Category: 8. Health

From fetal stages through adolescence, the b;rain undergoes rapid, layered development—from basic motor skills to complex emotional regulation. Yet this very dynamism, coupled with children’s physical and behavioral traits, makes brain imaging extraordinarily difficult. Common conditions like autism spectrum disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and perinatal brain injury often leave subtle but critical imprints on early neural architecture. Magnetic resonance imaging (MRI) is uniquely suited to study these changes safely and in detail, but traditional approaches—designed for adult brains—struggle to keep pace with pediatric needs. Motion artifacts, small anatomy, and the sensitivity to noise or sedation present major hurdles. Due to these issues, advancing specialized pediatric MRI tools and techniques has become an urgent and transformative focus of research.

In a comprehensive review (DOI: 10.1007/s12519-025-00905-7) published May 25, 2025, in World Journal of Pediatrics, researchers led by Dan Wu from Zhejiang University outline state-of-the-art developments in pediatric brain MRI. The paper explores innovative technologies in hardware, image acquisition, processing, and analysis tailored for young brains. These efforts are revolutionizing how clinicians and scientists visualize and understand early neural development—making brain scans faster, quieter, and more precise, while addressing the unique physiological and emotional needs of children.

The review presents a sweeping look at innovations transforming pediatric MRI. Foremost are specialized radiofrequency coils—sized and shaped for infants and children—that enhance image resolution and patient comfort. Wireless coils and ergonomic incubator-compatible designs further improve flexibility and safety. To counteract the ever-present challenge of movement during scans, technologies like self-navigated imaging, external optical tracking, and real-time motion correction are dramatically reducing artifacts. Silent MRI protocols, noise-canceling hardware, and redesigned gradient coils tackle acoustic discomfort, allowing infants to sleep through procedures and reducing the need for sedation.

Speed also matters. Fast-imaging strategies such as simultaneous multi-slice scanning and compressed sensing reduce time inside the scanner without sacrificing detail. AI now plays a central role—deep learning algorithms reconstruct sharper images, correct for motion, and even perform super-resolution enhancement. Perhaps most importantly, the field is moving toward age-specific imaging atlases and contrast protocols, recognizing that a 3-month-old’s brain is fundamentally different from a toddler’s or teen’s. These tailored approaches help interpret what’s “normal” at each age and detect subtle abnormalities sooner.

Together, these technical leaps are pushing pediatric MRI beyond diagnostics—into prediction, prevention, and personalized care.

“Children are not just small adults—their brains demand entirely different imaging strategies,” says Dr. Dan Wu, the review’s corresponding author, on behalf of her team. “We’ve made significant progress toward making MRI not only faster and more accurate, but also more humane. Our innovations reduce fear and discomfort, helping us see the brain more clearly and earlier. This technology is rewriting what’s possible in developmental neuroscience.”

These breakthroughs hold far-reaching potential. By enabling clearer, faster, and gentler scans, modern pediatric MRI could become a cornerstone of routine developmental screening, especially for conditions that benefit from early intervention. Customized imaging protocols and AI-enhanced data analysis will support large-scale studies linking brain development with genetics, environment, and behavior. In the clinic, radiologists may soon be able to flag at-risk children before symptoms arise, opening doors for targeted therapy. As the technology matures, these innovations could extend globally—bringing advanced neuroimaging to underserved populations and transforming child health outcomes around the world.

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A recent study examined the potential link between hearing loss and dementia, suggesting that treating hearing loss can help the brain. Although the possible connection is still being untangled, study co-author and audiologist Nicholas Reed advises prioritizing hearing health regardless.

“There are already more than enough established benefits related to hearing care,” says Reed, a faculty member of the NYU Langone Health Optimal Aging Institute.

What’s especially important about supporting hearing health is the effect it has on keeping people engaged in the world, Reed explains. Here’s what experts recommend in order to support your hearing as you age.

How does hearing loss occur?

Hearing loss can result from a wide range of genetic and environmental factors, such as chronic diseases and smoking. Some also experience age-related hearing loss, called presbycusis.

Hearing loss is “not about volume”, Reed explains. Instead, it’s a clarity issue. We lose our hearing at different frequencies at different rates, which can make sounds garbled.

