The findings of a 2021 study led by the Cedars-Sinai Medical Center team may help doctors better understand multisystem inflammatory syndrome in children (MIS-C), a severe complication of infection with COVID-19. The study first appeared in the peer-reviewed publication Journal of Clinical Investigation and was authored by the Cedars-Sinai team in collaboration with partners at Martin Luther University Halle-Wittenberg in Germany.
Tracing the value of biomarkers
This research offers the potential to use distinctive MIS-C biomarkers to more accurately predict the course of disease in young patients. It may also help physicians develop potentially lifesaving new treatments.
The study looked at data from a small cohort of patients to pinpoint a set of pathogenic trajectories that ended up as MIS-C. The researchers also examined blood proteins potentially able to act as biomarkers that would help predict symptom severity and thus better inform doctors about the optimal treatment for each patient.
Rare but terrifying
Only a few children develop MIS-C, but it can be fatal. The condition involves inflammation of various parts of the body, which can include the brain, lungs, heart, kidneys, and even the skin and eyes. While scientists do not yet understand the exact cause of MIS-C, they have shown that many children who manifest the condition have either been infected with SARS-CoV-2, the virus that causes COVID-19, or have been in close contact with an infected person.
The complications of MIS-C can appear even weeks after a child has been diagnosed with COVID-19. The median age of patients with MIS-C is nine years old.
Given prompt and appropriate medical care, most children who develop MIS-C have improved. Most pediatric patients in the U.S. presenting with the condition have required hospitalization in the intensive care unit.
Particularly if left untreated, the condition can worsen and result in death for a small number of patients.
From May 2020 to the last week in August 2021, the Centers for Disease Control and Prevention received more than 4,400 reports of cases of MIS-C. Out of those cases, more than three dozen children died.
With many schools reopening under less-than-optimum conditions and the spread of the Delta variant of COVID-19, parents and physicians are more concerned than ever about how the disease affects children. Statistics for summer 2021 showed more children being hospitalized than earlier in the pandemic. Physicians also noted troubling issues of equity: MIS-C is especially prevalent among Black and Latinx children.
These are all among the reasons why the director of Cedars-Sinai’s Pediatric Infectious Diseases Division told media outlets that the pathfinding study on biomarkers is especially important.
An immune system running riot
Research is slowly clearing away some of the unknowns surrounding MIS-C. Scientists now view it as an autoimmune disorder, in which the patient’s own immune system goes into hyperdrive, perhaps in response to the large-scale tissue damage that some people sustain from infection with SARS-CoV-2. This causes the immune system to literally attack the patient’s own organs.
Pediatric patients with MIS-C typically show up with the same “cytokine storms” that doctors had previously marked in adult patients with severe inflammatory responses to SARS-CoV-2. Among the symptoms are long-term fever, inflammation of the heart, shock, and acute respiratory or neurological system crises.
Connecting the dots
Previously, the Cedars-Sinai team published a 2020 study that can be considered a precursor to the newer one on biomarkers. In the earlier research, conducted with the University of Pittsburgh School of Medicine, the scientists discovered similarities in the biological reactions that characterize MIS-C, the cytokine storm phenomenon, and toxic shock syndrome, which has long been recognized as a rare outcome in cases of bacterial infection.
When doctors first identified MIS-C in their child patients earlier in the pandemic, they noted its multiple resemblances to toxic shock and Kawasaki syndrome, whose symptoms include fever, rash, and swelling of the lymph glands and extremities.
The researchers built a truly interdisciplinary team to conduct the biomarker study, with Cedars-Sinai and five partner organizations contributing specialists from a variety of fields in order to keep the project moving quickly. This dream team relied on a number of advanced technologies, including RNA sequencing, antibody analysis, and proteomics, the analysis of cell proteins. The researchers also analyzed immune system signaling, the complex biological process that allows the body to identify and respond to infectious agents.
The key limitation of this study, as the team acknowledges, was its small subject size of 69 children. Some had been diagnosed with MIS-C, others had not, and still others had been diagnosed with Kawasaki syndrome. Still, this study can serve as an anchor to see if its findings can be replicated in further research.
Symptoms? Get help promptly
The CDC urges parents to be alert for the signs of MIS-C, while understanding that not every child with the condition will develop the same symptoms. The typical scenario involves persistent fever, along with one or more other symptoms such as headache, extreme tiredness, rash, bloodshot eyes, vomiting, diarrhea, clammy skin, and difficulty breathing.
