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Written by: Victoria Colliver

Published: 31 March 2023

A new UC San Francisco-led study brings scientists closer to understanding the causes of a mysterious rash of cases of acute severe hepatitis that began appearing in otherwise healthy children after COVID-19 lockdowns eased in the United States and 34 other countries in the spring of 2022.

Pediatric hepatitis is rare, and doctors were alarmed when they started seeing outbreaks of severe unexplained hepatitis. There have been about 1,000 cases to date; 50 of these children needed liver transplants and at least 22 have died.

In the study, publishing on March 30 in Nature, researchers linked the disease to co-infections from multiple common viruses, in particular a strain of adeno-associated virus type 2 (AAV2). AAVs are not known to cause hepatitis on their own. They need “helper” viruses, such as adenoviruses that cause colds and flus, to replicate in the liver.

Once they returned to school, children were more susceptible to infections with these common pathogens. The study suggests that for a small subset of these children, getting more than one infection at the same time may have made them more vulnerable to severe hepatitis.

“We were surprised by the fact that the infections we detected in these children were caused not by an unusual, emerging virus, but by common childhood viral pathogens,” said Charles Chiu, MD, PhD, professor of laboratory medicine and medicine in the Division of Infectious Diseases, director of the UCSF Clinical Microbiology Laboratory, and senior author of the paper.

“That’s what led us to speculate that the timing of the outbreak was probably related to the really unusual situations we were going through with COVID-19 related school and daycare closures and social restrictions,” Chiu said. “It may have been an unintended consequence of what we have experienced during the last two-to-three years of the pandemic.”

By August 2022, clusters of cases were reported in 35 countries, including the U. S., where 358 cases were under investigation. The Centers for Disease Control and Prevention (CDC) launched an investigation into the causes.

Testing for viruses

To conduct the study, which was backed by the CDC, researchers used polymerase chain reaction (PCR) along with various metagenomic sequencing and molecular-testing methods to examine plasma, whole blood, nasal swab and stool samples from 16 pediatric cases in six states – Alabama, California, Florida, Illinois, North Carolina and South Dakota – from Oct. 1, 2021, to May 22, 2022. The specimens were compared with 113 control samples.

In genotyping the 14 available blood samples, adeno-associated virus 2 (AAV2) was detected in 93% of the cases and human adenoviruses (HAdVs) were found in all the cases; a specific type of adenovirus linked to gastroenteritis (HAdV-41) was found in 11 cases. Additional co-infections with Epstein-Barr, herpes and enterovirus were found in 85.7% of cases.

Chiu noted the results mirrored the findings of two concurrent studies conducted in the United Kingdom, which identified the same AAV2 strain. All three studies identified co-infections from multiple viruses, and 75% of the children in the U.S. study had three or four viral infections.

Since AAVs are not considered pathogenic on their own, a direct causal link with the severe acute hepatitis has yet to be established. The study notes, however, that children may be especially vulnerable to more severe hepatitis triggered by co-infections. While infections from adeno-associated viruses can occur at any age, the peak is typically between 1 and 5 years old, and the median age of the affected children in the study was 3 years old.

The clusters of acute severe hepatitis in children have recently waned, but Chiu said the best way to protect children from this unlikely outcome is by washing hands frequently and staying home when sick.

Authors: In addition to Chiu, authors include Venice Servellita, BS/CLS, Alicia Sotomayor Gonzalez, PhD, of UCSF, and Daryl Lamson of the New York State Department of Public Health. Please see the study for additional authors.

Funding: The study was funded in part by the U.S. Centers for Disease Control and Prevention (contracts 75D30121C12641 and 75D30121C10991 C.Y.C.) and the Biomedical Advanced Research and Development Authority (BARDA) (contract 75A50122C00022), and the National Institutes of Health/National Institute of Child Health and Human Development (grant R61HD105618 C.Y.C. and C.A.R.). Additional funding was awarded under Agreement No. HSHQDC-15-C-00064 to Battelle National Biodefense Institute by the Department of Homeland Security, Science and Technology Directorate, for the management and operation of the National Biodefense Analysis and Countermeasures Center.

