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Daniel Dunaief

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Mice. Pixabay photo

By Daniel Dunaief

Daniel Dunaief

The English language makes no sense. As soon as you create a rule, exceptions crop up like mushrooms colonizing an open field.

Let’s start with the plural form of nouns.

“Add an ‘s’ and be done with it,” you might say. While that’s a simple solution, the language laughs in the face of such elegant simplicity.

Take the words “chief” and “thief.” Chief” becomes “chiefs” easily enough, as Kansas City football fans will readily tell you.

But then thief changes everything. The plural becomes “thieves,” as if someone robbed the word of its “f” and replaced it with something that sounds more vile and villainous.

The plural for hoof, as in the bottom of a horse’s foot, is hooves, but the acceptable plural for roof, which also only has one different letter way at the start of the word, is roofs. Yes, I know people say “rooves,” but that doesn’t make it accurate.

A root at the bottom of the tree that draws nutrients from the ground becomes roots. A single owl calling to another across the treetops utters a hoot. Several owls responding reply in hoots. So far, so good.

But then, what’s wrong with those things that are important for walking and that smell up a room when they sweat too much? How is it that foot, which also only differs in the initial letter, becomes feet?

Then there are the plural forms of animals. A mouse hunting for food with his rodent pals becomes mice, while a moose eating in a field with his family becomes, well, moose.

The moose, however, hasn’t cornered the market on words that describe an individual and a group. Deer, sheep, salmon and trout also don’t budge when switching from one to several. 

And why are the words for a group of animals different? Couldn’t they all be packs, herds, groups or schools?

Wolves banding together to hunt, live and howl form a pack. A family of giraffes is, fittingly, called a tower. That seems appropriate for animals that are born 6 feet tall.

But what about a collection of bears? They’re a sleuth, while a group of bats is a cloud.

One goose pooping on a field is inconvenient and messy, but is still a goose. Two of them are geese. A group of them walking on the ground is a gaggle, while those same birds in flight become a skein.

People often describe the challenge of bringing people together as akin to herding cats. While the verb is accurate, the name for a group of cats is not: they are a clutter, a glaring or a pounce, although numerous other words also describe a cat confab.

Now, more than one dolphin, those adorable marine mammals that make cool clicking sounds and perform at aquariums, becomes a school, which is also true of more than one fish, even though other marine mammals, such as walruses become herds or pods

When several ducks get together, they aren’t a flock, despite the fact that they are birds. They are a raft, perhaps reflecting the fact that they look like independent floats sitting on the water. Sea lions also become rafts when they’re together in the water.

Returning to those hooting owls, they become a parliament. Sure, that makes sense.

A group of hippos is called a bloat. While hippos average 3,310 pounds as an adult, the same word doesn’t apply to the larger elephant, which is part of a herd.

A number of crows is a murder, reflecting, perhaps, their ominous role in literature.

Penguins may take the word group crown, having a wide array of terms for them when they get together. A group is called a colony, rookery or huddles. It doesn’t end there. Swimming penguins, like ducks, are a raft. More likely than not, you might guess the name for walking penguins: they are a waddle.

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Markus Seeliger, third from left, with members of his lab, from left, Terrence Jiang. Aziz Rangwala, Ian Outhwaite, Victoria Mingione,YiTing Paung, and Hannah Philipose. Photo from Markus Seeliger

By Daniel Dunaief

When a dart hits the center of a target, the contestant often gets excited and adds points to a score. But what if that well-placed dart slipped off the board before someone could count the points, rendering such an accurate throw ineffective?

With some cases of cancer treatments, that’s what may be happening, particularly when a disease develops a mutation that causes a relapse. Indeed, people who have chronic myeloid leukemia typically receive a treatment called Imatinib, or Gleevac.

The drug works, hitting a target called a kinase, which this white blood cell cancer needs to cause its cells to continue to divide uncontrollably. Patients, however, develop a mutation called N368S, which reduces the effectiveness of the drug.

While mutations typically make it more difficult for a drug to bind to its target, that’s not what’s happening with this specific mutation. Like the dart hitting the center of a board, the drug continues to reach its target.

Instead, in a model of drug resistance several scientists have developed, the mutation causes the drug to decouple.

Pratyush Tiwary with this year’s US top 20 students who are going to the international chemistry olympiad. Photo from Toward

A team of experimental and computational researchers including Markus Seeliger, Associate Professor of Pharmacological Sciences at Stony Brook University, and Pratyush Tiwary, Associate Professor in the Department of Chemistry & Biochemistry at the University of Maryland, published two research papers explaining a process that may also affect the way mutations enable resistance to other drugs.

Seeliger described how different disease-associated mutations bind to Gleevac in a paper published in the Proceedings of the National Academy of Sciences. 

Working with scientists at Memorial Sloan Kettering Cancer Center and Goethe University in Frankfurt, Germany, Seeliger used nuclear magnetic resonance spectroscopy, or NMR. The researchers showed how the drug bound to its target and then released.

Understanding the way diseases like cancer develop such resistance could affect drug discovery, giving pharmaceutical companies another way to prepare for changes diseases make that reduce the effectiveness of treatments.

A ‘hot paper’

Tiwary published research in which Seeliger was a coauthor in late April in the journal Angewandte Chemie that the publication labeled a “hot paper” for its implications in the field. Tiwary developed a way to simulate the kinetic processes that enable the mutated kinases to release the drug.

Tiwary created an artificial intelligence model that extended the time he analyzed the drug-protein interaction from milliseconds all the way out to thousands of seconds.

