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marleyelona · 3 months ago

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💘( HOPLESSLY DEVOTED! )✨

FOUR

[ Because of You ]

☆ 《》 ¤

THE WHISTLE OF THE WIND BLEW THROUGH THE TREES OF THE WOODS THAT SURROUNDED THE SMALL TOWN OF MYSTIC FALL as Mason Lockwood headed deep into the wilderness, fallen branches and leaves scrunching under his feet. And as he walked, he listened to the owls hoo and the crickets chirp. But then, he heard it—a voice—calling out to him.

"Uh, excuse me, sir. I believe you dropped this."

Mason spun around to find a brunette girl no older than twenty standing there, holding up his wallet. A smirk broke out across Mason's face at the sight of the girl with the soft brown eyes and the short length hair that flowed perfectly just over her shoulder blades. The moonlight radiated off her olive skin, enhancing her angelic beauty perfectly.

The girl matched the smile on his face as a squeal escaped her lips. And without a second thought, she was off, bolting over to him and landing safely in his outstretched arms. He held her tightly, chuckling as he spun her around, before stopping to pull her into a passionate kiss.

"Hey, baby," he murmured against her lips.

"Hi," she breathed out peacefully. Her eyes closed as she rested her head on his, her feet now safely planted on the ground. "I missed you."

"Careful, Dianna Claire, people might think you're going soft," he teased, his hands softly caressing her hips, sending goosebumps up her arms.

Dianna gasped, "Never," she declared playfully, placing a hand over her heart in mock defence.

Mason chuckled, shaking his head in amusement as he wrapped an arm over her shoulders, "You seriously camping out here?" he asked as they started to walk through the woods together.

"Shut up," she shot him a playful glare. "It's cosy. Under the stars and all," she mused, looking up to admire the diamonds of the sky.

"Well, now I know you're getting soft," he teased, flashing her his infamous smirk.

Dianna scoffed, slapping his chest, only making his grin widen, "What? It's where we first met..." she said, taking a few more steps as she looked around for a specific spot. "...right about..." When she spotted a tree she recognised with her intials carved into it—D.C.B—she stopped, moving to stand in front of Mason. "Here." Wrapping her arms around his neck, a grin stretched across her lips, making Mason's smirk turn into a genuine smile.

Mystic Falls

2009

Dianna was perched on the trunk of a large willow tree inside the woods that surrounded the small town. The leaves shadowed over her like a halo, the moon's light shone down on them, casting shapes across the earthy soil. Her head rested against the hard, barky surface as she gaze up at the night sky, admiring all the constellations.

That's when he appeared from the shadows, a figure of a man rushing past her so quickly she didn't even have time to react. And before she knew it, he dropped to his knees and hurled his guts out, all over her brand new converse sneakers.

A yelp escaped her lips as she shuffled further up the trunk, "What the hell, man?! What's wrong with you?! Don't you know it's rude to puke on someone." Her eyes looked down at her puke covered shoes, her nose scrunching up in disgust.

Mason was quick to push himself to his feet, shocked to see a girl in the woods at this late hour, "I'm sorry," he apologised, brushing off his board shorts. "I didn't know you were there."

"Well, next time use your eyes!" she snapped, pushing herself to her feet as she desperately tried to shake the puke off, scraping her shoes along the browning grass.

"It's pitch black out here!" Mason retorted, matching her tone as he motioned around them.

"What the hell did you take anyway?" Dianna contorted her face in digust as she took in his dishevelled appearance. His hair was indisaray, his skin as pale as a ghost, while redish bags hung under his eyes. "You look wrecked."

"I didn't take nothin'," he hissed. In reality, he had just downed some of the wolfsbane concoction he had made on his way too the old Lockwood cellar."

"Well, then lay off the booze," Dianna suggested with a roll of her eyes.

"I ain't drunk!"

Dianna quirked an eyebrow, not convinced, "Sure."

Suddenly, Mason dropped to his knees as he let out a scream of agony.

Dianna's eyes widened at the sight as she quickly rushed over to the stranger's side, "What the hell is wrong with you?!" She may not of known the man, but she was still human, still had a heart.

"You have to get out of here," Mason grunted through the pain, his fingers that were slowly forming into claws dug into the earth beneath him.

Dianna furrowed her eyebrows in confusion as she could of sworn she heard bones cracking, mingling with Mason agonising cries, "What—?"

