Earth

How much did SARS-CoV-2 need to change in order to adapt to its new human host? In a research article published in the open access journal PLOS Biology Oscar MacLean, Spyros Lytras at the University of Glasgow, and colleagues, show that since December 2019 and for the first 11 months of the SARS-CoV-2 pandemic there has been very little 'important' genetic change observed in the hundreds of thousands of sequenced virus genomes.

The study is a collaboration between researchers in the UK, US and Belgium. The lead authors Prof David L Robertson (at the MRC-University of Glasgow Centre for Virus Research, Scotland) and Prof Sergei Pond (at the Institute for Genomics and Evolutionary Medicine, Temple University, Philadelphia) were able to turn their experience of analysing data from HIV and other viruses to SARS-CoV-2. Pond's state-of-the-art analytical framework, HyPhy, was instrumental in teasing out the signatures of evolution embedded in the virus genomes and rests on decades of theoretical knowledge on molecular evolutionary processes.

First author Dr Oscar MacLean explains, "This does not mean no changes have occurred, mutations of no evolutionary significance accumulate and 'surf' along the millions of transmission events, like they do in all viruses." Some changes can have an effect; for example, the Spike replacement D614G which has been found to enhance transmissibility and certain other tweaks of virus biology scattered over its genome. On the whole, though, 'neutral' evolutionary processes have dominated. MacLean adds, "This stasis can be attributed to the highly susceptible nature of the human population to this new pathogen, with limited pressure from population immunity, and lack of containment, leading to exponential growth making almost every virus a winner."

Pond comments, "what's been so surprising is just how transmissible SARS-CoV-2 has been from the outset. Usually viruses that jump to a new host species take some time to acquire adaptations to be as capable as SARS-CoV-2 at spreading, and most never make it past that stage, resulting in dead-end spillovers or localised outbreaks."

Studying the mutational processes of SARS-CoV-2 and related sarbecoviruses (the group of viruses SARS-CoV-2 belongs to from bats and pangolins), the authors find evidence of fairly significant change, but all before the emergence of SARS-CoV-2 in humans. This means that the 'generalist' nature of many coronaviruses and their apparent facility to jump between hosts, imbued SARS-CoV-2 with ready-made ability to infect humans and other mammals, but those properties most have probably evolved in bats prior to spillover to humans.

Joint first author and PhD student Spyros Lytras adds, "Interestingly, one of the closer bat viruses, RmYN02, has an intriguing genome structure made up of both SARS-CoV-2-like and bat-virus-like segments. Its genetic material carries both distinct composition signatures (associated with the action of host anti-viral immunity), supporting this change of evolutionary pace occurred in bats without the need for an intermediate animal species."

Robertson comments, "the reason for the 'shifting of gears' of SARS-CoV-2 in terms of its increased rate of evolution at the end of 2020, associated with more heavily mutated lineages, is because the immunological profile of the human population has changed." The virus towards the end of 2020 was increasingly coming into contact with existing host immunity as numbers of previously infected people are now high. This will select for variants that can dodge some of the host response. Coupled with the evasion of immunity in longer-term infections in chronic cases (e.g., in immunocompromised patients), these new selective pressures are increasing the number of important virus mutants.

It's important to appreciate SARS-CoV-2 still remains an acute virus, cleared by the immune response in the vast majority of infections. However, it's now moving away faster from the January 2020 variant used in all of the current vaccines to raise protective immunity. The current vaccines will continue to work against most of the circulating variants but the more time that passes, and the bigger the differential between vaccinated and not-vaccinated numbers of people, the more opportunity there will be for vaccine escape. Robertson adds, "The first race was to develop a vaccine. The race now is to get the global population vaccinated as quickly as possible."

Orono, Maine -- The origins of ice age climate changes may lie in the Southern Hemisphere, where interactions among the westerly wind system, the Southern Ocean and the tropical Pacific can trigger rapid, global changes in atmospheric temperature, according to an international research team led by the University of Maine.

The mechanism, dubbed the Zealandia Switch, relates to the general position of the Southern Hemisphere westerly wind belt -- the strongest wind system on Earth -- and the continental platforms of the southwest Pacific Ocean, and their control on ocean currents. Shifts in the latitude of the westerly winds affects the strength of the subtropical oceanic gyres and, in turn, influences the release of energy from the tropical ocean waters, the planet's "heat engine." Tropical heat spreads rapidly through the atmosphere and ocean to the polar regions of both hemispheres, acting as the planet's thermostat.

The Southern Hemisphere climate dynamics may be the missing link in understanding longstanding questions about ice ages, based on the findings of the research team from UMaine, Columbia University's Lamont-Doherty Earth Observatory, the University of Arizona, and GNS Science in New Zealand, published in Quaternary Science Reviews.

For more than a quarter-century, George Denton, UMaine Libra Professor of Geological Sciences, the journal article's first author, has led research reconstructing the history of mountain glaciers in the Southern Hemisphere. In the late 1980s, he and Wallace Broecker, a geochemist at Columbia University, noted that a key question about ice ages remained unresolved -- the link between ice age climate and the orbital cycles in the length and strength of the Earth's season. Evidence showed that ice age climate changes were synchronous in both polar hemispheres, with rapid transitions from glacial to interglacial global climate conditions. They concluded that existing theories could not adequately account for changes in seasonality, ice sheet size and regional climate.

Mountain glaciers are highly sensitive to climate and well suited to climatic reconstruction, using distinctive moraine deposits that mark the former glacier limits. In the 1990s, Denton led research teams in the mapping and dating of moraine sequences in South America and, more recently, in New Zealand's Southern Alps, with co-author David Barrell, geologist and geomorphologist with the New Zealand government's geoscience research institute, GNS Science.

With advances in isotopic dating of moraines in the mid-2000s, Denton teamed up with Columbia University's Joerg Schaefer, who directs the Cosmogenic Nuclide Laboratory at the Lamont-Doherty Earth Observatory. Together with CU-LDEO colleague and co-author Michael Kaplan, Schaefer, Denton, and UMaine assistant professor and co-author Aaron Putnam have guided a succession of UMaine graduate student field and laboratory projects (including Putnam's Ph.D. work) that have developed a chronology of climate-induced glacier changes in the Southern Alps spanning many tens of thousands of years. The most recent participant in the UMaine-CU partnership is UMaine Ph.D. student and co-author Peter Strand.

