Monthly Archives: March 2022

C-PAPs do not help A-Fib, and seem to make heart health worse.

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In this blog-post, I’d like to report on the first random study of patients with Atrial fabulation, A-Fib, and sleep apnea, comparing the health outcome of those who use a C-PAP, a “Continuous Positive Airway Pressure” device, to the outcome those who do not. The original study was published in May, 2021 (read it here) in the American Journal of Respiratory and Critical Care Medicine. The American Journal, Pulmonary Advisor published a more-popular version here.

As a background, if you are over 65 and overweight, there is a 25% chance or so that your heart rate will begin to surge semi-randomly, and that it will flutter. This is Atrial fabulation, A-Fib. It tends to get worse and tends to lead to heart attacks and strokes. People with A-fib tend to be treated with drugs, aspirin, warfarin, beta blockers, and anti arrhythmics. They also tend to be prescribed a C-PAP because overweight, older folks tend to snore and wake up a lot during the night (several times per hour: apnea).

A C-PAP definitely stops the snoring and the Apnea, and the assumption was that it would help your heart as well, if only by giving you a better night’s sleep. As it turns out, the C-PAP seems to decrease heart health — significantly.

For this study, adult patients between 18 and 75 years old diagnosed with paroxysmal A-Fib (that’s occasional AF) were screened for moderate to severe sleep apnea. Those who agreed to participate were randomly assigned to either a treatment of C-PAP plus usual care (drugs mostly) or just usual care for the next 5 months. Of the 109 who enrolled in the study, 55 got the C-PAP plus usual care, 54 got usual care alone. The outcome was that there were 9 serious, adverse heart events (strokes and heart attacks); 7 were in the C-PAP group.

The CPAP pressure was, on average, 6.8 cm H2O; mean time of use was 4.4±1.9 hours per night. The C-PAPs did their jobs on the apnea too, reducing residual apnea-hypopnea to 2.3±1.9 events per hour for those in the C-PAP group.

There was a non-statistically significant reduction is AF among the C-PAP group. They reduced their time in AF by 0.6 percentage points compared to the control group  (95% CI, -2.55 to 1.30; P =.52). That not a statistically significant difference, and is most likely random.

There was a statistically significant decrease in heart health, though. A total of 7 serious adverse events occurred in the C-PAP group and only 2 in the control group. A total of 9 is a relatively small number of events, but there is a strong statistical difference between 7 and 2.

The authors conclude: “CPAP treatment does not seem to reduce or prevent paroxysmal AF.” They should also have concluded that it reduced heart health with a statistical confidence of ~82%: (1-2(36+10)/512) =82%. See more on this type of statistics.

A possible explanation of why a C-PAP would would make heart health worse is an outcome of the this recent sleep study (link here). It appears that the C-PAP helps restore breathing, but by doing so, it interferes with a mechanism the body uses to deal with A-fib. It seems that, for people with A-Fib, their bodies use breathing stoppages to get their heart back into rhythm. For these people, many of their breathing stoppage are not obstructive, but a bio-pathway to raise the CO2 level in the blood and thus regulate heart rate. The use of a C-PAP prevents this restorative mechanism and this seem to be the reason it is destructive to the heart-health of patients with A-fib. On the other hand, a C-PAP does improve the sleep those patients whose apnea is obstructive. It seems to me that sleep studies should do a better job distinguishing the two causes of apnea. C-PAPs seem counter-indicated for patients with A-fib.

Robert Buxbaum, March 30, 2022. I was diagnosed with apnea and A-Fib some years ago. The sleep doctor prescribed a C-PAP and was adamant that I had to use it to keep my heart healthy. There were no random studies backing him up or contradicting him until now.

A Nuclear-blast resistant paint: Starlite and co.

