Context-dependent motor skill and the role of practice

Research has shown that retrieval of learned information is better when the original learning context is reinstated during testing than when this context is changed. Recently, such contextual dependencies have also been found for perceptual-motor behavior. The current study investigated the nature of context-dependent learning in the discrete sequence production task, and in addition examined whether the amount of practice affects the extent to which sequences are sensitive to contextual alterations. It was found that changing contextual cues—but not the removal of such cues—had a detrimental effect on performance. Moreover, this effect was observed only after limited practice, but not after extensive practice. Our findings support the notion of a novel type of context-dependent learning during initial motor skill acquisition and demonstrate that this context-dependence reduces with practice. It is proposed that a gradual development with practice from stimulus-driven to representation-driven sequence execution underlies this practice effect

Dyslexic individuals orient but do not sustain visual attention:Electrophysiological support from the lower and upper alpha bands

Individuals with developmental dyslexia have been characterized by problems with attentional orienting. In the current study, we specifically focused on possible changes in endogenous visual orienting that may be reflected in the electroencephalogram. A variant of the Posner cuing paradigm was employed with valid or invalid central cues that preceded target stimuli that were presented in the left or right visual field. The target stimuli consisted of vertical or horizontal stripes with low (two thick lines) or high (six thin lines) spatial frequencies. We examined lateralized alpha power in the cue-target interval as recent studies revealed that a contra vs. ipsilateral reduction in alpha power relates to the orienting of attention. An initial orienting effect in the lower alpha band was more pronounced for dyslexic individuals than for controls, suggesting that they oriented at an earlier moment in time. However, in contrast with controls, at the end of the cue-target interval no clear contralateral reduction in the upper alpha band was observed for dyslexic individuals. Dyslexic individuals additionally displayed slower responses, especially for invalidly cued high spatial frequency targets in the left visual field. The current data support the view that dyslexic individuals orient well to the cued location but have a problem with sustaining their attention

Anti-alignments in conformance checking: the dark side of process models

Conformance checking techniques asses the suitability of a process model in representing an underlying process, observed through a collection of real executions. These techniques suffer from the wellknown state space explosion problem, hence handling process models exhibiting large or even infinite state spaces remains a challenge. One important metric in conformance checking is to asses the precision of the model with respect to the observed executions, i.e., characterize the ability of the model to produce behavior unrelated to the one observed. By avoiding the computation of the full state space of a model, current techniques only provide estimations of the precision metric, which in some situations tend to be very optimistic, thus hiding real problems a process model may have. In this paper we present the notion of antialignment as a concept to help unveiling traces in the model that may deviate significantly from the observed behavior. Using anti-alignments, current estimations can be improved, e.g., in precision checking. We show how to express the problem of finding anti-alignments as the satisfiability of a Boolean formula, and provide a tool which can deal with large models efficiently.Peer ReviewedPostprint (author's final draft

Quantification of marine benthic communities with metabarcoding

DNA metabarcoding methods have been implemented in studies aimed at detecting and quantifying marine benthic biodiversity. In such surveys, universal barcodes are amplified and sequenced from environmental DNA. To quantify biodiversity with DNA metabarcoding, a relation between the number of DNA sequences of a species and its biomass and/or the abundance is required. However, this relationship is complicated by many factors, and it is often unknown. In this study, we validate estimates of biomass and abundance from molecular approaches with those from the traditional morphological approach. Abundance and biomass were quantified from 126 samples of benthic intertidal mudflat using traditional morphological approaches and compared with frequency of occurrence and relative read abundance estimates from a molecular approach. A relationship between biomass and relative read abundance was found for two widely dispersed annelid taxa (Pygospio and Scoloplos). None of the other taxons, however, showed such a relationship. We discuss how quantification of abundance and biomass using molecular approaches are hampered by the ecology of DNA i.e. all the processes that determine the amount of DNA in the environment, including the ecology of the benthic species as well as the compositional nature of sequencing data

Doppler Ultrasound of Vascular Complications After Pediatric Liver Transplantation:Incidence, Time of Detection, and Positive Predictive Value