There is a tendency to “normalize hearing loss as we age to some extent”, says Reed. Other conditions can seem more pressing, and hearing loss becomes a low priority. There can be “downstream effects” in a healthcare context because hearing loss can hinder patient-provider communication, says Reed.

What is the relationship between hearing loss and dementia?

Early research suggests that hearing loss is associated with increased cognitive decline and an increased risk of new cases of dementia, although further studies are needed to understand this connection. Researchers have not, however, found a cause-and-effect relationship between hearing loss and dementia.

Reed and his colleagues wanted to calculate the number of cases of dementia there could be in a population if a potential risk factor, in this case hearing loss, was eliminated. They used a sample of nearly 3,000 adults aged 66 to 90 and found 32% of the dementia risk in the sample group was potentially associated with audiometric hearing loss (hearing loss measured through testing).

According to the authors, these results suggest that treating hearing loss may delay the onset of dementia in some older adults. However, this research cannot establish whether hearing loss causes dementia, explains co-author Jason Smith, a postdoctoral researcher at the University of North Carolina.

One potential reason hearing loss is associated with cognitive changes is that it can lead to more social isolation, which may strain the brain and affect memory, says Reed. Another theory is that because auditory signals stimulate the brain, the lack of stimulation caused by hearing loss can lead to accelerated brain atrophy.

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If hearing problems are linked to an increased risk of dementia, are there ways to reduce that risk? An influential 2020 Lancet report recommended the use of hearing aids and protecting ears from excessive noise exposure. A 2023 analysis found a connection between the use of devices like hearing aids and a decreased risk of cognitive decline. However, further research is needed.

What can you do to prevent hearing loss?

Hearing loss is not an inevitable part of ageing. But certain factors, such as age-related changes to the inner ear and auditory nerve, as well as genetics, are beyond our control.

We can still mitigate the likelihood of damage from other causes. For example, we can manage conditions associated with hearing loss, such as high blood pressure and diabetes. We can also limit exposure to sources of damaging noise, like construction equipment, lawn mowers, motorcycles and loud music. Small actions, like protecting your hearing at a loud concert with over-ear headphones, which Reed prefers to earplugs, can have a big impact.

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“A healthy lifestyle and healthy listening habits can go a long way,” says Reed.

Reed also recommends that people start getting their hearing tested in their late 30s or 40s. Establishing a baseline can help you identify changes over time, and indicate if and when new habits might be useful. The longer you live with impaired hearing, the harder it is to adjust to tools like hearing aids.

Is it possible to reverse hearing loss?

Several treatments and devices can help alleviate hearing loss, but their effectiveness depends on the individual. If you suspect you have hearing issues, it’s best to have your hearing checked and discuss options with your healthcare provider.

Hearing aids can be purchased over-the-counter or with a prescription. Reed says learning how to wear them takes time and practice. There’s a critical public health need to expand coverage for these tools, says Smith, because it’s well-established that hearing aids can improve quality of life.

While studies haven’t proven that hearing aids will delay dementia, scientists are intrigued by their potential to support brain health.

“The idea is that, in theory, if a person uses hearing aids, communication becomes easier and you lower the burden of cognitive load,” says Reed. “You’re stimulating the brain with more auditory signals.”

Staying engaged in social networks is key to maintaining mental and physical wellbeing, says Reed. In a 2025 study, Reed and colleagues found that, among people with hearing loss, participants who received hearing aids and were counseled on their use experienced less loneliness and social isolation. They also had more varied types of connections, such as friends, family and acquaintances.

Similarly, assistive technologies may help. These range widely in function and design, but generally amplify sound, reduce background noise, and improve communication. For example, apps that convert speech to text can assist with phone calls, and personal amplifiers can enhance hearing in conversations. People with mild to moderate hearing loss may find some relief in settings like crowded restaurants through items like the Apple AirPods Pro 2, which feature a built-in hearing aid, says Reed.

In some instances, what can help a person manage hearing loss best is how they are supported by their community. There’s a need for more equitable environments that support people with sensory health needs, says Smith.

“Some communication tips can go really far,” says Reed. “Good communication is looking someone in the face. It’s speaking slowly. It’s about rephrasing and adding context.”

The Conversation In late June, the Scientific Advisory Group for the Origins of Novel Pathogens (SAGO), a group of independent experts convened by the World Health Organization (WHO), published an assessment of the origins of COVID.