Victoria Colliver writes for UC San Francisco.

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Written by: Morgan Polikoff, University of Southern California

Published: 31 March 2023

 

The National Commission on Excellence in Education’s release of a report titled “A Nation at Risk” in 1983 was a pivotal point in the history of American education. The report used dire language, lamenting that “the educational foundations of our society are presently being eroded by a rising tide of mediocrity that threatens our very future as a Nation and a people.”

Using Cold War language, the report also famously stated: “If an unfriendly foreign power had attempted to impose on America the mediocre educational performance that exists today, we might well have viewed it as an act of war.”

The report ushered in four decades of ambitious education reforms at the state and federal levels. Those reforms included landmark policy shifts like George W. Bush’s No Child Left Behind Act, Barack Obama’s Race to the Top program and major state reforms in areas including teacher quality, school choice and test-based accountability for schools and teachers. But what is the legacy of “A Nation at Risk” 40 years after its publication? And what are the implications for school reform in the coming years?

As a scholar of education who specializes in standards-based reform and accountability, I believe important lessons can be learned about American education by examining what has taken place since the release of the report. Here are three:

1. Education reform has improved outcomes, but progress has slowed or reversed in the past decade

The U.S. has had major challenges with educational performance that long predate “A Nation at Risk.” One is that too many students are not mastering grade-level material. Another is that not enough are enrolling in and completing college given the benefits of college to individuals and society. Additionally, large gaps exist in both of those areas based on race and ethnicity and income.

Since the report, students from all racial, ethnic and socioeconomic groups have continuously made achievement gains, and gaps have narrowed considerably since the 1970s – especially in the early grades. Yet low levels of achievement and gaps in achievement remain. For instance, even before the COVID-19 pandemic, 34% of fourth graders scored below the “basic” level on the National Assessment of Educational Progress, meaning they weren’t reading at grade level. Since COVID-19, national assessment results in reading and math indicate the pandemic erased two decades of achievement gains; for instance, in eighth grade math the number of students scoring below basic increased from 31% in 2019 to 38% in 2022.

The nation has also made tremendous progress in outcomes beyond academic tests. For instance, the high school dropout rate has plummeted, dropping from about about 14% around the time of the report to about 6% now. Meanwhile, the proportion of 25-to-29-year-olds with a four-year college degree has doubled to about 38%.

2. The reforms did not address the root causes of the problems

The report spurred four decades of intense reform led by states and the federal government. But these reforms have largely not addressed the major causes of poor educational performance – poverty and other factors outside of school, as well as highly decentralized educational systems that thwart meaningful school improvement.

For example, child poverty is still widespread; many students lack access to quality early childhood education; and many children live in polluted environments that affect their learning.

The result of these factors in the early years is that only about half of children enter kindergarten healthy and ready to learn, and even fewer among children from low-income families.

While schools can help lessen these disparities in school readiness between more and less advantaged children, the report failed to look beyond schools for solutions to problems that stem from social inequality.

The narrow view of “A Nation at Risk” is notable because the widely accepted wisdom of the time, especially among Republicans, and going back to the 1966 Coleman Report, was that schools aren’t a primary driver of inequality. After all, the Coleman Report found that differences in school resources, like money and books, didn’t account for differences in student achievement between more and less advantaged children.

Even the education efforts since the report have not been able to address the structural barriers in U.S. education to large-scale improvement. For instance, in a recent book I show that state and federal policies over the past 30 years that focus on improving schools through better and clearer standards have only modestly improved teaching.

A big part of why standards and other education reforms have failed has to do with the fact that school systems in the U.S. are remarkably decentralized. About 13,000 school districts and their individual teachers exercise substantial control over what actually happens in classrooms. The inability of policymakers at higher levels – such as states or the federal government – to meaningfully change school practice partially explains why other major reforms have failed to achieve real results. Examples include the Obama administration’s US$7 billion school turnaround plan and teacher evaluation reforms. In a more centralized system, policies enacted at the state and federal levels could be implemented as intended; that is rarely the case in U.S. education.