“Even within the simulation world, if you can quantitatively predict a binding affinity, that’s amazing,” Seeliger said. “It’s extremely hard to calculate kinetics, and he got that right.”

Tiwary, who started talking with Seeliger about five years ago and has been actively collaborating for about three years, uses experimental data to inform the dynamics that affect his simulations.

Seeliger “had done the experiments of the dissociation rates beforehand, but did not have a way to explain why they were what they were,” Tiwary explained in an email. “Our simulations gave him insights into why this was the case and … insight into how to think about drugs that might dissociate further.”

Drug discovery

Tiwary hopes the work enables researchers to look at structural and kinetic intermediates in reactions, which could provide clues about drug design and delivery. While he worked with a single mutation, he said he could conduct such an analysis on alterations that affect drug interactions in other diseases.

He wrote that the computations, while expensive, were not prohibitive. He used the equivalent of 16 independent 64 CPUs for one to two weeks. He suggested that computing advances could cut this down by a factor of 10, which would enable the exploration of different mutations.

“The methods are now so easy to automate that we could run many, many simulations in parallel,” Tiwary explained. Machine learning makes the automation possible.

Given what he’s learned, Tiwary hopes to contribute to future drug begin that addresses mutation or resistance to treatment in other cancers. He also plans to continue to work with Seeliger to address other questions.

Next steps

Seeliger said he plans to extend this work beyond the realm of this specific type of cancer.

He will explore “how common these kinetic mutations are in other systems, other diseases and other kinases,” Seeliger said.

He would also like to understand whether other proteins in the cell help with the release of drugs or, alternatively, prevent the release of drugs from their target. The cell could have “other accessory proteins that help kick out the drug from the receptor,” Seeliger said.

The concept of drug resistance time comes from infectious disease, where microbes develop numerous mutations.

Seeliger, who is originally from Hanover, Germany, said he enjoys seeing details in any scene, even outside work, that others might not notice. 

He described how he was driving with postdoctoral fellows in Colorado when he spotted a moose. While the group stopped to take a picture, he noticed that the moose had an ear tag, which is something others didn’t immediately notice.

As for the research collaboration, Seeliger is pleased with the findings and the potential of the ongoing collaboration between experimental and computational biologists.

“The computational paper, aside from using interesting new methodology, describes why things are happening the way they are on a molecular level,” he said.

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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

I read bumper stickers, buttons, fortune cookies and messages on T-shirts. They are a form of poetry that captures a moment, an approach, an attitude, and a message in fewer words than some of the soupier birthday cards.

Like birthday cards, sometimes these messages work, are amusing, evoke a reaction, or make me laugh for intentional and unintentional reasons.

In the modern world, in which so many interactions seem less than optimal or contrary to the intentions, I have some suggested messages that reflect the current state of customer service and civility, or lack thereof.

— Please don’t interrupt. I’m in the middle of looking busy. When I started working many years ago, someone told me to balance between looking busy and being under control. She suggested I walk quickly and purposefully, even if just to the bathroom, to suggest that I’m too busy to tackle something new that might involve lots of administrative work.

— Yes, I am talking to you. Those of you old enough to have seen the Robert De Niro film “Raging Bull” will understand this one instantly. This message captures the prevalence of confrontations.

— I have no idea what’s good. I don’t eat here. Diners often ask waiters and waitresses, “what’s good.” More often than not, they tell people what’s popular dishes or their specials. The subtext here is that some of them don’t, can’t or wouldn’t eat where you’re eating, especially after spending considerable time in the kitchen.

— Everything and nothing is special today. Keeping with the dining theme, while blending in some grade inflation, waiters could provide something philosophical for their diners to consume.

— I believe in building suspense. The assignment, the job, or even the entree may be later than someone wanted. This message could suggest the tardiness was deliberate and was designed to enhance appreciation and add drama. So, you’re welcome.

— Sure, you can ask. I like the buttons people wear at Yankees games that encourage fans to ask a question. On a day when these customer service professionals are feeling tired or hung over, they could don messages that encourage people to move along or to figure out how to drive home to Pennsylvania from the Bronx on their own.

— How can I appear to help you? Life is all about optics. Yes, we should be helping and yes, people are paid to help each other, in person, on phone and on the Internet. Sometimes, the person (or artificial intelligence programs) that is offering assistance isn’t delivering much.

— I brought my own questions, thanks. I would love it if a politician wore this button to a debate. On one level, it could suggest the candidate has questions that are hopefully substantive for his or her opponent. On the other, it could be an honest way of acknowledging the disconnect between a question about the environment and an answer about the person’s commitment to family.

— What can you do for me? This is a way of turning the tables, literally, on a hostile or inappropriate customer. It also discourages people from asking too much of someone who is not eager to deliver.

— Is there anything else I can’t do for you? I’ve been on numerous calls with people who haven’t done anything, particularly when dealing with traveling details, who then ask if there’s anything else they can help me with. When they haven’t helped me with the first question, it’s hard to imagine they can help with a second. A more honest message might suggest that they also anticipate not being able to provide any help with a second problem or question.

— What did you get me for my birthday? People often want, or expect, something, even from strangers, on their birthday. They don’t often consider that the person from whom they expect service, help or extra treatment had a birthday they likely missed.

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Members of the CanCan team, from left,Oliver Maddocks, David Lewis, Johan Vande Voorde, Bette Caan, Marcus Goncalves, Eileen White, Mariam Jamal-Hanjani, Tobias Janowitz, Karen Mustian, Janelle Ayres andToni Hui

By Daniel Dunaief

If a team Cold Spring Harbor Laboratory Assistant Professor Tobias Janowitz co-leads succeeds, researchers will know more about the end stage of numerous types of cancer that involves the loss of tissue and muscle mass.

