[Phytotherapeutic recommendations in medical guidelines for the treatment of gastroenterological diseases - a systematic review]. / Phytotherapeutische Empfehlungen in medizinischen Leitlinien zur Behandlung gastroenterologischer Erkrankungen ­ ein systematischer Überblick.

Phytotherapeutics are gaining influence in the treatment of gastroenterological diseases. Their popularity and growing evidence of efficacy contribute to their integration into medical guidelines. A systematic screening identified recommended phytotherapeutic approaches. Based on current scientific data, some recommendations for the use of phytotherapeutic agents are given. For irritable bowel syndrome the use of peppermint oil is "strongly recommended", especially for pain and flatulence. Other phytotherapeutics such as STW-5, Tibetan Padma Lax or warm caraway oil pads have proven effective in alleviating symptoms. It is "recommended" to integrate them into the treatment concept. For chronic constipation, 30g of fiber per day is recommended. Best data exists for plantago psyllium with moderate evidence and chicory inulin. In case of ulcerative colitis, plantago psyllium as well as the combination of myrrh, chamomile flower extract, and coffee charcoal can be used as a complementary treatment in maintaining remission. There is also an "open recommendation" for curcumin for both, remission induction and maintenance. Some phytotherapeutic treatments (e.g., Artemisia absintium, Boswellia serata) show evidence of effectiveness for the treatment of Crohn's disease, but data are not yet sufficient for recommendations. Cannabis-based medicines can be considered for abdominal pain and clinically relevant appetite loss if standard therapy is ineffective or contraindicated, but they should not be used for acute inflammation in active Crohn's disease. Further recommendations for other gastroenterological diseases are discussed. The safety and tolerability of the phytotherapeutics were rated as predominantly "very good" to "acceptable". Some clear recommendations for the use of phytotherapeutics to treat gastroenterological diseases show their great potential. Due to their wide range of effects, phytotherapeutics can be used very well as a complement to conventional medicines in case of complex regulatory disorders. However, further methodologically well-conducted impact studies would be helpful in order to be able to make further recommendations.

Investigating the Influential Factors of Mild Water-Filtered Infrared-A Whole-Body Hyperthermia for Pain Relief in Fibromyalgia: A Mixed-Methods Approach Focusing on Predictors and Patient Perspectives.

Fibromyalgia syndrome (FMS) is a chronic condition characterized by chronic widespread pain, persistent fatigue, and disrupted sleep, significantly impacting well-being. Mild water-filtered infrared-A (wIRA) whole-body hyperthermia (WBH) is emerging as a promising pain management approach to FMS. Within the present randomized controlled trial (ClinicalTrials ID: NCT05135936), FMS patients underwent six sessions of mild wIRA-WBH over 3 weeks. Their pain levels were assessed at baseline and at week 12, while body core temperature and plateau phase duration were monitored during WBH. Qualitative interviews were conducted at week 12. Results from this mixed-methods study revealed that baseline pain intensity and plateau phase duration significantly predicted pain intensity at week 12. Thematic analysis of the interviews revealed diverse patient experiences with the treatment, with all patients reporting improvements in perceived pain and overall well-being. The onset and duration of pain relief varied among individuals. Overall, the findings suggest that the duration of the plateau phase may serve as an indicator for long-term pain reduction, although individual factors may influence treatment outcomes. Despite varying experiences, a prevailing trend of positive patient evaluations emerged. This study sheds light on the potential of wIRA-WBH as a therapeutic option for alleviating pain for and enhancing the well-being of FMS patients.

Naturalistic face adaptation: How we adapt to freckles fast and sustainably.

While sunbathing, our skin becomes susceptible to quite remarkable changes in visual appearance, that is, freckles appear or increase in intensity-most obviously on the face. Research on face adaptation repeatedly showed that the inspection of manipulated versions of faces (so-called adaptor faces) leads to robust and sustainable changes in the perception of subsequently presented faces. Therefore, during the adaptation phase of the present study, participants saw faces with either strongly increased or decreased intensities of freckles. After a 5-minute break, during the test phase, participants had to identify the veridical (non-manipulated) face out of two faces (a slightly manipulated face combined with a non-manipulated face). Results showed strong adaptation effects to increased and decreased levels of freckles. We conclude that updating facial representations in memory is relatively fast, and these representation updates seem to sustain over a certain time span (at least 5 minutes). Face-specificity of our effects will be discussed. The results align with our everyday experience that the appearance of freckles in spring is a salient change in a familiar face; however, we seem to not register these changes after a few exposures due to a loss of information quality.

Under the sun: adaptation effects to changes in facial complexion.

