Patients with progression of spinal metastases who present to the clinic have better outcomes compared to those who present to the emergency department.

BACKGROUND: As cancer therapies have improved, spinal metastases are increasingly common. Resulting complications have a significant impact on patient's quality of life. Optimal methods of surveillance and avoidance of neurologic deficits are understudied. This study compares the clinical course of patients who initially presented to the emergency department (ED) versus a multidisciplinary spine oncology clinic and who underwent stereotactic body radiation therapy (SBRT) secondary to progression/presentation of metastatic spine disease. METHODS: We performed a retrospective analysis of a prospectively maintained database of adult oncologic patients who underwent spinal SBRT at a single hospital from 2010 to 2021. Descriptive statistics and survival analyses were performed. RESULTS: We identified 498 spinal radiographic treatment sites in 390 patients. Of these patients, 118 (30.3%) presented to the ED. Patients presenting to the ED compared to the clinic had significantly more severe spinal compression (52.5% vs. 11.7%; p < 0.0001), severe pain (28.8% vs. 10.3%; p < 0.0001), weakness (24.5% vs. 4.5%; p < 0.0001), and difficulty walking (24.5% vs. 4.5%; p < 0.0001). Patients who presented to the ED compared to the clinic were significantly more likely to have surgical intervention followed by SBRT (55.4% vs. 15.3%; p < 0.0001) compared to SBRT alone. Patients who presented to the ED compared to the clinic had a significantly quicker interval to distant spine progression (5.1 ± 6.5 vs. 9.1 ± 10.2 months; p = 0.004), systemic progression (5.1 ± 7.2 vs. 9.2 ± 10.7 months; p < 0.0001), and worse overall survival (9.3 ± 10.0 vs. 14.3 ± 13.7 months; p = 0.002). CONCLUSION: The establishment of multidisciplinary spine oncology clinics is an opportunity to potentially allow for earlier, more data-driven treatment of their spinal metastatic disease.

Local Control in Patients with Metastatic Renal Cell Carcinoma to the Spine: The Experience of an Institution with a Multidisciplinary Spine Oncology Program.

BACKGROUND: The outcomes for patients with metastatic renal cell carcinoma (RCC) to the spine who underwent stereotactic body radiotherapy (SBRT) through a multidisciplinary spine oncology program are not well described. We sought to describe the clinical course and local control rates at 1 and 2 years for these patients. METHODS: A retrospective analysis of a prospectively maintained database of adult oncologic patients receiving SBRT to the spine through a multidisciplinary spine oncology program at a single institution from 2010 to 2021 was performed. Patients with a pathologic diagnosis of RCC were included. RESULTS: A total of 75 spinal sites were treated in 60 patients. Of the 60 patients, 75.0% were men, and the mean patient age was 59.2 ± 11.3 years. At 1 year after treatment, 6 of the 60 patients were lost to follow-up. Of the remaining 54 patients, 18 were censored by death and 7 treatment sites showed local recurrence, for 37 of 44 treatment sites with local control (87.8%). At 2 years, 1 additional local recurrence had developed, 15 patients were censored by death, and no additional patients had been lost to follow-up, resulting in 28 of 36 treatment sites with local control (83.2%). None of the patients who had undergone repeat SBRT had local recurrence at 1 or 2 years. For those with local recurrence, the average time from treatment to progression was 6.6 ± 6.5 months. CONCLUSIONS: In this cohort, one of the largest reported studies of spine SBRT for metastatic RCC, local control was high at 1 and 2 years. Our findings support the role of coordinated, algorithmic treatment for these patients.

Script concordance testing in genetic counseling training: A pilot study.