"Now!" Mason's head shot up as his eyes glowed with a golden hue, glistening in the moonlight as his canine teeth bared.

Dianna was quick to her feet, her eyes almost popped out of their sockets as she stumbled back into a tree. And when she looked up at the night sky, seeing the full moon, everything made sense, "You're a wolf," she breathed out in realisation.

Losing control of his own actions, Mason surged forward and slammed her against the tree, his hand wrapped around her throat, eliciting a hiss from Dianna as his claws pierced her skin, "What? How do—?"

"Long story," Dianna croaked over the pressure on jugular. "But I can help you. You just have to trust me," she choked out when his grip tightened.

"Trust you," Mason seethed, releasing her as he hurled over, grabbing at his stomach, letting out another painful groan. "I don't even know you!" Another cry slipped from his lips as his arm shot back, multiple bones cracking.

"Well, by the looks of things, you don't have much time to argue," she shot back smugly. "Now, where were you planning to go or did you just plan on tearing through the entire town square?!"

"Down there." Mason pointed to the direction of his family's cellar. "There's a cellar." He continued to groan in pain.

"Alright then." Dianna didn't waste any time as she scooped Mason up from the ground, his arm wrapped around her shoulders, while hers sat around his waist. With heavy breaths and small pants, she struggled to walk Mason over to the cellar as he continued to feel the effects of the full moon.

Once they arrived at the cellar, she dragged him down the stairs. Mason kneeled in the centre of the space as Dianna was quick to chain him to wall on Mason's instructions, but not before testing the chains and bolts first.

Mason managed to find the bottle of water infused with wolfsbane in his bag.

Dianna furrowed her eyebrows in confusion, watching him remove the cap with shaky hands, "What's that?"

"Wolfsbane," Mason replied as he lifted the bottle to his lips, preparing to take a swig.

But Dianna was quick to wave her hand, sending the bottle flying across the room, causing it to hit one of the stone walls, the contents spilling out all over the gravel.

Mason eyes were almost as big as the full moon, "What the hell was that?!" He looked between the bottle and the nineteen year old in complete shock and disbelief. "How did you—what are you—?" he stammered, his finger slowly moving between the busted bottle and the mysterious stranger.

"I'm a witch," she confessed.

"Like the pointy hat and the broomstick?" Mason asked, furrowing his eyebrows in confusion, momentarily forgetting the pain he was in as sweat coated his entire body.

"No!" Dianna's voice raised, offended. "This isn't Disney. Just, you don't want to do that. Trust me, the more you fight it, the more painful it'll be."

Mason looked up at up at her, almost pleadingly and Dianna could see the fear in his eyes, "I don't want to hurt anyone."

Dianna sighed, her features softening, "I won't let that happen, okay? You just got to—"

"Trust you," Mason cut in with a small smile.

Dianna returned the smile, "Yeah."

Mason's hand slammed onto the ground, his claws extracting once more as he let out an ear-piercing scream when his spinal cord suddenly shot up, "Okay! Just tell me what to do," he cried out, tears welling in his eyes.

"Just let it happen, and don't bite off my head," she rushed out as she magically removed the cuffs that kept him chained to the wall off his wrists.

Mason's golden eyes widened, "What are you doing?!" He screamed as rolled onto his side when his body started to mold into one of a wolf.

"Helping!" She rushed over, and dropped down beside him. "Listen to your body," she told him, cradling his face in her hands. "Feel the moons embrace and breathe through it. And when it's over...run!" That's when she pushed herself to her feet, snapping back as she watched Mason turned into a wolf right in front of her eyes, and she had to admit, he was beautiful.

His golden eyes met her hazel ones. Dianna then closed her eyes and muttered a few words in Latin, before her eyes fluttered open and she met the animal's gaze once more, and it was almost like he knew her—recognised her as he slowly stepped around her, before bolting with full speed out of the cellar, and into the wilderness.

☆ 《》 ¤

Mason groaned awake in the woods. Squinting his eyes, he used his hands to block the strong rays of the sun. His whole body ached and was covered in sweat, causing the bed of leaves he was lying in to stick to his back. At the sound of footsteps approaching, he turned, shooting up into a seated position.

But the tension and alarm on his face dimmed at the sight of the familiar brunette that had helped him out even though she didn't know him.

"I remember it," he rasped. "All of it. I didn't hurt anyone," he announced, a wide smile stretched across his face—glad no one was hurt because of him.