Tobias Janowitz

Recently, lead scientists Janowitz; Eileen White, Rutgers Cancer Institute of New Jersey Deputy Director and Chief Scientific Officer; and Dr. Marcus DaSilva Goncalves, Assistant Professor of Medicine at Weill Cornell Medicine received $25 million in funding as a part of a Cancer Grand Challenge, which is a combined trans-Atlantic funding effort between Cancer Research UK and the National Cancer Institute in the United States.

The cachexia group was one of four teams to receive funding among 11 finalists.

Bruce Stillman, president of Cold Spring Harbor Laboratory, described cachexia as “one of the most difficult clinical problems with late stage cancer.”

Stillman added that the collaboration is promising because it brings together a group of “remarkable” scientists, including White, who was a postdoctoral fellow in Stillman’s lab. “It has great potential for making a difference in the lives of patients.”

Stillman believes Janowitz is an ideal co leader for this challenging project because he has an MD and a PhD and is clinically certified as an oncologist.

CanCan team

For his part, Janowitz is looking forward to the opportunity to team up with other ambitious research efforts to create a virtual institute.

Eileen White

“It’s incredibly exciting to get the chance to do something you think is higher risk with a large group of people who have come together around this problem,” said Janowitz. “We often talked about how it would be nice to bring team members from other disciplines into this area.”

Indeed, the cachexia team, which White named CanCan for Cancer Cachexia Action Network believes cachexia is a tumor-driven metabolic imbalance. The group is pursuing different areas of research, including metabolism, neuroendocrinology, clinical research, and immunology, among others, to define clinical subtypes with the hopes of creating individualized therapies.

While the effort brings together a range of scientists with different expertise and technological skills, researchers don’t expect an immediate therapeutic solution within that time frame. Rather, they anticipate that their experiments and clinical data will help inform future approaches that could enhance efforts to prevent and treat a wasting disease that causes severe declines in a patient’s quality of life.

“What we would deem as a success is, if in five years time, we have maybe one to three strong lead hypotheses that comes out of our shared work on how we can either prevent or treat cachexia as it emerges,” Janowitz said.

The complexity of cachexia

Dr. Marcus DaSilva Goncalves

As a complex process that involves an understanding of numerous interconnected dynamics, cachexia has been a challenging field for researchers and a difficult one for funding agencies looking for discrete problems with definable results and solutions.

Cachexia research had “never reached this critical mass that people were seeing where we can say, ‘Okay, there’s enough work going on to really unravel this,’” Janowitz said.

The CanCan team has several scientific themes. Janowitz will be involved with metabolic dysregulation. He would like to understand the behavioral changes around appetite and food intake.

Additionally, the group will explore the interaction of normal cells and cancer cells by looking at the tumor micro environment. This research will explore how cancer cells can reprogram healthy host cells.

“We’ve got a really exciting axis of research” within the network, Janowitz said.

Searching for signaling molecules

Janowitz said Norbert Perrimon, James Stillman Professor of Developmental Biology at Harvard Medical School is one of the leading experts in fly genetics and fly biology. Perrimon has created a model of cachexia in the fruit fly. While that sounds far from patients, Perrimon can use single molecule resolution of the entire organism to get an insight and understanding of candidate molecules.

“We are hoping to search for new signaling molecules that might get involved” in cachexia, Janowitz said. Once the research finds new candidates, he and others can validate whether they also work in mouse models of cancer and cancer cachexia.

With numerous clinical groups, Janowitz hopes to contribute to the design and execution of experimental medicine studies.

The Cancer Grand Challenge will distribute the funds based on what members need. Janowitz described the allocation of funds as “roughly equitable.” He will use that funding to support a postdoctoral researcher, a PhD student and a technician, who can help with specific projects he’s merging in his lab to combine with the team effort.

The funds will also support his salary so he can supervise the work in his lab and help with the coordination of this effort.

The funding agencies have an additional budget to organize conferences and meetings, where researchers can discuss ideas in person and can ensure that any clinical and laboratory work is standardized and reproducible in different facilities.

Cold Spring Harbor Laboratory will host the first full gathering of the cachexia team in November.

Challenging beginnings

When he was a doctor in the United Kingdom, Janowitz was fascinated and confounded by cachexia. In the early years of his training, he saw patients who had a small tumor burden, but were so sick that they died. Those experiences made “such a strong imprint” that he wanted to help unravel this process as a junior oncologist, he said.

Getting funding was challenging because cachexia was complex and didn’t involve a finely defined project that linked a receptor protein to a cell type that led to a diseased condition.

Janowitz, among others in this field, felt passionate enough about this area to continue to search for information about cachexia. After he restructured his research into a narrower focus, he secured more funding.

An unsolved mystery

With enough researchers continuing along this path, Janowitz said the group developed an awareness that this is “one of the big, unsolved mysteries of cancer progression.”

Janowitz appreciates the opportunity to work with a team that has accomplished researchers who work in fields that are related or synergistic, but aren’t necessarily considered part of the cachexia field.

The significant funding comes with expectations.

“The grant is both a great joy, but also, essentially, a mandate of duty,” he said. “Now, you have to utilize this grant to make significant contributions to understand and hopefully treat this debilitating condition.”

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By Daniel Dunaief

Daniel Dunaief

We don’t usually go to bed thinking, “what if I’m wrong?” We don’t get up asking ourselves the same question.

