Culture

July 12, New Delhi - Women who received free meals in primary school have children with improved linear growth, according to a new study by researchers at the International Food Policy Research Institute (IFPRI).

India is home to the highest number of undernourished children and the largest school feeding program in the world--the Mid-Day Meal (MDM) scheme--yet long-term program benefits on nutrition are unknown. As school feeding programs target children outside the highest-return "first 1000-days" window spanning from conception until a child's second birthday, they have not been a focal point in the global agenda to address stunting. School meals benefit education and nutrition in participants, but no studies have examined whether benefits carry over to their children.

"Findings from previous evaluations of India's MDM scheme have shown a positive association with beneficiaries' school attendance, learning achievement, hunger and protein-energy malnutrition, and resilience to health shocks such as drought--all of which may have carryover benefits to children born to mothers who participated in the program," says study co-author, Harold Alderman.

The study, "Intergenerational nutrition benefits of India's national school feeding program", co-authored by University of Washington's Suman Chakrabarti and IFPRI's Samuel Scott, Harold Alderman, Purnima Menon and Daniel Gilligan, was published in Nature Communications. The authors used nationally representative data on mothers and their children spanning 1993 to 2016 to assess whether MDM supports intergenerational improvements in child linear growth. Further, they suggest a potential pathway through which school feeding programs may have intergenerational effects on child nutrition outcomes.

The study found that investments made in school meals in previous decades were associated with improvements in future child linear growth. "Our findings suggest that intervening during the primary school years can make important contributions to reducing future child stunting, particularly given the cumulative exposure that is possible through school feeding programs," explains study co-author Suman Chakrabarti.

Study results also show that school meals may contribute to education, later fertility decisions, and access to health care, reducing the risk of undernutrition in the next generation. "School feeding programs such as India's MDM scheme have the potential for stimulating population-level stunting reduction as they are implemented at scale and target multiple underlying determinants of undernutrition in vulnerable groups," explains study co-author Samuel Scott.
Importantly, further research is required to understand whether improving the quality or quantity of meals provided and extending the program beyond primary school might further enhance its benefits.

Boosting the body's own disease-fighting immune pathway could provide answers in the desperate search for new treatments for tuberculosis.

Tuberculosis still represents an enormous global disease burden and is one of the top 10 causes of death worldwide.

Led by WEHI's Dr Michael Stutz and Professor Marc Pellegrini and published in Immunity, the study uncovered how cells infected with tuberculosis bacteria can die, and that using new medicines to enhance particular forms of cell death decreased the severity of the disease in a preclinical model.

At a glance

Researchers were able to demonstrate that cells infected with tuberculosis bacteria have functional apoptosis cell death pathways, and showed their importance in combatting severe disease.

Using preclinical models, researchers were able to pinpoint the critical apoptotic pathways as targets for new therapies, whereby infected cells can be killed by drugs called IAP inhibitors.

The study demonstrated that host-directed therapies were viable for infections such as tuberculosis, which is important in the era of extensive antibiotic resistance.

Fighting antibiotic resistance

Tuberculosis is caused by bacteria that infect the lungs, spreading from person to person through the air. A challenge in the fight against tuberculosis is that the bacteria that cause the disease have developed resistance to most antibiotic treatments, leading to a need for new treatment approaches.

Tuberculosis bacteria grow within immune cells in the lungs. One of the ways that cells protect against these 'intracellular' pathogens is to undergo a form of cell death called apoptosis - destroying the cell as well as the microbes within it.

Using preclinical models, researchers sequentially deleted key apoptosis effectors, to demonstrate their roles in controlling tuberculosis infections. This demonstrated that a proportion of tuberculosis-infected cells could die by apoptosis - opening up new opportunities for controlling the disease.

Using host-directed therapies to reduce disease burden

Dr Stutz said researchers then tested new drugs that force cells to die. This revealed that a drug-like compound that inhibits cell death-regulatory proteins called IAPs could promote death of the infected cells.

"When we treated our infection models with this compound, we were able to significantly reduce the amount of tuberculosis disease," he said.

"The longer the treatment was used, the greater the reduction of disease."

The research team was able to replicate these results using various different IAP inhibitors.

"Excitingly, many of these compounds are already in clinical trials for other types of diseases and have proven to be safe and well-tolerated by patients," Dr Stutz said.

"We predict that if these compounds were progressed for treating tuberculosis, they would be most effective if used alongside existing antibiotic treatments."

Opening the door to new treatment methods

Professor Marc Pellegrini said until now, antibiotics were the only treatment for tuberculosis, which were limited in their application due to increasing antibiotic resistance.

"Unlike antibiotics, which directly kill bacteria, IAP inhibitors kill the cells that the tuberculosis bacteria need to survive," he said.

"The beauty of using a host-directed therapy is that it doesn't directly target the microbe, it targets a host process. By targeting the host rather than the microbe, the chances of resistance developing are incredibly low."

The team hope the research will lead to better treatments for tuberculosis.

"This research increases our understanding of the types of immune responses that are beneficial to us, and this is an important step towards new treatments for tuberculosis, very few of which have been developed in the last 40 years," Dr Stutz said.

"We have demonstrated that host-directed therapies are viable for infections such as tuberculosis, which is particularly important in the era of extensive antibiotic resistance."

Rather than waiting for certainty in sea-level rise projections, policymakers can plan now for future coastal flooding by addressing existing inequities among the most vulnerable communities in flood zones, according to Stanford research.

Using a methodology that incorporates socioeconomic data on neighborhood groups of about 1,500 people, scientists found that several coastal communities in San Mateo County, California - including half the households in East Palo Alto - are at risk of financial instability from existing social factors or anticipated flooding through 2060. Even with coverage from flood insurance, these residents would not be able to pay for damages from flooding, which could lead to homelessness or bankruptcy among people who are essential to the diversity and economic function of urban areas. The paper was published in the journal Earth's Future on July 12.

"These are workers that make a city run, they're the heart and soul of an urban operation. If you displace a significant majority too far outside the urban area, the functionality of that city crumbles," said senior co-author Jenny Suckale, an assistant professor of geophysics at Stanford's School of Earth, Energy & Environmental Sciences (Stanford Earth). "How can we make sure that we provide a future to these communities that does not entail their disintegration?"