Collectively, the UMaine, CU-LDEO and GNS Science partners have worked to create and compile mountain glacier chronologies from New Zealand and South America, producing a comprehensive chronology of glacier extent during and since the last ice age. The team then compared the moraine dating to paleoclimate data worldwide to gain insights into the climate dynamics of ice ages and millennial-scale abrupt climate events. The findings highlight a general global synchronicity of mountain-glacier advance and retreat during the last ice age.

Deep insights into the climate dynamics come from co-author Joellen Russell, climate scientist at the University of Arizona and Thomas R. Brown Distinguished Chair of Integrative Science. Following on her longstanding efforts at modeling the climatic modulation of the westerly winds, she evaluated simulations done as part of the Southern Ocean Model Intercomparison Project, part of the Southern Ocean Carbon and Climate Observations and Modeling initiative. The modeling showed the changes to the southern wind systems have profound consequences for the global heat budget, as monitored by glacier systems.

The "switch" takes its name from Zealandia, a largely submerged continental platform about a third of the size of Australia, with the islands of New Zealand being the largest emergent parts. Zealandia presents a physical impediment to ocean current flow. When the westerly wind belt is farther north, the southward flow of warm ocean water from the tropical Pacific is directed north of the New Zealand landmass (glacial mode). With the wind belt farther south, warm ocean water extends to the south of New Zealand (interglacial mode). Computer modelling shows that global climate effects arise from the latitude at which the westerlies are circulating. A southward shift of the southern westerlies invigorates water circulation in the South Pacific and Southern oceans, and warms the surface ocean waters across much of the globe.

The researchers hypothesize that subtle changes in the Earth's orbit affect the behavior of the Southern Hemisphere westerly winds, and that behavior lies at the heart of global ice age cycles. This perspective is fundamentally different from the long-held view that orbital influences on the extent of Northern Hemisphere continental ice sheets regulate ice age climates. Adding weight to the Zealandia Switch hypothesis is that the Southern Hemisphere westerlies regulate the exchange of carbon dioxide and heat between the ocean and atmosphere, and, thus, exert a further influence on global climate.

"Together with interhemispheric paleoclimate records and with the results of coupled ocean-atmosphere climate modeling, these findings suggest a big, fast and global end to the last ice age in which a southern-sourced warming episode linked the hemispheres," according to the researchers, whose work was funded by the Comer Family Foundation, the Quesada Family Foundation, the National Science Foundation and the New Zealand government.

The last glacial termination was a global warming episode that led to extreme seasonality (winter vs. summer conditions) in northern latitudes by stimulating a flush of meltwater and icebergs into the North Atlantic from adjoining ice sheets. Summer warming led to freshwater influx, resulting in widespread North Atlantic sea ice that caused very cold northern winters and amplified the annual southward shift of the Intertropical Convergence Zone and the monsoonal rain belts. Although this has created an impression of differing temperature responses between the polar hemispheres, the so-called "bipolar seesaw," the researchers suggest this is due to contrasting interregional effects of global warming or cooling. A succession of short-lived, abrupt, episodes of cold northern winters during the last ice age are suggested to have been caused by temporary shifts of the Zealandia Switch mechanism.

The southward shift of the Southern Hemisphere westerlies at the termination of the last ice age was accompanied by gradual but sustained release of carbon dioxide from the Southern Ocean, which may have helped to lock the climate system into a warm interglacial mode.

The researchers suggest that the introduction of fossil CO2 into the atmosphere may be reawakening the same dynamics that ended the last ice age, potentially propelling the climate system into a new mode.

"The mapping and dating of mid-latitude Southern Hemisphere mountain-glacier moraines leads us to the view that the latitude and strength of the austral westerlies, and their effect on the tropical/subtropical ocean, particularly in the region spanning the Indo-Pacific Warm Pool and Tasman Sea through to the Southern Ocean, provides an explanation for driving orbital-scale global shifts between glacial and interglacial climatic modes, via the Zealandia Switch mechanism," the research team wrote. "Such behavior of the ocean-atmosphere system may be operative in today's warming world, introducing a distinctly nonlinear mechanism for accelerating global warming due to atmospheric CO2 rise."

Sound sleep plays a critical role in healing traumatic brain injury, a new study of military veterans suggests.

The study, published in the Journal of Neurotrauma, used a new technique involving magnetic resonance imaging developed at Oregon Health & Science University. Researchers used MRI to evaluate the enlargement of perivascular spaces that surround blood vessels in the brain. Enlargement of these spaces occurs in aging and is associated with the development of dementia.

Among veterans in the study, those who slept poorly had more evidence of these enlarged spaces and more post-concussive symptoms.

"This has huge implications for the armed forces as well as civilians," said lead author Juan Piantino, M.D., MCR, assistant professor of pediatrics (neurology) in the OHSU School of Medicine and Doernbecher Children's Hospital. "This study suggests sleep may play an important role in clearing waste from the brain after traumatic brain injury - and if you don't sleep very well, you might not clean your brain as efficiently."

Piantino, a physician-scientist with OHSU's Papé Family Pediatric Research Institute, studies the effects of poor sleep on recovery after traumatic brain injuries.

The new study benefited from a method of analyzing MRIs developed by study co-author Daniel Schwartz and Erin Boespflug, Ph.D., under the direction of Lisa Silbert, M.D., M.C.R., professor of neurology in the OHSU School of Medicine. The technique measures changes in the brain's perivascular spaces, which are part of the brain's waste clearance system known as the glymphatic system.

"We were able to very precisely measure this structure and count the number, location and diameter of channels," Piantino said.

Co-author Jeffrey Iliff, Ph.D., professor of psychiatry and behavioral sciences and of neurology at the University of Washington and a researcher at the VA Puget Sound Health Care System, has led scientific research into the glymphatic system and its role in neurodegenerative conditions such as Alzheimer's disease. During sleep, this brain-wide network clears away metabolic proteins that would otherwise build up in the brain.

The study used data collected from a group of 56 veterans enrolled by co-authors Elaine Peskind, M.D., and Murray Raskind, M.D., at the Mental Illness Research, Education and Clinical Center at the VA Puget Sound between 2011 and 2019.

"Imagine your brain is generating all this waste and everything is working fine," Piantino said. "Now you get a concussion. The brain generates much more waste that it has to remove, but the system becomes plugged."

Piantino said the new study suggests the technique developed by Silbert could be useful for older adults.

"Longer term, we can start thinking about using this method to predict who is going to be at higher risk for cognitive problems including dementia," he said.