We develop our beliefs, stick with them and, as time goes on, we defend them or push for change based on something we think, or are fairly certain, we know.

But it’s worth considering the possibility that we might be wrong, particularly in connection with something as important as the only habitable planet we know.

If you don’t believe climate change is a threat and you think rules restricting environmental pollution are unnecessary and a federal government overreach, have you considered the consequences of being wrong?

I won’t trot out all the climate science experts who have what they consider incontrovertible proof that the climate is warming based on years of data.

You’d probably come back with the argument that the data can be interpreted in other ways or that science itself rarely has complete certainty.

You might even suggest that a warmer climate would mean we wouldn’t need to use as much heat during the winter months and that some crops might grow better during a longer, hotter growing season.

While I don’t ascribe to those thoughts —which a headline grabbing Republican recently espoused — because of the danger to so many staple crops from a warmer season that could include droughts and storms that cripple cities and destroy crops, I want those who don’t believe climate change is real to consider what might happen if they are wrong.

At the time of this writing, the Supreme Court hadn’t ruled on West Virginia vs. Environmental Protection Agency. If the conservative majority, who have been reshaping the political and legal landscape at a rapid pace, rules as expected, the EPA will have less authority to regulate power plant pollution.

That would mean power plants won’t have to comply with federal rules that limit the gases they emit into the environment and the pollutants they send into the air.

These companies may be able to make more money by continuing to operate as they had in the past. Yay for them? Right? Well, not so fast.

What’s the risk if they are wrong? We all make decisions when weighing risks, whether it’s the types of stocks we invest in, the places we go that might be dangerous at night, or the undercooked foods we eat.

So, if they’re wrong, the world continues to heat up, storms such as hurricanes move more slowly, dumping more rain on any one area, crops get destroyed, glaciers continue to melt causing sea levels to rise, and biodiversity declines, wiping out species that might have otherwise led to cures for disease or provide future food sources.

Some areas also become uninhabitable.

Our children, grandchildren and future generations can’t come back to tell us who was right. What we do or don’t do, however, will undoubtedly affect them.

Using the same logic climate change deniers use to suggest that nothing is certain, it seems critical to hedge their bets, protecting us from a future they believe is possible but unlikely.

Even if the Supreme Court acts (or acted, depending on the timing) as expected, we don’t have to be fatalistic or cynical about the next steps in the battle against our own gaseous waste.

Utilities and other companies that produce these gases have to take responsibility for their actions, regardless of what the Supreme Court says or does. Even reluctant legislators have to consider what might happen if they are wrong. Yes, leaders have numerous other problems.

We can’t ignore the Earth. If some people consider the consequences of freeing up companies to send carbon dioxide into the only air we have, they might be making a one-way mistake. They must consider what will happen if they are wrong.

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Photo from Stony Brook Medicine

By Daniel Dunaief

[email protected]

While looking after the physical and mental well-being of patients who come in for care, Suffolk County hospitals are also focused on protecting staff, patients and visitors from the kind of violence that has spread recently throughout the country.

Over the past six months, hospital security staff and administrators have added a host of procedures to enhance safety and are considering additional steps.

“New measures have been put in place to minimize risk and better secure our buildings from a variety of threats,” Frank Kirby, Catholic Health Service line manager, wrote in an email. Catholic Health includes St. Catherine of Siena in Smithtown and St. Charles in Port Jefferson, among others.

“All Catholic Health facilities have an ‘active shooter’ contingency policy, which includes training for our employees on what to do in such an event,” Kirby wrote.

Executives at several health care facilities shared specific measures they have put in place.

The safe room

“Over the last six months or so, we have created something called the safe room,” said Dr. Michel Khlat, director at St. Catherine of Siena. Inside that room, hospital staff can hide and can find emergency items, like a door stop, medical supplies, gauze and first aid equipment.

St. Catherine recommends putting all the tables down in the safe room and hiding.

Khlat added that the hospital recommends that staff not open a door where another staff member knocks, in case a criminal is squatting nearby, waiting for access to the hospital.

Kirby added that Catholic Health facilities actively conducts drills across their hospitals, medical buildings and administrative offices to “sharpen our preparedness for any potential crisis that could impact safety and security.”

Catholic Health hospitals have onsite security guards and field supervisors who have prior military or law enforcement experience, Kirby added.

Northwell Health

As for Northwell Health, which includes Huntington Hospital, Scott Strauss, vice president of Corporate Security at Northwell, said the hospitals have an armed presence that includes many former and active law enforcement officers.

Strauss himself is a retired New York Police Department officer who, as a first responder on 9/11, rescued a Port Authority officer trapped by the fall of the World Trade Center.

Northwell is researching the possibility of installing a metal detection system.

Strauss suggested that the security program could not be successful without the support of senior leadership.

He suggested that staff and visitors can play a part in keeping everyone safe by remaining vigilant, as anyone in a hospital could serve as the eyes and ears of a security force.

The security staff has relied on their 15 to 35 years of experience to deescalate any potentially violent situations, Strauss said.

Northwell hospitals also offer guidance to staff for personal relationships that might
be dangerous.

“People don’t realize they’re in a poor relationship, they might think it’s normal,” Strauss said.

Across social media and the Internet, the communications team at Northwell monitors online chatter to search for anything that might be threatening.

“We evaluate it and notify the police as needed,” said Strauss.

Aggressive behavior

Strauss urged people who see something threatening online to share it with authorities, either at the hospitals or in the police force. “You can’t take a chance and let that go,” he said.

