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Poikiloderma is a skin condition that combines atrophy, telangiectasia, and macular pigment changes (hypo- as well as hyperpigmentation). It is often mistaken for mottled pigmentation by general practitioners or nondermatology specialists. Poikiloderma can be a key presenting symptom of Rothmund-Thomson syndrome (RTS), dyskeratosis congenita (DC), hereditary sclerosing poikiloderma (HSP), hereditary fibrosing poikiloderma with tendon contractures, myopathy, and pulmonary fibrosis (POIKTMP), xeroderma pigmentosum (XP), Bloom syndrome (BS), Kindler syndrome (KS), and Clericuzio-type poikiloderma with neutropenia (PN). In these conditions, poikiloderma starts early in life, usually before the second or third year. They may also be associated with photosensitivity and other significant multi-organ manifestation developed later in life. Poikiloderma could indicate the presence of a genetic disorder with potentially serious consequences. Poikiloderma almost always precedes more severe manifestations of these genodermatoses. Prompt diagnosis at the time of presentation could help to prevent complications and mitigate the course of the disease. This review discusses these to help the practicing clinician manage patients presenting with the symptom. To further facilitate early recognition, this paper also proposes a simple diagnostic algorithm.When deciding whether to explore, agents must consider both their need for information and its cost. Do children recognize that exploration reflects a trade-off between action costs and expected information gain, inferring epistemic states accordingly? In two experiments, 4- and 5-year-olds (N = 144; of diverse race and ethnicity) judge that an agent who refuses to obtain low-cost information must have already known it, and an agent who incurs a greater cost to gain information must have a greater epistemic desire. Two control studies suggest that these findings cannot be explained by low-level associations between competence and knowledge. Our results suggest that preschoolers' theory of mind includes expectations about how costs interact with epistemic desires and states to produce exploratory action.

There is insufficient knowledge about how aerobic exercise impacts the disease process of multiple sclerosis, which is characterized by accumulation of white matter lesions and accelerated brain atrophy.

To examine the effect of aerobic exercise on neuroinflammation and neurodegeneration by magnetic resonance imaging and clinical measures of disease activity and progression in persons with multiple sclerosis.

An exploratory 12-week randomized control trial including an intervention group (n = 14, 12 weeks of aerobic exercise twice weekly) and a control group (n = 14, continuation of usual lifestyle). Primary outcomes were magnetic resonance imaging measures (lesion load, brain structure volume change), while secondary outcomes included disability measures, blood cytokine levels, cognitive tests and patient-reported outcomes.

The effects of aerobic exercise on whole brain and grey matter atrophy were minor. Surprisingly, the observed effect on volume (atrophy) in selected brain substructures was heterowith multiple sclerosis has a positive effect on the volume of some of the substructures of the brain, possibly indicating a slowing of the neurodegenerative process in these regions, but a negative impact on the volume of some other substructures, with unclear implications. Further research is needed to determine whether the slight decrease in active lesion volume and count implies an anti-inflammatory effect of aerobic exercise, and the exact significance of the heterogeneous results of volumetric assessments.

To investigate the effectiveness of robot-assisted therapy on balance function in stroke survivors.

PubMed, the Cochrane Library, Embase and China National Knowledge Infrastructure databases were searched systematically for relevant studies.

Randomized controlled trials reporting robot-assisted therapy on balance function in patients after stroke were included.

Information on study characteristics, demographics, interventions strategies and outcome measures were extracted by 2 reviewers.

A total of 19 randomized trials fulfilled the inclusion criteria and 13 out of 19 were included in the meta-analysis. Analysis revealed that robot-assisted therapy significantly improved balance function assessed by berg balance scale (weighted mean difference (WMD) 3.58, 95% confidence interval (95% CI) 1.89-5.28, p < 0.001) compared with conventional therapy. Secondary analysis indicated that there was a significant difference in balance recovery between the conventional therapy and robot-assisted therapy groups in the acute/subacute stages of stroke (WMD 5.40, 95% CI 3.94-6.86, p < 0.001), while it was not significant in the chronic stages. With exoskeleton devices, the balance recovery in robot-assisted therapy groups was significantly better than in the conventional therapy groups (WMD 3.73, 95% CI 1.83-5.63, p < 0.001). Analysis further revealed that a total training time of more than 10 h can significantly improve balance function (WMD 4.53, 95% CI 2.31-6.75, p < 0.001). No publication bias or small study effects were observed according to the Cochrane Collaboration tool.

These results suggest that robot-assisted therapy is an effective intervention for improving balance function in stroke survivors.

These results suggest that robot-assisted therapy is an effective intervention for improving balance function in stroke survivors.

Depression and impaired cognition are common consequences of stroke. The aim of this study was to determine whether cognitive impairment 36-48 h post-stroke could predict self-reported feeling of depression 3 months post-stroke.

A longitudinal, cohort study.

Patients aged ≥ 18 years at stroke onset.

Cognition was screened using the Montreal Cognitive Assessment, 36-48 h after admission to the stroke unit at Sahlgrenska University Hospital. Information about self-reported feeling of depression 3 months post-stroke was retrieved from Riksstroke (the national quality register for stroke in Sweden). Apilimod mouse Bootstrapped binary logistic regression analyses were performed.

Of 305 patients, 42% were female, median age was 70 years, and 65% had mild stroke. Three months post-stroke, 56% of patients had self-reported feeling of depression; of these, 65% were female. Impaired cognition at baseline could not predict self-reported feeling of depression 3 months later. The odds for self-reported feeling of depression were twice as high in female patients (odds ratio 2.