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Evaluation des TK-Onlinecoaches zur Gewichtsreduktion – eine
randomisierte kontrollierte Studie. DAS GESUNDHEITSWESEN 2022. [DOI: 10.1055/s-0042-1753763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Discovery of Dihydro-1,4-Benzoxazine Carboxamides as Potent and Highly Selective Inhibitors of Sirtuin-1. J Med Chem 2021; 64:5838-5849. [PMID: 33876629 DOI: 10.1021/acs.jmedchem.1c00017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sirtuins are signaling hubs orchestrating the cellular response to various stressors with roles in all major civilization diseases. Sirtuins remove acyl groups from lysine residues of proteins, thereby controlling their activity, turnover, and localization. The seven human sirtuins, SirT1-7, are closely related in structure, hindering the development of specific inhibitors. Screening 170,000 compounds, we identify and optimize SirT1-specific benzoxazine inhibitors, Sosbo, which rival the efficiency and surpass the selectivity of selisistat (EX527). The compounds inhibit the deacetylation of p53 in cultured cells, demonstrating their ability to permeate biological membranes. Kinetic analysis of inhibition and docking studies reveal that the inhibitors bind to a complex of SirT1 and nicotinamide adenine dinucleotide, similar to selisistat. These new SirT1 inhibitors are valuable alternatives to selisistat in biochemical and cell biological studies. Their greater selectivity may allow the development of better targeted drugs to combat SirT1 activity in diseases such as cancer, Huntington's chorea, or anorexia.
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Enantioselective Synthesis of a Tricyclic, sp 3 -Rich Diazatetradecanedione: an Amino Acid-Based Natural Product-Like Scaffold. Chemistry 2020; 26:4677-4681. [PMID: 31846111 PMCID: PMC7187416 DOI: 10.1002/chem.201905144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/06/2019] [Indexed: 01/21/2023]
Abstract
6-, 7-, and 8-membered rings are assembled from a linear precursor by successive cyclisation reactions to construct a tricyclic diazatricyclo[6.5.1.04, 9 ]-tetradecanedione scaffold. Advanced building blocks based on d-aspartic acid and l-pyroglutamic acid were combined by a sp3 -sp2 Negishi coupling. A carbamate-guided syn-diastereoselective epoxidation followed by an intramolecular epoxide opening allowed the construction of the piperidine ring. An efficient one-pot hydroxyl-group protection twofold deprotection reaction prepared the ground for the cyclisation to the bicycle. A final deprotection of the orthogonal protecting groups and lactamisation led to the novel, sp3 -rich tricycle. The final compound is a substrate mimic of peptidyl-prolyl cis-trans isomerases featuring a locked trans-amide bond. Cheminformatic analysis of 179 virtual derivatives indicates favourable physicochemical properties and drug-like characteristics. As proof of concept we, show a low micromolar activity in a fluorescence polarisation assay towards the FK506-binding protein 12.
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Cover Feature: Enantioselective Synthesis of a Tricyclic, sp
3
‐Rich Diazatetradecanedione: an Amino Acid‐Based Natural Product‐Like Scaffold (Chem. Eur. J. 21/2020). Chemistry 2020. [DOI: 10.1002/chem.202000858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Save the children by treating their mothers (PriVileG-M-study) - study protocol: a sequentially randomized controlled trial of individualized psychotherapy and telemedicine to reduce mental stress in pregnant women and young mothers and to improve Child's health. BMC Psychiatry 2019; 19:371. [PMID: 31775668 PMCID: PMC6880484 DOI: 10.1186/s12888-019-2279-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/10/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND As early as pregnancy, maternal mental stress impinges on the child's development and health. Thus, this may cause enhanced risk for premature birth, lowered fetal growth, and lower fetal birth weight as well as enhanced levels of the stress hormone cortisol and lowered levels of the bonding hormone oxytocin. Maternal stress further reduces maternal sensitivity for the child's needs which impairs the mother-child-interaction and bonding. Therefore, prevention and intervention studies on mental stress are necessary, beginning prenatally and applying rigorous research methodology, such as randomized controlled trials, to ensure high validity. METHODS A randomized controlled trial is used to assess the impact of psychotherapy and telemedicine on maternal mental stress and the child's mental and physical health. Mentally stressed pregnant women are randomized to an intervention (IG) and a not intervened control group. The IG receives an individualized psychotherapy starting prenatal and lasting for 10 months. Afterwards, a second randomization is used to investigate whether the use of telemedicine can stabilize the therapeutic effects. Using ecological momentary assessments and video recordings, the transfer into daily life, maternal sensitivity and mother-child-bonding are assessed. Psycho-biologically, the synchronicity of cortisol and oxytocin levels between mother and child are assessed as well as the peptidome of the colostrum and breast milk, which are assumed to be essential for the adaptation to the extra-uterine environment. All assessments are compared to an additional control group of healthy women. Finally, the results of the study will lead to the development of a qualification measure for health professionals to detect mental stress, to treat it with low-level interventions and to refer those women with high stress levels to mental health professionals. DISCUSSION The study aims to prevent the transgenerational transfer of psychiatric and somatic disorders from the mother to her child. The effects of the psychotherapy will be stabilized through telemedicine and long-term impacts on the child's and mothers' mental health are enhanced. The combination of psychotherapy, telemedicine and methodologies of ecological momentary assessment, video recording and bio banking are new in content-related and methodological manner. TRIAL REGISTRATION German Clinical Trials Register: DRKS00017065. Registered 02 May 2019. World Health Organization, Universal Trial Number: U1111-1230-9826. Registered 01 April 2019.