At this point, Northwell hasn’t noticed an increase in threats or possible security concerns. It has, however, seen an increase in aggressive behavior at practices and in
the hospitals.

In those situations, the security team investigates. They offer to get help, while making it clear that “threatening in any way, shape or form is not tolerated,” Strauss said. “There could be consequences” which could include being dismissed from the practice and filing police reports, Strauss said.

Anecdotally, Strauss believes Northwell has seen an increase in police reports.

When the draft of the Supreme Court’s decision that will likely overturn Roe vs. Wade, the landmark 1973 case that made it unconstitutional for states to restrict abortions, became public, Strauss was concerned about the potential backlash for health care providers.

So far, Strauss said gratefully, Northwell hasn’t seen any violence or threats related to the pending decision.

Stony Brook

Stony Brook University Hospital has an accredited and armed law enforcement agency on campus, in addition to a team of trained public safety personnel within the hospital, explained Lawrence Zacarese, vice president for Enterprise Risk Management and chief security officer at Stony Brook University.

Zacarese indicated that university officers are extensively trained in active shooter response protocols and are prepared to handle other emergency situations.

He added that the staff looks for ways to enhance security.

“Our training and security activities are continuous, and we are committed to exploring additional opportunities to maintain a safe and secure environment,” he explained in an email.

Kirby of Catholic Health Security suggested that hospitals do “more than provide care for surgical and medical inpatients. They also need to guarantee safety for all who enter our grounds.”

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Courtney Trzckinski, above, is an EMT in Port Jefferson and St. James and is a rising senior at Stony Brook University who recently took Medical Spanish. Photo by Stephanie Merrill

By Daniel Dunaief

[email protected]

As medicine becomes increasingly personalized, Stony Brook University Hospital is planning to provide the kind of personal services and connections that they hope will benefit the Hispanic population.

With people identifying as Hispanic in Suffolk County representing 19.6% of the total population, SBUH is building a Hispanic Heart Institute, which the hospital anticipates will open in the fall.

At the same time, undergraduates at SBU have had an opportunity to take two new courses in Spanish Medicine that focus on the language and culture of health care for a population whose background, experience and expectations often differs from that of a New York system.

“A patient who is addressed in their own language, even though a speaker is not necessarily fluent or proficient, enhances the experience greatly,” said Elena Davidiak, lecturer at the Department of Hispanic Languages and Literature at Stony Brook University. Davidiak teaches two Spanish Medicine classes at Stony Brook that she created for the university.

At the same time, Dr. Jorge Balaguer, associate professor of Surgery at the Renaissance School of Medicine, plans to create a Hispanic Heart Program that fills an unmet need to help cardiac patients of Hispanic descent learn about insurance, understand their medical options, and increase their connection with their health care providers.

The incidence of some forms of cardiovascular disease, which is the leading cause of death among the overall population, is even higher among Hispanics, according to a website created by Stony Brook that describes heart disease among Hispanics and Latinos.

For many people whose first language is Spanish or who come from a family with a strong Hispanic cultural identity, the connection to the health care system may be tenuous, making it difficult to navigate through the system, find the best care or advocate for their needs.

“There is a lack of follow up,” Balaguer said. “The whole health care maintenance is compromised. When you combine a [different] education, with a vulnerable situation, the Hispanic population doesn’t have the same medical safety net.”

Balaguer would like to add a full-time employee in the cardiology department who could answer questions in Spanish, help with insurance and various forms and field questions throughout the process of receiving heart-related care.

Cultural differences

Beyond the language barrier that could impede communication with Spanish-speaking patients, Balaguer and Davidiak suggested cultural differences could also affect the outcome of a medical interaction.

As an example, Balaguer suggested a general cultural phenomenon in Argentina where people don’t speak directly about the patient.

Rather, he said, the process of communicating is similar to the Billy Crystal, Robert DeNiro movie “Analyze This,” in which DeNiro’s character talks about a “friend” when he’s describing himself.

“You talk about someone else rather than the patient with the problem,” Balagauer said.

Hispanic patients sometimes have their own views on health care and their destiny, Davidiak said. Using the Spanish word “fatalismo” for fatalism, Davidiak described how some patients may believe their destiny is “somewhat predetermined.”

Health care providers need to take into account a patient’s beliefs, which affect the partnership between patient and doctor in developing an effective treatment plan.

In most American medical interactions, the culture is “businesslike and to the point,” Davidiak said. Many Hispanic cultures, however, expect a “warmup period,” which involves a more personal interaction.

In developing an interview project called “Understanding the Hispanic Patient” funded by the Faculty of Arts, Humanities and Social Sciences at SBU, Davidiak heard numerous anecdotes in which people of Hispanic origin felt that their doctors didn’t see or hear them.

In one such interview, a pediatrician said a son’s eye color, which was blue, would change because “all Latino people have dark eyes.”

The mother, who was sitting in the room, has blue eyes.

“She felt she was not being seen at all,” Davidiak recalled. She wondered if the doctor was “going to do the same thing when taking care” of her son.

Class lessons

Courtney Trzcinski, a junior majoring in health science, was a student in Davidiak’s Medical Spanish class.

An emergency medical technician in Port Jefferson and St. James with plans to be a physician assistant, she has had patients as an EMT with whom she struggled to communicate.

Trzcinski, who studied Spanish from 8th to 11th grade at Mattituck High School, recounted an incident in which she was responding to a woman who was having medical complications after she had her tonsils removed.