Clinical reasoning is a complex skill that represents a trainee's ability to use their professional knowledge and skills to assess and solve the problems that arise in clinical practice. As an integral tenet of the genetic counseling process, clinical reasoning skills underlie many of the Practice-Based Competencies (2019) across a variety of domains. Despite the long-lasting recognition of the importance of this complex skill in the training of genetic counselors, clinical reasoning has traditionally been difficult to assess in a standardized way in healthcare education. Script concordance testing is a standardized method of assessing clinical reasoning skills in ambiguous clinical situations. The tool has been used to successfully measure the clinical reasoning skills of trainees in various healthcare training programs and has never been used in a genetic counseling training program. We conducted a pilot study to assess the utility of script concordance testing in the field of genetic counseling as an objective measure of clinical reasoning in trainees. The script concordance test was constructed for the field of genetic counseling and administered to 22 second year genetic counseling students in the Joan H. Marks Graduate Program in Human Genetics at Sarah Lawrence College. Twelve genetic counselors served on a panel to provide expert clinical reasoning responses and a scoring grid was developed using the aggregate scores method. The utility of the tool was measured using Cronbach's alpha coefficient, and scores of students and the panel were compared using Hedge's g. Results revealed statistically significant differences between the scores of panelists and students and good reliability. This study shows that script concordance testing can be used to measure clinical reasoning skills in genetic counseling trainees in a way that is reliable, standardized, and easy to use, thereby allowing programs to better assess the clinical reasoning skills of trainees prior to graduation.

Native solitary bee reproductive success depends on early season precipitation and host plant richness.

Spring-emerging bees depend upon the synchronized bloom times of angiosperms that provide pollen and nectar for offspring. The emergence of such bees and bloom times are linked to weather but can be phenologically mismatched, which could limit bee developmental success. However, it remains unclear how such phenologically asynchrony could affect spring-emerging pollinators, and especially for those that forage over a relatively short time period. We examined the relationship between weather and host plant selection on the native spring-foraging solitary bee, Osmia lignaria, across 3 years at urban and rural sites in and around Seattle, Washington, USA. We used community science weather data to test the effects of precipitation, wind, and temperature on O. lignaria oviposition and developmental success. We also collected pollen data over two distinct foraging periods, early and late spring, and used Next-Generation Sequencing to identify plant genera from pollen. Among the weather variables, precipitation during the early foraging period adversely affected larval developmental success and adult bee emergence success, but not oviposition. Using DNA metabarcoding, we observed that increases in the number of plant genera in pollen increased adult emergence in both foraging periods, but not oviposition or larval development. We also observed that foraging bees consistently visited certain genera during each foraging period, especially Acer, Salix, and Rubus. However, pollen collected by O. lignaria over different years varied in the number of total genera visited, highlighting the importance of multi-year studies to ascertain bee foraging preferences and its link to developmental success.

Where word and world meet: Language and vision share an abstract representation of symmetry.

Symmetry is ubiquitous in nature, in logic and mathematics, and in perception, language, and thought. Although humans are exquisitely sensitive to visual symmetry (e.g., of a butterfly), symmetry in natural language goes beyond visuospatial properties: many words point to abstract concepts with symmetrical content (e.g., equal, marry). For example, if Mark marries Bill, then Bill marries Mark. In both cases (vision and language), symmetry may be formally characterized as invariance under transformation. Is this a coincidence, or is there some deeper psychological resemblance? Here we asked whether representations of symmetry correspond across language and vision. To do so, we developed a novel cross-modal matching paradigm. On each trial, participants observed a visual stimulus (either symmetrical or nonsymmetrical) and had to choose between a symmetrical and nonsymmetrical English predicate unrelated to the stimulus (e.g., "negotiate" vs. "propose"). In a first study with visual events (symmetrical collision or asymmetrical launch), participants reliably chose the predicate matching the event's symmetry. A second study showed that this "language-vision correspondence" generalized to objects and was weakened when the stimuli's binary nature was made less apparent (i.e., for one object, rather than two inward-facing objects). A final study showed the same effect when nonsigners guessed English translations of signs from American Sign Language, which expresses many symmetrical concepts spatially. Taken together, our findings support the existence of an abstract representation of symmetry which humans access via both perceptual and linguistic means. More broadly, this work sheds light on the rich, structured nature of the language-cognition interface. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Bacterial and Fungal Symbionts in Pollen Provisions of a Native Solitary Bee in Urban and Rural Environments.

Among insects, symbionts such as bacteria and fungi can be linked to their physiology and immature development, and in some cases are part of a defense system against parasites and diseases. Current bacterial and fungal symbiont associations in solitary bees are understudied, especially in the Pacific Northwest region of the USA. We collected pollen provisions from the native spring-foraging solitary bee, Osmia lignaria Say, across two distinct foraging periods over 2 years at 22 sites along an urban-to-rural gradient in western Washington. We then used next-generation sequencing to identify bacterial and fungi within pollen provisions and assessed the effect of their richness and diversity on O. lignaria larval development success and adult emergence. We detected a significantly positive relationship between bacterial diversity in pollen with O. lignaria larval developmental success, and higher bacterial richness and diversity during the later foraging period. Fungal generic richness and diversity decreased with increasing plant richness. Although neither was associated with O. lignaria developmental success, we did detect Ascosphaera spp. known to be pathogenic to O. lignaria and other bee species. Neither bacterial or fungal richness or diversity was affected by site type when classified as urban or rural. This study provides new information on bacterial and fungal symbionts present in pollen provisions of a native solitary bee when foraging across urban and rural areas of the Pacific Northwest.

