioRxiv, which CSHL operates, has had nearly 5,000 papers about COVID-19 since January. The preprints have “not only helped disseminate information rapidly [to the scientific community], but they are also “being used to determine policy by government leaders.”

Stillman urged scientists to apply the same analytical technique in reading preprinted research that they do with peer-reviewed studies, some of which have required corrections.

As for the government’s response, Stillman believes a retrospective analysis will provide opportunities to learn from mistakes. “I don’t think the [Centers for Disease Control and Prevention] has done a very good job,” he said. He suggested that the well-documented problems with the roll out of testing as community transmission was increasing, was a “disaster.”

The CSHL CEO also said the balkanized medical system, in which every state has a different system and even some local communities have their own processes, creates inefficiencies in responding to a fluid and dangerous public health crisis.

Coordinating those efforts “could have been done very, very rapidly to develop a modern, clear [polymerase chain reaction] test of this virus and yet states and federal agencies had regulations about how these tests can be approved and controlled and regulated that are far too bureaucratic and did not set a national standard quickly,” he said.

He hopes agencies like the CDC, FDA and the Biomedical Advanced Research and Development Authority have better coordination. The country needs a national response, like it had after the Homeland Security effort following 9/11.

Optimistically, Stillman expects a therapeutic antibody will be available by the end of the summer to treat COVID-19. The treatment, which will use monoclonal antibodies, will likely be injectable and will be able to prevent infection for a month or two. These treatments could also help limit the severity of symptoms for people who have been infected.

Regeneron has taken the same approach with Ebola effectively. Stillman doesn’t think such treatments can be used with everybody in the world, which increases the need to develop a vaccine. Creating a safe vaccine, which could be available as early as next year, is a “massive, under-recognized undertaking.”

Between now and next year, a second wave of the virus is certainly possible and may be likely, given that other coronaviruses have been seasonal. 

“This happened with the influenza pandemic a century ago, so we have to be careful about this,” Stillman said. He believes that the medical community has learned how to treat severe patients, which should help mitigate the effects of a second wave in the United States. 

That may not be the case in developing countries, which is a “concern,” he said.

METRO photo

By Daniel Dunaief

Daniel Dunaief

Hi, welcome to my store. It’s so good to see you after all these years. It hasn’t been years, I know, but it just feels like it because I’ve been a prisoner at home with my teenage children who have decided they are allergic to cooking, cleaning or almost anything else that has to do with helping around the house.

But, hey, this isn’t about me, it’s about you. You’re looking well, thank goodness. That’s the most important thing, right? This virus has been so hard on everyone, but I promised I wouldn’t say anything about the virus today.

Anyway, we have decided to move to a high touch environment because we can only have two people in our store at a time and one of them is me, which means you’ll have to leave the child you’re carrying in the stroller outside. 

You don’t have a stroller? No problem. I have a disinfected stroller just for this occasion that I can bring out from the back for you. In fact, I’m happy to sell it to you at a bargain price because I haven’t sold much of anything these days. I tried selling food to my teenage kids, but they just said I was a terrible cook, they weren’t hungry or they would be in their rooms and I shouldn’t bother them until 2021.

Oh, wait, there, I did it again. I’m so sorry. Silly me, I’m talking about myself. And, whoops, I see from your frown that you’re not happy I touched your shoulder when I made that joke. I have to make sure I socially distance. In fact, I have this new touch-the-shoulder-in-a-joking-way stick that’s exactly six feet long which I would also be happy to sell to you. I know it looks like two yard sticks taped together, which it kind of is, but it guarantees that you’ll be six feet away from everyone else. 

Yes, of course, I’m fine. Why do you ask? I’m so happy we’re entering Phase Two this week, you know? It’s a relief. I’m desperate for a haircut and I’m sure you are, too.

No, I didn’t mean to say that I thought you needed a haircut. Your hair looks great and the customer is always right.

Anyway, so I see you’re looking at those boots over there. What an excellent choice! You clearly have an eye for high fashion. I’m sure my daughter, who is on the other side of the plexiglass, wouldn’t mind taking them off and selling them to you.

Oh, you want new ones? Well, that may take a while because our shipment is in quarantine. Oh, no, wait, the shipment hasn’t even reached quarantine yet, so, ha ha, how about if you glance through the rest of the store while I pretend to read this dystopian book that I thought might be a good idea before we started to live in a dystopian society. 