Flood damage estimates are typically calculated by civil engineers in terms of monetary damage to physical structures. With their new model, called the Stanford Urban Risk Framework (SURF), the researchers bring a human-centered approach to risk assessment that focuses on the residents most likely to lose their livelihoods when water inundates their homes. While every household within the projected flood plain will be burdened by flood damages, the socioeconomic context determines how harmful the costs will be. In several coastal communities in San Mateo County, more than 50 percent of households will be facing financial instability.

"If you just look at the dollar amount, you're missing one major component of the problem," Suckale said. "What might be a nuisance in some communities is life-changing in other communities - it's really about the proximity to a tipping point."

The researchers determined which communities are near a fiscal tipping point by calculating their social risk, or financial instability, a metric intended to complement existing assessments of monetary risk from hazards. They overlaid coastal flood maps and building footprints with structural information, incorporated projected annual damages from sea-level rise and estimated household discretionary income based on labor and economic data in order to calculate losses based on census block groups - geographical units used by the U.S. Census Bureau to publish demographic estimates.

"It was surprising to see in the data how much more lower-income households were affected as a proportion of their income and just how unsustainable it is for those types of households to absorb these costs," said lead study author Avery Bick, a PhD student with the Norwegian Institute for Nature Research who worked on the project as a graduate student at Stanford.

Despite uncertainty over the magnitude of future climate change, researchers agree that sea-level rise will increase coastal flooding - a hazard that residents from Foster City to East Palo Alto have already experienced in the past several decades. Many of the neighborhoods with the highest social risk comprise single-parent households and are more racially diverse than the San Mateo County average, according to the research.

"Climate change isn't just about getting hotter or sea-level rise - it's literally going to change the entire fabric of society, especially if we continue to ignore it," Bick said. "This gave me a sense of how vulnerable the social fabric is to change and how we need to be proactive; otherwise it will change in favor of those that have more resources."

The researchers collaborated with local stakeholders to develop an equitable approach to sea-level rise adaptation planning. Through conversations with organizations like the San Mateo County Office of Sustainability and the U.S. Army Corps of Engineers, as well as community-based groups like Climate Resilient Communities, El Concilio and North Fair Oaks Community Alliance, they learned that what was missing from the climate discourse was a framing of dollar-amount damage relative to what people are able to pay. The team's approach involved a mind shift, from the amount of money you lose to the value of the goods and services you can no longer purchase because of the disaster, said study co-author Derek Ouyang, a geophysics lecturer at Stanford Earth.

"Any investment now can be directly linked to the resilience that prepares communities for future climate hazards, whatever they are," Ouyang said.

Because San Mateo County includes both very wealthy and low-income residents, averaging the costs of flooding in comparison to the income of its residents at the county scale "makes it look like you don't have much of a problem," Suckale said. By assessing impacts at a smaller scale, however, the researchers were able to highlight the areas of concern in a way that is more directly useful to policymakers.

The co-authors hope this new quantitative method for assessing social risk on a census block group scale can be used in other regions vulnerable to coastal flooding or for understanding different climate hazards through an equitable lens.

"I think it's useful to have a metric of social risk that is entirely agnostic of the actual hazard, because then we can just improve the ability of the household to absorb the disruption, no matter what it is," Suckale said.

Led by Professor Robert Read and Dr Jay Laver from the NIHR Southampton Biomedical Research Centre and the University of Southampton, the work is the first of its kind.

Together they inserted a gene into a harmless type of a bacteria, that allows it to remain in the nose and trigger an immune response. They then introduced these bacteria into the noses of healthy volunteers via nose drops.

The results, published in the journal Science Translational Medicine, showed a strong immune response against bacteria that cause meningitis. Published in Science Translational Medicine, those data also show long-lasting protection.

Meningitis occurs in people of all age groups but affects mainly infants, young children and the elderly. Meningococcal meningitis, is a bacterial form of the disease, causing 1,500 cases a year in the UK. It can lead to death in as little as four hours after symptoms start.

Around 10% of adults carry N. meningitidis in the back of their nose and throat with no signs or symptoms. However, in some people it can invade the bloodstream. That can lead to life-threatening conditions including meningitis and blood poisoning ('septicaemia).

The 'friendly' bacteria Neisseria lactamica (N. lactamica) also lives in some people's noses naturally. By occupying the nose, it protects from a severe type of meningitis. It does so by denying a foothold to its close cousin Neisseria meningitidis (N. meningitidis).

The new data build on the team's previous work aiming to exploit this natural phenomenon. That study showed nose drops of N. lactamica prevented N. meningitidis from settling in 60% of participants.

For those people, N. lactamica had locked out its deadly cousin. That drove work to make N. lactamica even more effective in displacing N. meningitidis.

The team did so by handing it one of N. meningitidis' key weapons; a 'sticky' surface protein that grips the cells lining the nose. By inserting a copy of the gene for this protein into N. lactamica's DNA, it could also it - levelling the playing field.

As well as inducing a stronger immune response, those modified bacteria stayed longer. Present for at least 28 days, with most participants (86%) still carrying it at 90 days, it caused no adverse symptoms.

The results of the study, which was funded by the Medical Research Council, are promising for this new way of preventing life-threatening infections, without drugs. It's an approach that could be critical in the face of growing antimicrobial resistance.

Dr Jay Laver, Senior Research Fellow in Molecular Microbiology at the University of Southampton, commented: "Although this study has identified the potential of our recombinant N. lactamica technology for protecting people against meningococcal disease, the underlying platform technology has broader applications.

"It is theoretically possible to express any antigen in our bacteria, which means we can potentially adapt them to combat a multitude of infections that enter the body through the upper respiratory tract. In addition to the delivery of vaccine antigens, advances in synthetic biology mean we might also use genetically modified bacteria to manufacture and deliver therapeutics molecules in the near future."

Prof Read, Director of the NIHR Southampton Biomedical Research Centre said: "This work has shown that it is possible to protect people from severe diseases by using nose drops containing genetically modified friendly bacteria. We think this is likely to be a very successful and popular way of protecting people against a range of diseases in the future."

Journal

Science Translational Medicine

DOI

10.1126/scitranslmed.abe8573

North Carolina State University researchers found that a four-week training course made a substantial difference in helping special education teachers anticipate different ways students with learning disabilities might solve math problems. The findings suggest that the training would help instructors more quickly identify and respond to a student's needs.

Published in the Journal of Mathematics Teacher Education, researchers say their findings could help teachers in special education develop strategies to respond to kids' math reasoning and questions in advance. They also say the findings point to the importance of mathematics education preparation for special education teachers - an area where researchers say opportunities are lacking.