The study is the latest in a growing body of research highlighting the importance of sleep in brain health.

Improving sleep is a modifiable habit that can be improved through a variety of methods, Piantino said, including better sleep hygiene habits such as reducing screen time before bed. Improving sleep is a focus of research of other OHSU scientists, including Piantino's mentor, Miranda Lim, M.D., Ph.D., associate professor of neurology, medicine and behavioral neuroscience in the OHSU School of Medicine.

"This study puts sleep at the epicenter of recovery in traumatic brain injury," Piantino said.

PHILADELPHIA -- (March 12, 2021) -- Scientists at The Wistar Institute identified a new function of ADAR1, a protein responsible for RNA editing, discovering that the ADAR1p110 isoform regulates genome stability at chromosome ends and is required for continued proliferation of cancer cells. These findings, reported in Nature Communications, reveal an additional oncogenic function of ADAR1 and reaffirm its potential as a therapeutic target in cancer.

The lab of Kazuko Nishikura, Ph.D., professor in the Gene Expression & Regulation Program of The Wistar Institute Cancer Center, was one of the first to discover ADAR1 in mammalian cells and to characterize the process of RNA editing and its multiple functions in the cell.

Similar to changing one or more letters in a written word, RNA editing allows cells to make discrete modifications to single nucleotides within an RNA molecule. This process can affect RNA metabolism and how it is translated into proteins and has implications for neurological and developmental disorders and antitumor immunity.

There are two forms of the ADAR1 protein, ADAR1p150 and ADAR1p110. While the RNA editing role of the former, located in the cytoplasm, has been extensively characterized, the function of the nuclear ADAR1p110 isoform remained elusive.

"We discovered that in the nucleus, ADAR1p110 oversees a similar mechanism to ADAR1p150, the better-known cytoplasmic variant, but the editing process in this case targets particular nucleic acid structures called R-loops when formed at the chromosome ends," said Nishikura. "Through this function, ADAR1p110 seems to be essential for cancer cell proliferation."

R-loops form during gene transcription when, instead of dissociating from its template DNA strand, the newly synthesized RNA remains attached to it, leading to a stable DNA/RNA hybrid. While these structures can be beneficial for transcriptional regulation in certain conditions, accumulation of R-loops can cause DNA damage, chromosome rearrangements and genomic instability and is linked to neurological disorders and cancer.

Nishikura and colleagues found that ADAR1p110 helps the cells resolve R-loops and prevent their accumulation by editing both the DNA and the RNA strands involved in the structure and facilitating degradation of the RNA strand by the RNase H2 enzyme.

Notably, researchers found that ADAR1p110 depletion results in accumulation of R-loops at the chromosome ends, indicating that ADAR1p110 acts on R-loops formed in the telomeric regions and is required to preserve telomere stability.

Telomeres serve as an internal clock that tells normal cells when it's time to stop proliferating. Just like the plastic coating on the tips of shoelaces, telomeres protect chromosome ends from the loss of genetic material at each cell division, by their progressive shortening eventually triggers growth arrest or cell death.

Cancer cells bypass this mechanism to become immortal. Researchers found that ADAR1p110 depletion leads to extensive telomeric DNA damage and arrested proliferation specifically in cancer cells.

"It has recently been suggested ADAR1 inhibitors could potentiate tumor response to immunotherapy by interfering with certain cytoplasmic ADAR1p150 functions," said Nishikura. "Based on our findings on the role of nuclear ADAR1p110 in maintaining telomere stability in cancer cells, we predict that ADAR1 inhibitors would be very effective anticancer therapeutics by interfering with two different and independent pro-oncogenic ADAR1functions exerted by the two isoforms."

During 1995-2015, fullerene derivatives had been the dominating electron acceptors in organic solar cells (OSCs) owing to their performance superior to other acceptors. However, the drawbacks of fullerenes, such as weak visible absorption, limited tunability of electronic properties and morphological instability, restrict further development of OSCs toward higher efficiencies and practical applications. Therefore, the development of new acceptors beyond fullerenes is urgent in the field of OSCs.

Professor Zhan Xiaowei from the College of Engineering at Peking University is one of the pioneers engaging in development of nonfullerene acceptors in the world. In 2007, Zhan's group pioneered perylene diimide-based polymer acceptors (J. Am. Chem. Soc., 2007, 129, 7246, cited 1067 times). In 2015, they invented the star molecule ITIC (Adv. Mater., 2015, 27, 1170, cited 1921 times) and proposed the concept of fused-ring electron acceptor (FREA). Then, they developed a variety of molecular design strategies, modulated the molecular properties through engineering on fused-ring cores, π-bridges, end groups and side chains, and revealed the structure-property relationships. They found new device physics and photophysics in FREAs, different from fullerenes. They fabricated high-performance OSCs and FREA-perovskite hybrid cells. The chemical features, physical features and device features of FREAs are different from traditional fullerenes. Thanks to the invention of FREA, OSCs have achieved unprecedented breakthroughs with efficiencies surpassing 18% in 5 years. FREA brings a revolution for OSC field and heralds the arrival of nonfullerene era.

FREAs have also been used in other fields, such as perovskite solar cells, quantum dot solar cells, solar water splitting, photodetectors, field-effect transistors, two-photon absorption, photothermal therapy, etc. FREAs have attracted broad attention around the world: over 150 groups are using FERAs in OSCs, over 50 groups are using FREAs in other fields, and over 10 companies are selling FREAs. Nowadays, FREA is a new and hot field led by Chinese scientists and followed worldwide.

Zhan's group has published over 150 papers with over 15000 citations in the field of FREA, among which 36 are selected as ESI highly cited papers, 20 as ESI hot papers, and 7 as the 100 most influential international papers in China. Recently, Zhan's group published an invited review entitled Fused-Ring Electron Acceptors for Photovoltaics and Beyond in Accounts of Chemical Research (Acc. Chem. Res., DOI: 10.1021/acs.accounts.0c00575). In this review, molecular design, device engineering, photophysics and applications of FREAs are discussed in detail, and the challenges and future research directions are also proposed.

New bioarchaeological research shows malaria has threatened human communities for more than 7000 years, earlier than when the onset of farming was thought to have sparked its devastating arrival.

Lead author Dr Melandri Vlok from the Department of Anatomy, University of Otago, says this ground-breaking research, published today in Scientific Reports, changes the entire understanding of the relationship humans have had with malaria, still one of the deadliest diseases in the world.