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About 20 years ago, an itinerate inventor named Maurice Ward demonstrated a super insulating paint that he claimed would protect most anything from intense heat. He called it Starlite, and at first no one believed the claims. Then he demonstrated it on TV, see below, by painting a paper-thin layer on a raw egg. He then blasting the egg with a blow torch for a minute till the outside glowed yellow-red. He then lifted the egg with his hand; it was barely warm! And then, on TV, he broke the shell to show that the insides were totally raw, not only uncooked but completely unchanged, a completely raw egg. The documentary below shows the demonstration and describes what happened next (as of 10 years ago) including an even more impressive series of tests.

Intrigued, but skeptical, researchers at the US White Sands National Laboratory, our nuclear bomb test lab, asked for samples. Ward provided pieces of wood painted as before with a “paper thin” layer of Starlite. They subjected these to burning with an oxyacetylene torch, and to a simulated nuclear bomb blast. The nuclear fireball radiation was simulated by an intense laser at the site. Amazing as it sounds, the paint and the wood beneath emerging barely scorched. The painted wood was not damaged by the laser, nor by an oxyacetylene torch that could burn through 8 inches of steel in seconds.

The famous egg, blow torch experiment.

The inventor wouldn’t say what the paint was made of, or what mechanism allowed it to do this, but clearly it had military and civilian uses. It seems it would have prevented the twin towers from collapsing, or would have greatly extended the time they stayed standing. Similarly, it would protect almost anything from a flame-thrower.

As for the ingredients, Ward said it was non-toxic, and that it contained mostly organic materials, plus borax and some silica or ceramic. According to his daughter, it was “edible”; they’d fed it to dogs and horses without adverse effects.

Starlite coasted wood. The simulated nuclear blast made the char mark at left.

The White sands engineers speculate that the paint worked by combination of ablation and intumescence, controlled swelling. The surface, they surmised, formed a foam of char, pure carbon, that swelled to make tiny chambers. If these chambers are small enough, ≤10 nm or so, the mean free path of gas molecules will be severely reduced, reducing the potential for heat transfer. Even more insulting would be if the foam chambers were about 1 nm. Such chambers will be, essentially air free, and thus very insulating. For a more technical view of how molecule motion affects heat transfer rates, see my essay, here.

Sorry to say we don’t know how big the char chambers are, or if this is how the material works. Ward retained the samples and the formula, and didn’t allow close examination. Clearly, if it works by a char, the char layer is very thin, a few microns at most.

Because Maurice Ward never sold the formula or any of the paint in his lifetime, he made no money on the product. He kept closed muted about it, as he knew that, as soon as he patented, or sold, or let anyone know what was in the paint, there would be copycats, and patent violations, and leaks of any secret formula. Even in the US, many people and companies ignore patent rights, daring you to challenge them in court. And it’s worse in foreign countries where the government actively encourages violation. There are also legal ways around a patent: A copycat inventor looks for ways to get the same behavior from materials that are not covered in the patent. Ward could not get around these issues, so he never patented the formula or sold the rights. He revealed the formula only to some close family members, but that was it till May, 2020, when a US company, Thermashield, LLC, bought Ward’s lab equipment and notes. They now claim to make the original Starlite. Maybe they do. The product doesn’t seem quite as good. I’ve yet to see an item scorched as little as the sample above.

Many companies today are now selling versions of Starlite. The formulas are widely different, but all the paints are intumescent, and all the formulas are based on materials Ward would have had on hand, and on the recollections of the TV people and those at White Sands. I’ve bought one of these copycat products, not Thermashield, and tested it. It’s not half bad: thicker in consistency than the original, or as resistive.

There are home-made products too, with formulas on the internet and on YouTube. They are applied more like a spackle or a clay. Still, these products insulate remarkably well: a lot better than any normal insulator I’d seen.

If you’d like to try this as a science fair project, among the formulas you can try; a mix of glue, baking soda, borax, and sugar, with some water. Some versions use sodium silicate too. The Thermoshield folks say that this isn’t the formula, that there is no PVA glue or baking soda in their product. Still it works.

Robert Buxbaum, March 13, 2022. Despite my complaints about the US patent system, it’s far better than in any other country I’ve explored. In most countries, patents are granted only as an income stream for the government, and inventors are considered villains: folks who withhold the fruits of their brains for unearned money. Horrible.