Anyone who suspects a child might be developing MIS-C should contact the child’s pediatrician right away. Symptoms that require an immediate call to emergency services include persistent chest pressure or pain, labored breathing, difficulty remaining awake, new confusion, and gray, blue, or abnormally pale skin, nails, or lips.
Since the earliest days of Vista Del Mar Child and Family Services’ long history of serving the people of Southern California, it has offered cottage-style homes to its children, the first-ever orphanage in the region to do so. In the intervening years, its offerings have expanded to include services for families with children on the autism spectrum and with other special needs, as well as those looking for mental health counseling, psycho-educational evaluation, parenting resources, and adoption services.
1. A trusted leader in adoption services
With the oldest adoption program in its region, Vista stands out as a pioneer in the field of adoption. The professionalism and attentive, compassionate engagement with families that characterize its other service programs also distinguish its adoption services, which enjoy widespread public trust. Fully accredited and licensed, its adoption services program has earned a national reputation for its thoroughness and integrity.
Vista’s professionals are able to address the entire range of needs centered on forming a new family, from foster care placement, the foster-to-adoption process, international adoptions, and counseling and support for birth parents who choose adoption. The Vista team also provides the required home study services, as well as pre-adoption workshops and post-adoption services, preparation of the necessary court paperwork, cooperative adoptions handled with attorneys and facilitators, and more.
Because Vista maintains strong relationships with not only multiple adoption attorneys and facilitators, but also local hospitals and maternity clinics that serve birth parents, it provides relatively short turnaround times; after completion of a home study, for example, the average wait time for a prospective adoptive family to be matched with a child ranges from a year to a year and a half.
Additionally, Vista can provide adoptive families with information on the federal Adoption Assistance Program (AAP), which gives most children adopted through an agency or foster care specified financial benefits, as well as health care benefits through the Medi-Cal program.
2. Compassion, respect, and cultural competence
On its website, Vista addresses several common adoption-related questions, including whether single adults and members of the LGBTQ community can qualify to adopt, to which the response is “yes.” In fact, Vista has earned a seal of recognition from the Human Rights Commission for its work in helping LGBTQ parents build their families.
The core values that each Vista adoption services professional observes are openness, honesty, and compassion. Each birth family and adoptive family is received with respect and a warm welcome at Vista, where its culturally competent staff focuses on developing a sense of comfort and trust.
3. Support through a life-changing process
These are among the key reasons that birth and adoptive families work with Vista. The adoption process offers a chance to start or complete a family, provide a loving home for a child in need, and create positive changes in the lives of everyone involved. But because it can also be stressful and demand emotional vulnerability, Vista makes a point to offer intensive support throughout the process – and afterwards.
In California, an estimated 2,000 children in need of an adoptive family enter the system daily. Some children wait for years in foster care before finding permanent adoptive homes. Many of the children most in need are older, are non-white, or have special needs. For children who age out of the foster care system without finding an adoptive family, the risks to social, emotional, and educational development are significant.
The right adoption offers a world of advantages to a child. As members of a family, they will develop lasting bonds with parents and family members. A successful adoption provides a child with a sense of belonging and security, setting the foundation for healthy development at each stage of growth toward maturity. Adopted children, like other children in stable homes, are also statistically less likely to experience domestic abuse and develop substance abuse issues or harmful behavior patterns.
Similarly, an adopted child offers their new family a chance for personal and emotional growth, in part by returning their adoptive family’s gift of love, care, and acceptance with trust and reliance as they build a new relationship. Adoptive parents can also experience gratification from sharing their good fortune with a child who might otherwise never have had even their most basic needs fulfilled.
For birth parents who decide that adoption gives their child the best chance in life, there is peace of mind in knowing that pre-screened, qualified, loving adoptive parents are ready and willing to provide their child with a home. A birth parent who is unready to raise a child can pursue dreams of education and career that otherwise might have had to wait for years or remain unfulfilled. And in many cases, birth parents and adoptive families can reach agreements to maintain a relationship, allowing the adopted child a continued connection that benefits everyone.
To learn more, visit Vista Del Mar Child and Family Services at VistaDelMar.org.