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Chemical Genetics Reveals a Role of dCTP Pyrophosphatase 1 in Wnt Signaling. Angew Chem Int Ed Engl 2019; 58:13009-13013. [DOI: 10.1002/anie.201905977] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Indexed: 12/12/2022]
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LIKABLE PHYSICAL ACTIVITIES TO CHOOSE WHEN GIVEN THE OPPORTUNITY: PREFERENCES FOR PHYSICAL ACTIVITY IN OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Photoactivatable Rhodamine Spiroamides and Diazoketones Decorated with “Universal Hydrophilizer” or Hydroxyl Groups. J Org Chem 2018; 83:6466-6476. [DOI: 10.1021/acs.joc.8b00756] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Test characteristics of milk amyloid A ELISA, somatic cell count, and bacteriological culture for detection of intramammary pathogens that cause subclinical mastitis. J Dairy Sci 2017. [PMID: 28647334 DOI: 10.3168/jds.2016-12446] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bovine mastitis is an important disease in the dairy industry, causing economic losses as a result of withheld milk and treatment costs. Several studies have suggested milk amyloid A (MAA) as a promising biomarker in the diagnosis of mastitis. In the absence of a gold standard for diagnosis of subclinical mastitis, we estimated the diagnostic test accuracy of a commercial MAA-ELISA, somatic cell count (SCC), and bacteriological culture using Bayesian latent class modeling. We divided intramammary infections into 2 classes: those caused by major pathogens (e.g., Escherichia coli, Staphylococcus aureus, streptococci, and lacto-/enterococci) and those caused by all pathogens (major pathogens plus Corynebacterium bovis, coagulase-negative staphylococci, Bacillus spp., Streptomyces spp.). We applied the 3 diagnostic tests to all samples. Of 433 composite milk samples included in this study, 275 (63.5%) contained at least 1 colony of any bacterial species; of those, 56 contained major pathogens and 219 contained minor pathogens. The remaining 158 samples (36.5%) were sterile. We determined 2 different thresholds for the MAA-ELISA using Bayesian latent class modeling: 3.9 µg/mL to detect mastitis caused by major pathogens and 1.6 µg/mL to detect mastitis caused by all pathogens. The optimal SCC threshold for identification of subclinical mastitis was 150,000 cells/mL; this threshold led to higher specificity (Sp) than 100,000 cells/mL. Test accuracy for major-pathogen intramammary infections was as follows: SCC, sensitivity (Se) 92.6% and Sp 72.9%; MAA-ELISA, Se 81.4% and Sp 93.4%; bacteriological culture, Se 23.8% and Sp 95.2%. Test accuracy for all-pathogen intramammary infections was as follows: SCC, sensitivity 90.3% and Sp 71.8%; MAA-ELISA, Se 88.0% and Sp 65.2%; bacteriological culture, Se 83.8% and Sp 54.8%. We suggest the use of SCC and MAA-ELISA as a combined screening procedure for situations such as a Staphylococcus aureus control program. With Bayesian latent class analysis, we were able to identify a more differentiated use of the 3 diagnostic tools. The MAA-ELISA is a valuable addition to existing tools for the diagnosis of subclinical mastitis.
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MEDICAL STUDENTS HAVE SPOKEN: IMPROVING UNDERGRADUATE EDUCATION ON CHILD DEVELOPMENT. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx086.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Synthesis of indolizinoquinolinones through three- and four-component domino Knoevenagel / hetero-Diels–Alder reactions: novel access to (+)-camptothecin. Chem Heterocycl Compd (N Y) 2017. [DOI: 10.1007/s10593-017-2070-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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IL-17A-mediated expression of epithelial IL-17C promotes inflammation during acute Pseudomonas aeruginosa pneumonia. Pneumologie 2017. [DOI: 10.1055/s-0037-1598419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Investigation of the refractive index repeatability for tantalum pentoxide coatings, prepared by physical vapor film deposition techniques. APPLIED OPTICS 2017; 56:C193-C200. [PMID: 28158073 DOI: 10.1364/ao.56.00c193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Random effects in the repeatability of refractive index and absorption edge position of tantalum pentoxide layers prepared by plasma-ion-assisted electron-beam evaporation, ion beam sputtering, and magnetron sputtering are investigated and quantified. Standard deviations in refractive index between 4*10-4 and 4*10-3 have been obtained. Here, lowest standard deviations in refractive index close to our detection threshold could be achieved by both ion beam sputtering and plasma-ion-assisted deposition. In relation to the corresponding mean values, the standard deviations in band-edge position and refractive index are of similar order.
