Schooling duration rather than chronological age predicts working memory between 6 and 7 years: memory maestros study

OBJECTIVE: Low working memory (WM) is strongly linked with poor academic outcomes. WM capacity increases across childhood but how exposure to school is associated with WM development is not known. We aimed to determine extent to which chronological age and schooling duration are associated with WM at the population level. METHODS: In 2012, children in Grade 1 (the second year of formal schooling in Victoria, Australia) from 44 schools in metropolitan Melbourne were recruited. Assessments occurred over the entire school year, with schools quasi-randomly allocated to one of the 4 school terms. WM (primary outcome) was measured using 2 subtests from the computerized Automated Working Memory Assessment: Backwards Digit Recall (verbal) and Mister X (visuospatial). Linear regression was used to examine relationships of WM with time in school and age. RESULTS: Of the 1765 who provided consent, 1727 children (97.9%) had WM assessed throughout the 2012 school year. WM scores became steadily higher over the course of the year. Thus, scores were .77 and .53 SDs higher in Term 4 than Term 1 for verbal and visuospatial WM, respectively (p values for trend for both scores <.001); conclusions were unchanged when adjusted for age and potential confounders. Conversely, age associations attenuated fully once adjusted for school duration. CONCLUSIONS: Our results demonstrate, for the first time, that the developmental increases in WM are strongly associated with time spent in the classroom, above and beyond chronological age.

Healthcare costs associated with language difficulties up to 9 years of age: Australian population-based study

PURPOSE: This study aimed to quantify the non-hospital healthcare costs associated with language difficulties within two nationally representative samples of children. METHOD: Data were from three biennial waves (2004-2008) of the Longitudinal Study of Australian Children (B cohort: 0-5 years; K cohort: 4-9 years). Language difficulties were defined as scores ≤ 1.25 SD below the mean on measures of parent-reported communication (0-3 years) and directly assessed vocabulary (4-9 years). Participant data were linked to administrative data on non-hospital healthcare attendances and prescription medications from the universal Australian Medicare subsidized healthcare scheme. RESULT: It was found that healthcare costs over each 2-year age band were higher for children with than without language difficulties at 0-1, 2-3, and 4-5 years, notably 36% higher (mean difference = $AU206, 95% CI = $90, $321) at 4-5 years (B cohort). The slightly higher 2-year healthcare costs for children with language difficulties at 6-7 and 8-9 years were not statistically different from those without language difficulties. Modelled to the corresponding Australian child population, 2-year government costs ranged from $AU1.2-$AU12.1 million (depending on age examined). Six-year healthcare costs increased with the persistence of language difficulties in the K cohort, with total Medicare costs increasing by $192 (95% CI = $74, $311; p = .002) for each additional wave of language difficulties. CONCLUSION: Language difficulties (whether transient or persistent) were associated with substantial excess population healthcare costs in childhood, which are in addition to the known broader costs incurred through the education system. It is unclear whether healthcare costs were specifically due to the assessment and/or treatment of language difficulties, as opposed to conditions that may be co-morbid with or may cause language difficulties.

A prospective observational study of prevalence and outcomes of patients with Gold Standard Framework criteria in a tertiary regional Australian Hospital

OBJECTIVES: Report the use of an objective tool, UK Gold Standards Framework (GSF) criteria, to describe the prevalence, recognition and outcomes of patients with palliative care needs in an Australian acute health setting. The rationale for this is to enable hospital doctors to identify patients who should have a patient-centred discussion about goals of care in hospital.

DESIGN: Prospective, observational, cohort study.

PARTICIPANTS: Adult in-patients during two separate 24 h periods.

MAIN OUTCOME MEASURES: Prevalence of in-patients with GSF criteria, documentation of treatment limitations, hospital and 1 year survival, admission and discharge destination and multivariate regression analysis of factors associated with the presence of hospital treatment limitations and 1 year survival.