Cedars-Sinai Medical Center got its start with two small community hospitals that opened at the start of the 20th century. Its mission expanded over the decades to focus on meeting the full range of the healthcare needs of both the Jewish and general communities.
Today, the massive hospital complex is the largest not-for-profit medical center in the western part of the United States. Its teams continue to provide research, patient care, and community outreach of a quality that has made it one of the world’s leading centers of breakthrough science, medical education, and service to its community.
It embodies the spirit of tikkun olam.
The hospital began by serving the Jewish community, fulfilling the highest social value of tikkun olam (“repairing the world” in Hebrew), but it didn’t stop there. It continues to work in the spirit of the Jewish ethical tradition, as it concentrates on reaching out to those most in need from every background across the diverse fabric of the Los Angeles area.
It is nicknamed the “hospital to the stars” thanks to its status as hospital of choice for numerous Hollywood celebrities. However, Cedars-Sinai further expanded its service to struggling communities in 2020 by broadening the income requirements necessary to receive free or reduced-cost services.
It was originally founded to treat Jewish patients with tuberculosis.
Cedars-Sinai as we know it today was formed from the merger of Cedars of Lebanon Hospital (originally Kaspare Cohn Hospital) with Mount Sinai Hospital (which developed out of the Bikur Cholim Society’s hospice). Kaspare Cohn Hospital opened its doors on Carroll Avenue in Los Angeles in 1902, out of the home of its founder and namesake. Kaspare Cohn was a businessman and founder of Union Bank who donated the residence located in the neighborhood now known as Echo Park.
The hospital’s original mission was to treat Jewish patients who had contracted tuberculosis. A pioneer in more ways than one, Kaspare Cohn included on its staff one of the area’s first-ever women doctors, Dr. Sarah Vasen, who served as medical director from 1906.
In a 2002 article tracing the Cedars-Sinai story, the Jewish Journal of Los Angeles noted that TB was a widespread problem among American Jewish communities of Eastern European origin. Many migrated west from the crowded tenements of New York and other eastern cities, hoping for a cure for the contagious disease then often referred to as “consumption.” The idea was that the cleaner, drier air would have a healing effect.
These “lungers,” as the slang term called them, produced a surge in the Los Angeles Jewish population, which quadrupled from the turn of the century to reach 10,000 by 1910. Several local Jewish benevolent organizations joined forces to try to help their new community members. Vista Del Mar, for example, now a broadly focused social service organization, originated in 1908 as an orphanage for Jewish youth who had lost their parents to tuberculosis.
It was a refuge from anti-Semitism.
The need for hospitals devoted specifically to the American Jewish community was great in the 19th century and much of the 20th. Most new Jewish immigrants were poor, with no other recourse to obtain professional medical care.
Many Jews also wanted to be treated in a hospital that would respect their religious and cultural traditions, such as keeping kosher and observing Shabbat. And due to the presence of widespread anti-Semitism in America at the time, Jewish patients could not always count on receiving equal treatment—or sometimes any treatment at all—at non-Jewish hospitals in their communities.
Jewish hospitals also existed as a way of offering top-flight medical training to Jewish healthcare professionals. Even in the 1930s and 1940s, it was often impossible for a Jewish doctor, regardless of experience or credentials, to get hired at a non-Jewish facility.
In 1918, Los Angeles’ Bikur Cholim Society (the literal translation of the Hebrew is “visiting the sick”) began treating hospice patients. Located in a residence in Boyle Heights after 1921, it remained the Bikur Cholim Hospital until its relocation to Beverly Boulevard in 1955 as Mount Sinai Hospital. It was on this site that the current Cedars-Sinai Medical Center began to expand after the hospitals merged in 1961.
It continues to pursue its mission in new ways.
Until the mid-20th century, Cedars-Sinai’s sole goal was direct patient care. While that has continued as the core mission, it expanded into research and medical education after the mid-1950s. Now, working as part of the Cedars-Sinai Health System, it employs more than 12,000 staff, and admits about 50,000 patients in a typical year.