What’s that? Oh, well, I’ve had a few cups of coffee this morning because I thought I’d need to be my sharpest and this stupid book kept me up all night. But, hey, I’m like a phoenix, returning to the world of selling and socializing and connecting with my customers, because that, after all, is the key to being successful in business.

Wait, no, please, don’t leave. I know your child is outside screaming. You can bring her in. It’s fine, really. In fact, can I give you a hug? I was kidding. That was a test and you passed, so, yay for you.

Oh, I see you’re really going. Well, tell your friends about the store. Did I mention that your hair looks great?

Nancy Reich. Photo from SBU

By Daniel Dunaief

Even as pharmaceutical companies are working furiously to produce a vaccine for COVID-19, scientists are taking other approaches that might lead to treatment for this disease or for other viruses that might threaten public health.

Nancy Reich, a Professor in the Department of Microbiology and Immunology at the Renaissance School of Medicine at Stony Brook University, and several colleagues at SBU recently received a $450,000 grant from the G. Harold and Leila Y. Mathers Foundation to pursue the laboratory study of two possible interventions.

Reich and her colleagues plan to investigate the use of interferon-lambda, which is in clinical trials for Hepatitis D virus, and an inhibitor for bradykinin called icatibant, which is approved for angioedema.

“Although we are very hopeful for a vaccine in the near future, vaccines can take months or years” to develop and use, Reich said. “The likelihood is that there will be more emerging diseases” which increases the need for broad spectrum first line defense therapeutics that might provide relief and save lives.

A few months ago, several faculty in microbiology and immunology got together on a Zoom call to discuss what they could do to combat COVID-19. The group was “very enthusiastic” about interferon, which is a natural hormone and is the only cytokine that’s antiviral. It has the ability to prevent the spread of the virus by reducing replication.

Reich will work with Patrick Hearing and Erich Mackow, who are both professors in the Department of Microbiology and Immunology, on the molecular aspects of COVID-19. Associate Professor Janet Hearing and Assistant Professor Hwan Kim are certified to work in high containment biosafety laboratories.

COVID-19 seems to have figured out how to block the action or production of interferon, Reich said, although the lower levels of the hormone haven’t been confirmed yet.

Other researchers are testing how the virus that has caused the pandemic has blocked the production of this defense mechanism. The Reich-led group is also planning to test this process.

To get protection from interferon, people would likely need an increased amount of the antiviral molecule early in the infection process, Reich said. She and her team are focusing on interferon lambda, which is a specific type that primarily affect epithelial cells, which are the type of cells that line the respiratory and digestive systems.

Interferon alpha and beta cause systemic problems, which can trigger an overactive immune system to cause a cytokine storm. This can lead to severe symptoms, if the body’s reaction is strong enough.

“Because interferon lambda is more specialized in the targets it hits, it doesn’t cause this crazy, global effect in your body,” Reich said.

At this point, Reich is looking to use a pre-clinical animal model of COVID-19 to understand the processes involved with the virus and its reaction to different concentrations of this hormone at different times after infection.

Reich has reached out to a company called EIGR Pharmaceuticals, which is the only company that produces a pegylated version of interferon lambda. By adding polyethlylene glycol, or PEG, EIGR can extend the time that the drug remains in the body, reducing the need for new doses.

The interferon lambda receptors are prevalent in hepatocytes, or liver cells. The liver is particularly important in capturing bacteria, viruses and macromolecules that might otherwise cause harm in the human body. The interest in the liver and interferon is mainly because of hepatitis viruses.

Interferon lambda’s higher specificity reduces potential side effects that other interferons trigger in the blood or in the central nervous system. EIGR has created this interferon to treat Hepatitis D.

“I have contacted [EIGR] to do some COVID work and now they are,” Reich said. “They have some clinical trials going on in the United States, Israel and Australia.” In addition to their research work with interferon lambda, the group will also study the effects of bradykinin, which is a small peptide hormone that the angiotensin-converting enzyme 2 (or ACE2) receptor inactivates.

The group is exploring the use of inhibitors for bradykinin, hoping to reduce a molecular trigger that exacerbates symptoms of the disease.

“We are taking two approaches; one is more about the symptoms, through bradykinin inhibition, and the other is trying to block virus replication,” said Reich.

In their research with interferon and inhibitors to bradykinin, Reich is hoping to generate data that will be ready within several months.

If both of the approaches proves effective independently, Reich said the next steps could involve combining them.