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[Amniotic Membrane Suspension and Autologous Serum - Are they Important for Wound Healing?]. Klin Monbl Augenheilkd 2017; 234:1015-1018. [PMID: 28114694 DOI: 10.1055/s-0042-122338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Autologous serum (AS) and amniotic membrane transplantation (AMT) are used in the treatment of several ocular surface diseases. AMT is associated with a surgical intervention. Surgery could be avoided by using eye drops prepared from an amniotic membrane homogenate (AMH) or amniotic membrane suspension (AMS). EGF, bFGF, IL-6 and IL-8 were detected in AMS. However, EGF and bFGF concentrations in AMS were about 1.7-17× lower than in AMH, and IL-6 and IL-8 could not be detected in AMH. 100 % AMS, 15 and 30 % AMH significantly decreased proliferation of human corneal epithelial cells (HCECs) compared to controls (p = <0.002 for all), but 15 and 30 % AMS did not affect proliferation. Migration increased significantly compared to controls with 15 and 30 % AMS (p < 0.001), but did not change significantly with 15 or 30 % AMH (p = 0.153 and p = 0.083). Proliferation of HCECs was significantly greater with 15 % AS than with 30 % AS (p < 0.001). HCEC migration was significantly greater with 30 % AS than with 5 % AS (p < 0.01). In summary, 15 and 30 % AMS and 15 and 30 % AS exhibit the best supportive effect on human corneal epithelial cells. Nevertheless, we always have to keep in mind that individual growth factor concentrations exhibit high inter-individual fluctuations in AS or AMS eye drops.
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Floral colours in a world without birds and bees: the plants of Macquarie Island. PLANT BIOLOGY (STUTTGART, GERMANY) 2016; 18:842-50. [PMID: 27016399 DOI: 10.1111/plb.12456] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 03/24/2016] [Indexed: 05/07/2023]
Abstract
We studied biotically pollinated angiosperms on Macquarie Island, a remote site in the Southern Ocean with a predominately or exclusively dipteran pollinator fauna, in an effort to understand how flower colour affects community assembly. We compared a distinctive group of cream-green Macquarie Island flowers to the flora of likely source pools of immigrants and to a continental flora from a high latitude in the northern hemisphere. We used both dipteran and hymenopteran colour models and phylogenetically informed analyses to explore the chromatic component of community assembly. The species with cream-green flowers are very restricted in colour space models of both fly vision and bee vision and represent a distinct group that plays a very minor role in other communities. It is unlikely that such a community could form through random immigration from continental source pools. Our findings suggest that fly pollination has imposed a strong ecological filter on Macquarie Island, favouring floral colours that are rare in continental floras. This is one of the strongest demonstrations that plant-pollinator interactions play an important role in plant community assembly. Future work exploring colour choices by dipteran flower visitors would be valuable.
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[PONV after strabismus surgery : Risk adapted prophylaxis?]. Anaesthesist 2016; 65:507-13. [PMID: 27295547 DOI: 10.1007/s00101-016-0183-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 03/10/2016] [Accepted: 04/19/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Following strabismus surgery, patients frequently develop variable degrees of postoperative nausea and vomiting (PONV). These symptoms cause discomfort and result in serious complications such as intramuscular bleeding and subconjunctival hemorrhage. In children long lasting PONV can lead to and electrolyte imbalance and dehydration. A prolonged course of recovery is the consequence. For the hospital, PONV can also involve negative economic impacts because of a damaged public reputation of the institution. There is still an ongoing debate on wether prophylaxis of PONV is necessary and how the prophylaxis of PONV should be performed. On one hand, there are proponents of a liberal prophylaxis. These intend to treat almost all patients regardless of their individual risk for PONV. On the other hand, opponents point out that every medication has to be indicated individually. In their view, risk scores should be the base of a risk-adapted approach. OBJECTIVES The aim of the study was to reduce the frequency of PONV by using an anesthetic technique adapted to the individual risk for PONV. Until now, all trials studying the efficiency of a score-based antiemetic prophylaxis were performed on adult patients. In this study, a risk-adapted approach was evaluated on children for the first time. PATIENTS AND METHODS In 92 patients, the incidence of PONV was analyzed after strabismus surgery. Before surgery we evaluated the risk factors for PONV according to the POVOC score in children (n = 45, 49 %) and the Apfel's score in adults (n = 47, 51 %). Patients with 0-2 risk factors received a balanced anesthesia (n = 47, 51 %). Those with 3-4 risk factors were operated in total IV anesthesia (TIVA) with propofol (n = 45, 49 %). In addition, as an antiemetic prophylaxis, 0.15 mg/kg dexamethason and 0.1 mg/kg ondansetron were applied in the latter patients. we documented the symptoms and severity of PONV 2, 6 and 24 h after surgery by means of a standardized questionnaire for PONV (Wengritzky-Score). RESULTS The incidence of PONV was 17 % (n = 16) in all of the patients. The incidence in low-risk patients receiving a BA without prophylaxis were 21 % in adults and 38 % in children. Of the patients at high risk for PONV receiving the multimodal antiemetic approach 8 % (adults) and 9 % (children) suffered from PONV. The combination of TIVA and antiemetics could reduce the incidence of PONV compared to the predicted values in a clinically relevant manner (OR = 0.26, KI: 0.76-0.87). CONCLUSION The overall incidence could be reduced to a level below 20 %. Particularly in patients with a high risk of PONV, TIVA could clearly reduce the incidence. However, the incidence in patients with 2 risk factors is still high (30-39 %). Therefore, it is important to reconsider the effort involved with risk screening and individually adapting anesthesia. Risk stratification means a pre- and perioperative effort. Therefore, we advocate a more liberal approach for PONV prophylaxis.