“I was trying to tell her to breathe in through her nose and out through her mouth,” Trzinski said. Her Spanish didn’t match the need.

“Now that I’ve taken Medical Spanish, I know how to say ‘inhale,’ ‘exhale,’ ‘medications’” and other relevant terms, Trzcinski said.

A direct translation, she discovered, also doesn’t work, as the people she interacts with translated what she said literally.

Trzcinski, who has been an EMT for two years, said she feels more confident in interacting on the job in Spanish.

Volunteers welcome

As for the heart program, Balaguer is thrilled to have the support of Leshya Bokka, a rising second-year medical school student who is also earning her master’s in public health.

Bokka sees the Hispanic Heart Program as a “great way to bridge my interest in working with minority populations and trying to get involved in doing some things for the community.”

Coming from a family that immigrated from India, Bokka understands the language and cultural barriers that might prevent people from getting quality health care.

“We are also trying to set up health screenings to connect patients to our program,” she said. She urged residents to reach out by email to receive directional guidance at [email protected].

The program is trying to recruit medical students and anyone “willing to come help,” she said.

Balaguer said he is working with recruiting bilingual volunteers and Hispanic Language and Literature students with advanced command of the language for internships in the program. These volunteers could serve as Hispanic patient concierges, among other roles. 

Bokka recognized that this kind of service could be valuable to other underserved populations as well.

“The health care system is incredibly complex and cryptic and confusing,” Bokka said. “Everyone could benefit from having a service like this to guide them.”

She said she hopes this becomes a framework for other departments and that other communities can also forge a language and cultural connection.

The goal is to “make patients more comfortable when they’re in a hospital,” Bokka said, which can be scary, expensive and confusing. The program wants to make sure people can “voice their concerns and walk away with care that works.”

Measuring success

The Hispanic Heart Program will measure its success in a host of ways. The hospital can compare the number of Hispanic patient visits to the hospital and in outpatient clinical settings during the first trimester after launching the program compared with earlier periods, Balaguer said.

It will also compare the number of procedures done on patients.

Through surveys, the hospital can determine patient satisfaction with the Hispanic Patient Concierge program.

The hospital can also determine the number of patients who obtain insurance.

On a financial level, the hospital can determine if the patients in the program provide profits and losses, while also factoring in donations and grants.

As for students, the program can consider the academic production of students who contribute to this effort as a part of their education.

Balaguer believes that these efforts will “help mitigate disparities” in health care.

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A view of Shinnecock Bay. Photo by Christopher Paparo/Fish Guy Photos
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A view of Shinnecock Bay. Photo by Christopher Paparo/Fish Guy Photos
Maria Grima holding an invasive European green crab from Shinnecock Bay. Photo by Leeanne Dion
A squid from Shinnecock Bay. Photo by Sara Cernadas-Martin
Konstantine Rounto
Konstantine Rountos with students.
Konstantine Rountos with St. Joseph's University students before going out on a trawl. Photo from Rountos
Brown tide before the restoration on Shinnecock Bay started in 2012. Photo from Chris Gobler
Clearnose skate from Shinnecock Bay. Photo by Sara Cernadas-Martin
Maria Grima. Photo by Sara Cernadas-Martin
Ellen Pikitch with sea horses from Shinnecock Bay. Photo from SBU
A summer flounder. Photo by Christopher Paparo/Fish Guy Photos

By Daniel Dunaief

The Galapagos Islands, the Great Barrier Reef, Little Cayman and … Shinnecock Bay? Yes, that’s correct, the 40 square kilometer bay located on the southern end of Long Island recently joined a distinguished list of celebrated marine locations identified by Mission Blue, a non-profit international organization led by famed marine biologist Sylvia Earle.

Mission Blue named Shinnecock Bay a Hope Spot, one of 132 such locations in the world that it considers critical to the health of the ocean.

Shinnecock Bay has the distinction of being the only Hope Spot in New York State, the only one near a major city and one of three on the Eastern Seaboard.

“The idea that you could have a Hope Spot so close to a major metropolitan area is pretty significant,” said Ellen Pikitch, Endowed Professor of Ocean Conservation Science at Stony Brook University and the School of Marine and Atmospheric Sciences and Director of the Institute for Ocean Conservation Science.

The designation by Mission Blue not only puts Shinnecock Bay in elite environmental company, but it also completes a comeback story driven by scientists, their students, numerous volunteers, and other supportive groups.

“The point of Mission Blue designating this place a Hope Spot isn’t only to bring more people and attention to Shinnecock Bay,” said Pikitch, but is also to “send the message of hope that we can turn things around.”

Pikitch, Christopher Gobler, Endowed Chair of Coastal Ecology and Conservation at the School of Marine and Atmospheric Sciences, and Bradley Peterson, Associate Professor at Somas, led the efforts at the bay.

The scientists created clam sanctuaries in the Western Shinnecock Bay with strict no take rules for people, which helped jump start the restoration. The clams helped meet natural filtration goals.

The researchers also helped restore eelgrass, also called seagrass, which is a more effective natural way to sequester carbon per square inch than the rainforest.

Between 1930 and the start of the project in 2012, New York State had lost about 90 percent of its eelgrass. A task force projected that eelgrass would be extinct in the Empire State by 2030. The bay now has about 100 more acres of eelgrass than it had in 2012.

These efforts have created a “huge leap in the number of forage fish” including bay anchovies and menhaden, said Pikitch, who studies forage fish. “The bay is in a much healthier place now that it was when we started,” she added.