If the combination works better than either of the treatments alone, the researchers, and, down the road, the doctors, who might use this approach could use a lower dose of both drugs, which could reduce any potential side effects.

Reich said this research is possible at Stony Brook because it has a Biosafety Level 3.“We are able to do these experiments that others may not be able to do,” she said.

The animal facility that will house the mice for her studies is still not accepting new animals. Reich hopes they start to accept them in June.

Reich appreciated the speed at which the Mathers Charitable Foundation reacted to their request for funds.

The Foundation, which was created by a Santa Barbara, California couple who donated their wealth to research in 1983, made a decision within weeks, reflecting the urgency that the public health crisis triggered by COVID-19 has created.

Many foundations typically take six to eight months to decide on funding.

Reich appreciates that she and her colleagues will have a chance to contribute to a growing body of research about a virus that has caused close to 100,000 deaths in the United States and has disrupted billions of lives around the world.

“Everybody realizes the urgency,” Reich said.

Hundreds of protesters stand at the corner of Routes 112 and 347 in Port Jefferson Station Monday, June 1 to protest police violence, especially against people of color. Photo by David Luces

By Daniel Dunaief

Daniel Dunaief

Stepping outside of our homes presents risks. We could have a car accident on the way to work or a branch could fall on us, among myriad other potential dangers.

These days, the risks of leaving our homes have escalated. We could catch the dreaded coronavirus anywhere if we stand closer than six feet to anyone.

Nowadays, interactions that we engaged in all of our lives with friends and family, such as shaking hands or hugging, increase the risk of picking up the invisible enemy, bringing it to our home sanctuaries and infecting our partners, children, and parents.

We have learned to manage the risks we’ve now heard about for months by staying as far away from other people as we can and by wearing masks.

And yet, for some Americans, the risks of stepping outside of homes where we were hopefully safe most of the time, was clearly higher than it was for other Americans.

Indeed, the risks of dying from coronavirus differed by race. The age-adjusted death rate in Suffolk County for whites was 49.5 per 100,000 people, according to statistics from the Department of Health. For Hispanics on Long Island, that number is 108.7, which is more than twice the rate per 100,000 people. For blacks, the number is an astronomical 170.1 deaths per 100,000 people in the county, which is well over three times the rate for whites.

Those statistics generally track the disproportionate toll the virus has had on communities of color.

Now, layer on top of that the death of Minneapolis resident George Floyd. Seemingly at the worst possible time for our country, as businesses are just starting to reopen and as standing within 6 feet of each other increases the chance of our catching a virus that has claimed over 100,000 American lives, people are going outside in huge numbers across the country to express their outrage over Floyd’s killing at the seemingly indifferent hands of a white police officer who faces third-degree murder charges.

Those African-Americans who gather, at the risk of contracting an infection that has already wreaked havoc in their communities, are expressing anger and frustration at a justice system that appears anything but just.

The news coverage of the protests has often focused on the most explosive and terrifying events, where looting and setting fire to police cars and engaging in random acts of violence have occurred. Those shocking actions are inexcusable manifestations of those frustrations, turning justifiable disappointment into illegal acts. These moments also threaten to overshadow the message from so many others who would like to see constructive changes.

Many peaceful protestors, however, might have the same approach to the risks of joining others to protest Floyd’s murder that President Donald Trump (R) did to the notion of taking hydroxychloroquine, which may or may not reduce the health effects and dangers of COVID-19.

What, they might wonder, do they have to lose at this point?

The answer is not so simple, particularly as the risk of getting arrested, hit with a rubber bullet or vomiting from inhaling tear gas increases.

The dangers in stepping outside into a world filled with a virus that infects our bodies and cultural viruses that threaten the soul of the country are especially high in a year with overtones from the civil unrest of the 1960’s.

Peaceful protestors can and should demand and expect the kind of changes that will allow them and their children to step outside to a country where the risks from being out of their homes shouldn’t depend on the color of their skin.

Jennifer Keluskar. Photo from SBU

By Daniel Dunaief

In the second of a two-part series, Times Beacon Record News Media describes the clinical and research work of Jennifer Keluskar, a Clinical Professor in the Department of Psychiatry at Stony Brook University.

Keluskar and Matthew Lerner, an Associate Professor of Psychology, Psychiatry & Pediatrics (see last week’s paper), recently received a grant from the Office of the Vice President for Research & the Institute for Engineering-Driven Medicine to study the effects of COVID-19-induced social isolation on people with Autism Spectrum Disorder. 