"Many special education programs do not include a focus on mathematics for students with disabilities, and few, if any, focus on understanding the mathematical thinking of students with disabilities in particular," said the study's first author Jessica Hunt, associate professor of mathematics education and special education at NC State. "This study was based on a course experience designed to do just that - to heighten teacher knowledge of the mathematical thinking of students with learning disabilities grounded in a stance of neurodiversity."

In the study, researchers evaluated the impact of a four-week course on 20 pre-service special education teachers. Researchers wanted to know if the course impacted the educators' ability to anticipate the mathematical reasoning of students with learning disabilities, and help teachers adjust tasks to make them more accessible. The course also emphasized neurodiversity, which defines cognitive differences as a natural and beneficial outgrowth of neurological and biological diversity.

"Neurodiversity says that all human brains are highly variable, with no average or 'normal' learners," Hunt said. "This means that we all have strengths and challenges, and as humans we use what makes sense to us to understand the world. It's a way to challenge pervasive deficit approaches to looking at disability, and to instead use an asset-based approach that positions students with learning disabilities as mathematically capable."

Before and after the course, the teachers took a 40-question assessment. In the test, researchers asked teachers to use words, pictures or symbols to describe a strategy that elementary school students with learning disabilities might use to solve a problem. They compared teachers' responses to see how well they anticipated students' thinking, and also how they might modify tasks for students.

After the course, they saw more anticipation of what they called "implicit action," which is using strategies like counting, halving, grouping, or predicting the number of people sharing a certain item to solve a problem. It's often represented by pictures or words. Before the test, many teachers used "static representations" in which they used mathematical expressions to show solutions. While static representations are abstract representations of solutions, researchers argued implicit actions can reflect how students with learning disabilities themselves might work through a problem.

They found teachers' use of implicit action increased from 32 percent to 82 percent of answers before and after the test, while static representation decreased from 50 percent of answers to 17 percent. Their responses didn't add up to 100 percent because some teachers left some answers blank.

"The course helped teachers move from a top-down, one-size-fits-all view of 'this is how you solve these problems,' to an anticipation of how actual students who are learning these concepts for the first time might think through these problems," Hunt said. "That's a very different stance in terms of educating teachers to anticipate student thinking so they can meet it with responsive instruction."

Researchers also tracked how teachers modified math problems to make them more accessible to
students before and after taking the course. After participating in the course, researchers saw that
more teachers changed the problem type. They saw a shift in 50 percent of answers.

"The benefit of anticipating students' thinking is to help teachers to be responsive and support students' prior knowledge as they're teaching, which is a really hard thing to do," Hunt said. "It's even harder if you don't yet appreciate what that thinking could be."

COLUMBUS, Ohio -- As typical social and academic interaction screeched to a halt last year, many young people began experiencing declines in mental health, a problem that appeared to be worse for those whose connections to family and friends weren't as tight, a new study has found.

In June 2020, researchers invited participants in an ongoing study of teenage boys and young men in urban and Appalachian Ohio to complete a survey examining changes to mood, anxiety, closeness to family and friends, and other ways the pandemic affected their lives. The study, co-led by researchers at The Ohio State University and Kenyon College, appears in the Journal of Adolescent Health.

Nearly a third of the 571 participants reported that their mood had worsened or their anxiety had increased between March 2020 and June 2020. The study found that worsening mood and increased anxiety during the pandemic were more likely in those with higher socioeconomic status, those who felt decreasing closeness to friends and family and those who were older. Self-reported increases in anxiety were more common among those with a history of depression and/or anxiety.

One example of feedback from a participant: "A return to a much more introverted, anxious and sedentary lifestyle, after recently making attempts to become more social, outgoing and level-headed."

The research team said the study shines light on those who could be most vulnerable to mental health struggles during a pandemic, and potentially during other situations in which they find themselves isolated from their typical social interaction.

"Though serious cases of COVID-19 have been rare among young people, the pandemic appears to have taken another toll on them," said study senior author Amy Ferketich, a professor of epidemiology at Ohio State.

Eleanor Tetreault, the study's lead author and a recent graduate of Kenyon College, said the existing relationships formed within the ongoing Buckeye Teen Health Study provided an opportunity to quickly assess any perceived changes in mood or anxiety at the onset of the pandemic.

Though the findings about worsening mental health are concerning, Tetreault said there were some surprising positive themes that emerged as she and fellow researchers dived into the respondents' answers to open-ended survey questions.

"The group that had really positive experiences talked about the opportunity for self-exploration, having more time to sit and think or get more connected to their family -- at this age, most people are just going, going, going all the time and all the sudden they had this period of time where they could slow down," said Tetrault, who completed a Pelotonia Summer Research Internship at Ohio State's Comprehensive Cancer Center in 2020.

Though the researchers can't be sure what contributed to the worsening mood and anxiety among some respondents, they do have theories.

Being cooped up with parents who were struggling to work from home and manage the stress of the pandemic could be distressing to young people, Ferketich said, adding that those whose home lives weren't stable to begin with would be hardest hit. Participants from higher socioeconomic groups may have been more likely to have parents who were able to work from home and were more likely to report worsening mental health in the first months of the pandemic.

And though the break from the usual routine "might have been kind of nice at first, it did seem that for some people that changed over time, leading them more toward social isolation, anxiety and depression," Tetreault said.

Though pandemics are rare, the findings from the study don't apply just to a global crisis, she said.

"I think this could apply to any kind of really big change or change in routine for an adolescent or group of adolescents. It highlights the importance of finding ways to maintain social connection, and to help young people maintain those connections when normal social interactions are disrupted."

LAWRENCE -- Substance use disorder has long been considered a key factor in cases of parental neglect. But new research from the University of Kansas shows that such substance abuse does not happen in a vacuum. When examining whether parents investigated by Child Protective Services engaged in neglectful behaviors over the past year, a picture emerges that suggests case workers should look at substance misuse within the context of other factors, like mental health and social supports, to better prevent child neglect and help families.

KU researchers analyzed data of parents investigated for neglectful behavior toward children aged 2-17 and gauged the level of their substance use as well as if they met the criteria for clinical depression. Researchers also studied whether parents had positive social supports such as friends or family, help with children or financial assistance. The results showed that the relationship between parental substance use behaviors and neglect behaviors varied depending on whether the parent was also experiencing clinical depression in the past year and the types of social supports present in their life. For example, substance use disorder among parents with no co-occurring clinical depression contributes to higher annual neglect frequencies compared to substance use disorder among parents with co-occurring clinical depression.