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Developmental Delay? Graduating Medical Students’ Knowledge of Child Development. Paediatr Child Health 2016. [DOI: 10.1093/pch/21.supp5.e65b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: Knowledge of child development is fundamental to medical practice. Previous studies have demonstrated gaps in knowledge and training among trainees and practicing physicians. We conducted a longitudinal study of medical students’ knowledge of child development. Previously, we reported that students’ knowledge of developmental milestones was poor at baseline, did not improve after preclinical teaching and improved marginally after pediatrics clerkship. Here, we report the report the data on graduating medical students.
OBJECTIVES: The present study aimed to describe graduating medical students’ knowledge of developmental milestones in comparison to their baseline knowledge. A secondary aim was to compare graduating students' knowledge to that of the general population.
DESIGN/METHODS: We assessed medical students' knowledge of developmental milestones using a previously published 17-item questionnaire. Milestones were categorized as motor or non-motor. Students were surveyed at the start of medical school in Year 1 and prior to graduation in Year 4. Changes in students' scores were assessed using paired t-tests. Graduating medical students were compared to a published general population sample using t-tests.
RESULTS: 56 students completed the survey in both Years 1 and 4 (33% of entering class). Overall, students’ percentage of correct answers increased from 24% at baseline to 32% at graduation (p<0.001). Knowledge of motor milestones did not change significantly between Years 1 and 4. Knowledge of non-motor milestones improved significantly between Years 1 and 4 (p<0.001). 85 medical students completed the questionnaire in Year 4 (50% of entering class). Compared to a sample of the general population (n=1198), graduating medical students answered 1.0 more questions correctly out of 17 (p<0.001). Students’ knowledge of non-motor milestones was greater than that of the general population (p<0.001). Knowledge of motor milestones did not differ significantly.
CONCLUSION: Medical students' knowledge of developmental milestones improved only modestly over the course of their undergraduate medical education. At graduation, their knowledge of developmental milestones was marginally better than that of the general population. This level of knowledge is likely insufficient for generalist practice. At the undergraduate level, curricular improvements including innovative teaching strategies and greater student engagement are likely necessary to remediate this knowledge gap. Pediatricians supervising medical students and residents should not assume that trainees have an adequate knowledge of normal child development and may wish to highlight the developmental achievements of typically developing children as part of their clinical teaching.
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[Short version S2e guidelines: "Positioning therapy and early mobilization for prophylaxis or therapy of pulmonary function disorders"]. Anaesthesist 2016; 64:596-611. [PMID: 26260196 DOI: 10.1007/s00101-015-0060-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The German Society of Anesthesiology and Intensive Care Medicine (DGAI) commissioned a revision of the S2 guidelines on "positioning therapy for prophylaxis or therapy of pulmonary function disorders" from 2008. Because of the increasing clinical and scientific relevance the guidelines were extended to include the issue of "early mobilization" and the following main topics are therefore included: use of positioning therapy and early mobilization for prophylaxis and therapy of pulmonary function disorders, undesired effects and complications of positioning therapy and early mobilization as well as practical aspects of the use of positioning therapy and early mobilization. These guidelines are the result of a systematic literature search and the subsequent critical evaluation of the evidence with scientific methods. The methodological approach for the process of development of the guidelines followed the requirements of evidence-based medicine, as defined as the standard by the Association of the Scientific Medical Societies in Germany. Recently published articles after 2005 were examined with respect to positioning therapy and the recently accepted aspect of early mobilization incorporates all literature published up to June 2014.
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The role of IL-1β in Pseudomonas aeruginosa in lung infection. Cell Tissue Res 2016; 364:225-9. [PMID: 26984603 DOI: 10.1007/s00441-016-2387-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 02/25/2016] [Indexed: 12/19/2022]
Abstract
This mini-review examines the role of the pro-inflammatory cytokine interleukin (IL)-1β in the interaction of Pseudomonas aeruginosa and the host immune system during lung infection. Different studies show that the reduction of the inflammatory response, especially a decrease in IL-1β, leads to a better outcome in acute lung infection with this bacterium. This includes a higher survival rate, reduced damage to the lung tissue and, in particular, a better clearance of the airways and the tissue of the lungs from P. aeruginosa.