Keluskar spends half her time working at the Outpatient Department of Psychiatry, Child and Adolescent Services, where she provides cognitive behavioral intervention and ASD diagnostic evaluations for youth with autism, and the other half working on the SB Autism Initiative.

The pandemic has challenged young people with autism, as they manage through social isolation and worry about an uncertain future. Many of Jennifer Keluskar’s patients are struggling, with some dreading the return to school in the fall and others grappling with the removal or change in a routine or structure.

Some of her clients have felt increased pressure to organize their time and be productive amid a lack of peer support and without the opportunities to model their performance based on interacting with other students at school.

Through modeling, some students take notes when they notice their classmates writing down concepts or ideas a teacher is sharing or gaining some measure of reassurance when they see that everyone is struggling with the work load.

“This latter point is particularly relevant given the novelty of this situation for teachers as well as the consequent likelihood that they will have trouble knowing how much work to give, especially given the wide variety” of circumstances at home, Keluskar explained in an email.

For some students with autism who have a measure of social-anxiety disorder, the remote learning environment has provided some measure of relief, reducing the difficulty in reading nonverbal cues from their classmates and teachers.

Now that these students are learning remotely, these “social stressors have been lifted,” Keluskar said.

Nonetheless, even the patients who have felt relieved about fewer anxiety-inducing social interactions are starting to develop concerns about a potential resumption of classes in the fall.

Keluskar has already seen some patients who are perseverating on that future upcoming transition. “We are going to see more of it in my clientele as we get closer to reopening schools,” she said, adding that she has some patients who are afraid of not being able to advance in life, to college or to jobs, but who, at the same time, are afraid of taking the next step after getting used to quarantine.

Jennifer Keluskar with her husband Raja, 5-year-old daughter Skylar and three-year-old son Colby.

Working with Alan Gerber, a graduate student in Matthew Lerner’s lab at SBU, Keluskar will assess responses to COVID-19. They have sent out two questionnaires. One, which was released by other researchers, examines how the pandemic has affected circumstances and behaviors, from employment changes to junk food consumption. The other is an evidence-based measure of parental stress that is not specific to the virus. She is going to measure anxiety and depression to see how they change during quarantine. 

Keluskar appreciates how the Initiative offers programs such as a homework club, which students can attend virtually for an hour each day. “I have connected some of my clients in the clinic to undergraduate mentors and so far this has been quite successful” although the scale of these connections has been small so far.

The Initiative currently has a mentoring program geared towards older adolescents. She is planning to offer this program to younger individuals.

Deborah Gross, the Initiative’s coordinator, runs a program called the Sidekicks Squad, which is for older adolescents and young adults with special needs.

“Some of my patients would benefit from pairing with a mentor,” Keluskar said. “Through these mentoring sessions, people with autism hang out with their mentors.”

Child-directed interpersonal time is “so important for people’s well being and development,” Keluskar explained, referring to both the mentor and the mentee.

She appreciates that this mentoring program is laid back and fun and believes that mentors benefit just as much from it as mentees.

Through the Initiative, the group has also done eight weekly, Facebook livestream events. The organizers discuss a topic and add three tips at the end. The tips have provided suggestions, including: using creativity to engage children by adding special interests into activities; taking a collaborative problem solving approach when running into difficulties getting a child to cooperate; and understanding emotional underpinnings to children’s behavioral difficulties.

Keluskar recognizes the challenge that come from having self-directed resources available to children and their parents. Even when people have access to many resources, they do not always know where to begin or what to prioritize, she said.

She advises a parents to try to get enough rest for themselves. “You need to take care of yourself so you can model [appropriate behavior] to your children,” she said.

Through the pandemic challenges, Keluskar also urges parents to be creative in their responses to the stressors that are affecting them and their children. She suggests people to take chances in how they approach their interactions with anxious children.

“You can’t be creative if you’re afraid of being wrong,” she said. “Being able to move past little mistakes shows flexible control. Set limits and be structured, but also be flexible at the same time.”

A resident of Commack, Keluskar lives with her husband Raja Keluskar, who is an engineer, their five-year old daughter Skylar and their three-year old son Colby.

Keluskar said she has been anxious about public speaking since she was young and can empathize with others who struggle with this. Through Facebook groups and other efforts, she said she can “personally attest to the value of multiple exposures and say that it can even become enjoyable with time and practice.”