RESULTS: Of 626 in-patients reviewed, 171 (27.3%) had at least one GSF criterion, with documentation of a treatment limitation discussion in 60 (30.5%) of those patients who had GSF criteria. Hospital mortality was 9.9%, 1 year mortality 50.3% and 3-year mortality 70.2% in patients with GSF criteria. One-year mortality was highest in patients with GSF cancer (73%), renal failure (67%) and heart failure (60%) criteria. Multivariate analysis revealed age, hospital length of stay and presence of the GSF chronic obstructive pulmonary disease criteria were independently associated with the likelihood of an in-hospital treatment limitation. Non-survivors at 3 years were more likely to have a GSF cancer (25% vs 6%, p=0.004), neurological (10% vs 3%, p=0.04), or frailty (45% vs 3%, p=0.04) criteria. After multivariate logistic regression GSF cancer criteria, renal failure criteria and the presence of two or more GSF clinical criteria were independently associated with increased risk of death at 3 years. Patients returning home to live reduced from 69% (preadmission) to 27% after discharge.

CONCLUSIONS: The use of an objective clinical tool identifies a high prevalence of patients with palliative care needs in the acute tertiary Australian hospital setting, with a high 1 year mortality and poor return to independence in this population. The low rate of documentation of discussions about treatment limitations in this population suggests palliative care needs are not recognised and discussed in the majority of patients.

TRIAL REGISTRATION NUMBER: 11/121.

BODE Index and GOLD Staging as Predictors of 1-Year Exacerbation Risk in Chronic Obstructive Pulmonary Disease

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Isotopic evidence for the late Brasiliano (500-550 Ma) ore-forming mineralization of the Araes gold deposit, Brazil

The Araes gold deposit, located in eastern Mato Grosso State, central Brazil, is hosted in Neoproterozoic volcanosedimentary rocks of the Paraguay belt, which formed during collision of the Amazonian craton and the Rio Apa block. Ar-40/Ar-39 geochronology and Pb and S isotopic analyses constrain the timing and sources of mineralization. Three biotite flakes from two samples of metavolcanic host rock yield Ar-40/Ar-39 plateau ages between 5941 and 531 Ma, interpreted as cooling ages following regional metamorphism. Clay minerals from a hydrothermal alteration zone yield an Ar-40/Ar-39 integrated age of 503 +/- 3 Ma. Galena grains from ore-bearing veins yield values of Pb-206/(204)pb from 17.952 to 18.383, Pb-207/Pb-204 from 15.156 to 15.811, and Pb-208/Pb-204 from 38.072 to 39.681. Pyrite grains from ore-bearing veins yield values of Pb-206/Pb-204 from 18.037 to 18.202, Pb-207/Pb-204 from 15.744 to 15.901., and Pb-208/(204)pb from 38.338 to 38.800. Pb isotope variations may be explained in terms of mixing a less radiogenic lead component (mu similar to 8.4) from mafic and ultramafic basement host-rocks (Nova Xavantina metavolcanosedimentary rocks) and a more radiogenic lead component (mu similar to 9.2) probably derived from supracrustal rocks (Cuiaba sedimentary groups). Sulfur isotope compositions are homogeneous, with delta S-34 values ranging from -1.1 parts per thousand to 0.9 parts per thousand (galena) and -0.7 parts per thousand to 0.9 parts per thousand (pyrite), suggesting a mantle-derived reservoir for the mineralizing solutions. Based on the Ar, Pb, and S isotope data, we suggest that the precious metals were remobilized from metavolcanic host rocks by hydrothermal solutions during Brasilide-Panafrican regional metamorphism. The Arabs gold deposit probably formed during a late stage of the orogeny, coeval with other mineralization events in the Paraguay Belt.