BACKGROUND: Many Western people enjoy sunshine, and through the sun's stimulated increase in melanin, the skin tone or skin complexion will darken (and lighten again during winter). Although the initial salience of such a new look is remarkable - especially in the face - we seem to adapt to this new look relatively quickly. Research on face adaptation in general repeatedly showed that the inspection of manipulated versions of faces (so-called adaptor faces) leads to a change of the perception of subsequently presented faces. The present study investigates face adaptation to very natural changes in faces such as changes in complexion. METHODS: During the adaptation phase in the present study, participants saw faces with either strongly increased or decreased complexion. After a pause of 5 min, participants had to identify the veridical (non-manipulated) face out of two faces (a face slightly manipulated in complexion combined with the non-manipulated face) during a test phase. RESULTS: Results show strong adaptation effects to decreased complexion intensities. DISCUSSION: It seems that we are updating our facial representations in memory quite quickly (i.e., optimizing our processing through adaptation) and seem to sustain those new representations over a certain timespan (at least 5 min). Our results demonstrate that changes in complexion draw our attention for deeper analysis (at least with decreased complexion). However, it loses its informative quality quickly via fast and relatively sustainable adaptation.

The unnoticed zoo: Inattentional deafness to animal sounds in music.

Inattentional unawareness potentially occurs in several different sensory domains but is mainly described in visual paradigms ("inattentional blindness"; e.g., Simons & Chabris, 1999, Perception, 28, 1059-1074). Dalton and Fraenkel (2012, Cognition, 124, 367-372) were introducing "inattentional deafness" by showing that participants missed by 70% a voice repeatedly saying "I'm a Gorilla" when focusing on a primary conversation. The present study expanded this finding from the acoustic domain in a multifaceted way: First, we extended the validity perspective by using 10 acoustic samples-specifically, excerpts of popular musical pieces from different music genres. Second, we used as the secondary acoustic signal animal sounds. Those sounds originate from a completely different acoustic domain and are therefore highly distinctive from the primary sound. Participants' task was to count different musical features. Results (N = 37 participants) showed that the frequency of missed animal sounds was higher in participants with higher attentional focus and motivation. Additionally, attentional focus, perceptual load, and feature similarity/saliency were analyzed and did not have an influence on detecting or missing animal sounds. We could demonstrate that for 31.2% of the music plays, people did not recognize highly salient animal voices (regarding the type of acoustic source as well as the frequency spectra) when executing the primary (counting) task. This uncovered, significant effect supports the idea that inattentional deafness is even available when the unattended acoustic stimuli are highly salient.

Less is More: Perception as a fun way to Rich Minimalism.

Perceptual science is important to understand how humans and other animals perceive and experience scenes, objects and events. So, it is the essential science to predict how we construct reality and our Umwelt. We learn from perceptual phenomena that we only need a minimal amount of information to create rich worlds of imagination and perception. As such, perception is the perfect analogue to what we would like to call "Rich Minimalism" - the way to save resources while having even more fun as our brains complete the missing parts in a creative way. Here, we briefly mention three little examples from basic research to demonstrate the power of perception for creating efficiency, effectiveness, and economy while having great fun with the resulting minimalism.

Face Adaptation-Investigating Nonconfigural Saturation Alterations.

Recognizing familiar faces requires a comparison of the incoming perceptual information with mental face representations stored in memory. Mounting evidence indicates that these representations adapt quickly to recently perceived facial changes. This becomes apparent in face adaptation studies where exposure to a strongly manipulated face alters the perception of subsequent face stimuli: original, non-manipulated face images then appear to be manipulated, while images similar to the adaptor are perceived as "normal." The face adaptation paradigm serves as a good tool for investigating the information stored in facial memory. So far, most of the face adaptation studies focused on configural (second-order relationship) face information, mainly neglecting non-configural face information (i.e., that does not affect spatial face relations), such as color, although several (non-adaptation) studies were able to demonstrate the importance of color information in face perception and identification. The present study therefore focuses on adaptation effects on saturation color information and compares the results with previous findings on brightness. The study reveals differences in the effect pattern and robustness, indicating that adaptation effects vary considerably even within the same class of non-configural face information.

Face Adaptation Effects on Non-Configural Face Information.

