Mastery of the logic of natural numbers is not the result of mastery of counting: evidence from late counters.

To master the natural number system, children must understand both the concepts that number words capture and the counting procedure by which they are applied. These two types of knowledge develop in childhood, but their connection is poorly understood. Here we explore the relationship between the mastery of counting and the mastery of exact numerical equality (one central aspect of natural number) in the Tsimane', a farming-foraging group whose children master counting at a delayed age and with higher variability than do children in industrialized societies. By taking advantage of this variation, we can better understand how counting and exact equality relate to each other, while controlling for age and education. We find that the Tsimane' come to understand exact equality at later and variable ages. This understanding correlates with their mastery of number words and counting, controlling for age and education. However, some children who have mastered counting lack an understanding of exact equality, and some children who have not mastered counting have achieved this understanding. These results suggest that understanding of counting and of natural number concepts are at least partially distinct achievements, and that both draw on inputs and resources whose distribution and availability differ across cultures.

Native Amazonian children forego egalitarianism in merit-based tasks when they learn to count.

Cooperation often results in a final material resource that must be shared, but deciding how to distribute that resource is not straightforward. A distribution could count as fair if all members receive an equal reward (egalitarian distributions), or if each member's reward is proportional to their merit (merit-based distributions). Here, we propose that the acquisition of numerical concepts influences how we reason about fairness. We explore this possibility in the Tsimane', a farming-foraging group who live in the Bolivian rainforest. The Tsimane' learn to count in the same way children from industrialized countries do, but at a delayed and more variable timeline, allowing us to de-confound number knowledge from age and years in school. We find that Tsimane' children who can count produce merit-based distributions, while children who cannot count produce both merit-based and egalitarian distributions. Our findings establish that the ability to count - a non-universal, language-dependent, cultural invention - can influence social cognition.

Processing relative clauses in supportive contexts.

Results from two self-paced reading experiments in English are reported in which subject- and object-extracted relative clauses (SRCs and ORCs, respectively) were presented in contexts that support both types of relative clauses (RCs). Object-extracted versions were read more slowly than subject-extracted versions across both experiments. These results are not consistent with a decay-based working memory account of dependency formation where the amount of decay is a function of the number of new discourse referents that intervene between the dependents (Gibson, 1998; Warren & Gibson, 2002). Rather, these results support interference-based accounts and decay-based accounts where the amount of decay depends on the number of words or on the type of noun phrases that intervene between the dependents. In Experiment 2, presentation in supportive contexts was directly contrasted with presentation in null contexts. Whereas in the null context the extraction effect was only observed during the RC region, in a supportive context the extraction effect was numerically larger and persisted into the following region, thus showing that extraction effects are enhanced in supportive contexts. A sentence completion study demonstrated that the rate of SRCs versus ORCs was similar across null and supportive contexts (with most completions being subject-extractions), ruling out the possibility that an enhanced extraction effect in supportive contexts is due to ORCs being less expected in such contexts. However, the content of the RCs differed between contexts in the completions, such that the RCs produced in supportive contexts were more constrained, reflecting the lexical and semantic content of the preceding context. This effect, which we discuss in terms of expectations/lexico-syntactic priming, suggests that the enhancement of the extraction effect in supportive contexts is due to the facilitation of the subject-extracted condition.

HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide.