Middle Proterozoic vein-hosted gold deposits in the Pontes e Lacerda region, southwestern Amazonian craton, Brazil

Structural, geochemical, and isotope studies were carried out on the gold deposits of the Pontes e Lacerda region (Mato Grosso state, Brazil), where rocks of the Aguapei and Rondoniano mobile belts (southwestern Amazonian craton) occur. The orebodies are hosted in metavolcanic, gneiss-granite, quartzite, tonalite, and granite units. Tectonics involve oblique overthrusting (from northeast to southwest), which led to the formation of recumbent folds and thrusts (pathways for the mineralizing fluids), upright folds, and faults with dominant strike-slip component. These unconformities represent potential sites for mineralization. During geological mapping, it was observed that the orebodies consist of quartz, pyrite, and gold, and that the hydrothermal alteration zone contains quartz, sericite, pyrite (altered to limonite), and magnetite (altered to hematite). Chalcopyrite, galena, and sphalerite occur only in the Onça deposit. Chemical analysis of sulfides indicates high contents of Bi, Se, and Te in sulfides and gold, suggesting plutonic involvement in the origin of hydrothermal solutions. K-Ar dating of hydrothermal sericites from gold veins yielded ages in the range from 960 to 840 Ma, which may indicate the age of original crystallization of sericite. Pb-Pb dating in galenas yielded model ages in the range from 1000 to 800 Ma for the Onça deposit, which is in agreement with K-Ar ages. Pb-isotopic ratios indicate high U/Pb and low Th/Pb for the upper-crustal Pb source before incorporation in galena crystals. The Pontes e Lacerda gold deposits yielded ages correlated to the Aguapei event and probably were formed during a Proterozoic contractional tectonic period in the southwestern part of the Amazon craton, which may characterize an important metallogenic epoch in the Pontes e Lacerda region.

U-Pb SHRIMP and 40Ar/39Ar constraints on the timing of mineralization in the Paleoproterozoic Caxias orogenic gold deposit, São Luís cratonic fragment, Brazil

Caxias é um depósito de ouro orogênico do fragmento cratônico São Luís, que é correlacionável aos terrenos Riacianos do Cráton Oeste-Africano. O depósito se formou após o metamorfismo regional (estimado em 2100 ± 15 Ma) e está hospedado em zona de cisalhamento que secciona xistos do Grupo Aurizona (2240 ± 5 Ma) e o Microtonalito Caxias. O microtonalito foi aqui datado em 2009 ± 11 Ma, e representa um estágio magmático tardio na evolução do fragmento cratônico São Luís. Cristais de zircão com idades de 2139 ± 10 Ma foram herdados da fonte magmática ou são produto de contaminação durante a intrusão. A composição dos isótopos de chumbo sugere que granitoides de arco de ilhas de ca. 2160 Ma são a fonte provável para o Pb incorporado na pirita relacionada com o minério. Sericita hidrotermal mostra idade ⁴⁰Ar/³⁹Ar de 1990 ± 30 Ma, que, combinada com a idade de posicionamento do microtonalito hospedeiro, limita o evento mineralizador ao intervalo 2020-1960 Ma.

