Metabolic Syndrome and Stroke Risk

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To evaluate the association between ischemic stroke and metabolic syndrome, DeBoer and Gurka reviewed more than 13,000 participants in prior studies and their stroke outcomes. Among that group, there were 709 ischemic strokes over a mean period of 18.6 years assessed in the studies. (Ischemic strokes are caused when blood flow to the brain is obstructed by blood clots or clogged arteries. Hemorrhagic strokes, on the other hand, are caused when blood vessels rupture.)

DeBoer developed the scoring tool, an online calculator to assess the severity of metabolic syndrome, with Matthew J. Gurka, PhD, of the Department of Health Outcomes and Biomedical Informatics at the University of Florida, Gainesville. The tool is available for free at https://metscalc.org/.

Journal Reference: Mark D. DeBoer, Stephanie L. Filipp, Mario Sims, Solomon K. Musani, Matthew J. Gurka. Risk of Ischemic Stroke Increases Over the Spectrum of Metabolic Syndrome Severity. Stroke, 2020; 51 (8): 2548 DOI: 10.1161/STROKEAHA.120.028944

This online calculator can predict your stroke risk

Presented with the following caveat:

I tried the calculator but I’m not quite sure how useful it will be in clinical settings.  As far as insurance underwriting is concerned I probably won’t use it.

The Implosion of Freelance Work

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I live in LA, and the article is really about people who work in entertainment/media — every tv show, commercial, music video and movie is the result of anywhere from a few dozen to hundreds of people who work for the run of the project, then move on to another project. It’s everything from the building trades – carpentry, electrical, rigging/framing – to business services — legal, accounting, HR – to tech heavy work – video/sound editing — and finally, a lot of musicians — people who write and play the music you hear. All of these people are employees of the production, not AB5 type gig workers.

It’s a lifestyle/career choice and not for everyone. People hustle, build relationships and are always on the lookout for the next gig. But the work has been steady for decades, and then very suddenly the whole sector shut down hard.

Los Angeles Hit Hard by Implosion of Freelance Work

 

The pandemic has only exacerbated tenuous financial conditions for many in the flexible workforce.  According to a survey of more than 1,100 U.S.-based respondents interested in flexible work, more than half (53%) of people are currently earning half or less of their pre-pandemic income. Approximately one-third (31%) of respondents have lost their entire income since the pandemic started. This survey was conducted by FlexJobs, fielded in partnership with Prudential (1), in late June 2020.

Demographic breakdown of the 1,100 U.S.-based respondents interested in flexible work. Gender: female (81%), Male (17%) Prefer not to identify (2%) Ages: 20-39 (29%), 40-59 (53%), 60+ (18%); Education: high school degree or equivalent (4%), some college but no degree (15%), associate or bachelor’s degree (48%), graduate degree (33%); Career level: entry-level (11%), experienced (56%), manager (21%), senior level or higher (12%). Household income: Less than less than $50,000 (35%), $50,000 to less than $75,000 (18%); $75,000 to less than $100,000 (17%), $100,000 to less than $150,000 (17%), $150,000+ (13%). 34% of respondents were unemployed and looking for work.

Survey Finds 53% Earning Half Or Less Of Their Pre-COVID-19 Income

As a former freelancer my heart goes out to all of the gig workers whose lives have been upended by the pandemic.  I transitioned back to the world of W-2 work quite some time ago and haven’t regretted the move.

Meanwhile in Georgia…

“I think quite honestly this week went real well other than a couple of virtual photos,” Gov. Brian Kemp said at a news conference with the U.S. surgeon general.

Georgia governor: School openings going well except photos of crowded hallways

3rd Cherokee County school closes due to new COVID-19 cases

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FDA Approval – SalivaDirect

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The Food and Drug Administration on Saturday authorized emergency use of a new and inexpensive saliva test for Covid-19 that could greatly expand testing capacity.

The new test, which is called SalivaDirect and was developed by researchers at the Yale School of Public Health, allows saliva samples to be collected in any sterile container. It is a much less invasive process than the nasal swabs currently used to test for the virus that causes Covid-19, but one that has so far yielded highly sensitive and similar results. The test also avoids a key step that has caused shortages of chemical reagents used in other tests.

The research team validated SalivaDirect in part by testing NBA players, coaches, and staff, and Yale said the test is now being studied in asymptomatic people through the program with the NBA and its players union.

FDA clears saliva test for Covid-19, opening door to wider testing

Get tested and wear a mask.

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To understand why this is a potential game changer this article on rapid screening tests.

First, frequent testing catches the vast majority of cases. Someone who is infected but gets a false-negative and slips through the cracks is likely to be caught the next time they’re tested. For a test that misses 20% of positive cases, the chance of an infected person getting two false negatives in a row may be as low as 4%. It’s like bailing a boat with a leaky bucket: You just have to bail more quickly to get the job done.

Second, most people who get false-negative results are unlikely to be contagious. Antigen-based screening tests are good at detecting the high virus levels needed to be contagious. By design, screening tests sacrifice accuracy where it matters least to achieve low costs, speed and ease of use.

AND I learned that the SalivaDirect test was funded by the NBA.

“My goal is not to test athletes,” Grubaugh said. “That’s not my target population. My target population is everybody. There were concerns about partnering with the NBA when all these other people need testing. But the simple answer ended up being the NBA was going to do all this testing anyway, so why not partner with them and try to create something for everyone?”