3. The political coalitions that brought reform have fallen apart

As on other topics, Americans are highly polarized on education policy. From “A Nation at Risk” through even much of the Obama administration, many aspects of the education reform agenda had bipartisan agreement. Governors of both parties came together to enact standards and testing reforms that set expectations for student learning and measured student progress against those expectations in the 1980s and 1990s. Congress voted overwhelmingly for the No Child Left Behind Act in 2001, calling for more rigorous standards and more frequent testing to drive educational improvement.

And some versions of school choice – especially charter schools – were supported by Republican and Democratic administrations in Washington and nationwide. Even the now-controversial Common Core standards, which aimed to create consistent expectations for student learning in math and English nationwide, were originally bipartisan. That is, they were created and endorsed by leaders from both parties.

This broad reform coalition is no more.

Debates over what to teach children in schools are driving a partisan wedge between schools and parents. Republican states are removing racial and LGBT-related topics from the curriculum. Meanwhile, Democratic states mandate their inclusion.

And expanding choice programs continue to drive down public school enrollment in states across the nation. Over a million students have been lost from public schools, and private school enrollment has increased 4% since the onset of COVID-19.

The result of these trends is that the reform consensus that brought about a broadly national approach to education reform is splintering into red state and blue state versions. I expect red state reform will likely emphasize school choice and a back-to-basics curriculum focused on reading, math and the avoidance of controversial topics. I expect blue state reform will likely emphasize whole-child supports like mental health, social-emotional learning and curriculum that is intended to reflect the culture of the nation’s increasingly diverse student body.

The problems raised in “A Nation at Risk” remain as important as they were in 1983. In my view, national leaders need to continue to improve educational opportunity and performance for America’s schoolchildren. Improved education benefits individuals – those with college degrees have longer life expectancies, higher earnings and wealth and even more happiness than those with a high school degree or lower. Education also benefits societies, leading to greater economic growth. But 40 years after the report, policymakers don’t seem to have learned the lesson that schools alone won’t solve the nation’s educational problems. And if that’s true, the nation remains at risk.

Morgan Polikoff, Associate Professor of Education, University of Southern California

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Written by: LAKE COUNTY NEWS REPORTS

Published: 30 March 2023

LAKE COUNTY, Calif. — Middletown Art Center is seeking artists interested in being a part of a unique opportunity to revitalize the beloved EcoArts Sculpture Walk and being paid to do it.

The 15th installation will focus on responding to Lake County’s cultural landscape.

Cultural landscape is a term used in the fields of geography, ecology, and heritage studies, to describe a symbiosis of human activity and environment.

Collectively, cultural landscapes are works of art, narratives of culture, and expressions of regional identity. They invite us to draw the focus of conservation from the protection of past fabric toward the management of future change. It can be a vehicle for people-centered approaches, which support a sense of belonging and participation.

Work should inquire into and acknowledge the history of place, take a deep look at the present, and/or envision a healthy future for us and the ecosystems we are a part of.

This year, and moving forward, the center’s intention is to utilize the platform of the outdoor exhibit to dialogue with nature while recognizing the inherent healing that can happen by making art in nature with community.

The organization especially encourages works that bring awareness to social justice and environmental issues and concepts.

Artists are invited (but not required) to facilitate community engaged artmaking projects that amplify voices that might not otherwise be heard; or host a workshop in which the artist shares skills and receives support in completing work.

Pieces can be permanent, temporary or constructed to return to the earth. Working with materials found at the park and other natural materials is preferred. Please see Installation criteria and learn more at Middletownartcenter.org/ecoarts. All submissions will be juried.

Please apply by April 15 for consideration for permanent installations. Seasonal installation applications accepted until April 24.

Installation and community art making activities may begin late June and preferably extend through August.

Because permanent pieces may take longer, the deadline for permanent pieces extends to Sept. 1 or thereafter as needed.

Funding opportunities range from $300 to $6,000 depending on the piece and contingent upon grant approval.

For more details and application visit the Middletown Art Center’s website.

Questions? Email This email address is being protected from spambots. You need JavaScript enabled to view it. with subject line “Sculpture Walk” or call the MAC at 707-809-8118.