Inspecting new visual information in a face can affect the perception of subsequently seen faces. In experimental settings for example, previously seen manipulated versions of a face can lead to a clear bias of the participant's perception of subsequent images: Original images are then perceived as manipulated in the opposite direction of the adaptor while images that are more similar to the adaptor are perceived as normal or natural. These so-called face adaptation effects can be a useful tool to provide information about which facial information is processed and stored in facial memory. Most experiments so far used variants of the second-order relationship configural information (e.g., spatial relations between facial features) when investigating these effects. However, non-configural face information (e.g., color) was mainly neglected when focusing on face adaptation, although this type of information plays an important role in face processing. Therefore, we investigated adaptation effects of non-configural face information by employing brightness alterations. Our results provide clear evidence for brightness adaptation effects (Experiment 1). These effects are face-specific to some extent (Experiments 2 and 3) and robust over time (Experiments 4 and 5). They support the assumption that non-configural face information is not only relevant in face perception but also in face retention. Brightness information seems to be stored in memory and thus is even involved in face recognition.

The More-or-Less Morphing Face Illusion Revisited: Perceiving Natural Transient Changes in Faces Despite Fast Saccades.

van Lier and Koning introduced the more-or-less morphing face illusion: The detection of changes in a constantly morphing face-sequence is strongly suppressed by fast eye saccades triggered by a moving fixation dot. Modulators of this intriguing effect were investigated with systematically varied facial stimuli (e.g., human faces from varying morphological groups, emotional states) and fixation location. Results replicated the overall pattern of moving fixations substantially reducing the sensitivity to detect transitions. Importantly, a deviation from real to perceived changes could only be detected when faces were altered in a way not happening in real world-by changing identity. When emotional states of faces were changed, people were capable of perceiving these changes: A situation very similar to everyday life where we might quickly inspect a face by executing fast eye saccades but where we are still aware of transient changes of the emotional state of the very same person.

Face Adaptation and Face Priming as Tools for Getting Insights Into the Quality of Face Space.

During the recognition of faces, the incoming perceptual information is matched against mental representations of familiar faces stored in memory. Face space models describe an abstract concept of face representations and their mental organization, in which facial representations are located on various characteristic dimensions, depending on their specific facial characteristics. However, these models are defined just as incompletely as the general understanding of face recognition. We took two phenomena from face processing to better understand face recognition, and so the nature of face space: face adaptation and face priming. The face literature has mainly focused on face adaptation, largely neglecting face priming when trying to integrate outcomes regarding face recognition into the face space framework. Consequently, the present paper aims to review both phenomena and their contributions to face recognition, representation, and face space.

Is the Thatcher Illusion Modulated by Face Familiarity? Evidence from an Eye Tracking Study.

Thompson (1980) first detected and described the Thatcher Illusion, where participants instantly perceive an upright face with inverted eyes and mouth as grotesque, but fail to do so when the same face is inverted. One prominent but controversial explanation is that the processing of configural information is disrupted in inverted faces. Studies investigating the Thatcher Illusion either used famous faces or non-famous faces. Highly familiar faces were often thought to be processed in a pronounced configural mode, so they seem ideal candidates to be tested in one Thatcher study against unfamiliar faces-but this has never been addressed so far. In our study, participants evaluated 16 famous and 16 non-famous faces for their grotesqueness. We tested whether familiarity (famous/non-famous faces) modulates reaction times, correctness of grotesqueness assessments (accuracy), and eye movement patterns for the factors orientation (upright/inverted) and Thatcherisation (Thatcherised/non-Thatcherised). On a behavioural level, familiarity effects were only observable via face inversion (higher accuracy and sensitivity for famous compared to non-famous faces) but not via Thatcherisation. Regarding eye movements, however, Thatcherisation influenced the scanning of famous and non-famous faces, for instance, in scanning the mouth region of the presented faces (higher number, duration and dwell time of fixations for famous compared to non-famous faces if Thatcherised). Altogether, famous faces seem to be processed in a more elaborate, more expertise-based way than non-famous faces, whereas non-famous, inverted faces seem to cause difficulties in accurate and sensitive processing. Results are further discussed in the face of existing studies of familiar vs. unfamiliar face processing.

Afterimages are biased by top-down information.

The afterimage illusion refers to a complementary colored image continuing to appear in the observer's vision after the exposure to the original image has ceased. It is assumed to be a phenomenon of the primary visual pathway, caused by overstimulation of photoreceptors of the retina. The aim of the present study was to investigate the nature of afterimage perceptions; mainly whether it is a mere physical, that is, low-level effect or whether it can be modulated by top-down processes, that is, high-level processes. Participants were first exposed to five either strongly female or male faces (Experiment 1), objects highly associated with female or male gender (Experiment 2) or female versus male names (Experiment 3), followed by a negativated image of a gender-neutral face which had to be fixated for 20s to elicit an afterimage. Participants had to rate their afterimages according to sexual dimorphism, showing that the afterimage of the gender-neutral face was perceived as significantly more female in the female priming condition compared with the male priming condition, independently of the priming quality (faces, objects, and names). Our results documented, in addition to previously presumed bottom-up mechanisms, a prominent influence of top-down processing on the perception of afterimages via priming mechanisms (female primes led to more female afterimage perception).