Barshalder 2 : Studies of late Iron Age Gotland

The prehistoric cemetery of Barshalder is located along the main road on the boundary between Grötlingbo and Fide parishes, near the southern end of the island of Gotland in the Baltic Sea. The ceme-tery was used from c. AD 1-1100. The level of publication in Swedish archaeology of the first millennium AD is low compared to, for instance, the British and German examples. Gotland’s rich Iron Age cemeteries have long been intensively excavated, but few have received monographic treatment. This publication is intended to begin filling this gap and to raise the empirical level of the field. It also aims to make explicit and test the often somewhat intuitively conceived re-sults of much previous research. The analyses deal mainly with the Migration (AD 375–540), Vendel (AD 520–790) and Late Viking (AD 1000–1150) Periods. The following lines of inquiry have been prioritised. 1. Landscape history, i.e. placing the cemetery in a landscape-historical context. (Vol. 1, section 2.2.6) 2. Migration Period typochronology, i.e. the study of change in the grave goods. (Vol. 2, chapter 2) 3. Social roles: gender, age and status. (Vol. 2, chapter 3) 4. Religious identity in the 11th century, i.e. the study of religious indicators in mortuary cus-toms and grave goods, with particular emphasis on the relationship between Scandinavian paganism and Christianity. (Vol. 2, chapter 4) Barshalder is found to have functioned as a central cemetery for the surrounding area, located on pe-ripheral land far away from contemporary settle-ment, yet placed on a main road along the coast for maximum visibility and possibly near a harbour. Computer supported correspondence analysis and seriation are used to study the gender attributes among the grave goods and the chronology of the burials. New methodology is developed to distin-guish gender-neutral attributes from transgressed gender attributes. Sub-gender grouping due to age and status is explored. An independent modern chronology system with rigorous type definitions is established for the Migration Period of Gotland. Recently published chronology systems for the Vendel and Viking Periods are critically reviewed, tested and modified to produce more solid models. Social stratification is studied through burial wealth with a quantitative method, and the results are tested through juxtaposition with several other data types. The Late Viking Period graves of the late 10th and 11th centuries are studied in relation to the contemporary Christian graves at the churchyards. They are found to be symbolically soft-spoken and unobtrusive, with all pagan attributes kept apart from the body in a space between the feet of the deceased and the end of the over-long inhumation trench. A small number of pagan reactionary graves with more forceful symbolism are however also identified. The distribution of different 11th cen-tury cemetery types across the island is used to in-terpret the period’s confessional geography, the scale of social organisation and the degree of alle-giance to western and eastern Christianity. 11th century society on Gotland is found to have been characterised by religious tolerance, by an absence of central organisation and by slow piecemeal Christianisation.

Complications with computer-aided designed/computer-assisted manufactured titanium and soldered gold bars for mandibular implant-overdentures: short-term observations

BACKGROUND Implant-overdentures supported by rigid bars provide stability in the edentulous atrophic mandible. However, fractures of solder joints and matrices, and loosening of screws and matrices were observed with soldered gold bars (G-bars). Computer-aided designed/computer-assisted manufactured (CAD/CAM) titanium bars (Ti-bars) may reduce technical complications due to enhanced material quality. PURPOSE To compare prosthetic-technical maintenance service of mandibular implant-overdentures supported by CAD/CAM Ti-bar and soldered G-bar. MATERIALS AND METHODS Edentulous patients were consecutively admitted for implant-prosthodontic treatment with a maxillary complete denture and a mandibular implant-overdenture connected to a rigid G-bar or Ti-bar. Maintenance service and problems with the implant-retention device complex and the prosthesis were recorded during minimally 3-4 years. Annual peri-implant crestal bone level changes (ΔBIC) were radiographically assessed. RESULTS Data of 213 edentulous patients (mean age 68 ± 10 years), who had received a total of 477 tapered implants, were available. Ti-bar and G-bar comprised 101 and 112 patients with 231 and 246 implants, respectively. Ti-bar mostly exhibited distal bar extensions (96%) compared to 34% of G-bar (p < .001). Fracture rate of bars extensions (4.7% vs 14.8%, p < .001) and matrices (1% vs 13%, p < .001) was lower for Ti-bar. Matrices activation was required 2.4× less often in Ti-bar. ΔBIC remained stable for both groups. CONCLUSIONS Implant overdentures supported by soldered gold bars or milled CAD/CAM Ti-bars are a successful treatment modality but require regular maintenance service. These short-term observations support the hypothesis that CAD/CAM Ti-bars reduce technical complications. Fracture location indicated that the titanium thickness around the screw-access hole should be increased.