The NBA, Yale and the players’ association do not intend to take royalties from any use of the testing method, Grubaugh and others said. The NBA and union contributed more than $500,000 combined to fund the Yale work, sources told ESPN.

Saliva-based coronavirus test funded by NBA, NBPA gets emergency authorization from FDA

COVID Isolation and Anxiety Reinforce Eating Disorders

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In March and April, the National Eating Disorders Association (NEDA) saw a 78% increase in messages sent to its helpline compared with the same period last year.

Dr. John Morton, medical director of bariatric surgery for Yale New Haven Health System, says he’s seeing patients via telehealth who have gained up to 30 pounds recently. He says it can happen within months.

In addition to a confidential and toll-free helpline, NEDA has created a list of free or low-cost resources related to eating disorders: https://www.nationaleatingdisorders.org/help-support/covid-19-resources-page.

COVID Isolation, Anxiety ‘Really Reinforce’ Eating Disorders

Georgia Health News © 2020

Citation: Judi Kanne. COVID Isolation, Anxiety ‘Really Reinforce’ Eating Disorders – Medscape – Aug 13, 2020.

The article focuses mainly on anorexia and bulemia but the quote from Dr. Morton caught my eye.  A 30 pound weight gain in a few months is pretty substantial.  I start to panic after a pound or two.  But if you lose 200 pounds and keep it off you tend to overreact  if the scale shows your weight creeping up.

My pandemic weight journey (so far) has been about taking a few of those stubborn pounds off.  I started the year at 192.  This morning I was 179.  There has to be more happy weight loss stories out there.  The article also didn’t mention anything on Orthorexia Nervosa.  I worry about those people too.

 

Trends in excess mortality associated with atrial fibrillation over 45 years (Framingham Heart Study)

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Conclusions

We found no evidence of a temporal trend in hazard ratios between newly diagnosed atrial fibrillation and all cause mortality. The hazard ratios for non-cardiovascular death declined over time but no evidence of a temporal trend for cardiovascular death was found. Mortality associated with newly diagnosed atrial fibrillation remained high compared with individuals without atrial fibrillation, despite showing some improvements over the past 45 years. More than 10 years after a diagnosis of atrial fibrillation, individuals with atrial fibrillation lose about two years of life compared with matched referents.

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2724 (Published 11 August 2020)

Cite this as: BMJ 2020;370:m2724

Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020

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The survey results are in line with recent data from Mental Health America, which indicate dramatic increases in depression, anxiety, and suicidality since the start of the COVID-19 pandemic.

Citation: Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: http://dx.doi.org/10.15585/mmwr.mm6932a1external icon.

 

 

COVID-19 Cases in Children Up 90% in Four Weeks

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Screenshot_2020-08-13 COVID-19 Cases in Children Nearly Doubled in Just 4 Weeks

The joint report from the AAP and the Children’s Hospital Association draws on data from state and local health departments in 49 states, New York City, the District of Columbia, Puerto Rico, and Guam.  The cumulative number of COVID-19 cases in children as of Aug. 6, 2020, was 380,174, and that number is 90% higher – an increase of 179,990 cases – than the total on July 9, just 4 weeks earlier, the two organizations said in the report.

Yikes!

Aspen Market – Report July 2020 – the Great Urban Exodus

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6 Bedrooms / 7 Full Baths / 2 Half Baths / 7,489 SF
$4,299,000 — EXTREMELY well priced at $575./sq ft
Extremely well priced relative to Aspen proper.  The most recent highest Sale in Aspen was $27,000,000 or $3090/sq ft for a 7-bedroom home on Willoughby Way built in 2015.
Aspen 072020

 

The real estate market is booming! Demand has reached unprecedented levels as people escape the big cities, take advantage of record low interest rates and opt to work remotely. This was the biggest July our market has ever seen by far with 42 closings in Aspen and Snowmass, a 100% increase compared to last July, and dollar volume increased 215%. July sales for Aspen and Snowmass combined are illustrated below.

The local realtor’s email contains tons more information and data on her real estate market.  Her email was forwarded to me from my project who lives and works in the Aspen area.  If I could get $3090/sq ft for my house I’d get $11,124,000!  (minus realtor commissions).

Time to reread Jane Jacobs’ Life and Death of American Cities.

 

Two-layered polypropylene mask doubly better than a single-layered cotton mask, study finds — Science Chronicle

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While fitted N95 masks allowed zero droplets to pass through, the three-layered surgical masks too performed very well with 0-10% droplet transmission. N95 masks with exhalation valve fared poorly. Double-layered cotton masks were better that single-layered ones. Finally, the efficiency of N95, surgical masks and 12 other masks made of different materials to reduce droplet […]

via Two-layered polypropylene mask doubly better than a single-layered cotton mask, study finds — Science Chronicle

Screenshot_2020-08-02 1-OSDH-Sign-General-Safety-4key-8 5x11-ENG pdf Powered by Box

Many Children With COVID-19 Present Without Classic Symptoms

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“I was not surprised by the finding that most children did not present with the classic symptoms of COVID-19 in adults based on other published studies and my personal clinical experience taking care of hospitalized children in New York City,” said Dr. Lee. “Studies from the U.S. and other countries have reported that fewer children experience fever, cough, and shortness of breath [compared with] adults, and that most children have a milder clinical course, though there is a small percentage of children who can have severe or critical illness,” she said.

  Many Children With COVID-19 Present Without Classic Symptoms

Tiny human disease vectors.

Yikes!