The report concluded that although we don’t know conclusively where the virus that caused the pandemic came from:

a zoonotic origin with spillover from animals to humans is currently considered the best supported hypothesis.

SAGO did not find scientific evidence to support “a deliberate manipulation of the virus in a laboratory and subsequent biosafety breach”.

This follows a series of reports and research papers since the early days of the pandemic that have reached similar conclusions: COVID most likely emerged from an infected animal at the Huanan market in Wuhan, and was not the result of a lab leak.

But conspiracy theories about COVID’s origins persist. And this is hampering our ability to prevent the next pandemic.

Attacks on our research

As experts in the emergence of viruses, we published a peer-reviewed paper in Nature Medicine in 2020 on the origins of SARS-CoV-2, the virus that causes COVID.

No one knows exactly how many doses of coronavirus vaccines were discarded during the pandemic. But the numbers are high. Media reported that 125,000 doses went unused in Norway during 2021 alone.

“We started planning quite late in Norway. There wasn’t enough information about what kind of vaccines we’d get and when they’d arrive. There were also no systems to effectively gather and use data.”

This is what Hossein Baharmand says. He is a researcher at the University of Agder (UiA) and has led the development of a new system to assist authorities in distributing vaccines.

Many considerations to be made

The system uses data accessible to decision-makers. This can include the number of vaccines and the population count in each municipality.

“Let’s say we have 10,000 vaccines to be distributed among the 50,000 residents in Grimstad. The system calculates how we can allocate these equitably,” says Baharmand.

The model takes into consideration prioritized groups, distances between storage and vaccination sites, available transport, and the capacities of health centres.

The result is a plan for vaccine distribution that is both fair and feasible.

During the Covid pandemic, Norwegian authorities struggled to organise all this information effectively.

“It was difficult for authorities to know how many vaccines to send where. Data on people’s preferred vaccine manufacturer, for instance, wasn’t stored properly. The result was that many vaccines had to be thrown away,” says Baharmand.

Equitable planning

There will always be different views on what constitutes a fair distribution of vaccines. But the reality is there won’t be enough for everyone initially.

The system developed by the researchers requires authorities to first decide who should be first in line for vaccines. This could be the elderly, sick or other groups.

“Let’s say groups A, B and C get vaccinated first. Other groups have to wait a bit. The system uses the number of people in these groups to create a plan,” explains Baharmand.

The goal is to maintain a smooth pace for vaccination. For instance, ensuring 60 per cent of each group is vaccinated within four weeks.

“Some won’t make it to the vaccination site for various reasons. We can expect at least 50 per cent to get the first dose and 50 per cent to come for the second round,” he says.

Once the first groups are done, the same process begins for the next group. The system ensures everyone gets a chance to take the vaccine.

“It’s fair for all and provides an opportunity for everyone. Whether the vaccination rate in each group should be 60, 70 or 80 per cent, that’s for the authorities to decide,” says Baharmand.

International use

The system developed by the researchers is particularly useful for countries with poor infrastructure. For instance, Uganda only has one international airport and limited means to keep vaccines refrigerated during transport.

“When Uganda receives vaccines, they must be dispatched quickly. But authorities also need to know that health centres have the capacity to administer all the vaccines. Otherwise, vaccines might be discarded due to insufficient storage capacity,” says Baharmand.

The researchers have provided the vaccination system to health authorities in several African countries through the Africa Centres for Disease Control and Prevention. Baharmand hopes the system will be further developed by them and implemented in African countries.

“In poorer countries, the margin for error is much higher. We can’t risk people going without vaccines because poor decisions are made in Europe.”

Further research

Baharmand emphasises the importance of supporting vaccination efforts worldwide for global health.

“We live in a world where everything is interconnected. If those in poorer countries don’t receive enough vaccines, new variants of diseases may emerge which will also affect us,” he says.

Researchers are now seeking funding to study vaccine distribution in Senegal, where many live in remote areas.

“In many African countries, fewer want vaccines now compared to during Covid. This could relate to trust in authorities but also misinformation and other factors. We need to understand why and find solutions,” he says.

The system developed by the researchers is ready for use when a new pandemic arises. It can be adjusted for any country and situation.

The CONTRA project

• Funded by the Research Council of Norway
• Led by Hossein Baharmand at UiA
• Participants from Belgium, Turkey and Norway
• Developed a tool for planning vaccine distribution in a smart and equitable manner
• The system is available as open source and can be adapted to different countries and contexts.