Indeterminate QunatiFERON-TB Gold In-Tube assay results in association with procedural specimen collection in children

BACKGROUND. The development of interferon-gamma release assays (IGRA) has introduced powerful tools in diagnosing latent tuberculosis infection (LTBI) and may play a critical role in the future of tuberculosis diagnosis. However, there have been reports of high indeterminate results in young patient populations (0-18 years). This study investigated results of the QunatiFERON-TB Gold In-Tube (QFT-GIT) IGRA in a population of children (0-18 years) at Texas Children's Hospital in association with specimen collection procedures using surrogate variables. ^ METHODS. A retrospective case-control study design was used for this investigation. Cases were defined as having QFT-GIT indeterminate results. Controls were defined as having either positive or negative results (determinates). Patients' admission status, staff performing specimen collection, and specific nurse performing specimen collection were used as surrogates to measure specimen collection procedures. ^ To minimize potential confounding, abstraction of patients' electronic medical records was performed. Abstracted data included patients' medications and evaluation at the time of QFT-GIT specimen collection in addition to their medical history. QFT-GIT related data was also abstracted. Cases and controls were characterized using chi-squared tests or Fisher's exact tests across categorical variables. Continuous variables were analyzed using one-way ANOVA and t-tests for continuous variables. A multivariate model was constructed by backward stepwise removal of statistically significant variables from univariate analysis. ^ RESULTS. Patient data was abstracted from 182 individuals aged 0-18 years from July 2010 to August 2011 at Texas Children's Hospital. 56 cases (indeterminates) and 126 controls (determinates) were enrolled. Cancer was found to be an effect modifier with subsequent stratification resulting in a cancer patient population too small to analyze (n=13). Subsequent analyses excluded these patients. ^ The exclusion of cancer patients resulted in a population of 169 patients with 49 indeterminates (28.99%) and 120 determinates (71.01%), with mean ages of 9.73 (95% CI: 8.03, 11.43) years and 11.66 (95% CI: 10.75, 12.56) years (p = 0.033), respectively. Median age of patients who were indeterminates and determinates were 12.37 and 12.87 years, respectively. Lack of data for our specific nurse surrogate (QFTNurse) resulted in its exclusion from analysis. The final model included only our remaining surrogate variables (QFTStaff and QFTInpatientOutpatient). The staff collecting surrogate (QFTStaff) was found to be modestly associated with indeterminates when nurses collected the specimen (OR = 1.54, 95% CI: 0.51, 4.64, p = 0.439) in the final model. Inpatients were found to have a strong and statistically significant association with indeterminates (OR = 11.65, 95% CI: 3.89, 34.9, p < 0.001) in the final model. ^ CONCLUSION. Inpatient status was used as a surrogate for indication of nurse drawn blood specimens. Nurses have had little to no training regarding shaking of tubes versus phlebotomists regarding QFT-GIT testing procedures. This was also measured by two other surrogates; specifically a medical note stating whether a nurse or phlebotomist collected the specimen (QFTStaff) and the name and title of the specific nurse if collection was performed by a nurse (QFTNurse). Results indicated that inpatient status was a strong and statistically significant factor for indeterminates, however, nurse collected specimens and indeterminate results had no statistically significant association in non-cancer patients. The lack of data denoting the specific nurse performing specimen collection excluded the QFTNurse surrogate in our analysis. ^ Findings suggests training of staff personnel in specimen procedures may have little effect on the number of indeterminates while inpatient status and thus possibly illness severity may be the most important factor for indeterminate results in this population. The lack of congruence between our surrogate measures may imply that our inpatient surrogate gauged illness severity rather than collection procedures as intended. ^ Despite the lack of clear findings, our analysis indicated that more than half of indeterminates were found in specimens drawn by nurses and as such staff training may be explored. Future studies may explore methods in measuring modifiable variables during pre-analytical QFT-GIT procedures that can be discerned and controlled. Identification of such measures may provide insight into ways to lowering indeterminate QFT-GIT rates in children.^

Geological and geochemical characteristics of the Tersang gold deposit, Malaysia: implications for genesis and gold exploration