Parietal substrates for dimensional effects in visual search: evidence from lesion-symptom mapping.

In visual search, the detection of pop-out targets is facilitated when the target-defining dimension remains the same compared with when it changes across trials. We tested the brain regions necessary for these dimensional carry-over effects using a voxel-based morphometry study with brain-lesioned patients. Participants had to search for targets defined by either their colour (red or blue) or orientation (right- or left-tilted), and the target dimension either stayed the same or changed on consecutive trials. Twenty-five patients were categorized according to whether they showed an effect of dimensional change on search or not. The two groups did not differ with regard to their performance on several working memory tasks, and the dimensional carry-over effects were not correlated with working memory performance. With spatial, sustained attention and working memory deficits as well as lesion volume controlled, damage within the right inferior parietal lobule (the angular and supramarginal gyri) extending into the intraparietal sulcus was associated with an absence of dimensional carry-over (P < 0.001, cluster-level corrected for multiple comparisons). The data suggest that these regions of parietal cortex are necessary to implement attention shifting in the context of visual dimensional change.

Mas-allatotropin in the developing antennal lobe of the sphinx moth Manduca sexta: distribution, time course, developmental regulation, and colocalization with other neuropeptides.

The paired antennal lobes (ALs) of the sphinx moth Manduca sexta serve as a well-established model for studying development of the primary integration centers for odor information in the brain. To further reveal the role of neuropeptides during AL development, we have analyzed cellular distribution, developmental time course, and regulation of the neuropeptide M. sexta allatotropin (Mas-AT). On the basis of morphology and appearance during AL formation, seven major types of Mas-AT-immunoreactive (ir) cells could be distinguished. Mas-AT-ir cells are identified as local, projection, and centrifugal neurons, which are either persisting larval or newly added adult-specific neurons. Complementary immunostaining with antisera against two other neuropeptide families (A-type allatostatins, RFamides) revealed colocalization within three of the Mas-AT-ir cell types. On the basis of this neurochemistry, the most prominent type of Mas-AT-ir neurons, the local AT neurons (LATn), could be divided in three subpopulations. The appearance of the Mas-AT-ir cell types occurring during metamorphosis parallels the rising titer of the developmental hormone 20-hydroxyecdysone (20E). Artificially shifting the 20E titer to an earlier developmental time point resulted in the precocious occurrence of Mas-AT immunostaining. This result supports the hypothesis that the pupal rise of 20E is causative for Mas-AT expression during AL development. Comparing localization and developmental time course of Mas-AT and other neuropeptides with the time course of AL formation suggests various functions for these neuropeptides during development, including an involvement in the formation of the olfactory glomeruli.

Direct peptide profiling of lateral cell groups of the antennal lobes of Manduca sexta reveals specific composition and changes in neuropeptide expression during development.

The paired antennal lobes are the first integration centers for odor information in the insect brain. In the sphinx moth Manduca sexta, like in other holometabolous insects, they are formed during metamorphosis. To further understand mechanisms involved in the formation of this particularly well investigated brain area, we performed a direct peptide profiling of a well defined cell group (the lateral cell group) of the antennal lobe throughout development by MALDI-TOF mass spectrometry. Although the majority of the about 100 obtained ion signals represent still unknown substances, this first peptidomic characterization of this cell group indicated the occurrence of 12 structurally known neuropeptides. Among these peptides are helicostatin 1, cydiastatins 2, 3, and 4, M. sexta-allatotropin (Mas-AT), M. sexta-FLRFamide (Mas-FLRFamide) I, II, and III, nonblocked Mas-FLRFamide I, and M. sexta-myoinhibitory peptides (Mas-MIPs) III, V, and VI. The identity of two of the allatostatins (cydiastatins 3 and 4) and Mas-AT were confirmed by tandem mass spectrometry (MALDI-TOF/TOF). During development of the antennal lobe, number and frequency of ion signals including those representing known peptides generally increased at the onset of glomeruli formation at pupal Stage P7/8, with cydiastatin 2, helicostatin 1, and Mas-MIP V being the exceptions. Cydiastatin 2 showed transient occurrence mainly during the period of glomerulus formation, helicostatin 1 was restricted to late pupae and adults, while Mas-MIP V occurred exclusively in adult antennal lobes. The power of the applied direct mass spectrometric profiling lies in the possibility of chemically identifying neuropeptides of a given cell population in a fast and reliable manner, at any developmental stage in single specimens. The identification of neuropeptides in the antennal lobes now allows to specifically address the function of these signaling molecules during the formation of the antennal lobe network.