Tough beginnings

Indeed, in 2012, parts or all of the bay had to close because of brown or red tides. The tides sometimes “looked like coffee spilled across the entire bay,” Pikitch said.

The steps the researchers took to improve water quality took some time. “Harmful algal blooms didn’t disappear right away,” Pikitch said. “As the study progressed, the amount of time brown tides occurred got shorter and shorter. Ultimately we stopped seeing brown tides several years ago.”

Red tides, which can cause paralytic shellfish poisoning that could be fatal to people, had also been a problem in Shinnecock Bay. Nearly half the bay was closed to shellfishing in 2011, 2014, and 2015. In 2017 and 2028, about 1/4 of the bay was closed due to red tides. Since 2019, however, red tides haven’t threatened the bay.

On the water

Throughout the restoration process, scientists in training and volunteers contributed to various efforts. Konstantine Rountos, Associate Professor of Biology at St. Joseph’s University in New York, earned his Master’s and PhD and conducted his post doctoral research at Stony Brook University. He also served as the lead research scientist for the Shinnecock Bay Restoration Program trawl survey from 2012 to 2016. 

Rountos called the designation “remarkable and extremely exciting.” When he started working on the bay in 2005 as a Master’s candidate, he saw stressors such as eelgrass declines.

“Not only was the ecosystem showing signs of collapse (decreased seagrass, decreased hard clams, increased harmful algal blooms), but the Bay was supporting fewer and fewer baymen,” he said. The Long Island “cultural identity of ‘living off the bay’ was in serious danger.”

Rountos believes people often overlook the significant ecological importance of this area, driving past these environmental and ecological treasures without appreciating their importance. 

Amid his many Bay memories, he recalls catching a seven-foot long roughtail stingray. “It was very surprising to pull that up by hand in our trawl net,” he said.

A veteran of the bay since 2016, Maria Grima spent time on Shinnecok as an undergraduate at Stony Brook and more recently for her Master’s training, which she hopes to complete this August.

Grima has been studying the invasive European green crab that shreds eelgrass and consumes shellfish such as clams, oysters and mussels. In a preliminary analysis, the population of this crab has declined. Grima noted that it’s difficult to prove cause and effect for the reduction in the number of these crabs.

Rather than pursue a potential career in medicine, which was her initial focus when she arrived at Stony Brook, Grima decided to focus on “fixing the environmental issues that cause human health problems.”

She is “really proud that Shinnecock Bay” achieved the Hope Spot designation. 

One of her favorite Bay memories involves seeing an ocean sunfish, which is a distinctive and large fish that propels itself through water with its dorsal and ventral fins and is the world’s largest bony fish. Seeing the biodiversity on a bay that has had historically poor water quality “gives you hope when you’re on the boat,” Grima said.

When friends and volunteers have joined her on the Bay, she has delighted in watching them interact with seahorses, which “wrap their little tail around your finger.”

Looking toward the future

While Pikitch is pleased with the designation, she said the work of maintaining it continues.

“We can’t rest on our laurels,” she said. “Continued construction on Long Island’s East End and the growing threat of climate change may require additional restoration work. We need to keep a close eye on what is happening in Shinnecock Bay and be ready to take action if necessary.”

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The White House. METRO photo

By Daniel Dunaief

Daniel Dunaief

Dear President Biden,

In an ideal world, everyone would be rooting for you. After all, as the leader of the country, your success is our success.

That’s certainly how the late George H.W. Bush (41, not 43) felt when he left a supportive note for Bill Clinton, the politician who defeated him.

We don’t live in that world. People are actively rooting against you, many of them American and many of them eager for power, influence and opportunity. Against that backdrop, I’m sure it’s challenging to get out in front of any story or narrative. You can’t control gas prices, right? You can’t control the weather, the global economy, the war in Ukraine or anything else that’s casting a pall over the nation and the world.

And yet, your job requires a certain level of messaging, communicating and leadership. You might not feel you can do much about the litany of problems you face — Republicans won’t let you, inflation is cutting everyone’s pay, and Covid continues to make people sick.

But here’s the thing: you need to get out in front of something. You need to step up and tell us how things will get better. We want to believe you because everyone wants happier days.

That starts with you. In the midst of some heated tension with the Soviet Union, Ronald Reagan offered the country the kind of reassurance that you haven’t provided. Despite the collection of nuclear missiles pointed at us, Reagan suggested that we were safe and should sleep well.

Look, I get it. People pounce on every syllable you say that might be a bit hard to follow. You’ve had a long history of verbal gaffes. But you can’t let fear of saying the wrong thing keep you from saying anything. Americans see you periodically, but you rarely tell us anything memorable or offer us a digestible helping of hope.

Your administration as a whole seems to be following your lead. No one in your cabinet has given us the sense that things will get better soon or, for lack of a better phrase, “you got this.” You have the largest bully pulpit in the world. The press follows your every move. Use that to your advantage. Seize the narrative. Give us a Project Hope or a positive message. Celebrate Americans doing good for their country.

The talking heads on both sides have given Americans an enormous dose of anger every day. It’s become an outlet for their energy and a way to keep Americans glued to their screens, waiting for the latest outrage and the newest opportunity to be disgusted by the other side.

When you ran for office, you assured us that we would return to normalcy and that you’d bring some measure of civility and decency back to the oval office. Here we are, the clock is ticking, and the anger machines from our two parties are in full gear.

Show the kind of leadership the situations demand. You don’t have to solve everything at the same time, but give us a regular update or an idea of what you know will work.

We need you to show us you have ideas we can support and that you have a plan you’re putting into action.