The NF-κB signaling pathway plays a pivotal role in how our bodies fight infection, heal, and regulate inflammation. At the heart of this pathway is the NEMO protein, encoded by the IKBKG gene. When this gene malfunctions, it can lead to a diverse spectrum of diseases—from pigment changes and dental anomalies to severe immunodeficiency (ID) and inflammation. The challenge for clinicians is that these mutations often present in vastly different ways across patients, sometimes with subtle or overlapping symptoms. Due to these complexities, there is an urgent need for a comprehensive clinical map of IKBKG mutations to improve early diagnosis and personalized care.

On January 12, 2025, researchers from Chongqing Medical University published a comprehensive review (DOI: 10.1016/j.gendis.2025.101531) in Genes & Diseases, offering one of the most detailed clinical landscapes of IKBKG mutations to date. Analyzing 144 studies and 564 cases, the team systematically classified how specific genetic mutations correspond to a variety of rare disorders—including incontinentia pigmenti (IP), anhidrotic ectodermal dysplasia with immunodeficiency (EDA-ID), ID, and the recently identified NDAS. By drawing connections between genetic variations and disease severity, the study equips clinicians with a clearer diagnostic framework for recognizing these complex conditions rooted in NF-κB dysfunction.

The research revealed a striking range of disease presentations driven by IKBKG mutations. Most cases were diagnosed as IP (78%), followed by EDA-ID (15.8%), ID (5.0%), and NDAS (1.2%). Female patients predominantly had IP, while the other syndromes mainly affected males. Common symptoms ranged from skin pigmentation abnormalities and dental defects to recurrent, severe infections and systemic inflammation.

The study found that the zinc finger (ZF) domain of IKBKG was especially prone to disease-causing mutations, many of which led to the most severe outcomes. Variants such as E390RfsX5, H413R, and X420W were associated with multi-organ involvement and high phenotype scores. Notably, some mutations—like E390RfsX5—appeared across multiple disease categories, complicating diagnosis and treatment decisions. Beyond symptom mapping, the study identified patterns in infection susceptibility. Mycobacteria and Streptococcus were frequent culprits, and immunoglobulin abnormalities—especially IgG and IgM deficiencies—were common among EDA-ID and ID patients. The detailed genotype-phenotype correlations developed in this review offer a roadmap for clinicians navigating ambiguous or overlapping presentations.

This research sheds light on a notoriously elusive group of disorders. What makes IKBKG-related conditions so challenging is their variability—two patients with the same mutation can present entirely different symptoms. Our findings offer a much-needed clinical guide to help physicians recognize these cases earlier, improve outcomes, and reduce diagnostic delays, especially in children.”

Dr. Yuan Ding, senior author of the study

The study offers a practical foundation for precision diagnostics in rare ID and inflammatory diseases. By linking specific IKBKG mutations to clinical outcomes, healthcare providers can better anticipate disease progression and tailor treatments—whether through immunoglobulin therapy, stem-cell transplantation, or emerging gene-editing technologies. The review also underscores the urgency of recognizing underdiagnosed cases, especially in infants and young children with unusual infections or skin and dental anomalies. As gene therapy research accelerates, this comprehensive mutation map may serve as a reference point for designing mutation-specific interventions, bringing hope to patients and families affected by these complex syndromes.

Palmoplantar keratodermas is a chronic skin disease characterized by excessive thickening of the epidermis of palms and soles and it is secondary to many diseases.¹ Any medication can potentially cause pseudoainhum disease. It is very difficult to cure palmoplantar keratoderma and patients with such a disease may have lifelong symptoms. Pseudoainhum is a condition characterized by the development of ring-shaped constriction or exhaustion around a digit.² The pathological mechanism of pseudoainhum remains unclear and it is possibly related to infection, trauma, and congenital ectodermal defects.² Furthermore, a small percentage of palmoplantar keratosis will eventually progress to pseudoainhum.³ Pseudoainhum is a condition that occurs as a secondary effect of various diseases or is caused by a congenital defect in the ectoderm. It presents symptoms similar to those of achondroplasia. The onset usually occurs as a painful horizontal fissure on the flexor side of the toe (finger) joint, followed by inflammation and ulceration. The lesion gradually deepens and expands, extending around the toe (finger) to form a ring-shaped contraction band. The ring-shaped end of the toe (finger) becomes edematous, cyanotic, and ulcerated, eventually falling off naturally.⁴

Here, we reported one case of palmoplantar keratodermas complicated by pseudoainhum, reviewed previous related literature, and summarized the clinical characteristics of palmoplantar keratodermas complicated by pseudoainhum so as to improve the cognition of such a disease and thereby avoid clinical missed diagnosis or misdiagnosis.