Purpose Doppler ultrasound (DUS) is widely used to detect vascular complications after pediatric liver transplantation (LT). This study aimed to assess the moment of first detection of vascular complications with DUS, and to determine the positive predictive value (PPV) of DUS. Materials and Methods Patients aged 0–18 years who underwent LT between 2015 and 2019 were retrospectively included. 92 LTs in 83 patients were included (median age: 3.9 years, interquartile range: 0.7–10.5). Patients underwent perioperative (intra-operative and immediately postoperative) and daily DUS surveillance during the first postoperative week, and at 1, 3, and 12 months. Vascular complications were categorized for the hepatic artery, portal vein, and hepatic veins. DUS findings were compared to surgical or radiological findings during the 1-year follow-up. Results 52 vascular complications were diagnosed by DUS in 35/92 LTs (38%). 15 out of 52 (28.8%) were diagnosed perioperatively, 29/52 (55.8%) were diagnosed on postoperative days 1–7, and 8/52 (15.4%) after day 7. The PPV for all vascular complications diagnosed with DUS was 92.3%. During the 1-year follow-up, 18/19 (94.7%) hepatic artery complications, 19/26 (73.1%) portal vein complications, and 7/7 (100%) hepatic vein complications were diagnosed perioperatively or during the first week. Conclusion The majority of vascular complications during the first year after pediatric LT were diagnosed by DUS perioperatively or during the first week, with a high PPV. Our findings provide important information regarding when to expect different types of vascular complications on DUS, which might improve DUS post-LT surveillance protocols

Assessment of hepatic artery anatomy in pediatric liver transplant recipients:MR angiography versus CT angiography

During LT screening, children undergo CTA to determine hepatic artery anatomy. However, CTA imparts radiation, unlike MRA. The aim was to compare MRA to CTA in assessing hepatic artery anatomy in pediatric LT recipients. Twenty-one children (median age 8.9 years) who underwent both CTA and fl3D-ce MRA before LT were retrospectively included. Interreader variability between 2 radiologists, image quality, movement artifacts, and confidence scores, were used to compare MRA to CTA. Subgroup analyses for ages <6 years and ≥6 years were performed. Interreader variability for MRA and CTA in children <6 years was comparable (k = 0.839 and k = 0.757, respectively), while in children ≥6 years CTA was superior to MRA (k 1.000 and k 0.000, respectively). Overall image quality and confidence scores of CTA were significantly higher compared to MRA at all ages (2.8/3 vs. 2.3/3, p = .001; and 2.9/3 vs. 2.5/3, p = .003, respectively). Movement artifacts were significantly lower in CTA compared to MRA in children ≥6 years (1.0/3 vs. 1.7/3, p = .010, respectively). CTA is preferred over fl3D-ce MRA for the preoperative assessment of hepatic artery anatomy in children receiving LT, both at ages <6 years and ≥6 years

Doppler-ultrasound reference values after pediatric liver transplantation:a consecutive cohort study

OBJECTIVES: Doppler ultrasound (DUS) is the main imaging modality to evaluate vascular complications of pediatric liver transplants (LT). The current study aimed to determine reference values and their change over time.METHODS: A consecutive cohort of pediatric patients undergoing an LT were retrospectively included between 2015 and 2020. Timepoints for standardized DUS were intra-operative and postoperative (day 0), days 1-7, months 1 and 3, and years 1 and 2. DUS measurements of the hepatic artery (HA), portal vein (PV), and hepatic vein(s) (HV) were included if there were no complications during 2 years follow-up. Measurements consisted of: peak systolic velocity (PSV) and resistive index (RI) for the HA, PSV for the PV, and venous pulsatility index (VPI) for the HV. Generalized estimating equations were used to analyze change over time.RESULTS: One hundred twelve pediatric patients with 123 LTs were included (median age 3.3 years, interquartile range 0.7-10.1). Ninety-five HAs, 100 PVs, and 115 HVs without complications were included. Reference values for HA PSV and RI, PV PSV, and HV VPI were obtained for all timepoints (4043 included data points in total) and presented using 5th-95th percentiles and threshold values. All reference values changed significantly over time (p = 0.032 to p &lt; 0.001).CONCLUSIONS: DUS reference values of hepatic vessels in children after LT are presented, reference values change over time with specific vessel-dependent patterns. Timepoint-specific reference values improve the interpretation of DUS values and may help to better weigh their clinical significance.KEY POINTS: • Doppler ultrasound reference values of pediatric liver transplantations are not static but change over time. Applying the correct reference values for the specific timepoint may further improve the interpretation of the measurements. • The pattern of change over time of Doppler ultrasound measurements differs between the hepatic vessel and measurement; knowledge of these patterns may help radiologists to better understand normal postoperative hemodynamic changes.</p