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S2e guideline: positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders : Revision 2015: S2e guideline of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). Anaesthesist 2015; 64 Suppl 1:1-26. [PMID: 26335630 PMCID: PMC4712230 DOI: 10.1007/s00101-015-0071-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The German Society of Anesthesiology and Intensive Care Medicine (DGAI) commissioneda revision of the S2 guidelines on "positioning therapy for prophylaxis or therapy of pulmonary function disorders" from 2008. Because of the increasing clinical and scientificrelevance the guidelines were extended to include the issue of "early mobilization"and the following main topics are therefore included: use of positioning therapy and earlymobilization for prophylaxis and therapy of pulmonary function disorders, undesired effects and complications of positioning therapy and early mobilization as well as practical aspects of the use of positioning therapy and early mobilization. These guidelines are the result of a systematic literature search and the subsequent critical evaluation of the evidence with scientific methods. The methodological approach for the process of development of the guidelines followed the requirements of evidence-based medicine, as defined as the standard by the Association of the Scientific Medical Societies in Germany. Recently published articles after 2005 were examined with respect to positioning therapy and the recently accepted aspect of early mobilization incorporates all literature published up to June 2014.
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Brief learning induces a memory bias for arousing-negative words: an fMRI study in high and low trait anxious persons. Front Psychol 2015; 6:1226. [PMID: 26347689 PMCID: PMC4543815 DOI: 10.3389/fpsyg.2015.01226] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 08/03/2015] [Indexed: 12/29/2022] Open
Abstract
Persons suffering from anxiety disorders display facilitated processing of arousing and negative stimuli, such as negative words. This memory bias is reflected in better recall and increased amygdala activity in response to such stimuli. However, individual learning histories were not considered in most studies, a concern that we meet here. Thirty-four female persons (half with high-, half with low trait anxiety) participated in a criterion-based associative word-learning paradigm, in which neutral pseudowords were paired with aversive or neutral pictures, which should lead to a valence change for the negatively paired pseudowords. After learning, pseudowords were tested with fMRI to investigate differential brain activation of the amygdala evoked by the newly acquired valence. Explicit and implicit memory was assessed directly after training and in three follow-ups at 4-day intervals. The behavioral results demonstrate that associative word-learning leads to an explicit (but no implicit) memory bias for negatively linked pseudowords, relative to neutral ones, which confirms earlier studies. Bilateral amygdala activation underlines the behavioral effect: Higher trait anxiety is correlated with stronger amygdala activation for negatively linked pseudowords than for neutrally linked ones. Most interestingly, this effect is also present for negatively paired pseudowords that participants could not remember well. Moreover, neutrally paired pseudowords evoked higher amygdala reactivity than completely novel ones in highly anxious persons, which can be taken as evidence for generalization. These findings demonstrate that few word-learning trials generate a memory bias for emotional stimuli, indexed both behaviorally and neurophysiologically. Importantly, the typical memory bias for emotional stimuli and the generalization to neutral ones is larger in high anxious persons.
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Abstract
Aim To identify morphologic factors affecting aortic expansion in patients with uncomplicated type B aortic dissections. Methods Computed tomography data of 24 patients (18 male; median age: 61 years), diagnosed with acute uncomplicated type B aortic dissections between 2002 and 2013, were retrospectively reviewed. All patients had at least two computed tomography angiography scans and six months of uneventful follow-up. Computed tomography scans were assessed by two independent readers with regard to presence and number of entry tears. Thoracic and abdominal aortic diameters were derived using image processing software. Results Twenty-two of 24 patients showed aortic expansion over a median computed tomography angiographic follow-up of 33.2 months. Annual rates showed an increase of 1.7 mm for total aortic diameter, 2.1 mm for the false and a decrease of −0.4 mm for the true lumen. In three patients (12.5%), aortic diameter exceeded 60 mm during follow-up, and all three patients underwent thoracic endovascular aortic repair. Patients with a maximum aortic diameter <4 cm at baseline showed a significantly higher expansion rate compared to cases with an initial maximum aortic diameter of ≥4 cm ( p=0.0471). A median of two entries (range: 1–5) was recognized per patient. Presence of more than two entry tears ( n = 13) was associated with faster overall diameter expansion (mean annual rates: 2.18 mm vs. 1.16 mm; p = 0.4556), and decrease of the cross-sectional surface of the true lumen over time (annual rate for > 2 entries vs. ≤2 entries: −7.8 mm2 vs. +37.5 mm2; p = 0.0369). Median size of entry tears was 12 mm (range: 2–53 mm). Conclusions The results presented herein suggest that uncomplicated type B aortic dissection patients with more than two entry tears and/or an initial maximum aortic diameter of<4 cm are at risk for aortic dilatation and, therefore, may require stricter follow-up including the possible need for early intervention.