The claim that Ukrainians are Nazis is also Ukraine’s claim to statehood.

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Recently Putin claimed he was going into Ukraine to fight Nazis. Twitter makes fun of this, but also shows many pictures of these Nazis. Under the hashtag #AzovBattalion, you’ll see many pictures of white boys with swastikas and Ukraine flags (see below). Perhaps these pictures are just Russian propaganda: According to our media there are no Nazis to speak of, and besides, the president of Ukraine is a Jew. Still, the pictures look real, and based on Ukraine history, there is quite a bit reason to think they are not an aberration. Still, to the extent that they represent Ukraine, these individuals are a major basis of Ukraine’s claim for independence. They are also a good reason to leave Ukraine out of NATO, IMHO.

Let’s go back to the late days of the Tartars and the early days of the Cossacks, about 1600. There is a painting, below depicting Cossacks of those days writing a letter to The Sultan (original in the Kharkov museum). They do not seem the most savory of people, but they do seem independent and egalitarian. The letter is not written by a noble, but by a committee of pirates, and not everyone is happy about it.

Zaporozhian Cossacks write a letter to the sultan. These are the people who Putin claims should be loyal to Russia, but they have a long history of behaving otherwise. I like the scribe. A couple of people at left seem unhappy.

From 1250 to the mid 1700s, Southern Ukraine was ruled, to a greater or lesser extent, by the Crimean Tartars, a group of horse-riding Mongols who nominally served the great Khan. Moscow paid dues to them, and in 1571 the Tartar ruler,  Devlet I Giray burnt Moscow to collect his dues. The early Cossacks were Black-sea pirates, and enemies of the Tartars. Around 1600, the Cossacks and Tartars realized they had a lot in common (alcoholism, pederasty…) and formed an alliance. Mainly this was against the Poles and Jews. A famous result of this alliance was the Khmelnytsky Uprising (about 1650). Khmelnytsky was the “Hetman” (Head man?), the elected, temporary ruler for the uprising. He has become a symbol of Ukrainian independence, but he was also a brutal murderer of virtually all the Jews and Catholics. Today, he graces Ukraine’s $5 bill, and sits atop a statue in Kyiv’s central square. This elevation of Khmelnytsky is no small insult to Jews, Catholics, and civilization.

Ukrainian Republic passport, 1919.

 In 1654, via the Pereyaslav Agreement, Khmelnytsky’s Tartar-Cossacks formed an allegiance with the Tsar while retaining autonomy in Ukraine. This autonomy eroded over the years, and ended with Bolshevik rule in the early 20th century. After WWI, Ukrainians briefly tried for independence, forming the Ukraine Peoples Republic and the Ukraine Democratic republic, from 1917 to 1921. The head of the Republic was called hetman, an elected leader but also a throwback to a mass-murderer.

Stalin punished the Cossack remnant before WWIi, and when the Germans invaded in 1939, many of the remaining Ukrainians supported the Nazi invasion, and provided some of the most brutal murders of Jews; the murderers of Baba Year, for example. Putin recalls this collaboration when he calls the Ukrainians Nazis, and I suspect that he’s more right than our press will admit. These #azovbattalion pictures don’t look faked. On the other hand, the autonomy of the Ukrainians and Cossacks, and their attempts at independence provide historical backing for Ukraine’s claim to independence. Putting this another way, the more you accept that Ukraine is full of Nazi sympathizers, the more you should accept them as a distinct society from Russia.

Ukrainians of the Azov Battalion with a statue of Khmelnytsky, or some other murderer.

As an idea of how the war might go, I should mention another group of Tartar-Cossacks. These were Moslems who operated between the Don and Volga Rivers in what is known as Chechnya. Chechnya fought Russia in a long, bloody, unsuccessful struggle, that is only recently ended. Russia may win in Ukraine, but it is not likely to win easily or cheaply if Chechnya is any model.

Robert Buxbaum, Mar. 2, 2022