Nociceptor spontaneous activity is responsible for fragmenting non-rapid eye movement sleep in mouse models of neuropathic pain.

Spontaneous pain, a major complaint of patients with neuropathic pain, has eluded study because there is no reliable marker in either preclinical models or clinical studies. Here, we performed a comprehensive electroencephalogram/electromyogram analysis of sleep in several mouse models of chronic pain: neuropathic (spared nerve injury and chronic constriction injury), inflammatory (Freund's complete adjuvant and carrageenan, plantar incision) and chemical pain (capsaicin). We find that peripheral axonal injury drives fragmentation of sleep by increasing brief arousals from non-rapid eye movement sleep (NREMS) without changing total sleep amount. In contrast to neuropathic pain, inflammatory or chemical pain did not increase brief arousals. NREMS fragmentation was reduced by the analgesics gabapentin and carbamazepine, and it resolved when pain sensitivity returned to normal in a transient neuropathic pain model (sciatic nerve crush). Genetic silencing of peripheral sensory neurons or ablation of CGRP+ neurons in the parabrachial nucleus prevented sleep fragmentation, whereas pharmacological blockade of skin sensory fibers was ineffective, indicating that the neural activity driving the arousals originates ectopically in primary nociceptor neurons and is relayed through the lateral parabrachial nucleus. These findings identify NREMS fragmentation by brief arousals as an effective proxy to measure spontaneous neuropathic pain in mice.

A scoping literature review of the associations between highly visual social media use and eating disorders and disordered eating: a changing landscape.

BACKGROUND: Although the etiology of eating disorders (ED) and disorder eating (DE) is multifactorial, exposure to highly visual social media (HVSM) may be an important contributor to the onset or worsening of DE and ED symptoms. We aim to understand HVSM use, ED, and DE with a particular focus on gender differences, as well as details of engagement on "selfies" in adolescents and young adults (AYA) through a scoping review of the literature. METHODS: We conducted a literature search in Psycho ED, PubMed, MEDLINE of articles, including participants with DE/ED and users of HVSM, focused on AYA. Studies in which the study population did not include AYA, the SM platforms used did not include HVSM platforms, and the methodology to assess ED/HVSM use was not robust were excluded. RESULTS: We found a strong relationship between HVSM and ED and DE with existing gender differences related to the nature of engagement and preference of content. The literature also shows effects of the specific mechanisms of use of these platforms involving "selfie" preparation and posting. Existing research is limited and consists of mostly cross-sectional studies with no uniform methodology and with participant populations that are not well-defined. CONCLUSIONS: The use of unregulated and profit-driven SM platforms can increase risk for ED. To use these HVSM platforms for positive influence, there is a need to have more transparency, and involvement of clinicians, researchers, and educators. PUBLIC SIGNIFICANCE: Due to HVSM's popularity among the AYA population, it is important to identify its effects on the development of DE and ED, as well as recognize any gender differences. Clinicians, parents, and other adults working with youth should be aware of HVSM's impact on DE/ED, as described in this review.

We reviewed existing literature considering the effects of highly visual social media (HVSM) on the development of eating disorders (ED) and disordered eating (DE) in the adolescent and young adult (AYA) population. There are gender differences in the use of HVSM and its associations with DE/ED through females' and males' distinct engagement styles. The main individual drivers for DE/ED are worsened body image, low self-esteem, and low body dissatisfaction, and these are influenced by other individual, family, and social factors. In addition, maladaptive use of HVSM leads to tolerance, withdrawal, and craving and is linked to anxiety and depression. Total time spent on HVSM, preoccupation with photo editing, and posting with blurred demarcation of real vs. virtual presentations is associated with DE/ED development. Given HVSM's popularity among the AYA and the risk for ED/DE in this population, it is important for clinicians, parents and other adults working with youth to be aware of HVSM's impacts.

Nephrolithiasis: Approach to Diagnosis and Management.

Although kidney stones are less common in children than in adults, incidence in children is rising. Kidney stones may lead to significant morbidity in addition to escalating medical costs. Clinical presentation is variable. Bilateral kidney stones in a younger child should prompt work-up for primary hyperoxaluria. Metabolic abnormalities are more frequent in children and can result in frequent stone recurrence. Whole exome sequencing data shows genetic defects in about 30% of stone formers. 24 h urine collection should be conducted when patient receives his usual diet and fluid intake with normal activity. Infrared spectroscopy and X-ray diffraction are used for stone analysis. Urine studies should be delayed by 4-6 wk after stone fragmentation or treatment of any stone related complications. The goal of evaluation is to identify modifiable risk factors for which targeted therapy may be instituted. Primary indications for surgical intervention include pain, infection and obstruction. Extracorporeal shockwave lithotripsy (ESWL), ureteroscopy, and percutaneous nephrolithotomy (PCNL) are most commonly used, and selection is based on stone size, anatomy, composition and anatomy. Advances in technology have allowed a shift to minimally invasive surgeries. Comprehensive management requires multidisciplinary team. Children with kidney stones require long term follow-up with periodic assessment of stone forming activity and ascertaining stone burden. High index of suspicion should be there to diagnose diseases like primary hyperoxaluria, Dent's disease, renal tubular acidosis (RTA) etc. as these diseases have ramifications on kidney function and growth.