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Effekt photodynamischer Inaktivierung (PDI) mit Riboflavin oder riboflavinkonjugierten Antikörpern gegen Staphylococcus aureus. Klin Monbl Augenheilkd 2015; 232:988-92. [DOI: 10.1055/s-0035-1545834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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The effect of IL-17A deficiency on infection and inflammation is strain dependent in acute murine pneumonia. Pneumologie 2015. [DOI: 10.1055/s-0035-1548642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Der systemische Mangel an Vitamin D3 führt zu keiner Beeinträchtigung des pulmonalen Immunsystems im Mausmodell. Pneumologie 2015. [DOI: 10.1055/s-0035-1548650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cigarette smoke exposure promotes bacterial colonization of the upper-respiratory tract. Pneumologie 2015. [DOI: 10.1055/s-0035-1544853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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28
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Efficacy, safety, and clinical outcomes of incompetent perforator vein ablation using 1470nm laser bare tip fiber. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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[Growth Factors and Interleukins in Amniotic Membrane Tissue Homogenate]. Klin Monbl Augenheilkd 2015; 232:858-62. [PMID: 25581044 DOI: 10.1055/s-0034-1383393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Application of amniotic membrane homogenate eye drops may be a potential treatment alternative for therapy resistant corneal epithelial defects. The purpose of this study was to determine the concentrations of epidermal growth factor (EGF), fibroblast growth factor basic (bFGF), hepatocyte growth factor (HGF), keratinocyte growth factor (KGF), interleukin-6 (IL-6) and interleukin-8 (IL-8) in amniotic membrane homogenates. METHODS Amniotic membranes of 8 placentas were prepared and thereafter stored at - 80 °C using the standard methods of the LIONS Cornea Bank Saar-Lor-Lux, Trier/Westpfalz. Following defreezing, amniotic membranes were cut in two pieces and homogenized in liquid nitrogen. One part of the homogenate was prepared in cell-lysis buffer, the other part was prepared in PBS. The tissue homogenates were stored at - 20 °C until enzyme-linked immunosorbent assay (ELISA) analysis for EGF, bFGF, HGF, KGF, IL-6 and IL-8 concentrations. RESULTS Concentrations of KGF, IL-6 and IL-8 were below the detection limit using both preparation techniques. The EGF concentration in tissue homogenates treated with cell-lysis buffer (2412 pg/g tissue) was not significantly different compared to that of tissue homogenates treated with PBS (1586 pg/g tissue, p = 0.72). bFGF release was also not significantly different using cell-lysis buffer (3606 pg/g tissue) or PBS treated tissue homogenates (4649 pg/g tissue, p = 0.35). HGF release was significantly lower using cell-lysis buffer (23,555 pg/g tissue), compared to PBS treated tissue (47,766 pg/g tissue, p = 0.007). CONCLUSION Containing EGF, bFGF and HGF, and lacking IL-6 and IL-8, the application of amniotic membrane homogenate eye drops may be a potential treatment alternative for therapy-resistant corneal epithelial defects.
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Anticipating action effects with different attention foci is reflected in brain activation. Percept Mot Skills 2015; 120:36-56. [PMID: 25565059 DOI: 10.2466/22.24.pms.120v10x7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Anticipation is informed by experience. Having focused on action effects in the past will lead to differences when the focus is now on the effector. Boules-type throwing movements were presented as point-light displays of shoulder and arm-markers. Activation in motor-related areas measured with functional magnetic resonance imaging was compared between two tasks: Task A anticipating action effects and Task B judging the velocity of the hand marker. One group of participants performed a session of Task A followed by a session of Task B; the other group started with Task B followed by Task A. The group starting with Task A exhibited higher brain activation during Task A bilaterally in intraparietal areas and in right hemispheric frontal and premotor areas. These areas are known to be involved in effect estimation and action simulation. The second group showed higher activation during Task B in premotor cortex and human intraparietal area 3 of the right hemisphere. The results suggest that the instruction to focus on anticipating action effects facilitates the recruitment of core components of the simulation network during anticipation and when effect anticipation is not the primary intention.
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31
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Abstract
An enantioselective total synthesis of the natural (+)-linoxepin (1) was accomplished in eleven steps from bromovanin (24). Key steps are a domino carbopalladation/ Mizoroki-Heck reaction with the formation of a pentacyclic system, an asymmetric hydroboration as well as an oxidative lactonization.
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32
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Nellix® Endovascular Aneurysm Sealing (EVAS) – eine neue Technologie zur endovaskulären Ausschaltung infrarenaler Aortenaneurysmen. Zentralbl Chir 2014. [DOI: 10.1055/s-0034-1383254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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33
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Stereoselective construction of the 5-hydroxy diazabicyclo[4.3.1]decane-2-one scaffold, a privileged motif for FK506-binding proteins. Org Lett 2014; 16:5254-7. [PMID: 25286062 DOI: 10.1021/ol5023195] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
A stereoselective synthesis of a derivatized bicyclic [4.3.1]decane scaffold based on an acyclic precursor is described. The key steps involve a Pd-catalyzed sp(3)-sp(2) Negishi-coupling, an asymmetric Shi epoxidation, and an intramolecular epoxide opening. Representative derivatives of this novel scaffold were synthesized and found to be potent inhibitors of the psychiatric risk factor FKBP51, which bound to FKBP51 with the intended molecular binding mode.