Nancy Kepple"Substance use may matter differently across different contexts. When a parent is already experiencing clinical levels of depression, does substance misuse exacerbate already present neglect behaviors? Nobody really knows; the evidence is mixed," said Nancy Kepple, associate professor of social welfare at KU and lead author of the study. "This study is a part of building a case that it's not one single story when it comes to thinking about how parental substance use is associated with neglectful behaviors."

The study, co-written with recent KU doctoral graduate Amittia Parker, was published in the journal Children and Youth Services Review.

The study analyzed data from 3,545 parents of children from Wave 4 of the National Survey of Child and Adolescent Well-Being. Parents in the survey reported their levels of substance use as well as symptoms of depression and data on different types of social supports. Previously, little research had been done on the interaction of substance use, clinical depression and social support for parental neglect, as substance use has been viewed as the primary factor in such behaviors. Neglect is a difficult topic to study, Kepple said, as it is the omission of a behavior -- providing care and basic needs for a child -- as opposed to enacting physical or emotional harm.

Findings showing that the presence of clinical depression and varying types of social support alters the established relationship between substance use disorder and child neglect, suggesting that treatment should look beyond simply promoting abstinence among parents misusing alcohol and other drugs, the researchers said.

For parents without clinical depression, the types of social support alone did not explain neglectful behaviors. But, for their counterparts, it did. Parents experiencing clinical depression were associated with lower neglect frequency when they had people present in their life who they perceived could help raise their children, but those who reported having more friends to spend time with socially had higher rates of neglect.

"For parents who have clinical depression, their substance use does not seem to have as large of an effect if they have social supports that can provide tangible resources to help care for the child," Kepple said. "Interestingly, having more people to spend time with and who can pull parents out of their home may create opportunities for neglect. People in our lives can pull us away from our responsibilities as much as they can help us navigate through challenges."

The relationship between substance use and social supports is more complicated for parents with no co-occurring clinical depression. Social companionship could be protective or risky, depending on the type of substance use behaviors that a parent reported. For example, the study found neglect rates were comparable among parents reporting no people in their lives who provided opportunities for recreational activities, regardless of substance use behaviors. In contrast, researchers observed higher neglect risk for parents reporting either harmful/risky substance use or substance use disorders for parents reporting one to two people providing social companionship. Yet, findings showed parents reporting three or more sources of social companionship only increased neglect risks for the subsample of parents reporting past year substance use disorder.

Kepple said future research will further examine the types of social interactions parents have with individuals within their social networks and how that influenced neglectful or harmful behaviors. She also plans to work with parents in recovery from prior substance use disorder to understand how their experiences in recovery services and communities have affected their parenting.

Study results show the importance of not simply relying on a single factor to make determinations in services or treatment for parents who have neglected or are at risk of neglecting their children. To better serve families, evaluating the big picture, including factors like clinical depression, social supports and substance use is necessary, researchers argue. It may require more time, resources and clinical thinking; the data supports modern interventions that are providing comprehensive services that support recovery and well-being of parents to address neglect behaviors.

"Neglect is highly contextual," Kepple said. "There are lots of reasons it might be occurring, and that's what we need to understand and further explore. We can't just say 'there's substance misuse, that's a problem,' or 'they have social support, that's good.' When you break these things down, context matters. These findings suggest an individualized plan is likely the best plan, given the complex interactions that are occurring among different risk and protective factors. If systems mandate a parent remain abstinent from alcohol or substance use without addressing underlying mental health or social supports needs, we are not addressing the whole picture."

Skoltech researchers and their colleagues from the University of Southern California have performed genetic analysis of a Russian sunflower collection and identified genetic markers that can help predict the oil's fatty acid composition. The research was published in BMC Genomics.

Genomic selection, which helps quickly create new crop varieties, has been a much-discussed topic worldwide for the last 10 years. DNA sequencing and extensive genotyping have been applied to obtain genetic profiles of crops. When analyzed and compared to field data, those profiles help identify genetic markers for traits of interest to farming and predict the properties and value of a crop based on its genetic profile alone.

"Our work is the first large-scale study of the Russian sunflower genetic collection and one of the first attempts to create new varieties using genomic selection. Predicting what a plant will be like before actually planting it - an idea that seemed utterly unrealistic until recently - has become commonplace in many countries thanks to technological advances. Classical breeding can hardly cope with the challenges posed by the global climate change, growing human needs, and evolving food quality requirements. To get a head start, we should turn to genetics," Alina Chernova, Skoltech PhD and lead author of the study, notes.

This long-term research project has been carried out by a joint team led by Skoltech professor Philipp Khaitovich and featuring scientists from Skoltech, the University of Southern California, Vavilov All-Russian Institute of Plant Genetic Resources, and Pustovoit All-Russian Research Institute of Oil Crops, joined by breeders from the seed-producing company Agroplasma.

The team looked at species from two major Russian sunflower gene banks and Agroplasma's collection. Their genetic analysis covered 601 lines of cultivated sunflower to check genetic diversity against the global collection and compare the results with chemical tests of oil obtained from these lines. Bioinformatic analysis revealed genetic markers that can help control the oil's fatty acid content.

"The reason we chose the sunflower is that it is a key source of vegetable fats, and Russia is the world's leading supplier of sunflower oil. You can vary the oil's fatty acid composition - which was the focus of our research - to obtain oils with different properties suitable for roasting, dressings or industrial uses," Skoltech PhD student and study co-author Rim Gubaev says.

"Thanks to this project, we have gained valuable insights and built a team of like-minded people keen on helping breeders to introduce genetics in their work. We have founded Oil Gene - it's a startup that will focus on practical tasks and provide genomic selection services," Gubaev adds.

New Brunswick, NJ--Children and adolescents with multisystem inflammatory syndrome in children (MIS-C) who are treated initially with intravenous immune globulin (IVIG) and glucocorticoids have reduced risk for serious short-term outcomes, including cardiovascular dysfunction, than those who receive an initial treatment of IVIG alone, a new study finds.

MIS-C is a rare but serious--and sometimes fatal--condition associated with COVID-19, in which different body organs or systems become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal system. It can occur weeks after having COVID-19 and even if the child or caregivers did not know the child had been infected.