The Central gold belt of peninsular Malaysia comprises a number of gold deposits located in the east of the N-S striking Bentong-Raub Suture Zone. The Tersang gold deposit is one of the gold deposits in the gold belt and hosted in sandstone, rhyolite and breccia units. The deposit has an inferred resource of 528,000 ounces of gold. The geochronology of the Tersang deposit has been newly constrained by LA ICP-MS U-Pb zircon dating. The maximum depositional age of the host sedimentary rocks ranges from Early Carboniferous to Early Permian (261.5 ± 4.9 Ma to 333.5 ± 2.5 Ma) for the host sandstone and Late Triassic for the rhyolite intrusion (218.8 ± 1.7 Ma). Textural characteristics of pyrite have revealed five types including (1) Euhedral to subhedral pyrite with internal fracturing and porous cores located in the sandstone layers (pyrite 1); (2) Anhedral pyrite overgrowths on pyrite 1 and disseminated in stage 1 vein (pyrite 2); (3) Fracture-filled or vein pyrite located in stages 1 and 2 vein (pyrite 3); (4) Euhedral pyrite with internal fractures also located in stage 2 vein (pyrite 4); and (5) Subhedral clean pyrite located in the rhyolite intrusion (pyrite 5). Based on pyrite mapping and spot analyses, two main stages of gold enrichment are documented from the Tersang gold deposit. Gold in sandstone-hosted pyrite 1 (mean 4.3 ppm) shows best correlation with Bi and Pb (as evidenced on pyrite maps). In addition, gold in pyrite 3 (mean 8 ppm) located in stage 2 vein shows a good correlation with As, Ag, Sb, Cu, Tl, and Pb. In terms of gold exploration, we suggest that elements such as As, Ag, Sb, Cu, Tl, Bi, and Pb associated with Au may serve as vectoring tools in gold exploration. Our new geological, structural, geochemical and isotopic data together with mineral paragenesis, pyrite chemistry and ore fluid characteristics indicate that the Tersang gold deposit is comparable to a sediment-hosted gold deposit. Our new genetic model suggests deposition of the Permo-Carboniferous sediments followed by intrusion of rhyolitic magma in the Late Triassic. At a later stage, gold mineralisation overprinted the rhyolite intrusion and the sandstone.

Composition and age of ores and bottom sediments accumulated within and near the Rainbow hydrothermal field

Results of direct geological and geochemical observations of the modern Rainbow hydrothermal field (Mid-Atlantic Ridge, 36°14'N; 33°54'W) carried out from the deep-sea manned Mir submersibles during Cruises 41 and 42 of the R/V Akademik Mstislav Keldysh in 1998-1999 and data of laboratory studies of collected samples are under consideration in the paper. The field lacks neovolcanic rocks and the axial part of the rift is filled in with a serpentinite protrusion. In this field there occur metalliferous sediments, as well as active and relict sulfide edifices composed of sulfide minerals; pyrrhotite, chalcopyrite, isocubanite, sphalerite, marcasite, pyrite, bornite, chalcosine, digenite, magnetite, anhydrite, rare troilite, wurtzite, millerite, and pentlandite have been determined. Sulfide ores are characterized by concentric-zoned textures. During in situ measurements during 35 minutes temperature of hydrothermal fluids was varying within a range from 250 to 350°C. Calculated chemical and isotopic composition of hydrothermal fluid shows elevated concentrations of Cl, Ni, Co, CH4, and H2. Values of d34S of H2S range from +2.4 to +3.1 per mil, of d13C of CH4 from -15.2 to -11.2 per mil, and d13C of CO2 from +1.0 to -4.0 per mil. Fluid inclusions are homogenized at temperatures from 140 to 360°C, whereas salinity of the fluid varies from 4.2 to 8.5 wt %. d34S values of sulfides range from +1.3 to +12.5 per mil. 3He/4He ratio in mineral-forming fluid contained in the fluid inclusions from sulfides of the Rainbow field varies from 0.00000374 to 0.0000101. It is shown that hydrothermal activity in the area continues approximately during 100 ka. It is assumed that the fluid and sulfide edifices contain components from the upper mantle. A hypothesis of phase separation of a supercritical fluid that results in formation of brines is proposed. Hydrothermal activity is related to the tectonic, not volcanic, phase of the Mid-Atlantic Ridge evolution.