Case Data

A 43-year-old man who had developed diffuse plaques on both hands and feet for 10 years and ring-shaped constriction or exhaustion around the fifth digit of the right foot for 1 year was included in this case report. Ten years ago, the patient began to develop hypertrophic plaques with white debris on the surface on both hands, which gradually became worsened and spread to the palms of both hands and soles of both feet (Figure 1A and B). The patient used topical ointment by himself, but the specific drugs used were unknown. The topical ointment had no obvious effects and the disease frequently recurred. One year ago, the patient had ring-shaped constriction at the transverse striation of the interphalangeal joint in the distal fifth phalanx of the right foot and had intermittent pain. The flexion and extension of the fifth phalanx were restricted (Figure 2A–C). The patient was admitted to our hospital on March 21, 2022. The patient denied a previous history of hypertension, diabetes mellitus, hepatitis B, tuberculosis, and drug/food allergy. There was no similar medical history in his pedigree.

Figure 1 (A) Yellow-brown cuticular hypertrophy on both hands; (B) A photo of dorsum of both feet, with the fifth digit of the right foot narrowed.

Figure 2 (A) The right foot presented ring-shaped constriction around the fifth digit and hypertrophic and globular toe. (B and C) is the enlarged version of the local detail image.

Physical examination: The patient developed well, was well-nourished, had normal intelligence, and no abnormality in head and hair. No abnormality was observed in each system. Skin examination: Diffuse hyperplastic yellow-brown plaques were observed in the palms of both hands and soles of both feet. Yellowish crusting formed on the plaques. There was much white debris on the surface lesions. The fifth phalanx of the right foot was ring-shaped and narrowed, and the toe was globular. Color Doppler ultrasound examination revealed arteriosclerosis and multiple small plaques in the right lower limb vessel. The deep vein of the right lower limb had smooth blood flow. An antero-posterior radiograph of the right foot showed constriction of the fifth phalanx (Figure 3A and B).

Figure 3 (A) Antero-posterior radiographs of the right foot showed constriction of the fifth phalanx. “R” stands for the right side. (B) Expand the display of image details.

Laboratory examination revealed that anti-streptolysin O level was 48 IU/mL (reference range 0–200 IU/mL), uric acid level 230 µmol/L (reference range 140–420 µmol /mL), rheumatoid factor level 8 IU/mL (reference range 0–20 IU/mL), anti-cyclic citrullinated peptide antibody 12.34 U/mL (reference range 0–35 U/mL).

Diagnosis: The patient was diagnosed with palmoplantar keratodermas complicated by pseudoainhum.

Treatment: Acitretin capsule (20 mg p.o. q.d), dipyridamole tablet (25 mg p.o.t.i.d), vitamin E soft capsule (0.1 g p.o. t.i.d), and topical mucopolysaccharide polysulfate cream (p.o.b.i.d) were administered.

Discussion

Palmoplantar keratoderma, also known as keratosis palmaris et plantaris, is an autosomal dominant genetic disease characterized by excessive keratotic plaques in the friction areas such as palms and soles. It can be divided into more than 10 subtypes according to different clinical characteristics, including punctate, coin shaped, localized, diffuse, and mutilated, of which diffuse palmoplantar keratoderma is the most common.⁵ Palmoplantar keratoderma, as a chronic skin disease, is hardly cured. It is a lifelong disorder. Patients with mild palmoplantar keratoderma only showed rough palmoplantar skin, while most patients will have thickening and cuticle on both palmoplantar parts, erythema around the epidermis, and pain. Patients with severe palmoplantar keratoderma will have limited movement of the metacarpophalangeal joints, and those whose deck was involved may have cloudy deck, sweating, and other symptoms.⁶ Palmoplantar keratoderma mainly affects the finger joints and has little impact on the knee and elbow joints. Some patients may have congenital abnormalities such as pseudoainhum, skin pigment disorders, and ichthyosis. Palmoplantar keratoderma, palmoplantar pustulosis, and eczema tyloticum all have erythema and hyperkeratosis, which need to be identified through histopathological examination. Palmoplantar pustulosis has typical pustular symptoms. After the pustules subside, brown spots will be left, accompanied by skin scaling, while eczema tyloticum is often accompanied by itching and inflammation.⁷ Currently, surgical treatment is the preferred method for treating pseudoainhum disease, as it can release the constrictive bands around the affected fingers. Emollient cream, cuticle relaxant, and vitamin A capsule were mainly used to alleviate clinical symptoms of palmoplantar keratoderma, which can effectively inhibit the proliferation of keratinocytes, thereby relieving hyperkeratosis and delaying the progress of the disease.⁸