The new study, published in the New England Journal of Medicine, analyzed treatment and outcomes of more than 596 children and adolescents who had been admitted with MIS-C to one of 58 U.S. hospitals between March 15 and Oct. 31, 2020, in the hopes of providing data that could guide MIS-C treatment in the future, study authors noted.

"It is important to realize that MIS-C is still a new disease process in its infancy, and this is the first large-scale article published looking at treatment options and patient outcomes," said Dr. Steven M. Horwitz, assistant professor of pediatrics in the Division of Pediatric Critical Care at Rutgers Robert Wood Johnson Medical School, and one of the authors of the study. "At our own institution, we have seen an evolution of the initial work-up and treatment of MIS-C over the past year, and a relatively large study such as this will help guide future treatment options."

Study findings showed that, while nearly a third (31%) of children and adolescents treated with IVIG alone experienced new or persistent cardiovascular dysfunction on the second day of treatment or later, that number dropped to 17% for patients whose initial therapy combined IVIG and glucocorticoids. In addition, IVIG and glucocorticoids as initial treatment required less adjunctive therapy on or after the first day of treatment than those who were initially treated with IVIG alone: 34% compared to 70%.

IVIG is a highly concentrated, diverse group of antibodies, delivered through the vein, that is used either to bolster an individual's own antibodies if they are immunodeficient or, as in the case of MIS-C, to help the body defend against an attack on its cells by its own immune system. It is a standard treatment for Kawasaki's disease, which has similarities to MIS-C, and viral myocarditis. Glucocorticoids, meanwhile, are steroid hormones that help suppress inflammation from autoimmune disorders; they include methylprednisolone (prescribed to 68% of those studied who received glucocorticoids), prednisolone and dexamethasolone.

The study's findings regarding treatment outcomes are particularly important given the ongoing issues related to the COVID-19 pandemic, noted Dr. Horwitz.

"While vaccines have played a massive role in reducing the spread of COVID, we are all aware that COVID and MIS-C are not going away anytime soon," he said. "We are now seeing new variants with higher transmission rates and less protection from the vaccines. As such, we expect to keep seeing MIS-C."

While MIS-C is a very serious condition that should not be taken lightly, they have seen the majority of patients do very well, Dr. Horwitz added: "Although MIS-C by definition affects multiple organ systems, the cardiac dysfunction--including arrhythmias, dilated coronary arteries and decreased function--continues to be the biggest concern. With effective treatment, these patients tend to improve in a timely manner and quicker than what we have historically seen with other forms of viral myocarditis."

The new study was funded by the Centers for Disease Control and Prevention under a contract to Boston Children's Hospital as part of the Overcoming COVID-19 surveillance registry, designed to track COVID-19-related severe complications in children and adolescents hospitalized in the United States. Specialists from Robert Wood Johnson Medical School's Department of Pediatrics and The Bristol-Myers Squibb Children's Hospital at Robert Wood Johnson University Hospital are among the Overcoming COVID-19 investigators.

"I give credit to the CDC and Boston Children's Hospital in helping lead this effort. One of the key aspects of this work has been our ability to come together as a pediatric medical community, to collaborate and share information about this new and evolving disease," Dr. Horwitz said.

That understanding involves not only MIS-C as an acute illness, but also long-term follow-up, he added.

"We are not sure if MIS-C is 'just the tip of the iceberg,'" Dr. Horwitz explained. "While most patients with MIS-C recover relatively quickly, we don't know the long-term effects that this disease may carry. Are patients who have had MIS-C prone to developing similar symptoms in the future? Is it safe for patients who have had MIS-C to receive the COVID vaccine? Are there certain genetic predispositions that make people more susceptible to developing MIS-C? These are just some of the questions that we are continuing to study."

Taken together, the bacteria, viruses, fungi and other microbes that live in our intestines form the gut microbiome, which plays a key role in the health of people and animals. In new research from the University of Minnesota, University of Notre Dame and Duke University, scientists found that genetics nearly always plays a role in the composition of the gut microbiome of wild baboons.

"In humans, research has shown that family members share a significant portion of microbes in their gut, but it's hard to answer if our microbiome is shaped more by nature, such as those we inherit from our family, or nurture, such as the similar diets, environments and behaviors families share," said lead author Laura Grieneisen, a postdoctoral fellow in the College of Biological Sciences. "Many human diseases and other markers of health have a genetic component. The number and types of bacteria in the gut are no different. By understanding the heritability of the gut microbiome will help us better link genes, the gut and health."

To examine consistent data, researchers turned to more than 16,000 microbiome samples collected from 585 wild baboons over the course of 14 years. The size and generational scope of this microbiome data -- crucial for understanding how the microbiome is affected by genetics (i.e. microbiome heritability) -- has not yet been collected in humans.

In the research, published in the journal Science, the team tested how host traits (e.g., age, sex), behaviors (e.g., social group membership, grooming), diet, pedigree relatedness, and environmental characteristics (e.g., season, year) predicted 1,034 gut microbiome traits.

Researchers found that:

while prior research in humans indicated that heritable gut microbiome taxa (i.e., species, family and class of an organism) were uncommon, 95% of microbial taxa were heritable in the wild baboon population;

heritability estimates are strongly and positively correlated between humans and baboons, suggesting that traits with low heritability in baboons may also be heritable -- but have gone undetected -- in humans;

microbiome heritability is dynamic and context-dependent, such that heritability is greater in the dry season, with low diet diversity, and in older hosts.

"Our results qualitatively change the field's perspective on the determinants of microbiome composition," said co-author Ran Blekhman, an associate professor in the College of Biological Sciences. "From one in which the host genotype plays no role in the majority of microbiome taxa to one in which the host genotype nearly always plays a role. As a result, microbiome traits might evolve via natural selection on the host."

Researchers state that this opens the door to identifying individual microbes that are particularly shaped by host genetics.

"As a result, if there are microbes that are heritable and linked to health outcomes, it would allow us to better understand the genetic basis of these outcomes," said Grieneisen. "Most of the microbiome may be visible to natural selection on the host genome."

The researchers add that their results are consistent with past work: although the role of a host's genotype is universal, their environment and behaviors are still much more important than genetics in shaping microbiome composition. The team will continue to work with the wild baboon dataset to pursue questions about the drivers and physiological consequences of long-term changes in the microbiome.