Elevated atherogenic lipid profile in youth with bipolar disorder during euthymia and hypomanic/mixed but not depressive states.

OBJECTIVE: Abnormal blood lipid levels are common in individuals with bipolar disorder (BD). Previous studies have revealed lipid-mood associations in adults with BD, but no data on this relationship is available in youth populations. This cross-sectional study examined the associations of lipid levels with mood states and symptoms in a cohort of youth with BD. METHODS: Participants were youth with BD and healthy controls (HCs) between the ages of 13-20 years. We compared the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and TG/HDL-C ratio between 4 participant episode groups: BD-euthymic (n = 28), BD-depressed (n = 29) BD-hypomanic/mixed (n = 31), and HCs (n = 89). We also examined for dimensional associations of lipids with mania and depression scores in the overall BD group and within BD episode subgroups. RESULTS: TG levels were significantly higher in the BD-euthymic group (p = 0.008, d = 0.59) and in the BD-mixed/hypomanic group (p = 0.03, d = 0.44) compared to the HC group. TG/HDL-C ratio was also higher in the BD-euthymic group compared to the HC group (p = 0.01, d = 0.51). No dimensional associations were found between lipids and mood symptom scores in the overall BD group. However, within the BD-mixed/hypomanic subgroup, higher mania scores were associated with higher TG (ß = 0.42, p = 0.04), TG/HDL-C ratio (ß = 0.59, p = 0.002), and lower HDL-C (ß = 0.56 p = 0.002). CONCLUSIONS: Youth with BD demonstrate atherogenic lipid profiles. Higher atherogenic lipids were associated with hypomanic but, contrasting adult BD studies, not depressive symptoms. Future prospective studies are warranted to evaluate the temporal association between lipids and mood among youth with BD.

Recollecting What We Once Knew: My Life in Psycholinguistics.

The mid-twentieth century brought a radical change in how the linguistics community formulated its major goal, moving from a largely taxonomic science to Chomsky's revolution, which conceptualized language as a higher-order cognitive function. This article reviews the paths (not always direct) that brought Lila Gleitman into contact with that revolution, her contributions to it, and the evolution in her thinking about how language is learned by every child, regardless of extreme variation in the input received. To understand how that occurs, we need to discover what must be learned by the child and what is already there to guide that learning-what must be, in Plato's terms, "recollected." The growing picture shows a learner equipped with information-processing mechanisms that extract evidence about word meanings using various evidential sources. Chief among these are the observational and linguistic-syntactic contexts in which words occur. The former is supported by a mechanism Gleitman and her collaborators call "propose but verify," and the latter by a mechanism known as "syntactic boot-strapping."

A stem cell journey in ophthalmology: From the bench to the clinic.

Debilitating diseases of the eye represent a large unmet medical need potentially addressable with stem cell-based approaches. Over the past decade, the California Institute for Regenerative Medicine (CIRM) has funded and supported the translation, from early research concepts to human trials, of therapeutic stem cell approaches for dry age-related macular degeneration, retinitis pigmentosa, and limbal stem cell deficiency. This article chronicles CIRM's journey in the ophthalmology field and discusses some key challenges and questions that were addressed along the way as well as questions that remain.

Comparison of Pollen Grain Treatments Without Mechanical Fracturation Prior to Protein Quantification.

Protein and amino acids in pollen are important nutritional components for larval development in several insect species, especially in Apoidea. The Bradford assay is a widely used method to measure relative protein content of pollen, which can shed light on pollen quality and consequences to fitness. Prior to using the Bradford assay, protein must be released from pollen grains, often using a mixture of chemical and mechanical fracturation methods. In this study, we tested the efficacy of protein extraction without using mechanical fracturation. We used pollen collected by the solitary bee Osmia lignaria Say to compare two known buffers associated with pollen protein analysis: phosphate-buffered saline and sodium hydroxide, and deionized water, and with different pollen weights from which we quantified protein using the Bradford assay. While all buffers and deionized water were useful in releasing protein from pollen grains collected by O. lignaria, the use of sodium hydroxide resulted in significantly higher protein quantification across all pollen weights. This methodological study can inform future studies of pollen nutrition in pollen-foraging species.