"Until now we've believed malaria became a global threat to humans when we turned to farming, but our research shows in at least Southeast Asia this disease was a threat to human groups well before that.

"This research providing a new cornerstone of malaria's evolution with humans is a great achievement by the entire team," Dr Vlok says.

Still a serious health issue, as recently as 2019 the World Health Organization reported an estimated 229 million cases of malaria around the world, with 67 per cent of malaria deaths in children under the age of 5 years.

While malaria is invisible in the archaeological record, the disease has changed the evolutionary history of human groups causing consequences visible in prehistoric skeletons. Certain genetic mutations can lead to the inheritance of Thalassemia, a devasting genetic disease that in its milder form provides some protection against malaria.

Deep in humanity's past, the genes for malaria became more common in Southeast Asia and the Pacific where it remains a threat, but up until now the origin of malaria has not been pinpointed. This research has identified thalassemia in an ancient hunter-gatherer archaeological site from Vietnam dated to approximately 7000 years ago, thousands of years before the transition to farming in the region.

In some parts of the world, slashing and burning in agricultural practice would have created pools of stagnant water attracting mosquitos carrying malaria, but in Southeast Asia these mosquitos are common forest dwellers exposing humans to the disease long before agriculture was adopted.

The study Forager and farmer evolutionary adaptations to malaria evidenced by 7000 years of thalassemia in Southeast Asia is a result of combined efforts from years of investigation by a team of researchers led by Professor Marc Oxenham (currently at the University of Aberdeen) and including researchers from University of Otago, the Australian National University (ANU), James Cook University, Vietnam Institute of Archaeology and Sapporo Medical University.

The research is the first of its kind to use microscopic techniques to investigate changes in bone tissue to identify thalassemia. In 2015, Professor Hallie Buckley from the University of Otago noticed changes in the bone of hunter-gatherers that made her suspicious that thalassemia might be the cause, but the bones were too poorly preserved to be certain. Professor Buckley called in microscopic bone expert Dr Justyna Miszkiewicz of ANU to investigate. Under the microscope, the ancient samples from Vietnam showed evidence for abnormal porosity mirroring modern-day bone loss complications in thalassemic patients.

At the same time, Dr Vlok, completing her doctoral research in Vietnam, found changes in the bones excavated in a 4000-year-old agricultural site in the same region as the 7000-year-old hunter-gatherer site. The combined research suggests a long history of evolutionary changes to malaria in Southeast Asia which continues today.

"A lot of pieces came together, then there was a startling moment of realisation that malaria was present and problematic for these people all those years ago, and a lot earlier than we've known about until now," Dr Vlok adds.

Humans rely on nature extensively for everything from food production to coastal protection, but those contributions might be more threatened than previously thought, according to new findings from the University of Colorado Boulder.

This research, out today in Nature Communications, looked at three different coastal food webs that include those services provided to humans, or ecosystem services, and found that even if the services themselves aren't directly threatened, they can become threatened when other species around them go extinct--often called secondary extinctions.

With human-induced threats to biodiversity and ecosystems, such as climate change and degradation, on the rise, these findings could have ripple effects not just on our management of the ecosystems themselves, but on conservation science, policy and funding broadly.

"These extinctions can cascade, impacting services, so protecting certain species that are disproportionately contributing to services either by supporting them or directly providing them can potentially help mitigate any indirect threats," said Aislyn Keyes, a PhD student in ecology and evolutionary biology at CU Boulder and the lead author on the paper.

"There's not nearly enough money for conservation, and I think this approach could be a way to better allocate resources to protect multiple species and services."

Ecosystem services can be anything from fish in a fishery to bees or bats pollinating food to grass helping mediate coastline loss. While quite a bit has been studied on these systems, such research tends to focus specifically on the species providing the service. That leaves the ecosystem surrounding it--and the cascading effects they have on each other--largely unknown.

To explore that question, the researchers took concepts and metrics from network science, insight and knowledge from ecosystem service science, and then combined them with a very well-known research area--food web ecology--merging the fields together in a way not previously explored.

"I think it (this research) is a really cool mesh of all of these different fields," Keyes commented.

Particularly, researchers took three different salt marsh food web datasets collected off the coast of California and Baja California, added their respective ecosystem services to the datasets, and then ran 12 extinction sequences simulations.

They found that food web and ecosystem service responses to extinctions are strongly and positively correlated, meaning what happens to one happens to the other, especially as they pertain to secondary species that support the ecosystem service provider. For those, researchers found that they are integral to maintaining ecosystem services, and if one falls, the ripple effects can be felt throughout the system.

However, they also found that it was not even across the board with services provided by species higher up the food chain (such as a large fish in a fishery) more vulnerable from those secondary extinctions than those lower on the food chain, like plants, with services provided multiple places the most tolerant to extinction.

"A lot of ecosystem service assessments focus on only the species that directly provides the service, but we know that impacts can cascade through an ecosystem, and so we show that these secondary extinctions represent an increased vulnerability for services that hasn't necessarily been considered in previous ecosystem service assessments," Keyes said.

The team next plans to use this research to create an interactive game for K-12 students to play so that they can learn more about ecosystem services. Additionally, they plan to look at whether factors that make food webs more tolerant to extinction extend to services.

"I think it's a really promising way forward for thinking about threats to ecosystem services amidst global change. It highlights that traditional approaches that assess ecosystem services might be missing a lot of this stuff," Keyes said.

"We've opened this box, but what else can we find?"

Contains updated information not available in the abstract.

DALLAS, March 11, 2021 — Having an ischemic stroke increases dementia risk, and that risk escalates with the number and severity of strokes, according to preliminary research to be presented at the American Stroke Association’s International Stroke Conference 2021. The virtual meeting is March 17-19, 2021 and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

Ischemic stroke is the most common stroke type, accounting for 87% of all strokes. It occurs when a vessel supplying blood to the brain is obstructed. Stroke is the leading preventable cause of disability in adults, and severity of stroke is a main determinant of poor functional outcome after stroke.

“Studies have shown that stroke is a strong predictor of dementia. What isn’t clear is how stroke severity and having more than one stroke impact dementia risk,” said study author Silvia Koton, Ph.D., MOccH, R.N., FAHA, head of the Herczeg Institute on Aging at Tel Aviv University and head of the Ph.D. program in the department of nursing, Sackler Faculty of Medicine at Tel Aviv University in Tel Aviv, Israel. “Our study uniquely characterizes the link between stroke and dementia and sets the stage for prevention strategies aimed at reducing the risk of dementia after a stroke.”