This research was supported by funding from the National Institutes of Health, the University of Minnesota Grand Challenges Biology Postdoctoral

A team led by researchers at Baylor College of Medicine found that a screening method known as untargeted metabolomics profiling can improve the diagnostic rate for inborn errors of metabolism, a group of rare genetic conditions, by about seven-fold when compared to the traditional metabolic screening approach.

The study, published in JAMA Network Open, shows that untargeted metabolomics identifies many more disorders of greater variety as compared to traditional methods, including disorders for which there was not a clinically available biochemical test. The researchers hope that adoption of metabolomics to screen for inborn errors of metabolism will result in a more rapid, more efficient and less expensive diagnostic journey for individuals and families with rare metabolic disorders.

"Currently, newborn screening is conducted in every infant born in the U.S. to check for serious but rare health conditions at birth. Screening includes blood, hearing and heart tests," said corresponding author Dr. Sarah Elsea, professor of molecular and human genetics at Baylor and senior director of biochemical genetics at Baylor Genetics. "While newborn screening in general has improved in the last 10 years, clinically screening for inborn errors of metabolism has not changed substantially in the last 40 to 50 years."

Inborn errors of metabolism include conditions that disrupt the normal processes the body uses to transform food into energy and can result in serious conditions. Having an early diagnosis can lead to early treatment, when available. For instance, newborn screening looks for signs of conditions such as phenylketonuria, the body's inability to break down the amino acid phenylalanine, which results in its accumulation. Buildup of phenylalanine can irreparably harm the nervous system, but early intervention may help manage the condition.

"We developed a clinical test - untargeted metabolomics profiling - that looks at a broader range of metabolic compounds in the blood, therefore screening for many more disorders than the currently used approach," said Elsea, a member of Baylor's Dan L Duncan Comprehensive Cancer Center and Center for Drug Discovery. "In the current study, we compared the standard approach and untargeted metabolomics on their effectiveness identifying metabolic conditions."

The researchers compared the results of applying the two approaches to 4,464 clinical samples received from 1,483 unrelated families. They found that the traditional standard analysis has a positive rate of diagnosis of about 1%. However, using the untargeted metabolomics analysis the researchers were able to confirm a positive rate of diagnosis of 7%.

"This is a substantial increase in the ability to diagnose these conditions," Elsea said. "We are now able to identify in one blood sample more conditions than ever before."

"In addition, our analysis of many metabolic compounds in a single blood sample reduces the need of having to take more samples to do further testing looking for specific conditions. This includes taking samples of cerebrospinal fluid, which involves a more invasive procedure than drawing a blood sample," said co-author Dr. V. Reid Sutton, professor of molecular and human genetics at Baylor, medical director of the biochemical genetics laboratory at Baylor Genetics and director of the Inborn Errors of Metabolism Service at Texas Children's Hospital.

This screening approach offers the critical advantages of reducing the time to having a diagnosis and starting treatment, if available.

Using untargeted metabolomics in combination with genetic screening enables researchers and physicians not only to confirm a diagnosis with high degree of confidence, but also to rule out potential conditions. The novel, broader screening approach identifies severe forms of diseases and also mild forms that may not quite fit the characteristics observed in the more severe cases.

"We are finding individuals with milder forms of a disease are more common in our populations than those with severe forms," Elsea said. "Our approach has been quite successful identifying seizure disorders, movement disorders and autism spectrum disorders. Our analyses have taught us to open our minds to a much greater spectrum of disease, allowing us to improve early diagnosis."

The sharp eyes of an eagle, the extraordinary hearing of an owl - to successfully find food, the eyes and ears of birds have adapted optimally to their living conditions. Until now, the sense of smell has played a rather subordinate role. When meadows are freshly mowed, storks often appear there to search for snails and frogs. Researchers at the Max Planck Institute for Animal Behavior in Radolfzell and the Max Planck Institute for Chemistry in Mainz have now studied the birds' behavior and discovered that the storks are attracted by the smell of the mown grass. Only storks that were downwind and could thus perceive the smell reacted to the mowing. The scientists also sprayed a meadow with a spray of green leaf scents released during mowing. Storks appeared here as well. This shows that white storks use their sense of smell to forage and suggests that the sense of smell may also play a greater role in other birds than previously thought.

For farmers around Lake Constance, it's a familiar sight: when they start mowing their meadows, storks often appear next to the tractors as if out of nowhere. The white storks live in the wet areas around the lake, feeding on snails, frogs and small rodents that find shelter in high meadows. If these meadows are mowed, the small animals are easy prey. However, the storks do not always appear when mowing takes place. Until now, it was not known how the storks locate the rich food source.

Previously, it was believed that birds relied primarily on their eyes and ears rather than their sense of smell. "It was simply assumed that birds can't smell well because they don't have real noses," says Martin Wikelski, director at the Max Planck Institute of Animal Behavior. "Yet they have a very large olfactory bulb in the brain with many receptor molecules for scents." So birds have the best prerequisites for a fine nose.

Testing for smell

Wikelski has spent many years observing storks and researching their migratory behavior, among other things. When he talked to his colleague Jonathan Williams about the storks' puzzling reaction to mowed meadows, Williams had an idea. Williams works at the Max Planck Institute for Chemistry in Mainz, Germany, studying volatile organic compounds and their effects on humans and the environment. "My guess was that the storks were reacting to the intense smell of freshly cut grass," Williams says. This typical smell is produced by so-called green leaf odorants and consists of only three different molecules. "These are also added to perfumes, for example, to give them a fresh, "green" note," explains Williams.

The researchers now wanted to find out whether the sense of smell actually leads the storks to freshly mown meadows. To do this, they monitored the birds' movements both from aircraft and via GPS sensors of tagged animals. "We first had to rule out the possibility that the storks could hear the tractor or see the mowing process," Wikelski says. Therefore, they only included storks in the observation that were more than 600 meters away from the mowed meadow and did not have direct visual contact. The researchers also made sure that the storks were not alerted to the mowing process by the behavior of conspecifics or other birds.

Direction downwind

When mowing began, only the storks that were downwind flew to the meadow in question. The conspecifics that were upwind and thus could not perceive the grass smell did not react. To test whether the smell of the cut grass alone attracted the storks, the researchers switched to a meadow that had been mowed two weeks earlier. "The grass of this meadow was still very short. Therefore, it is uninteresting for the storks to forage," Wikelski explained. On this meadow, he and colleagues spread grass that had been mowed a short time before at a greater distance. A short time later, the first storks flew in and searched for food in the mown grass.