We evaluated the safety and efficacy of high-dose, posttransplantation cyclophosphamide (Cy) to prevent graft rejection and graft-versus-host disease (GVHD) after outpatient nonmyeloablative conditioning and T cell-replete bone marrow transplantation from partially HLA-mismatched (haploidentical) related donors. Patients with advanced hematologic malignancies (n = 67) or paroxysmal nocturnal hemoglobinuria (n = 1) received Cy 50 mg/kg i.v. on day 3 (n = 28) or on days 3 and 4 (n = 40) after transplantation. The median times to neutrophil (>500/microL) and platelet recovery (>20,000/microL) were 15 and 24 days, respectively. Graft failure occurred in 9 of 66 (13%) evaluable patients, and was fatal in 1. The cumulative incidences of grades II-IV and grades III-IV acute (aGVHD) by day 200 were 34% and 6%, respectively. There was a trend toward a lower risk of extensive chronic GVHD (cGVHD) among recipients of 2 versus 1 dose of posttransplantation Cy (P = .05), the only difference between these groups. The cumulative incidences of nonrelapse mortality (NRM) and relapse at 1 year were 15% and 51%, respectively. Actuarial overall survival (OS) and event-free survival (EFS) at 2 years after transplantation were 36% and 26%, respectively. Patients with lymphoid malignancies had an improved EFS compared to those with myelogenous malignancies (P = .02). Nonmyeloablative HLA-haploidentical BMT with posttransplantation Cy is associated with acceptable rates of fatal graft failure and severe aGVHD or cGVHD.

Dose escalation of carmustine in surgically implanted polymers in patients with recurrent malignant glioma: a New Approaches to Brain Tumor Therapy CNS Consortium trial.

PURPOSE: This New Approaches to Brain Tumor Therapy CNS Consortium study sought to determine the maximum-tolerated dose (MTD) of carmustine (BCNU) that can be implanted in biodegradable polymers following resection of recurrent high-grade gliomas and the systemic BCNU exposure with increasing doses of interstitial BCNU. PATIENTS AND METHODS: Forty-four adults underwent tumor debulking and polymer placement. Six patients per dose level were studied using polymers with 6.5%, 10%, 14.5%, 20%, and 28% BCNU by weight. Toxicities were assessed 1 month after implantation by a safety monitoring committee to determine whether subsequent escalations should occur. Nine additional patients were studied at the MTD to confirm safety. BCNU blood levels were obtained before and after polymer implantation. RESULTS: No dose-limiting toxicities were identified at the 6.5%, 10%, or 14.5% dose levels, although difficulties with wound healing, seizures, and brain edema were noted. At the 20% dose, these effects seemed more prominent, and six additional patients were treated at this dose and tolerated treatment well. Three of four patients receiving the 28% polymers developed severe brain edema and seizures, and accrual to this cohort was stopped. Nine additional patients received 20% polymer, confirming this as the MTD. Maximum BCNU plasma concentrations with the 20% loaded polymers were 27 ng/mL. Overall median survival was 251 days. CONCLUSION: The MTD of BCNU delivered in polymer to the surgical cavity is 20%. This polymer provides five times more BCNU than standard commercially available BCNU polymers and results in minimal systemic BCNU exposure. Additional studies are needed to establish the efficacy of high-dose BCNU polymers.

Autologous bone marrow transplantation with 4-hydroperoxycyclophosphamide purging for acute myeloid leukaemia beyond first remission: a 10-year experience.

Between January 1987 and January 1997, 69 eligible patients with acute myeloid leukaemia (AML) in either second (CR2) or third (CR3) complete remission (CR2 = 60, CR3 = 9) underwent 4-hydroperoxycyclophosphamide-purged autologous bone marrow transplantation (BMT) at the Johns Hopkins Oncology Center. The patients' median age was 27 years (range 1-62) and all received busulphan and cyclophosphamide as their preparative regimen. The probability of event-free survival (EFS) at 5 years was 30% [95% Confidence Interval (CI): 19-42%] for CR2 patients and 22% (3-51%) for those in CR3, with a median follow up of 8 years in the surviving group. The median time to an absolute neutrophil count of 0.5 x 109/l was 45 d (range 20-185). Relapse was the major cause of failure with a relapse rate of 55% in CR2 and 44% in CR3, while the non-relapse, transplant-related mortality rate was 15% in CR2 and 33% in CR3. In univariate analysis, patient age, cytogenetics, white blood cell count at presentation, CR1 duration and the sensitivity of clonogeneic leukaemia (CFU-L) in the graft to 4HC were all prognostic for EFS. Using each of these significant variables in multivariate modelling, patient age and sensitivity of CFU-L to 4HC were determined to be predictors of EFS. 4HC-purged autologous BMT produced results similar to allogeneic BMT for AML patients beyond first remission.