Researchers studied the health information of nearly 15,800 adults (aged 45-64 years) at baseline (enrolled from 1987-1989) from the Atherosclerosis Risk in Communities (ARIC) study, which is an ongoing, prospective study in four U.S. communities (Forsyth County, North Carolina; Jackson, Mississippi; the suburbs of Minneapolis, Minnesota; and Washington County, Maryland). Researchers used follow-up data from three decades of the ARIC database, which includes the enrollment period starting in 1987 and continuing throughout 2019 with data collected at both in-person visits several years apart and follow-up telephone calls conducted yearly until 2012 and twice each year through 2019.

Using all the available information in ARIC to study the link between stroke occurrence, stroke severity and dementia, the researchers found:

The risk of dementia in individuals who had at least one ischemic stroke was 2 times higher than for those with no stroke. 

Dementia risk increased with the severity and number of ischemic strokes.
Adults who had one stroke were almost 80%  more likely than those with no stroke to have dementia.
The dementia risk jumped to 8.5  times more likely for people who had three or more strokes during the study period, from 1987 to 2019.
Among adults with severe stroke, the risk of dementia was almost five times higher than for those with minor stroke.

“The association of stroke occurrence and stroke severity with dementia risk was surprisingly strong, and the continued rise in risk of dementia after the first stroke and each subsequent stroke was a remarkable finding,” Koton said.

“Our findings emphasize the importance of preventing stroke to prevent dementia and to maintain high levels of physical and cognitive function and quality of life, especially at older ages,” Koton said. “Stroke is largely preventable. Treatment and control of high blood pressure, diabetes and obesity, together with the adoption of a healthy lifestyle, which includes regular physical activity and no smoking, are crucial for the prevention of stroke and dementia.”

Researchers only studied ischemic stroke. “Analyzing the impact of other stroke subtypes on dementia risk would be important,” Koton added. “Next, we plan to study the link between stroke and mild cognitive impairment as well as between stroke and changes in cognitive performance over time. Future studies will also include information on brain imaging that will help to evaluate possible effects of vascular brain lesions in addition to stroke.”

Polarization control is essential for tailoring light-matter interactions and is the foundation for many applications such as polarization imaging, nonlinear optics, data storage, and information multiplexing. A linear polarizer, which is a polarization optical element that filters a specific linear polarization from unpolarized light, plays an important role in both polarization generation and manipulation. However, the generation of arbitrary polarization states other than linear polarization usually requires cascading of multiple optical polarization elements, including both linear polarizers and waveplates based on anisotropic materials or nanostructures, leading to bulky optical systems that are far from the long-sought miniaturization and integration.

In a new paper in Light Science & Application, a team of scientists, supervised by Prof. Xiangping Li and Zi-Lan Deng from Guangdong Provincial Key Laboratory of Optical Fiber Sensing and Communications, Institute of Photonics Technology, Jinan University, China and co-workers have proposed an effective approach to achieve full Poincaré sphere polarizers in one step by extending circular conversion dichroism (CCD) to arbitrary polarization conversion dichroism (APCD) by means of a monolayer metasurface. By using dimerized meta-molecules composed of a pair of birefringent meta-atoms with properly tailored anisotropic phase responses and relative orientation angles, the collective interference of far-field radiation from those meta-atoms can be controlled to generate APCD. This system is able to preferentially transmit one polarization state that can be located at an arbitrary position on a Poincaré sphere and convert it into transmitted light with flipped handedness while completely blocking the orthogonal polarization state. This APCD metasurface is capable of generating an arbitrarily polarized beam located at an arbitrary position on the Poincaré sphere, irrespective of input polarization, and thus acts as a polarizer that can cover the full Poincaré sphere by design.

In practice, we realize such APCD in an all-dielectric metasurface platform in the visible frequency range, manifesting transmissive polarization dichroism (PD) of nearly 100% in theory and greater than 90% experimentally. We exploit the perfect PD feature of this system to demonstrate arbitrary polarization, including linear, circular and elliptical polarization, directly from unpolarized light. This all-in-one metasurface polarizer serves as a monolithic arbitrary polarization generator, ultimately promising miniaturized optical devices for integrated nanophotonic systems with substantially reduced complexity. These scientists summarize the operational principle of their Poincaré sphere polarizer:

"We design arbitrary state polarizers based on arbitrary polarization conversion dichroism without consideration of incident polarizations: (1) Analyzing the Jones matrix of the planar metasurface realizing the arbitrary polarization conversion dichroism; (2) Applying the Jones matrix in diatomic dielectric metasurface with carefully tailored geometric parameters; (3) Demonstrating the generated polarization without influences from input beams."

"The dichroism parameter is near 100% in simulation and greater than 90% experimentally, this perfect performance make the designed metasurface works as polarizer for arbitrary polarization, even on unpolarized beam" they added.

In contemporary society, the demand for high-bandwidth optical communication, including mobile high-definition videos, autonomous vehicles, remote surgery, telepresence, and interactive 3D virtual reality gaming, is sharply increasing. The electro-optical modulator is the key component for optical fiber communication, which modulates the light signal for loading information through electricity. Lithium niobate (LiNbO3, LN) exhibits a high-performance electro-optic effect and high optical transparency. On the other hand, the ferroelectric domain engineering on LN crystals has been extended from 1D to 2D and 3D. Moreover, considering the device size, reliability, cost, and energy consumption, the photonic integrated circuit (PIC) technology has recently gained signi?cant interest in the rise of the integrated photonics field. Integrated photonics is concerned with the integration of all the key components connected by a waveguide in a single chip (photonic platform) using a single material (monolithic integration) or multi-materials (hybrid integration). Over the past 25 years, integrated lithium niobate photonics have relied almost exclusively on the high-quality lithium niobate thin film on insulator (LNOI) technology and advanced PIC technology for etching nanophotonic waveguides and microphotonic modulators. Lithium niobate has launched a photon revolution as silicon did for electronics. Herein, we review the progress of microstructure engineering and domain engineering of LNOI for integrated lithium niobate photonics, including photonic modulation and nonlinear photonics.