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Parietal and premotor cortices: Activation reflects imitation accuracy during observation, delayed imitation and concurrent imitation. Neuroimage 2014; 100:39-50. [DOI: 10.1016/j.neuroimage.2014.05.074] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 05/23/2014] [Accepted: 05/28/2014] [Indexed: 11/16/2022] Open
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Timing accuracy in self-timed movements related to neural indicators of movement initiation. Hum Mov Sci 2014; 37:42-57. [PMID: 25058625 DOI: 10.1016/j.humov.2014.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 06/27/2014] [Accepted: 06/29/2014] [Indexed: 11/16/2022]
Abstract
Timely movement initiation is crucial in quick reactions or when a series of movements has to be strung together in a timed fashion to create a coordinated sequence. Stochastic neural variability can lead to misinitiation errors as reaction time studies suggest. Higher reaction times occur when preparatory neural activity reaches an initiation threshold later relative to shorter reaction times. Whether this also applies to self-timed movements is harder to scrutinize because they lack an external event that could serve as a reference for timing accuracy estimations. By example of a self-timed goal-oriented throwing task, we used a method that synchronizes the throwing movements by their kinematic profiles to assess relative timing differences in throwing release. We determined neural preparatory processes of the release using the movement-related electrophysiological Bereitschaftspotential (BP). By analyzing differences in shape and timing of the BP in delayed and non-delayed throws, two variables could be extracted that are related to timing differences on the kinematic level. First, temporal deviations in BP curves partly meet the kinematic deviations. Second, delayed releases were preceded by a short flattening of the BP curves prior to release. Thus, temporal and shape deviations in the neural movement initiation are assumed to delay self-timed movements.
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Blockade of Pannexin-1 (PX1) reduces inflammation and colonization in bacterial pneumonia. Pneumologie 2014. [DOI: 10.1055/s-0034-1367899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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37
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Probenecid reduces inflammation and colonization during bacterial pneumonia. Pneumologie 2014. [DOI: 10.1055/s-0033-1363138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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38
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Effect of carbon catabolite responsive elements on infectivity of Staphylococcus aureus in a murine model of lung infection. Pneumologie 2014. [DOI: 10.1055/s-0033-1363131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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39
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Bakterienspezies werden in der Alveole unterschiedlich phagozytiert – eine Untersuchung in vivo. Pneumologie 2014. [DOI: 10.1055/s-0033-1363134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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40
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Prediction of human actions: expertise and task-related effects on neural activation of the action observation network. Hum Brain Mapp 2014; 35:4016-34. [PMID: 24453190 DOI: 10.1002/hbm.22455] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 11/18/2013] [Accepted: 12/11/2013] [Indexed: 11/08/2022] Open
Abstract
The action observation network (AON) is supposed to play a crucial role when athletes anticipate the effect of others' actions in sports such as tennis. We used functional magnetic resonance imaging to explore whether motor expertise leads to a differential activation pattern within the AON during effect anticipation and whether spatial and motor anticipation tasks are associated with a differential activation pattern within the AON depending on participant expertise level. Expert (N=16) and novice (N=16) tennis players observed video clips depicting forehand strokes with the instruction to either indicate the predicted direction of ball flight (spatial anticipation) or to decide on an appropriate response to the observed action (motor anticipation). The experts performed better than novices on both tennis anticipation tasks, with the experts showing stronger neural activation in areas of the AON, namely, the superior parietal lobe, the intraparietal sulcus, the inferior frontal gyrus, and the cerebellum. When novices were contrasted with experts, motor anticipation resulted in stronger activation of the ventral premotor cortex, the supplementary motor area, and the superior parietal lobe than spatial anticipation task did. In experts, the comparison of motor and spatial anticipation revealed no increased activation. We suggest that the stronger activation of areas in the AON during the anticipation of action effects in experts reflects their use of the more fine-tuned motor representations they have acquired and improved during years of training. Furthermore, results suggest that the neural processing of different anticipation tasks depends on the expertise level.
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Abstract
Much recent research has shown an association between mood disorders and an altered emotion perception. However, these studies were conducted mainly with stimuli such as faces. This is the first study to examine possible differences in how people with major depressive disorder (MDD) and healthy controls perceive emotions expressed via body movements. Thirty patients with MDD and thirty healthy controls observed the video scenes of human interactions conveyed by point-light displays (PLDs). They rated the depicted emotions and judged their confidence in their rating. Results showed that patients with MDD rated the depicted interactions more negatively than healthy controls. They also rated interactions with negative emotionality as being more intense and were more confident in their ratings. It is concluded that patients with MDD exhibit an altered emotion perception compared to healthy controls when rating emotions expressed via body movements depicted in PLDs.