One component of Cedars-Sinai’s multi-strategy pandemic response is its innovative COVID-19 Recovery Program. Launched at the beginning of 2021, this effort works specifically with patients dealing with the symptoms of “long COVID” months after their recovery from SARS-CoV-2. The related Cedars-Sinai Cardiology Program assists people with lingering heart problems, and its Post-ICU Post-COVID Clinic supports those with post-intensive care issues stemming from COVID or another critical illness. This work falls squarely within the original mission of the Kaspare Cohn Hospital from 1902: to bring healing to patients stricken with infectious diseases and other ills, using the best-available scientific treatment and the highest standards of care.
Vista Del Mar Child and Family Services has served the people of Southern California for well over a century. The organization grew from a very small Jewish orphanage in 1908 to its current network of state-of-the-art services spanning mental health, education, adoption, autism spectrum outreach, early intervention programs, and more for people of all faiths and backgrounds.
Vista Del Mar has changed as the community around it has changed, yet has always strived to meet people where they are, and to provide what they need with understanding and compassion.
A haven for Jewish orphans
It started with a dream of safety.
By the first years of the 20th century, millions of Jews were desperate to escape the antisemitic pogroms in Eastern Europe. Those who were lucky found their way to America. But even in this land of relative security, newcomers were crowded into dank tenement apartments where polio, tuberculosis, and other deadly diseases often ran rampant. Those who could move farther west hoped to find in those then-wide-open spaces the climate that would provide a cure.
When many of the adults newly arrived in Southern California still died of these illnesses, their surviving children were left without refuge or care.
Enter Sigfried Marshutz.
The German-born Marshutz was an accomplished optometrist and a leader in the B’nai B’rith Lodge #487 in Los Angeles. He and his fellow members worried about the fate of these Jewish orphans, many of whom could be found living on the streets. In 1908, they opened the doors of the Jewish Orphans Home of Southern California in an old mansion formerly owned by wine merchant Alfred Stern. Marshutz served as president until 1914.
After a fire destroyed this first building (fortunately without injury to the children), the orphanage relocated to, first, a boardinghouse near Hollenbeck Park, before designing its own buildings based on modern ideas about child development.
A new standard of care
In 1909, President Theodore Roosevelt led a White House Conference on the Care of Dependent Children, which promoted the value of an enriched, loving, homelike atmosphere for any children in institutional care. The conference urged adults in charge of creating group housing for children to model their buildings on the “cottage plan.” And in 1912, President William Howard Taft’s administration established the Children’s Bureau, the first federal agency providing up-to-date professional guidance on the wellbeing of children and families.
Within this atmosphere, Marshutz and his team built a new home for the children in their care on 10 acres in Huntington Park, at the intersection of Miles (then Irvington) and Gage Streets. The fresh, contemporary look of the cottage homes was revolutionary in 1912, offering a stark contrast to the typical orphanages that crowded numerous children into a single building.
In these cottages, sibling groups stayed together whenever possible. All children in a cottage lived under the supervision of a “house mother,” who taught them to prepare meals, clean, and care for their home just as if they lived in a traditional family. Their own cows and hens supplied the children with fresh milk and eggs daily.
A ranch with some famous neighbors
By 1925, the orphanage had moved to expansive new quarters at Vista Del Mar in West Los Angeles, with five two-story cottage homes for the children, as well as a ranch house and a barn amid more than 20 acres of rolling hills.
The new site was also close to the studios of 20th Century Fox and MGM Studios; a connection to Hollywood was also forged when director George Cukor and producer Louis B. Mayer joined the board of the organization. The children enjoyed movie screenings, donations of costumes, and Hanukkah presents courtesy of these connections. Moreover, it was the film community’s support that helped the orphanage survive the Great Depression relatively intact.
Facing new traumas
The dark days of World War II and the Holocaust saw a flood of new arrivals at the orphanage: Jewish child refugees from Nazi Germany. After the war, displaced children whose parents had perished in the fighting or the concentration camps continued to join the Vista Del Mar family.
It was then that superintendent Joseph Bonapart, a teacher with advanced degrees in psychology and sociology, noticed many of his newer orphans arriving with severe emotional and behavioral conditions with a variety of causes. So, in the 1950s, Vista Del Mar began focusing on caring for these traumatized youth, building a special treatment cottage directed by well-trained psychiatric and teaching staff.