For photonic modulation, both the complementary approaches of microstructure engineering for photonic circuits, i.e., the direct etching of LNOI (monolithic integration) and other photonic materials rib-loaded on LNOI (hybrid integration), are reviewed. The sub-wavelength waveguides with a low propagation loss of 2.7 dB/m as well as an ultra-high Q of 5 × 106 have been fabricated by direct etching on a LNOI platform. Furthermore, The integrated MZI modulator with a small size of several millimeters on a x-cut LNOI exhibited a very high bandwidths of up to 100 GHz. The smart cut method for the preparation of wafer-scale LNOI samples (NanoLN, Jinan Jingzheng Electronics Co., Ltd.) greatly promoted the development of integrated lithium niobate photonics. the substitution of z-cut LN film by a x-cut LN film greatly promoted the integration level of photonic circuits. The channel patterns with electrodes were easily transferred into a x-cut LN film, while the bottom electrode generally occupy the whole plane for a z-cut LN film. Importantly, the gold electrodes can be placed very tightly from the edge of a resonator on a x-cut LN film, which results in strong phase modulation without affecting the Q factor.

In addition, the hybrid integration of photonic materials with a LN film is an effective approach for the integrated photonics, which can avoid the etching of LN. However, no matter the LN film works as top cladding or substrate, the transition loss between the two layers is still a problem for this hybrid waveguide. Though the design of VACs nearly resolved the problem of transition loss, the nanophotonic LN waveguide was still adopted and the waveguide parameters must be precisely controlled for high modulation efficiency and low optical loss. It doesn't fully reflect strengths of hybrid integration which avoids the etching of LN. Therefore, the approach of hybrid integration still needs further improvement.

High-efficiency, compact, and integration-compatible wavelength converters using optical waveguides involve nonlinear integrated photonics. Generally, photonic microstructures used for frequency conversion are designed based on a stronger mode confinement because the nonlinear effect can significantly enhance inside a small modal volume due to the increased field strength and temporal confinement of the interacting modes. Metasurfaces consisting of nanoantennas are often used for enhanced optical nonlinearities. A nanophotonic LN waveguide patterned with gradient metasurfaces was fabricated to achieve a monotonic increase in SHG power, resulting in a high-efficiency SHG of approximately 1000% W?1 cm?2, which is three orders of magnitude more efficient than the bare LN waveguide. However, the obvious phase mismatch between the interacting waves often results from material dispersion. Therefore, several phase-matching techniques as well as the associated waveguide microstructure engineering have been explored for second harmonic generation (SHG) processes. Recently developed the integrated frequency-conversion devices on PPLN films also involved hybrid and monoclinic approaches. Generally, the phase-matching condition is a critical factor in nonlinear frequency conversion processes. However, the phase-matching-free SHG has been achieved with high-efficiency conversion by the gradient metasurface on an on-chip integrated nonlinear photonic device. This found will promote the development of nonlinear integrated photonics on LNOI. Of course, many integrated nonlinear photonic devices were fabricated by following the phase-matching SHG, especially quasi-phase-matching. The preparation of PPLN film greatly promoted the nonlinear integrated photonics on LNOI, especially the nanophotonic PPLN waveguides which realized a conversion efficiency of up to 4600% W-1 cm-2. In the future, the nanophotonic PPLN waveguides will be applied in quantum technology to develop the integrated quantum technology.

Over the last decade, integrated lithium niobate photonics has rapidly developed and proved invaluable in the development of future optical communication and quantum technologies. The large-scale and low-cost manufacturing of integrated photonic devices and systems by mature manufacturing processes will enable new revolutionary applications in optical communication and quantum technologies.

Looking at the night sky, one's thoughts might be drawn to astrochemistry. What molecules inhabit the vast spaces between the stars? Would we see the same molecules that surround us here on Earth? Or would some of them be more exotic--something rarely observed or even unknown?

Recent research by a multinational team led by Prof. Robert Ko?os from the Institute of Physical Chemistry of the Polish Academy of Sciences has revealed an unusual molecule obtained and detected for the first time in laboratory conditions and also paved a smooth path to produce and further study another. Now that they can be seen and studied, they may prove worthy of wider astrochemical interest. Let's get a closer look at this scientific development.

Interstellar clouds - where the story begins...

The medium permeating the space between stars is mainly filled with hydrogen, helium, and cosmic dust. However, average distances between atoms or molecules in these interstellar clouds are so vast that entire days may pass before they collide. In the vacuum of space, the passage of time and the impact of radiation are crucial factors for the development of more advanced chemical compounds.

As the physical conditions found in interstellar clouds are drastically different from those on our planet, the detection of some of the chemical compounds found in them requires advanced studies on Earth. As part of this, scientists create molecules which are normally unstable under Earth conditions and then conduct research on their properties. They discover them on Earth first so that we can more easily detect them in space. Sounds interesting, but how does it look in practice?

Phosphorus menagerie

Jupiter and Saturn have been in the spotlight in our own solar system for more than two decades due to the detection of phosphine (PH3), ammonia's analog, in their atmospheres. In 2020, all eyes shifted towards Venus following claims that PH3 had been found in its atmosphere as well. The appearance of phosphine in an astronomical object is momentous because of its tremendous importance for living organisms. Molecules containing phosphorus are crucial for enzymatic processes which are responsible for the formation of the structural materials of our skeletons, nucleic acids like DNA and RNA, and even energy transport in all living cells. Although it is the 6th most abundant element in Earth's biomass and the 12th most abundant on the planet overall, it is a billion times less abundant in the interstellar medium. Due to their rarity, detecting P-containing molecules in interstellar clouds continues to intrigue scientists.

We know very little about the behavior and existence of P-containing molecules in extreme interstellar conditions. Only a few have been found and are limited to PN, CP, PO, HCP, CCP, PH3, and NCCP. Of these only PO and PN have been detected in molecular clouds. It is possible that the low abundance of reactants containing phosphorus in such media makes the formation of larger molecules quite rare and difficult to detect. We also need to characterize a wider variety of P-containing chemicals so that our search may be expanded to include a larger selection of appropriate targets. The search for new molecules is challenging since many known and promising P-containing species are unstable under typical laboratory conditions.

The IPC PAS researchers: Dr. Arun-Libertsen Lawzer, Dr. Thomas Custer, and Prof. Robert Ko?os, working in collaboration with Prof. Jean-Claude Guillemin of the Ecole Nationale Supérieure de Chimie de Rennes (France) have recently presented an efficient, UV-light-assisted cryogenic synthesis of the HCCP molecule, opening new possibilities for the spectroscopic investigation of this unusual chemical compound. It was detected using infrared and UV-vis spectroscopy. This characterization should be useful for possible future extraterrestrial detections.