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Selection of trait combinations through bee and fly visitation to flowers of Polemonium foliosissimum. J Evol Biol 2013; 27:325-36. [PMID: 24341383 DOI: 10.1111/jeb.12295] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 11/11/2013] [Accepted: 11/11/2013] [Indexed: 11/27/2022]
Abstract
Pollinators are known to exert natural selection on floral traits, but the extent to which combinations of floral traits are subject to correlational selection (nonadditive effects of two traits on fitness) is not well understood. Over two years, we used phenotypic manipulations of plant traits to test for effects of flower colour, flower shape and their interaction on rates of pollinator visitation to Polemonium foliosissimum. We also tested for correlational selection based on weighting visitation by the amount of conspecific pollen delivered per visit by each category of insect visitor. Although bumblebees were the presumed pollinators, solitary bees and flies contributed substantially (42%) to pollination. In manipulations of one trait at a time, insects visited flowers presenting the natural colour and shape over flowers manipulated to present artificial mutants with either paler colour or a more open or more tubular flower. When both colour and shape were manipulated in combination, selection on both traits arose, with bumblebees responding mainly to colour and flies responding mainly to shape. Despite selection on both floral traits, in a year with many bumblebees, we saw no evidence for correlational selection of these traits. In a year when flies predominated, fly visitation showed a pattern of correlational selection, but not favouring the natural phenotype, and correlational selection was still not detected for expected pollen receipt. These results show that flower colour and shape are subject to pollinator-mediated selection and that correlational selection can be generated based on pollinator visitation alone, but provide no evidence for correlational selection specifically for the current phenotype.
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Korrelation zwischen mikrobiellem Wachstum in Bindehautabstrichen von Hornhautspendern und Kontamination des Organkulturmediums. Ophthalmologe 2013; 111:553-9. [DOI: 10.1007/s00347-013-2901-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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44
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Cigarette smoke suppresses innate immunity of the upper-respiratory tract leading to enhanced colonization of the lung. Pneumologie 2013. [DOI: 10.1055/s-0033-1334527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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45
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IL-17C is a mediator of respiratory epithelial innate immune response. Pneumologie 2013. [DOI: 10.1055/s-0033-1334617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Neural simulation of actions: effector- versus action-specific motor maps within the human premotor and posterior parietal area? Hum Brain Mapp 2013; 35:1212-25. [PMID: 23427116 DOI: 10.1002/hbm.22246] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 11/26/2012] [Accepted: 12/03/2012] [Indexed: 11/11/2022] Open
Abstract
This study addresses the controversy over how motor maps are organized during action simulation by examining whether action simulation states, that is, motor imagery and action observation, run on either effector-specific and/or action-specific motor maps. Subjects had to observe or imagine three types of movements effected by the right hand or the right foot with different action goals. The functional magnetic resonance imaging results showed an action-specific organization within premotor and posterior parietal areas of both hemispheres during action simulation, especially during action observation. There were also less pronounced effector-specific activation sites during both simulation processes. It is concluded that the premotor and parietal areas contain multiple motor maps rather than a single, continuous map of the body. The forms of simulation (observation, imagery), the task contexts (movements related to an object, with usual/unusual effector), and the underlying reason for performing the simulation (rate your subjective success afterwards) lead to the specific use of different representational motor maps within both regions. In our experimental setting, action-specific maps are dominant especially, during action observation, whereas effector-specific maps are recruited to only a lesser degree.
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48
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Total Synthesis of Linoxepin through a Palladium-Catalyzed Domino Reaction. Angew Chem Int Ed Engl 2013; 52:3191-4. [DOI: 10.1002/anie.201209868] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Indexed: 12/22/2022]
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49
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How equivalent are the action execution, imagery, and observation of intransitive movements? Revisiting the concept of somatotopy during action simulation. Brain Cogn 2013. [DOI: 10.1016/j.bandc.2012.09.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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50
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Neural Correlates of Switching Attentional Focus during Finger Movements: An fMRI Study. Front Psychol 2012; 3:555. [PMID: 23444053 PMCID: PMC3581438 DOI: 10.3389/fpsyg.2012.00555] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 11/26/2012] [Indexed: 11/13/2022] Open
Abstract
Research on motor-related attentional foci suggests that switching from an internal to an external focus of attention has advantageous effects on motor performance whereas switching from an external to an internal focus has disadvantageous effects. We used functional magnetic resonance imaging to investigate the neural correlates of switching the focus of attention. Two experimental groups were trained to apply one focus direction – internal or external – on a previously learned finger tapping sequence. Participants with an internal focus training were instructed to attend to their moving fingers; those with an external focus training were instructed to attend to the response buttons. In the first half of the experiment, participants performed with their trained focus, in the second half, they were unexpectedly asked to switch to the untrained attentional focus. Our data showed that the switch from a trained internal to an unfamiliar external focus of attention elicited increased activation of the left lateral premotor cortex (PMC). We propose that this activation can be linked to the role of the PMC in action planning – probably indicating a facilitation effect on selectional motor processes. Switching from a trained external to an unfamiliar internal focus of attention revealed enhanced activation of the left primary somatosensory cortex and intraparietal lobule. We interpret these modulations as a result of the amplifying influence of afferent information on motor processing when asked to attend internally in a motor task after being trained with an external focus.
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