The violin case.

Three humorous episodes, reproduced here, illustrate debates that played out on the pages of Cognition under the aegis of its founding editor, Jacques Mehler. These are the formal structure of language, the mechanisms by which speech unfolds in time, and the constrained creativity of ordinary language use.

The Utility of 68Ga-DOTATATE PET/CT in Localizing Primary/Metastatic Pheochromocytoma and Paraganglioma: Asian Indian Experience.

Purpose: Pheochromocytoma and paraganglioma (PGL), together called PPGL, are rare tumors with a limited number of studies on the diagnostic performance of 68Ga-DOTA (0)-Tyr (3)-octreotate positron emission tomography-computed tomography (68Ga-DOTATATE PET/CT) from the Asian-Indian subcontinent. Materials and Methods: In this retrospective study, PPGL suspects (n = 87) who had undergone at least contrast-enhanced computed tomography (CECT) and 68Ga-DOTATATE PET/CT, were included. Lesion-wise, patient-wise, and region-wise sensitivities of 68Ga-DOTATATE PET/CT, 18F fluorodeoxyglucose positron emission tomography CT (18F-FDG PET/CT, n = 53), 131I-metaiodobenzylguanidine (131I-MIBG, n = 37), and CECT were compared, and diagnostic performance of 68Ga-DOTATATE PET/CT in the detection of PPGL was calculated. Results: 68Ga-DOTATATE PET/CT had significantly higher lesion-wise sensitivity than 131I-MIBG for both primary (94% vs 75%, P = 0.004) and metastatic disease (85% vs 59%, P = 0.001) and higher sensitivity than CECT for metastatic lesions (83% vs 43%, P = 0.0001). The lesion-wise sensitivity of 68Ga-DOTATATE PET/CT was similar to 18F-FDG PET/CT for both primary tumors (94% vs 85%, P = 0.08) and metastatic lesions (82% vs 84%, P = 0.76) in the whole cohort but tended to be inferior in the head to head comparison. Conclusion: 68Ga-DOTATATE PET/CT had higher sensitivity for detection of PPGL than 131I-MIBG (primary and metastatic) and CECT (metastatic) but similar to 18F-FDG PET/CT (primary and metastatic).

CIRM tools and technologies: Breaking bottlenecks to the development of stem cell therapies.

The California Institute for Regenerative Medicine (CIRM) has a mission to accelerate stem cell treatments to patients with unmet medical needs. This perspective describes successful examples of work funded by CIRM's New Cell Lines and Tools and Technologies Initiatives, which were developed to address bottlenecks to stem cell research and translation. The tools developed through these programs evolved from more discovery-oriented technologies, such as disease models, differentiation processes, and assays, to more translation focused tools, including scalable good manufacturing processes, animal models, and tools for clinical cell delivery. These tools are available to the research community and many are facilitating translation of regenerative therapeutics today.

Easy Words: Reference Resolution in a Malevolent Referent World.

This article describes early stages in the acquisition of a first vocabulary by infants and young children. It distinguishes two major stages, the first of which operates by a stand-alone word-to-world pairing procedure and the second of which, using the evidence so acquired, builds a domain-specific syntax-sensitive structure-to-world pairing procedure. As we show, the first stage of learning is slow, restricted in character, and to some extent errorful, whereas the second procedure is determinative, rapid, and essentially errorless. Our central claim here is that the early, referentially based learning procedure succeeds at all because it is reined in by attention-focusing properties of word-to-world timing and related indicants of referential intent.

Comparison of Topical and Intravenous Tranexamic Acid for Total Knee Replacement: A Randomized Double-Blinded Controlled Study of Effects on Tranexamic Acid Levels and Thrombogenic and Inflammatory Marker Levels.

BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug. Topical administration of TXA during total knee arthroplasty (TKA) is favored for certain patients because of concerns about thrombotic complications, despite a lack of supporting literature. We compared local and systemic levels of thrombogenic markers, interleukin (IL)-6, and TXA between patients who received intravenous (IV) TXA and those who received topical TXA. METHODS: Seventy-six patients scheduled for TKA were enrolled in this randomized double-blinded study. The IV group received 1.0 g of IV TXA before tourniquet inflation and again 3 hours later; a topical placebo was administered 5 minutes before final tourniquet release. The topical group received an IV placebo before tourniquet inflation and again 3 hours later; 3.0 g of TXA was administered topically 5 minutes before final tourniquet release. Peripheral and wound blood samples were collected to measure levels of plasmin-anti-plasmin (PAP, a measure of fibrinolysis), prothrombin fragment 1.2 (PF1.2, a marker of thrombin generation), IL-6, and TXA. RESULTS: At 1 hour after tourniquet release, systemic PAP levels were comparable between the IV group (after a single dose of IV TXA) and the topical group. At 4 hours after tourniquet release, the IV group had lower systemic PAP levels than the topical group (mean and standard deviation, 1,117.8 ± 478.9 µg/L versus 1,280.7 ± 646.5 µg/L; p = 0.049), indicative of higher antifibrinolytic activity after the second dose. There was no difference in PF1.2 levels between groups, indicating that there was no increase in thrombin generation. The IV group had higher TXA levels at all time points (p < 0.001). Four hours after tourniquet release, wound blood IL-6 and TXA levels were higher than systemic levels in both groups (p < 0.001). Therapeutic systemic TXA levels (mean, 7.2 ± 7.4 mg/L) were noted in the topical group. Calculated blood loss and the length of the hospital stay were lower in the IV group (p = 0.026 and p = 0.025). CONCLUSIONS: Given that therapeutic levels were reached with topical TXA and the lack of a major difference in the mechanism of action, coagulation, and fibrinolytic profile between topical TXA and a single dose of IV TXA, it may be a simpler protocol for institutions to adopt the use of a single dose of IV TXA when safety is a concern. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

The Pursuit of Word Meanings.

We evaluate here the performance of four models of cross-situational word learning: two global models, which extract and retain multiple referential alternatives from each word occurrence; and two local models, which extract just a single referent from each occurrence. One of these local models, dubbed Pursuit, uses an associative learning mechanism to estimate word-referent probability but pursues and tests the best referent-meaning at any given time. Pursuit is found to perform as well as global models under many conditions extracted from naturalistic corpora of parent-child interactions, even though the model maintains far less information than global models. Moreover, Pursuit is found to best capture human experimental findings from several relevant cross-situational word-learning experiments, including those of Yu and Smith (), the paradigm example of a finding believed to support fully global cross-situational models. Implications and limitations of these results are discussed, most notably that the model characterizes only the earliest stages of word learning, when reliance on the co-occurring referent world is at its greatest.

Two- and three-year-olds track a single meaning during word learning: Evidence for Propose-but-verify.

A child word-learning experiment is reported that examines 2- and 3-year-olds' ability to learn the meanings of novel words across multiple, referentially ambiguous, word occurrences. Children were told they were going on an animal safari in which they would learn the names of unfamiliar animals. Critical trial sequences began with hearing a novel word (e.g., "I see a dax! Point to the dax!") while seeing photos of two unfamiliar animals. After responding and performing on two filler trials with known animals, participants encountered the novel word again ("I see another dax! Point to the dax!") in one of two experimental conditions. In the Same condition, participants saw the animal they pointed to previously when hearing "dax" alongside another unfamiliar animal that had been seen before but not paired with "dax". In the Switch condition, participants saw the animal they had not pointed to previously alongside the unfamiliar animal. Children were well above chance on Same trials, but at chance on Switch trials. Thus, although children could remember a previously selected referent and use it to inform later referent selection (Same condition), a potential referent that was not previously selected and merely co-occurred with the target word (Switch condition) was either not remembered, or simply deemed irrelevant to word meaning. This finding suggests young children do not store multiple possible meanings from a single word occurrence, but rather restrict learning to what they deemed to be the unique referent of the novel word in the moment, testing that word-meaning hypothesis on the next occurrence.

Therapeutic hypothermia for infants with hypoxic ischemic encephalopathy: A five years' single center experience in Kuwait.