"We use ultraviolet to dehydrogenate phosphorus containing organic molecules to produce exotic phosphorus species. We were able to produce triplet HCCP which is a molecule of astrochemical importance. The trick to detecting it lies in using the environment of a frozen inert gas." - remarks Dr. Lawzer.

The experiments performed as part of the project, and relevant theoretical studies show that the molecule has a linear shape and peculiar chemical bonding. Prof. Ko?os comments: "You may have heard in your school days that phosphorus was either 3- or 5-valent in its chemical compounds. Well, here it is monovalent, sporting a single bond to carbon. This is pretty unusual indeed."

The researchers also confirmed the existence of CH2=C=PH (phosphaallene), a molecule never observed before. It was formed along the route leading from CH3CP (the precursor species) to HCCP.

Experiments backed by quantum chemical computations, recently reported in Angewandte Chemie, have proven what was once but a theoretical construct. "If you asked a regular chemist, some of the most prominent species of the astrochemical menagerie would likely be ridiculed as mere molecular fragments rather than genuine molecules" - admits Prof. Ko?os.

The laboratory characterization of exotic compounds like HCCP and CH2=C=PH marks an important step towards their extraterrestrial detection. And such detections would greatly advance our knowledge concerning the astrochemistry of phosphorus. This should inspire even more scientists to look towards the stars above...

Recently, a research group led by Prof. WAN Yinhua from the Institute of Process Engineering (IPE) of the Chinese Academy of Sciences developed a novel targeted modification strategy to improve the separation selectivity of polyamide NF membranes.

The study was published in Journal of Membrane Science on March 10.

The low selectivity of commercial nanofiltration (NF) membranes to monosaccharides and monovalent salts is mainly due to the nonuniform pore size distribution and strong electronegativity.

Targeted modification can regulate the pore size distribution and electronegativity of polyamide NF membranes, and thus improve the separation selectivity.

In the strategy, carboxyl groups (-COOH) on the surface are activated by N-(3-Dimethylaminopropyl)-N'-ethyl carbodiimide (EDC) and N-Hydroxy succinimide (NHS), and subsequently grafted onto monomer or polymer containing amino groups (-NH2) for more precise separation.

The novel targeted modification strategy reduced the effective mean pore size while maintaining the porosity of the NF membrane, due to pore segmentation. This resulted in a remarkable improvement in glucose/fructose rejection (from 67.96% to 84.14%) and separation factor (from 2.20 to 6.78), with only a 4.70% permeability loss.

"The outcome of this work not only improves the separation efficiency of small organic and inorganic salts by NF, but also provides a new perspective in regulating pore size distribution and surface charge of NF membranes for precisely separating small molecules," said Prof. LUO Jianquan from IPE, the corresponding author of the study.

The modified membrane also maintained separation performance in crossflow filtration and after alkaline cleaning, which outperformed the pristine NF membrane and those modified by uniform coating and simple physical adsorption.

Extremely preterm infants can suffer from a life-threatening inflammation of the gut. A new clinical study has shown that supplements of a lactic acid bacterium may have positive effects by increasing the diversity of intestinal bacteria in these infants. The study has been led by researchers at Linköping University, Sweden, and published in the scientific journal Cell Reports Medicine.

A litre of milk weighs a kilogram. Most infants who are born extremely prematurely weigh less than that. An infant who should have developed and grown for three more months in the protective environment of the mother's womb is, of course, extremely vulnerable. As a consequence of advances in neonatal care, many premature infants survive, although one out of four of the extremely premature infants die.

"Preterm infants can be affected by a very severe inflammation of the intestines, which almost only occurs in such infants. The condition, necrotising enterocolitis (or NEC), leads to parts of the intestine dying. One of three infants who contract the infection die, and those who survive often suffer from long-term complications such as short gut syndrome and neurodevelopmental disabilities", says Thomas Abrahamsson, paediatrician at the neonatal intensive care unit at Crown Princess Victoria Children´s Hospital and associate professor at the Department of Biomedical and Clinical Sciences (BKV) at Linköping University, who has led the study.

The bacteria in the intestine of preterm infants differ from those in full-term infants. This has led many people to investigate whether giving probiotic supplements that contain certain bacteria has a positive effect. One finding is that the lactic acid bacterium Lactobacillus reuteri can reduce the risk of NEC in preterm infants. It is, however, not clear whether this is true also for extremely preterm infants, nor is the mechanism behind the positive effect known.

The study now published is part of a clinical study carried out in Linköping and Stockholm. The researchers looked at 132 infants who had been born extremely prematurely, between week 23 and 28 of pregnancy, i.e. 17 to 12 weeks before the due date. All weighed less than a kilogram at birth. Each infant was randomly assigned to one of two groups: to receive oil drops that contained the probiotic or placebo. The treatment was given daily during the neonatal period. The scientists investigated how the intestinal bacterial flora was influenced by the supplement of L. reuteri, and analysed bacteria in the stools at several time points.

"We see that the composition of bacteria in the intestine differs during the first month of the probiotic treatment. During the first week of life, the bacterial groups Staphylococcus and Klebsiella, which may cause disease, were more common in the group that received placebo", says Magalí Martí Generó, principal research engineer in BKV, and principal author of the article.

Klebsiella can cause inflammation and has been associated with NEC and sepsis. The present study does not allow any conclusions about whether the probiotic treatment influences the risk of these diseases in these extremely premature infants. Larger studies will be required to determine this.

"The supplemented probiotic L. reuteri survives in the intestine, even though these extremely premature infants are treated with large doses of antibiotics that kill bacteria. The positive effect of the treatment in increasing the diversity of intestinal bacteria may be one mechanism behind the positive effects of this probiotic shown in previous studies", says Thomas Abrahamsson.

Supplementation with probiotics is used in increasing numbers of neonatal clinics. The scientific evidence that supplements of probiotics to preterm infants have a positive effect and can be used safely is considered to be sufficiently strong.