Ainhum, also known as dactylolysis spontanea, is a skin disorder accompanied by abnormal bone absorption of unknown causes.⁹ It mainly occurs in 30–40-year-old men. It predisposes to occur in subtropical and tropical regions. It has a high prevalence in dark-skinned people, such as populations in Africa and America.³ Its pathogenesis remains unclear. It may be related to the fact that people in tropical regions like to walk barefoot. In addition, its pathogenesis may be related to excessive fibrosis in the distal extremities, which are caused by sensory disorders, infection, trauma, and hyperkeratosis. Ainhum usually occurs in the toes, most common in the fifth toe. Most patients with ainhum suffered bilateral involvement. In the early stage of the disease, chapped skin and deep circular grooves develop, which progress to osteoporosis, bone deformation, ulceration, and swelling distal to circular grooves that are often secondary to infection or trauma, followed by spontaneous amputation 5–10 years later.¹⁰

The pathological manifestations of pseudoainhum disease are mostly characterized by excessive epidermal keratinization, with significantly thickened stratum corneum, thickened spinous layer, and thickened dermis. In the contraction zone, dense fibrous connective tissue resembling scar tissue is seen surrounding the blood vessels.¹¹ Sometimes, there are coronal sheet-like and keratin layer depression, and punctate subtype features.¹¹ The main difference in clinical diagnosis from diseases with excessive keratinization is through the characteristics of the skin lesions and the fibrotic band formation with hyperkeratosis observed in pseudoainhum disease.

Wells and Robinson¹² classified constriction rings occurring in the limbs into four categories: a) ainhum-like band complicated by other diseases; b) congenital constriction band; c) secondary zone caused by trauma; d) ainhum. Neumann referred to the first three as “pseudoainhum” and differentiated them from ainhum.¹² Congenital pseudoainhum occurs immediately after birth and it is easy to differentiate congenital pseudoainhum from ainhum, but it is difficult to differentiate pseudoainhum caused by infection or trauma from ainhum. Pseudoainhum is secondary to some hereditary (such as pachyonychia congenita, palmophalangeal keratoderma, pityriasis rubra) or non-hereditary diseases (cervical spondylosis, syphilis, scleroderma), or it is caused by congenital ectodermal defects, and it has similar clinical symptoms to ainhum.¹³

In addition, ainhum can be induced by mechanical damage, physical damage, chemical damage, burns, and other factors, resulting in limb annular constriction. Ainhum often initiates at the flexor side of the toe joint, and presents as painful transverse fissure, accompanied by ulcer or inflammation. With the progression of the disease, a circular constriction band appears, and finally it is naturally cut off.¹⁴

At present, diffuse palmoplantar keratoderma complicated by pseudoainhum is relatively rare in China. Porokeratosis,¹⁵ dermatomyositis,¹⁶ lichen planus¹⁷ have been reported to be complicated by pseudoainhum. In 2016, Mao et al¹⁸ reported one case of palmoplantar keratoderma complicated by pseudoainhum of the hand with bone destruction. In 2022, Song et al¹⁹ reported one case of Kindler-like epidermolysis bullosa complicated by pseudoainhum. The patient reported by Song et al¹⁹ presented with blisters repeatedly after birth, and then developed photosensitivity, skin atrophy, and abnormal pigment. After 10 years of age, hyperkeratosis of palms and soles and pseudoainhum of the little fingers of both hands gradually appeared. This patient first had diffuse palmoplantar keratoderma, which was characterized by diffuse hyperplastic yellow-brown plaques on the palms of both hands and soles of both feet. Yellowish crusting formed on the plaques. There was much white debris on the surface lesions. Later, the fifth phalanx of the right foot was gradually ring-shaped and narrowed, and the toe was globular. Therefore, this patient was diagnosed with palmoplantar keratodermas complicated by pseudoainhum.