I understand your plan is to run for office in 2024. Why? How would that help the country? We know Republicans in the house, outraged on behalf of the two impeachments of your predecessor, may launch a host of investigations into you and your son if, as expected, they take the majority in the upcoming midterms.

When that process starts, being angry and outraged will only throw your own fury on the fire. We, and you, need positive and effective leadership now. Talk to Americans, share your plan for a better today and tomorrow. We need you to succeed. While what you’ve done so far might be undervalued and undercovered, we need visible wins. Break this pattern and give us reasons to believe in you and in the future.

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In left photo, Zhiyang Zhai, on the right, with John Shanklin and Jantana Keereetaweep; in right photo, Zhiyang Zhai with Hui Liu. Photos courtesy of BNL

By Daniel Dunaief

In a highly competitive national award process, the Department of Energy provides $2.5 million to promising researchers through Early Career Research Funding.

Recently, the DOE announced that Zhiyang Zhai, an associate biologist at Brookhaven National Laboratory, was one of 83 scientists from around the country to receive this funding.

“Supporting talented researchers early in their career is key to fostering scientific creativity and ingenuity within the national research community,” DOE Office of Science Director Asmeret Asefaw Berhe, said in a statement.

Zhai, who has worked at BNL for 11 years, is studying a signaling protein called Target Of Rapamycin (TOR) kinase, which is important in the plant and animal kingdom.

He hopes to develop a basic understanding of the way this kinase reacts to different conditions, such as the presence of carbon, to trigger reactions in a plant, including producing oils through photosynthesis or making seeds.

Zhiyang Zhai. Photo from BNL

“Ancient systems like this evolve in different lineages (like plants and animals) to work differently and [Zhai] wants to find out the details of how it works in plants,” John Shanklin, chair of BNL’s Biology Department, explained in an email. 

Zhai is trying to define which upstream signals interact with TOR and what the effects of those interactions are on TOR to learn how the kinase works.

He is hoping to get a clear idea of how different nodes interact and how signaling through carbon, nutrients and sunlight affects TOR kinase levels and its configuration.

Researchers may eventually use the knowledge of upstream regulators to reprogram responses by introducing enzymes that would cause the synthesis, or degradation, of upstream regulatory metabolites, Shanklin suggested.

This could be a way to “tune” the sensor kinase activity to increase the synthesis of storage compounds like oil and starch.

In the bigger picture, this type of research could have implications and applications in basic science that could enhance the production of renewable resources that are part of a net-zero carbon fuel strategy.

The DOE sponsors “basic science programs to discover how plants and other organisms convert and store carbon that will enable a transition towards a net zero carbon economy to reduce the use of fossil fuels,” Shanklin said.

In applying for the award, Zhai paid “tremendous attention” to what the DOE’s mission is in this area, Shanklin said. Zhai picked out a project that, if successful, will directly contribute to some of the goals of the DOE.

Through an understanding of the way TOR kinase works, Zhai hopes to provide more details about metabolism.

Structure and function

Jen Sheen, Professor in the Department of Genetics at the Harvard Medical School, conducted pioneering work on how TOR kinase regulates cell growth in plants in 2013. Since then, TOR has attracted attention from an increasing number of biologists and has become “a hot and rapidly-developing research direction in plant biology,” Zhai explained.

He hopes to study the structure of TOR using BNL’s Laboratory of Biomolecular Structure at the National Synchrotron Lightsource II.

Zhai, who hopes to purify the plant version of TOR, plans to study how upstream signaling molecules interact with and modify the structure of the enzyme.

He will also use the cryo-electron microscope to get a structure. He is looking at molecular changes in TOR in the presence or absence of molecules or compounds that biochemically bind to it.

Through this funded research, Zhai hopes to explain how signals such as carbon supply, nutrients and sunlight regulates cell growth.

Once he’s conducted his studies on TOR, Zhai plans to make mutants of TOR and test them experimentally to see if a new version, which Zhai described as “TOR 2.0,” has the anticipated effects.

Zhai is building on his experience with another regulatory kinase, called SnRK1, which is involved in energy signaling.

“His expertise in defining SnRK1’s mechanism ideally positions him to perform this work,” Shanklin said.

At this point, Zhai is focused on basic science. Other researchers will apply what he learns to the development of plants for commercial use.

A seminal moment and a call home

Zhai described the award as “very significant” for him. He plans to continue with his passionate research to explore the unknown.

He will use the funds to hire new postdoctoral researchers to build up his research team. He also hopes this award gives him increased visibility and an opportunity to add collaborators at BNL and elsewhere.

The funding will support part of Zhai’s salary as well as that of his staff. He will also purchase some new lab instruments and tap into the award to attend conferences and publish papers.

When he learned he had won the award, Zhai called his mother Ruiming, who lives in his native China. “She is so proud of me and immediately spread the good news to my other relatives in China,” Zhai recalled.

When Shanklin spoke with Zhai after the two had learned of the award, he said he had “never seen Zhai look happier.”Shanklin suggested that this is a “seminal moment” in a career that he expects will have other such milestones in the future.

A resident of Mt. Sinai, Zhai lives with his wife Hui Liu, who is a Research Associate in Shanklin’s group specializing in plant transformation, fatty acids and lipidomics analysis.The couple has two sons, nine-year-old Terence and three-year-old Steven.

As for his work, Zhai hopes it has broader implications.

“The knowledge of TOR signaling will provide us [with] tools to achieve hyperaccumulation of lipids in plant vegetative tissues, which is a promising source for renewable energy,” he said.

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