Intrauterine growth restriction (IUGR) is common and concerning, but few therapeutic options exist for pregnant mothers who receive this diagnosis. IUGR is a condition in which a baby in the womb is measuring small for its gestational age, often because of issues with the placenta, resulting in compromised or insufficient transfer of oxygen and nutrients to the growing fetus. The developing fetal brain is particularly vulnerable to these effects. One out of every 10 babies is diagnosed with IUGR, and infants with IUGR are at increased risk of death and neurodevelopmental impairment. Recent research on polyphenol-rich pomegranate juice has suggested that it may help protect the brain from injury. In an exploratory, randomized, controlled clinical trial, supported by philanthropic funding and a gift from POM Wonderful, the largest grower and producer of fresh pomegranates and pomegranate juice in the United States, investigators at Brigham and Women's Hospital enrolled pregnant mothers whose infants were diagnosed with IUGR. The team found evidence that drinking pomegranate juice daily may reduce risk of brain injury in IUGR infants, especially during the third trimester when the infant brain may be particularly vulnerable. Findings are published in Scientific Reports.

"There are dietary factors that may influence neuroprotection, especially in high-risk settings such as during labor and delivery," said co-author Terrie Inder, MBCHB, chair of the Department of Pediatric Newborn Medicine at the Brigham. "We were intrigued by findings from preclinical research suggesting that polyphenols, which are found at high concentrations in pomegranate juice, might be highly protective. Our clinical trial provides the most promising evidence to date that polyphenols may provide protection from risk of brain injury in IUGR infants."

"While exploratory, our results are promising and suggest that being able to intervene before birth may aid in protecting the newborn brain from the devastating effects of brain injury," said corresponding author Lillian G. Matthews, PhD, a neuroscientist at Monash Biomedical Imaging and Turner Institute for Brain and Mental Health in Australia. Prior to joining Monash, Matthews was at Harvard Medical School and the Brigham in the Department of Pediatric and Newborn Medicine, where she maintains a current affiliation.

Polyphenols are part of a class of antioxidants found in certain foods and beverages, including almonds, berries, red wine and teas. Pomegranate juice is a particularly rich source of these molecules. Polyphenols are known to cross the blood-brain barrier, and studies in animal models have demonstrated protective effects against neurodegenerative diseases.

For their clinical trial, Inder and colleagues recruited 99 pregnant mothers at the Brigham. The participants were randomly assigned to consume either 8 ounces of pomegranate juice or a polyphenol-free beverage matched for color, taste and calorie-count. Participants drank the juice daily from the time of enrollment until delivery.

The team performed fetal MRI measurements on approximately half of the participants prior to mothers starting the juice regimen and found no evidence of fetal brain injury at that time. After delivery, neonatal MRI measurements showed that infants whose mothers consumed pomegranate juice were less likely to have brain injury compared to those randomized to placebo. Infants had lower risk of cortical grey matter injury and white matter injury. The team also found no evidence of ductal constriction, a potential safety concern.

Given the exploratory nature of the study and its limited size, the authors caution that larger controlled trials are needed. The team also plans to continue studying infants enrolled in their study over the next 2-3 years to assess the infants' neurodevelopmental outcome.

"Our neurodevelopmental follow-up studies are ongoing, and we encourage other investigators studying high-risk infant populations to consider the influence of polyphenols for neuroprotection," said Inder. "My dream is that we will one day be able to offer women a way to help shield their infant's brain from potential injury. In the meantime, we'll continue to follow participants to provide further insight into the potential clinical implications of prenatal pomegranate juice."

Exposure to SARS-Co-V2, the virus that causes COVID-19, can put otherwise healthy children and adolescents at risk for Multisystem Inflammatory Syndrome in Children (MIS-C), a rare but possibly life-threatening pediatric condition that can cause severe inflammation in organs like the heart, brain, lungs, kidneys and gastrointestinal system.

Diagnosing and treating MIS-C -- which has affected 2,600 children since May 2020 and is known to occur in children who have tested positive for SARS-Co-V2 or been exposed to someone with COVID-19 -- is difficult because respiratory and gastrointestinal symptoms can be similar to severe COVID-19. Other features of MIS-C are very similar to Kawasaki disease, which causes inflammation in blood vessels.

Steven Horwitz, assistant professor of pediatrics at Rutgers Robert Wood Johnson Medical School, and an author of a recently published study in The Journal of the American Medical Association, looked at 1,116 people under 21 hospitalized from March through October 2020 with symptoms that could have been caused by any of these disorders and compared their clinical and laboratory results to determine how to more accurately diagnose MIS-C.

What is MIS-C and why is it difficult to diagnose?

MIS-C is a new phenomenon in pediatrics. It occurs in association with SARS-CoV-2 infection, but the symptoms can be several weeks delayed in children who have COVID-19, the disease resulting from the virus, but who are asymptomatic. Complicating the diagnosis, MIS-C symptoms also are similar to those of Kawasaki disease, the leading cause of acquired heart disease in children.

Although the symptoms are similar, the potential complications, treatments and outcomes can be different. If we can distinguish these conditions better, it will improve treatment and follow-up care.

How is MIS-C similar to and different from severe COVID-19 and Kawasaki disease?

In general, children with MIS-C tend to get sicker than those with acute COVID-19 since more organs are involved. While children with acute COVID-19 can have respiratory and gastrointestinal symptoms directly related to the virus, MIS-C seems to be an inflammatory response to the infection that occurs several weeks later, and that can resemble COVID-19. In our study, 80 percent of the children with MIS-C and COVID-19 each had severe respiratory symptoms, but more children with MIS-C had multiple organ involvement including cardiac problems and mucus membrane conditions, such as rashes or redness in the eyes resulting in a similar presentation to patients with Kawasaki disease.

Compared with COVID-19 and Kawasaki disease, MIS-C is more likely to affect children who are Hispanic/Latino or Black; more likely to affect children who have no underlying conditions; and more likely to affect those between ages 6 and 12. It is more likely to cause gastrointestinal symptoms than Kawasaki disease.

Both Kawasaki disease and MIS-C affect boys more, but Kawasaki disease affects primarily those of East Asian descent and appears in younger children, around ages 2 and 3.

How will this study inform treatment?

What we learned will help refine how MIS-C is diagnosed and treated. For example, while children with COVID-19 or MIS-C could benefit from anti-inflammatory treatments like steroids, children with MIS-C could further benefit from other treatment options such as intravenous immune globulin. These patients should also follow up with a cardiologist to check for changes in heart function, cardiac arrhythmia or coronary artery disease.

What should parents know?

I have children, so I understand how nervous parents are about this new syndrome. If your child develops a multitude of symptoms such as persistent fevers, rash or seem unusually tired, have your child assessed by a medical professional to rule out MIS-C. While MIS-C is a serious condition, most children including those with severe cardiac symptoms usually recover within 30 days.