OBJECTIVE: We aimed to evaluate the effect of therapeutic hypothermia (TH) on brain MRI findings, neurological outcome, and mortality in patients with perinatal hypoxic ischemic encephalopathy (HIE) and compare between two modalities of TH: whole body cooling (WBC) and selective head cooling (SHC). PATIENTS AND METHODS: Sixty-two inborn babies with HIE admitted to the NICU of a Kuwaiti teaching hospital between 2006 and 2013 were retrospectively reviewed. Patients were divided into two groups: group 1 (2006-2008, n = 30) never received hypothermia, and group 2 (2009-2013, n = 32) treated with hypothermia. Group 2 patients were chronologically divided into two subgroups: 2a, the SHC, (2009-2010, n = 15) and 2b, the WBC, (2011-2013, n = 17). Brain MRI taken 7-10 days after birth, neurological status and mortality at time of hospital discharge were evaluated. RESULTS: Patients who received TH showed significantly fewer MRI hypoxic changes (P = 0.04) and had better neurological outcome. Their need for anticonvulsants diminished (P = 0.04). However, their need for inotropes and duration of mechanical ventilation were increased (P = 0.001 & 0.02 respectively). No significant difference in mortality was found between the two groups (P = 0.6). In regression analysis, only MRI hypoxic changes predicted the occurrence of neurological abnormalities (P = 0.001). No difference in brain MRI findings, neurological outcome and mortality was observed between subgroups 2a and 2b (P > 0.05). CONCLUSION: TH improved the neurological outcome of HIE patients but had no effect on mortality. There was no difference between the two modalities of TH on patients' outcome.

Semantic ambiguity and syntactic bootstrapping: The case of conjoined-subject intransitive sentences.

When learning verb meanings, learners capitalize on universal linguistic correspondences between syntactic and semantic structure. For instance, upon hearing the transitive sentence "the boy is glorping the girl" two-year olds prefer a two-participant event (e.g., a boy making a girl spin) over two simultaneous one-participant events (a boy and a girl separately spinning). However, two- and three-year-olds do not consistently show the opposite preference when hearing conjoined-subject intransitive sentences ("the boy and the girl are glorping"). We hypothesized that such difficulties arise in part from the indeterminacy of the mapping between intransitive syntax and events in the world: a conjoined-subject intransitive sentence can be matched by the one-participant event (if "glorp" means "spin"), both events ("play"), or even the two-participant event ("fight"). A preferential looking study provided evidence for this hypothesis: sentences that plausibly block most non-target interpretations for novel verbs ("the boy and the umbrella are glorping") eliminated the asymmetric difficulty associated with conjoined-subject intransitives. Thus, while conjoined-subject intransitives clearly pose some special challenges for syntax-guided word learning ("syntactic bootstrapping") by novices (Gertner & Fisher, 2012), children's difficulties with this sentence type also reflect expected performance in situations of semantic ambiguity. In discussion, we consider the interacting effects of syntactic- and message-level indeterminacy.

Perceiving referential intent: Dynamics of reference in natural parent-child interactions.

Two studies are presented which examined the temporal dynamics of the social-attentive behaviors that co-occur with referent identification during natural parent-child interactions in the home. Study 1 focused on 6.2 h of videos of 56 parents interacting during everyday activities with their 14-18 month-olds, during which parents uttered common nouns as parts of spontaneously occurring utterances. Trained coders recorded, on a second-by-second basis, parent and child attentional behaviors relevant to reference in the period (40 s) immediately surrounding parental naming. The referential transparency of each interaction was independently assessed by having naïve adult participants guess what word the parent had uttered in these video segments, but with the audio turned off, forcing them to use only non-linguistic evidence available in the ongoing stream of events. We found a great deal of ambiguity in the input along with a few potent moments of word-referent transparency; these transparent moments have a particular temporal signature with respect to parent and child attentive behavior: it was the object's appearance and/or the fact that it captured parent/child attention at the moment the word was uttered, not the presence of the object throughout the video, that predicted observers' accuracy. Study 2 experimentally investigated the precision of the timing relation, and whether it has an effect on observer accuracy, by disrupting the timing between when the word was uttered and the behaviors present in the videos as they were originally recorded. Disrupting timing by only ±1 to 2 s reduced participant confidence and significantly decreased their accuracy in word identification. The results enhance an expanding literature on how dyadic attentional factors can influence early vocabulary growth. By hypothesis, this kind of time-sensitive data-selection process operates as a filter on input, removing many extraneous and ill-supported word-meaning hypotheses from consideration during children's early vocabulary learning.