Distribution of neuropeptides in the primary olfactory center of the heliothine moth Heliothis virescens.

Neuropeptides are a diverse widespread class of signaling substances in the nervous system. As a basis for the analysis of peptidergic neurotransmission in the insect olfactory system, we have studied the distribution of neuropeptides in the antennal lobe of the moth Heliothis virescens. Immunocytochemical experiments with antisera recognizing A-type allatostatins (AST-As), Manduca sexta allatotropin (Mas-AT), FMRFamide-related peptides (FaRPs), and tachykinin-related peptides (TKRPs) have shown that members of all four peptide families are present in local interneurons of the antennal lobe. Whereas antisera against AST-As, Mas-AT, and FaRPs give similar staining patterns characterized by dense meshworks of processes confined to the core of all antennal-lobe glomeruli, TKRPs are present only in neurons with blebby processes distributed throughout each glomerulus. In addition to local neurons, a pair of centrifugal neurons with cell bodies in the lateral subesophageal ganglion, arborizations in the antennal lobe, and projections in the inner antenno-cerebral tracts exhibits tachykinin immunostaining. Double-label immunofluorescence has detected the co-localization of AST-As, Mas-AT, and FaRPs in certain local interneurons, whereas TKRPs occurs in a distinct population. MALDI-TOF mass spectrometry has revealed nearly 50 mass peaks in the antennal lobe. Seven of these masses (four AST-As, two N-terminally extended FLRFamides, and Mas-AT) match known moth neuropeptides. The data thus show that local interneurons of the moth antennal lobe are highly differentiated with respect to their neuropeptide content. The antennal lobe therefore represents an ideal preparation for the future analysis of peptide signaling in insect brain.

Development of A-type allatostatin immunoreactivity in antennal lobe neurons of the sphinx moth Manduca sexta.

The antennal lobe (AL) of the sphinx moth Manduca sexta is a well-established model system for studying mechanisms of neuronal development. To understand whether neuropeptides are suited to playing a role during AL development, we have studied the cellular localization and temporal expression pattern of neuropeptides of the A-type allatostatin family. Based on morphology and developmental appearance, we distinguished four types of AST-A-immunoreactive cell types. The majority of the cells were local interneurons of the AL (type Ia) which acquired AST-A immunostaining in a complex pattern consisting of three rising (RI-RIII) and two declining phases (DI, DII). Type Ib neurons consisted of two local neurons with large cell bodies not appearing before 7/8 days after pupal ecdysis (P7/P8). Types II and III neurons accounted for single centrifugal neurons, with type II neurons present in the larva and disappearing in the early pupa. The type III neuron did not appear before P7/P8. RI and RII coincided with the rises of the ecdysteroid hemolymph titer. Artificially shifting the pupal 20-hydroxyecdysone (20E) peak to an earlier developmental time point resulted in the precocious appearance of AST-A immunostaining in types Ia, Ib, and III neurons. This result supports the hypothesis that the pupal rise in 20E plays a role in AST-A expression during AL development. Because of their early appearance in newly forming glomeruli, AST-A-immunoreactive fibers could be involved in glomerulus formation. Diffuse AST-A labeling during early AL development is discussed as a possible signal providing information for ingrowing olfactory receptor neurons.

In vivo 3D MRI of insect brain: cerebral development during metamorphosis of Manduca sexta.

High-resolution 3D MRI of male pupae of Manduca sexta was performed at 2.35 T in order to evaluate its potential for an in vivo characterization of insect brain during metamorphosis. T1-weighted 3D FLASH (TR/TE = 20/7.8 ms, 25 degrees flip angle) and T2-weighted 3D fast SE MRI data sets (TR/TEeff = 3000/100 ms) were acquired at different developmental stages with an isotropic resolution of 100 microm. Both T1- and T2-weighted 3D MRI allowed for the identification of cerebral structures such as the antennal nerve, antennal and optical lobe, and central brain. Pronounced developmental alterations of the morphology were observed during metamorphosis. The results demonstrate the feasibility of 3D MRI at nanoliter resolution to identify major brain systems of M. sexta and respective changes during pupal development from caterpillar to sphinx moth. Together with the use of suitable contrast agents, this approach may provide new ways for studying the axonal connectivity and neural function of the developing insect brain.