An updated campus for a growing mission
The 1970s saw the development of Vista Del Mar’s own school to serve its children unable to attend public schools. The ‘70s and ‘80s were also the era of extensive renovations to construct modernized “cluster cottages,” even as Vista Del Mar further developed its focus on serving youth with developmental disabilities and other special needs. Mergers with the Reiss David Child Study Center and other progressive local agencies supported this growth, bringing in a burst of new expertise in child development, counseling, and mental health services.
In the century since Vista Del Mar’s founding, tuberculosis, polio, and orphanages have faded into history. As it has changed with the times, the organization has expanded both its reach and its heart, and continues as one of the Los Angeles area’s most beloved and valued service providers.
Business casual got quite the rebrand during the COVID-19 pandemic. Thanks to Zoom and other video communication platforms, what now passes as “business appropriate” is a button-down shirt and boxer briefs, or perhaps even pajamas or cozy loungewear that technically passes as an outfit. While some opted to continue on with getting ready and dressed each day just to log into a meeting from a makeshift office in their home kitchen, others took advantage of working from home and saw it as a chance to slow down a little bit and get their work done in a more relaxed manner.
Within weeks after nationwide stay-at-home orders were announced, loungewear sales skyrocketed. For many people, “dress for success” became an antiquated notion during a time when stress levels became beyond comprehensible. The definition of success shifted as so many people had to learn how to juggle managing their children’s homeschooling while showing up to video conferences on time and meeting various deadlines. To some, “success” was showing up at all, dress slacks or not. Employers understood this; after all, they have families, too, and we were all going through the same mindboggling reality shift.
Whether working from home was a juggling act for you or simply a chance to sleep in and show up to the 9 am Zoom meeting wearing yoga pants and a hoodie, the question on everybody’s minds as they head back to the office seems to be: What am I supposed to wear now?
Offices are opening their doors once again after more than a year of functioning remotely, and some companies are switching it up a bit. Employees are coming back to work to find new, relaxed dressed codes and hybrid work arrangements, effectively blurring the lines between what was formerly considered work attire and leisurewear. After all, if we were able to be productive wearing less constricting clothing, why not have the option to continue? Of course, button-downs and boxer briefs are out of the question now that we can see each other’s entire bodies, but the fashion industry took note of the change and are making quite a few changes of their own.
In an interview with the Washington Post, chief brand officer Ana Andjelic for Banana Republic said, “We are seeing hybrid dressing: workwear meets evening wear meets leisurewear. All bets are off.” Retailers that formerly sold work attire have shifted to designing more comfortable and expressive options for their customers, such as flowy dresses and brightly-colored shirts meant for the office. But what exactly is this new dress code? Certainly, pajamas are out of the question, but what about yoga pants? Shorts? How do we navigate another “new normal?” The short answer: we have to communicate.
The pandemic sparked a conversation about whether or not “business attire” is still relevant. Many people realized they could get their work done just as well in a less restricting outfit as they could while wearing full penguin suits in a cubicle– maybe even better. Perhaps people feel more seen when they’re able to wear something that better reflects their personalities and style, or maybe it’s just a complete drag to wear something uncomfortable all day long and then realize it’s “dry clean only” after ruining it in the washing machine.
Whatever the case, the people have spoken, and they don’t want everything to return back to how it was pre-pandemic. Instead, they want hybrid work options and the ability to splurge on luxury loungewear instead of slacks and a blouse.
If you’re anxious about what you can now wear and what is better suited for your work-from-home days, talk to your colleagues and superiors. It’s likely they’re in the same confused boat as you, and having open discussions about what is acceptable and what isn’t is the best way to navigate yet another change in our lives. Hopefully, you know your colleagues and superiors well enough to gauge the change.
A more casual environment will still have its limits, and it may be in your best interest to test the waters with care before walking through the door looking like you confused your first meeting with a Netflix binge. But with the biggest department stores and retailers rapidly changing their inventory to incorporate these new, more relaxed dress codes, finding what works best for you shouldn’t be too much of an issue.
Viral dances, concise skincare tutorials, fashion, and humor are all part of what has made TikTok a sensation amongst its users. Primarily, the popular social media app consists of members of Gen Z, who seemingly spent most of the last year uploading and sharing these short, creative videos. It would make sense if you’ve already written off TikTok as a nonsensical medium better meant for silliness and trivial content– but you’d be making a hefty marketing mistake.