Taken together, palmoplantar keratodermas complicated by pseudoainhum is relatively rare in clinical practice, and there is no effective treatment method. The patient included in this study has no other systemic diseases and has not undergone surgical treatment. He was temporarily treated with acitretin capsule, dipyridamole tablet, vitamin E soft capsule and apply mucopolysaccharide polysulfate cream topically to the affected area. However, long-term follow-up is still needed to observe the progression of the disease.

Ethical Informed Consent Statement

Written informed consent has been provided by the patient to have the case details and any accompanying images published. This case has been approved by the Fifth People’s Hospital of Hainan Province and can be made public.

Disclosure

The authors report no conflicts of interest in this work.

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None of those statements is true. But young men who take a passive approach to news and information — consuming whatever flows over their social media transoms — were likely to believe them in a national survey conducted by Washington State University researchers.

And because young men are also more likely than others to misuse prescription drugs like Adderall or take intoxicants generally, the study suggests that creating gender-specific interventions to improve media literacy are needed.      

That is a key finding from new research published this month in the journal Substance Use & Misuse. The study used a cross-sectional national survey of 1,201 people ages 18–29, looking to evaluate whether those with “news finds me” attitudes are more likely to believe incorrect health claims, at a time when dubious medical information is abundant.

“Misinformation was a big problem during Covid and I think it has become a grave public health concern overall,” said Hae Yeon Seo, the lead author on the paper. “I wanted to see how passive information-seeking behavior leads to misinformation beliefs around prescription drug use and how that leads to substance use behavior.”

Seo conducted study as a doctoral student at WSU’s Murrow College of Communications, where she focused on health communications and public health; she has since earned her PhD and taken a position as a post-doctoral research associate at Louisiana State University. Her co-authors included  Erica Austin, professor and founding director of the Murrow Center for Media and Health Promotion Research; Porismita Borah, a professor on the graduate faculty at the Murrow College; and Andrew Sutherland, a PhD student in the college.

Individuals who consume information passively tend to be more vulnerable to misinformation because they don’t seek out more facts about the issue they’re interested in.

Hae Yeon Seo, PhD graduate
Washington State University

As the media landscape has fractured and proliferated, young people are bombarded with information through various social media channels of wide-ranging credibility. Many young people simply take in what they come across in these channels from friends, family, influencers and marketers without seeking out specific, trusted sources of news, while remaining confident that they are well-informed — that the news will find them.

“Individuals who consume information passively tend to be more vulnerable to misinformation because they don’t seek out more facts about the issue they’re interested in,” Seo said.

Seo, who grew up in South Korea and came to the U.S. to earn her doctorate, said she first became interested in the link between misinformation and substance use when she arrived in 2020 to find something she had never encountered: widespread legal use of cannabis, often surrounded by dubious claims about its medical benefits or safety.

“It was new to me, and I thought it could be very interesting to study that,” she said.

In the most recent study, she and her fellow researchers conducted the national survey between June and August 2023. They looked for associations between a passive information-seeking behaviors and belief in a series of medical myths. The team found a strong association between news-finds-me attitudes and belief in the misinformation — but only among the male participants.

The findings reinforce other research that has shown men tend to rely more on “accidental information exposure” without checking multiple sources, and that women are more likely to be cautious about the quality of information they encounter, according to the paper.

It may also reflect other factors surrounding young men and drug use: they tend to use drugs, alcohol and tobacco more than others, and are more likely to model risky behaviors socially and online. Previous research has established associations between belief in medical misinformation and such substance use.

Seo said that one limitation of the survey is that it examined ideas only among those identifying as male and female. Further studies could examine how the attitudes play out among non-binary people and other demographic populations, she said.

The fact that the association between passive information-gathering and misinformation was so strong with just young men suggests that targeting interventions based on gender differences is worth considering, the paper concludes. Seo said that the key strategies for combatting misinformation involve teaching media literacy and critical thinking skills.