The researchers finally mixed a solution of green leaf scents and sprayed it on a meadow with short grass. The meadow then smelled intensely of mown grass and also attracted storks from the surrounding area. "This proves that storks find their way to feeding sites via scents in the air," Williams says.

This finding contradicts the previous assumption that storks primarily use their eyes to find food. Rather, the birds rely on their sense of smell to do so. "There have been storks that have flown more than 25 kilometers from the other side of Lake Constance to mowed meadows," Wikelski says. The researchers suspect that the sense of smell may also play a greater role than previously thought in the foraging activities of other bird species. Birds of prey such as buzzards and red kites are regularly observed flying over freshly mown meadows.

The function of a protein can depend on its abundance in a cell. So, when investigating the properties of a new protein, it is essential to make sure that the same amount is produced by every cell. Researchers at Baylor College of Medicine and Rice University have found a new way to do just that through the creation of new genetic circuits called Equalizers.

The findings, in the current edition of Nature Communications, show how researchers engineered these genetic circuits to buffer protein output from variations in the number of copies of the gene inside the cell, thereby helping to create consistent protein expression. This property is called "gene dosage compensation."

The researchers use an analogy of heating a house to help explain how Equalizers work. Imagine using randomly placed space heaters to heat your home. To ensure each room gets a heater you would purchase some extra ones, but that would mean some rooms might have extra heaters. Those rooms might be too hot, so a solution would be to have thermostats on each heater to downregulate the heat when a room becomes too hot. Those thermostats act as the Equalizer.

Researchers typically encode genes to be expressed on circular pieces of DNA called plasmids. Excess plasmids are often used to ensure that most cells get one, but some cells will get several. The Equalizer is composed of transcriptional negative feedback and post-transcriptional incoherent feedforward loops. These loops counteract the presence of extra plasmids: they sense the outputs, in this case the proteins and mRNAs that the plasmids produce, and tune down their expression if they rise too high.

"We didn't invent the parts, but rather we invented a new way to connect them together into a circuit," said Jin Yang, who shared co-first authorship of the paper with graduate student Jihwan Lee of Rice University. Jin was a bioengineering undergrad at Rice University while developing this work and currently is a Ph.D. student at the Massachusetts Institute of Technology. "In natural systems, some gene networks must control gene dosage variation to remain functional and conserve their properties.

We repurposed and combined two types of gene dosage compensation circuits to create a version that enables uniform expression of any protein scientists want to produce in the lab."

Negative feedback and incoherent feedforward circuit subcircuits can each help compensate for gene dosage, but the researchers found that coupling the two improved overall performance. This is because each circuit is not perfect. For example, the incoherent feedforward loop can saturate because it requires other proteins that are present in limited quantities in the cell. The negative feedback loop is limited in its inhibitory capacity, similar to a leaky sink faucet that cannot be fully closed. But combining these two imperfect circuits produced robust performance, with each circuit helping mitigate the limitation of the other.

"The process we used for these findings was a collaborative effort bringing together computer simulations and biology. This is similar to how engineers work - they draw up their plans, create a model and then build their structure," said Dr. Oleg Igoshin, professor of bioengineering, of biosciences and of chemistry at Rice University and a senior author on the paper. "In this case we were able to create our model and show the effectiveness through computational models before it was then synthetically engineered in the lab."

But why is minimizing expression variation important when it comes to biological research?

"The effect of a protein can depend on its abundance in a cell. If you're studying a new protein and its concentration is too low, you may not be able to observe its function in the cell. If its concentration is too high, the protein may mislocalize, aggregate, produce cytotoxicity or otherwise produce responses that are not physiological. It is therefore important that a protein is expressed at the desired level in every cell under investigation," said Dr. François St-Pierre, assistant professor of neuroscience and McNair Scholar at Baylor and corresponding author of this study. "We believe Equalizers will be of high value both for basic research and for industry."

Maunakea, Hawai'i - Astronomers have made the rare sighting of two stars spiraling to their doom by spotting the tell-tale signs of a teardrop-shaped star.

The tragic shape is caused by a massive nearby white dwarf distorting the star with its intense gravity, which will also be the catalyst for an eventual supernova that will consume both. Found by an international team of astronomers and astrophysicists led by the University of Warwick, it is one of only a very small number of star systems discovered that will one day see a white dwarf star reignite its core.

The team's new research is published in today's issue of the journal Nature Astronomy.

With the help of W. M. Keck Observatory on Maunakea in Hawai'i, the astronomers were able to confirm that the two stars are in the early stages of a spiral that will likely end in a Type Ia supernova - a type that helps astronomers determine how fast the universe is expanding.

The couple - a binary star system called HD265435 - is located roughly 1,500 light-years away; it is comprised of a hot subdwarf star and a white dwarf star orbiting each other closely at a dizzying rate of around 100 minutes. White dwarfs are 'dead' stars that have burned all their fuel and collapsed in on themselves, making them small but extremely dense.

A type Ia supernova is generally thought to occur when a white dwarf star's core reignites, leading to a thermonuclear explosion. There are two scenarios where this can happen. In the first, the white dwarf gains enough mass to reach 1.4 times the mass of our Sun, known as the Chandrasekhar limit. HD265435 fits in the second scenario, in which the total mass of a close stellar system of multiple stars is near or above this limit. Only a handful of other star systems have been discovered that will reach this threshold and result in a Type Ia supernova.

Lead author Ingrid Pelisoli from the University of Warwick Department of Physics explains: "We don't know exactly how these supernovae explode, but we know it has to happen because we see it happening elsewhere in the universe."

"One way is if the white dwarf accretes enough mass from the hot subdwarf, so as the two of them are orbiting each other and getting closer, matter will start to escape the hot subdwarf and fall onto the white dwarf. Another way is that because they are losing energy to gravitational wave emissions, they will get closer until they merge. Once the white dwarf gains enough mass from either method, it will go supernova," she says.

Using data from NASA's Transiting Exoplanet Survey Satellite, the team was able to observe the hot subdwarf. While they did not detect the white dwarf, the researchers observed the brightness of the hot subdwarf varied over time; this suggests a nearby massive object was distorting the star into a teardrop shape.

The astronomers then used Palomar Observatory and Keck Observatory's Echellette Spectrograph and Imager (ESI) to measure the radial velocity and rotational velocity of the hot subdwarf star, which allowed them to confirm that the hidden white dwarf is as heavy as our Sun, but just slightly smaller than the Earth's radius. Combined with the mass of the hot subdwarf, which is a little over 0.6 times the mass of our Sun, both stars have the mass needed to cause a Type Ia supernova.