Some of the most viral videos showcase extravagant mansions with infinity pools, massive home gyms, home theatres, and driveways lined with Range Rovers and G Wagons. These videos are packed with more than just appeal; they aim to sell a lifestyle millions and millions of people are working to achieve.
And if you think Gen Z is the only group flocking to the app, you need to take a closer look inside this unbelievably hot social medium.
Building A Brand
When you hear the term “influencer,” you may picture a young creative with a keen eye for what makes content go viral. Maybe her avenue is lifestyle or quick, healthy meal recipes, and she may be easily dismissed by older generations. In fact, I can confidently say she has been dismissed. But why? In an age where building your brand on social media has led to success for countless influencers, why are we dismissing their pioneering efforts?
Simply put: we have underestimated their power, and somewhere in the process, we told ourselves to fear it.
Dylan Brush, a Los Angeles-based real estate agent with SJF Group, began sharing luxury properties on TikTok in late January and quickly went viral. His videos have amassed millions of views, and his follower count has grown to influencer status. But it didn’t just take a quick upload or two to make that happen.
Brush worked on his brand with a constant stream of luxury properties and an edge to go with it. His simple, yet clever “Client Says” captions such as, “Client says I want a place to entertain,” followed by a gorgeous view of the property have helped him cement who he is on the app, and mostly, what he represents: himself. Brush says he gets his listings more exposure than any other platform. This exposure spreads more than just the addresses he’s selling; it’s getting his name out there to people across the globe.
Leads, Leads, Leads
As salespeople, we love our leads. Since the Covid-19 pandemic shut down agents’ abilities to host open houses, other avenues of marketing became the new norm. But even with 3-D and self-guided tours, options seemed limited. Dylan Brush’s trendy vibe attracted him leads from all over, with people DMing him on the platform asking for help or referring him out to friends looking to buy or sell their homes.
“TikTok is creating that Million Dollar Listing and Selling Sunset buzz, which in turn is getting people to reach out to me. The market I work in is Los Angeles, and people love that vibe,” Brush says.
Facebook, Instagram, and TikTok all share one major roadblock to viral success: challenging algorithms. Even with all the right planning and content-capturing tools, a post can still flop thanks to the algorithms designed to either help or hurt your view count. What agents find works for them the most is posting daily, and oftentimes, reposting content. The trick is to keep going, keep posting, and ensure the content is, for a lack of a better word, cool.
It’s not some industry secret that Millennials conduct much of their lives through social media. Whether looking for new skincare tips, the best spots to vacation, or showcasing their own wannabe luxurious lifestyles, Millennials use various social media sites to gather their information.
While TikTok may seem intimidating outside of its primary audience, industry experts believe agents should invest their time and money into the platform. For one, you never know who is watching your videos. It could be a teen fantasizing about his future, or a Millennial investor looking to grow her fortune. Facebook, Instagram, Twitter, and Myspace all started out with a young audience viewing and engaging with the posts of young users. And while Myspace is no longer with us, the other platforms have rocketed their users to success.
Scott Durkin, president and chief operating officer at Douglas Elliman, believes that TikTok’s younger user base is actually an advantage. “This is the exact audience we want to be targeting,” Mr. Durkin said. “Millennials are said to buy the most real estate in the next year.”
That’s right: the generation so consumed with dropping their hard-earned cash on avocado toast is the next group gearing up to buy homes. While Millennial millionaires make up only 2 percent of the total millionaire population in the United States, their wealth and influence will continue to grow ahead of the Great Wealth Transfer. Many are turning to real estate to further build their wealth, and more than nine in 10 millennial millionaires are homeowners as of 2019
Millennials may not feel they share much with their younger cronies, but they do have one major thing in common, and that’s a borderline obsession with social media. I don’t make this point to drag these people– quite the opposite. They know that these platforms are what make or break a brand.
Where To Start
TikTok is the most downloaded app of 2020, and if you’re not on that long list of users, you’re not just missing out on some mindless entertainment; you’re missing out on learning more about what makes a product or service sell.
The first obvious step is to download the app and get to know its users through their captions, comments, and content. Next, follow the users who are already doing what you aim to do: create your brand, build on it, and use it to your advantage. Much like with any project, it’s in your best interest to do your research. And when it comes to social media, your research never ends.
Keep up with the trends, comment and engage on posts, and upload the best content that reflects not only your listings but your ideal brand as well.