Genetic sequencing of peptides in rebound virus in individuals with HIV who had analytic treatment interruptions (ATIs) confirmed the peptides’ expression in HIV-1 infection, according to data presented at the International AIDS Society Conference on HIV Science. 

Previous research has shown that HIV-specific CD8 T-cell responses directed against five genetically conserved HIV-1 protein regions (Gag, Pol, Vif, Vpr, and Env) are associated with viral control, wrote Josefina Marín-Rojas, PhD, Faculty of Medicine and Health, University of Sydney, Sydney, Australia, and colleagues in their abstract.

However, data on whether these peptides are expressed in rebound virus among individuals with HIV who experienced ATI are limited, they wrote.

The researchers applied an immunoinformatics analysis pipeline (IMAP) to select 182 peptides (IMAP-peptides) from structurally important and mutation-intolerant regions of HIV-1 proteins, said senior author Sarah Palmer, PhD, co-director of the Centre for Virus Research at the Westmead Institute for Medical Research and professor in the Faculty of Medicine and Health at the University of Sydney, in an interview.

“Our studies indicate if the immune system targets these structurally important and mutation-intolerant regions of HIV-1 proteins, this can contribute to virological control in the absence of HIV-1 therapy,” she explained.

The researchers reviewed data from the PULSE clinical trial, which included 68 men who have sex with men living with HIV in Australia. The study participants underwent three consecutive ATIs. A total of seven participants’ transiently controlled HIV rebound during the third ATI. The researchers examined whether the IMAP peptides were present in the HIV-1 RNA sequences of the rebound virus in four noncontrollers (patients who had viral rebound in all three ATIs) and five of the seven transient controllers who showed viral control during the third ATI.

The technique of near full-length HIV-1 RNA sequencing of rebound virus from three noncontrollers and two transient controllers identified the Gag, Pol, Vif, Vpr, and Env IMAP-peptides in 52%-100% of the viral sequences obtained from these participants across three ATI timepoints.

“We assumed that cells from people living with HIV that experience virological control after treatment interruption would have the immune response to our IMAP-peptides that we observed; however, we are amazed and encouraged by the level and extent of this immune response,” Palmer told Medscape Medical News.

The researchers also compared CD8 T-cell response between the IMAP peptides and a control peptide pool without the IMAP peptides.

The CD8 T-cells from three transient controllers had a 15- to 53-fold higher effector response to the IMAP-peptides than the CD8 T-cells from two noncontrollers, the researchers wrote in their abstract. The relative response to the IMAP-peptides in noncontrollers was 20 times lower than that to the control peptides, but the IMAP-peptide response in transient controllers group was similar to that in the control group, the authors noted.

The results highlight the potential of IMAP in developing treatment strategies. Although the results are too preliminary to impact clinical practice at this time, the findings from the current study could lead to the development of an mRNA vaccine to clear HIV-infected cells from people living with HIV, Palmer told Medscape Medical News.

“Our next steps include developing and testing mRNA vaccine constructs that contain our IMAP-peptides to assess the immune response of cells from people living with HIV to these vaccines,” Palmer told Medscape Medical News. “From there we will conduct studies of the most promising mRNA vaccine constructs in a humanized mouse model,” she said.

Data Enhance Understanding of Immunity

The current study may provide information that can significantly impact understanding of the immune responses to HIV, said David J. Cennimo, MD, associate professor of medicine & pediatrics in the Division of Infectious Disease at Rutgers New Jersey Medical School, Newark, New Jersey, in an interview.

“The investigators looked at highly conserved regions of multiple HIV proteins,” said Cennimo, who was not involved in the study. “Conserved regions and antibody responses to them may play a role in controlling HIV viral replication and rebound,” Cennimo told Medscape Medical News. “The investigators showed these regions were present in rebounding viremia, and individuals that exhibited greater immune recognition of these regions suppressed rebound viremia longer, and perhaps targeting these regions could impact HIV prevention or cure strategies,” he said.

Secondarily, the study showed the success of the novel technique (IMAP) to identify conserved peptides, said Cennimo. The technique could potentially be applied to other viruses that mutate to escape host response, he said.

The study was funded by the US National Institutes of Health, the Foundation for AIDS Research, the Australian National Health and Medical Research Council, and Sandra and David Ansley. 

The researchers disclosed no financial conflicts of interest. 

Cennimo had no financial conflicts to disclose.