"Keck's ESI data was crucial in determining that the compact binary system exceeds the Chandrasekhar mass limit, which makes HD265435 one of the very few supernova Ia progenitor systems known," says co-author Thomas Kupfer, assistant professor at Texas Tech University's Department of Physics and Astronomy.

As the two stars are already close enough to begin spiraling closer together, the white dwarf will inevitably go supernova in around 70 million years. Theoretical models produced specifically for this study also predict that the hot subdwarf will contract to become a white dwarf star before merging with its companion.

Type Ia supernovae are important for cosmology as 'standard candles.' Their brightness is constant and of a specific type of light, which means astronomers can compare what luminosity they should be with what we observe on Earth, and from that work out how distant they are with a good degree of accuracy. By observing supernovae in distant galaxies, astronomers combine what they know of how fast this galaxy is moving with our distance from the supernova and calculate the expansion of the universe.

"The more we understand how supernovae work, the better we can calibrate our standard candles. This is very important at the moment because there's a discrepancy between what we get from this kind of standard candle, and what we get through other methods," says Pelisoli.

She adds, "The more we understand about how supernovae form, the better we can understand whether this discrepancy we are seeing is because of new physics that we're unaware of and not taking into account, or simply because we're underestimating the uncertainties in those distances."

"There is another discrepancy between the estimated and observed galactic supernovae rate, and the number of progenitors we see. We can estimate how many supernovae are going to be in our galaxy through observing many galaxies, or through what we know from stellar evolution, and this number is consistent. But if we look for objects that can become supernovae, we don't have enough. This discovery was very useful to put an estimate of what a hot subdwarf and white dwarf binaries can contribute. It still doesn't seem to be a lot, none of the channels we observed seems to be enough," Pelisoli says.

Children with a devastating genetic disorder characterized by severe motor disability and developmental delay have experienced sometimes dramatic improvements in a gene therapy trial launched at UCSF Benioff Children's Hospitals.

The trial includes seven children aged 4 to 9 born with deficiency of AADC, an enzyme involved in the synthesis of neurotransmitters, particularly dopamine, that leaves them unable to speak, feed themselves or hold up their head. Six of the children were treated at UCSF and one at Ohio State Wexner Medical Center.

Children in the study experienced improved motor function, better mood, and longer sleep, and were able to interact more fully with their parents and siblings. Oculogyric crisis, a hallmark of the disorder involving involuntary upward fixed gaze that may last for hours and may be accompanied by seizure-like episodes, ceased in all but one patient. Results appear July 12, 2021, in Nature Communications.

Just 135 children worldwide are known to be missing the AADC enzyme, with the condition affecting more people of Asian descent.

The trial borrowed from gene delivery techniques used to treat Parkinson's disease, pioneered by senior author Krystof Bankiewicz, MD, PhD, of the UCSF Department of Neurological Surgery and the Weil Institute for Neurosciences, and of the Department of Neurological Surgery at Ohio State University. Both conditions are associated with deficiencies of AADC, which converts levodopa into dopamine, a neurotransmitter involved in movement, mood, learning and concentration.

Viral Vector, Real-Time MR Imaging Key to Success

In treating both conditions, Bankiewicz developed a viral vector containing the AADC gene. The vector is infused into the brain via a small hole in the skull, using real-time MR imaging to enable the neurosurgeon to map the target region and plan canula insertion and infusion.

"Children with primary AADC deficiency lack a functional copy of the gene, but we had presumed that their actual neuronal pathway was intact," said co-first author Nalin Gupta, MD, PhD, of the UCSF Department of Neurological Surgery and the surgical principal investigator. "This is unlike Parkinson's disease, where the neurons that produce dopamine undergo degeneration."

While the Parkinson's trial focused on the putamen, a part of the brain that plays a key role in this degeneration, Gupta said the AADC gene therapy trial targeted neurons in the substantia nigra and ventral tegmental area of the brainstem, sites that may have more therapeutic benefits.

"The approach for treating AADC deficiency is much more straightforward than it is for Parkinson's," said Bankiewicz. "In AADC deficiency, the wiring of the brain is normal, it's just the neurons don't know how to produce dopamine because they lack AADC."

Physicians who follow patients with AADC deficiency agree that it is usually treated with limited success by managing symptoms, such as with medications used for Parkinson's disease to increase dopamine, melatonin for sleep disturbances and benzodiazepines to relieve oculogyric crisis.

Following gene delivery, PET imaging demonstrated increased brain AADC activity and screening of neurotransmitter metabolites from cerebrospinal fluid showed elevated concentrations, the researchers noted.

At the start of the study, only two of the seven children had partial head control, just one could reach or grasp and none were able to sit independently. Six of the seven were described as irritable and all but one had insomnia. Their baseline motor skill scores were all within the severe impairment range. Symptoms eased after surgery, starting with oculogyric crisis.

"Remarkably, these episodes were the first to disappear and they never returned," said Bankiewicz. "In the months that followed, many patients experienced life-changing improvements. Not only did they begin laughing and have improved mood, but some were able to start speaking and even walking."

New Goals Reached in Sitting, Walking, Feeding, Speech

All patients experienced recognizable gains in motor function, manifested by increased tone and better head and trunk control, and purposeful limb movements. Head control was attained by six of the seven children by month 12 and four were able to sit independently by this time. Also, at 12 months, three patients could reach and grasp and two were able to walk with trunk support. Two-and-a-half years after surgery, one patient started to take independent steps. One patient was able to speak using a vocabulary of about 50 single words by 12 months and a second was able to communicate with an assistive device between 12 to 18 months after gene delivery.

Significant improvements were reported by parents and caregivers in sleep and mood, as well as in feeding difficulties, such as vomiting, and upper airway obstruction due to profuse mucus secretions and congestion. The procedure was well tolerated without adverse short-term or long-term effects, but one child died at seven months after surgery. The patient appeared to be in good health and the cause of death is "most likely attributable to the underlying primary disease," the researchers stated.

The study follows the Parkinson's trial, which also showed positive results with increased durations of well-controlled symptoms. The Bankiewicz team will start two new gene therapy trials, using the same surgical techniques and viral vector, for early Alzheimer's disease and for multiple system atrophy, a rare neurodegenerative disorder. Both trials will run at Ohio State University and will start next month.