Limited Resection Versus Pancreaticoduodenectomy for Duodenal Gastrointestinal Stromal Tumors? Enucleation Interferes in the Debate: A European Multicenter Retrospective Cohort Study

Background The optimal surgical procedure for duodenal gastrointestinal stromal tumors (D-GISTs) remains poorly defined. Pancreaticoduodenectomy (PD) allows for a wide resection but is associated with a high morbidity rate. Objectives The aim of this study was to compare the short- and long-term outcomes of PD versus limited resection (LR) for D-GISTs and to evaluate the role of tumor enucleation (EN). Methods In this retrospective European multicenter cohort study, 100 patients who underwent resection for D-GIST between 2001 and 2013 were compared between PD (n = 19) and LR (n = 81). LR included segmental duodenectomy (n = 47), wedge resection (n = 21), or EN (n = 13). The primary objective was to evaluate disease-free survival (DFS) between the groups, while the secondary objectives were to analyze the overall morbidity and mortality, radicality of resection, and 5-year overall survival (OS) and recurrence rates between groups. Furthermore, the short- and long-term outcomes of EN were evaluated. Results Baseline characteristics were comparable between the PD and LR groups, except for a more frequent D2 tumor location in the PD group (68.3% vs. 29.6%; p = 0.016). Postoperative morbidity was higher after PD (68.4% vs. 23.5%; p < 0.001). OS (p = 0.70) and DFS (p = 0.64) were comparable after adjustment for D2 location and adjuvant therapy rate. EN was performed more in American Society of Anesthesiologists (ASA) stage III/IV patients with tumors < 5 cm and was associated with a 5-year OS rate of 84.6%, without any disease recurrences. Conclusions For D-GISTs, LR should be the procedure of choice due to lower morbidity and similar oncological outcomes compared with PD. In selected patients, EN appears to be associated with equivalent short- and long-term outcomes. Based on these results, a surgical treatment algorithm is proposed

Dynamic indicators of mother-infant prosodic and illocutionary coordination

This report introduces tools designed to detect and quantify ways in which caregivers and infants coordinate their face-to-face communicative interactions. The tools analyze this coordination at multiple levels, linking prosodic patterns to illocutionary aspects of prelinguistic discourse. Data include fundamental voice frequency and sound pressure level parameters extracted from recorded interactions and observers‟ codings of vocalizations according to their perceived illocutionary forces. In this approach, we do not assume that the infants‟ prosodic records associate categorically with any specific mature forms of linguistic or pragmatic constructs, but propose that the dyadic use of these parameters can be seen as evidence for the development of a foundational social system between mothers and infants upon which linguistic conventions can then be built. The tools are drawn accordingly from dynamic recurrence analysis and coupled-oscillators modeling and present possibilities for objective and quantitative indices of social interaction

Dynamic indicators of Mother-Infant Prosodic and Illocutionary Coordination

This report introduces tools designed to detect and quantify ways in which caregivers and infants coordinate their face-toface communicative interactions. The tools analyze this coordination at multiple levels, linking prosodic patterns to illocutionary aspects of prelinguistic discourse. Data include fundamental voice frequency and sound pressure level parameters extracted from recorded interactions and observers ‟ codings of vocalizations according to their perceived illocutionary forces. In this approach, we do not assume that the infants ‟ prosodic records associate categorically with any specific mature forms of linguistic or pragmatic constructs, but propose that the dyadic use of these parameters can be seen as evidence for the development of a foundational social system between mothers and infants upon which linguistic conventions can then be built. The tools are drawn accordingly from dynamic recurrence analysis and coupled-oscillators modeling and present possibilities for objective and quantitative indices of social interaction. 1

A New Workflow for Semi-automatized Annotations: Tests with Long-Form Naturalistic Recordings of Childrens Language Environments

Interoperable annotation formats are fundamental to the utility, expansion, and sustainability of collective data repositories.In language development research, shared annotation schemes have been critical to facilitating the transition from raw acoustic data to searchable, structured corpora. Current schemes typically require comprehensive and manual annotation of utterance boundaries and orthographic speech content, with an additional, optional range of tags of interest. These schemes have been enormously successful for datasets on the scale of dozens of recording hours but are untenable for long-format recording corpora, which routinely contain hundreds to thousands of audio hours. Long-format corpora would benefit greatly from (semi-)automated analyses, both on the earliest steps of annotation—voice activity detection, utterance segmentation, and speaker diarization—as well as later steps—e.g., classification-based codes such as child-vs-adult-directed speech, and speech recognition to produce phonetic/orthographic representations. We present an annotation workflow specifically designed for long-format corpora which can be tailored by individual researchers and which interfaces with the current dominant scheme for short-format recordings. The workflow allows semi-automated annotation and analyses at higher linguistic levels. We give one example of how the workflow has been successfully implemented in a large cross-database project

Multiple Coordination Patterns in Infant and Adult Vocalizations

The study of vocal coordination between infants and adults has led to important insights into the development of social, cognitive, emotional, and linguistic abilities. We used an automatic system to identify vocalizations produced by infants and adults over the course of the day for fifteen infants studied longitudinally during the first 2 years of life. We measured three different types of vocal coordination: coincidence-based, rate-based, and cluster-based. Coincidence-based coordination and rate-based coordination are established measures in the developmental literature. Cluster-based coordination is new and measures the strength of matching in the degree to which vocalization events occur in hierarchically nested clusters. We investigated whether various coordination patterns differ as a function of vocalization type, whether different coordination patterns provide unique information about the dynamics of vocal interaction, and how the various coordination patterns each relate to infant age. All vocal coordination patterns displayed greater coordination for infant speech-related vocalizations, adults adapted the hierarchical clustering of their vocalizations to match that of infants, and each of the three coordination patterns had unique associations with infant age. Altogether, our results indicate that vocal coordination between infants and adults is multifaceted, suggesting a complex relationship between vocal coordination and the development of vocal communication