Keeping tabs on your cooperating partners

This article argues that opportunities for unilateral influence within international bureaucracies create a delegation problem akin to that in coalition governments. Parties in coalitions that suspect each another of diverting from the coalition bargain avail themselves of mechanisms, such as junior ministers and parliamentary scrutiny, to monitor their coalition partners’ actions within the executive. Similarly, states that suspect cooperating partners of abusing their unilateral influence within the bureaucracy employ mechanisms, reminiscent of those in coalition governments, in order to ‘keep tabs’ on one another. I illustrate the plausibility of this claim using the case of the European Commission. However, this delegation problem of interstate control can be expected to apply more widely. The article has implications for the study of international organization, international delegation and informal governance

Utility of preoperative CT-based body metrics in relation to postoperative complications in pediatric liver transplant recipients

BACKGROUND: Computed tomography (CT) derived body metrics such as skeletal muscle index (SMI), psoas muscle index (PMI), and subcutaneous fat index (ScFI) are measurable components of sarcopenia, frailty, and nutrition. While these body metrics are advocated in adults for predicting postoperative outcomes after liver transplantation (LT), little is known about the value in pediatric populations. This study assessed the relation between preoperative CT-based body metrics and postoperative short-term outcomes in pediatric LT recipients. METHODS: Patients aged 0-18 years who underwent a primary LT were retrospectively included (N=101, median age 0.5 years, range 0.2-17.1). SMI, PMI, and ScFI were derived from preoperative axial CT slices. Postoperative outcomes and complications within 90 days were correlated with the CT-based body metrics. To classify postoperative infections, the Clavien-Dindo (CD) classification was used. Subgroup analyses were performed for age groups (10 years old). An optimal threshold for test performance was defined using Youden's J-statistic and receiver operating characteristic curve as appropriate. RESULTS: ScFI was significantly (P=0.001) correlated with moderate to severe postoperative infections (CD grade 3-5) in children <1 year old, with the optimal ScFI threshold being ≤27.1 cm2 /m2 (sensitivity 80.4% and specificity 77.8%). A weak negative correlation between SMI and the total duration of hospital stay (R=-0.33, P=0.010) and intensive care unit stay (R=-0.32, P 0.013) was observed in children <1 year old. No other associations between CT-based body metrics and postoperative outcomes were shown. CONCLUSIONS: In children <1 year old with cirrhotic liver disease undergoing LT, pre-operative CT-based body metrics were correlated with moderate to severe postoperative infections (ScFI), and with longer duration of hospital and ICU stay (SMI), and thus can be considered important tools for pre-LT risk assessment

Portal vein obstruction after pediatric liver transplantation:A systematic review of current treatment strategies

INTRODUCTION: Portal vein obstruction (PVO) is a significant vascular complication after liver transplantation (LT) in pediatric patients. Current treatment strategies include percutaneous transluminal angioplasty (PTA), with or without stent placement, mesorex bypass (MRB), splenorenal shunt, mesocaval shunt, endovascular recanalization (EVR), splenic artery embolization and splenectomy. However, specific characteristics of patients undergoing intervention and selection of individual treatment and its efficacy have remained unclear. This review systematically analyzed biochemical and clinical characteristics, selection of treatment, efficacy, and post-procedural complications. METHODS: We systematically searched PubMed and Embase between January 1995 and March 2021 for studies on the management of PVO after LT. We analyzed the reports for biochemical and clinical characteristics at the timing of the intervention in different patients, selection of treatment, and reported efficacies. RESULTS: We found 22 cohort studies with 362 patients who had the following characteristics: biliary atresia (83%), living-donor LT (85%), thrombocytopenia (73%), splenomegaly (40%), ascites (16%), or gastrointestinal bleeding (26%). The 3-year primary patency of PTA without stent placement was similar to that with stent placement (70%-80% and 43%-94%, respectively). MRB was used as an initial treatment with a 3-year patency of 75% to 100%. One study showed that 5-year primary patency of EVR was 80%. Secondary patency was 90% to 100% after 3 years in all studies with PTA alone, PTA/stent placement, and stent placement alone. CONCLUSION: This is the first review of all treatment protocols in PVO after pediatric LT. We showed that an important group of patients has severe symptoms of portal hypertension. Efficacy of all treatment modalities was high in the included studies which make them important modalities for these patients