She dumped some clothes by his feet, "Told you." Even Dianna couldn't help the smile that tugged at the corner of her mouth—this man was willing to chain himself up, put poison into his body, because he didn't want to hurt anyone—maybe there was hope for humanity after all.

Mason was quick to place on the clothing, and now on his feet, he turned to address her, "How can I remember?" Mason furrowed his eyebrows in confusion, looking up at the witch for an answer. "I've never remembered before."

"Because you finally embraced who you are."

Her mother's words echoing inside her mind, 'Darling, once you embrace who you truly are, you'll finally feel free.'

Mason was lost for words, he was completely and utterly mesmerised by this woman, "Who are you?" he murmured, his voice no louder than a whisper.

Dianna let her smile grace her face, "Dianna. Dianna Claire," she introduced herself, offering him her hand to help him out of the ditch he was in.

Mason matched her smile, "Nice to meet you, Dianna Claire. I'm Mason. Mason Lockwood." He now stood before her, still holding each other's hand as they got lost in one another's eyes, feeling drawn to this person they just met, unable to explain the pull they felt between them.

"Well, Mason Lockwood. You owe me a new pair of shoes."

Mason chuckled, looking down at the puke stained converses, "I owe you more than shoes. How 'bout dinner? Tomorrow night?"

"Free food. I'm so there."

"Great. It's a date."

"Deal." Dianna shook his hand as they shared a smile, standing there, their hands intertwined, not able to tear their eyes away from each other.

"What were you doing here in the middle of the night anyway?" he asked, suspiciously.

Dianna shrugged, waving a dismissive hand, "You know, looking out for Bonnie. She often sleep walks. I just wanted to make sure she didn't step off a cliff or anything."

Mason frowned in confusion, raising an eyebrow, "In the woods?"

"Yeah, I think it's a witch thing," she replied, casually. "Someone trying reach out to her maybe." When she said those words, a chill ran down her spine as they past the old church ruins. And Dianna could of sworn she heard someone call out her name in a gentle but eerie whisper.

"That's creepy."

Dianna shrugged, brushing off the strange feeling that came over her, "You get used to it. How is Bonnie? Did you see her today when you were on your murder mission?" She shot him a knowing look.

A smirk tugged at the corner of Mason's lips, knowing what that look was for, "Yeah, she's good."

"She staying out of everything like you should of been," she said with narrowed eyes, scolding her boyfriend for his idiotic behaviour today.

Mason could no longer hide his amusement, "She's trying. But come on, babe, you gotta admit, they deserved it."

"Deserved it or not. Taking on two vampires by yourself, do you have a death wish?"

Mason sighed, his features softening when he saw the concern in her eyes, "I'm sorry."

"It's fine," Dianna said, continuing to weave through the trees with Mason by her side.

"You know, I don't get why you don't just say hello. She'd love to meet you."

Dianna stopped dead in her tracks, making Mason come to a holt as well, "It's more complicated than that, Mas. Our parents have been fighting since before either of us were born. She doesn't even know I exist." She turned away as she felt her eyes well with tears, trying hard to keep her composure.

"You can change that, baby," Mason soothed, cupping her chin and gently turning her head, so she could meet his gaze once more.

"Just drop it, okay?!" she snapped, removing his hand from her face.

Mason shocked at her out burst, stepped back, raising his hands in defence, "Alright! Jesus. I'll drop it."

"So, did you find it? Or were you too busy playing whose dick is bigger with the Salvatores?"

His smirk was back in seconds as he placed his hand into his pocket and pulled out the moonstone, holding it up for her to see.

"You got it?" Dianna instantly matched his smirk.

"I got it."

Dianna squealed, practically jumping on him as she pulled him into a passionate kiss. Their lips molding together like two puzzle pieces. And as the kiss turned heated, Dianna ran her tongue over his bottom lip, asking for access, and he didn't hesitate giving it to her, his tongue immediately going into battle with hers for dominance.

Dianna pulled back for air, grinning from ear to ear, "I'll never doubt you again," she declared, going to grab the moonstone.

But Mason was quick to move it away, so she couldn't, "I don't know why you're even helping her."

"'Cause I owe her," she stated, snatching the stone from him with narrowed eyes.

"You don't owe her anything, babe," he shot back, snatching it back off her.

Dianna gasped, "She saved my life," she reminded, snatching it right back.

Mason grabbed the stone once again, "She also put it in danger on several different occasions! Remember that?"

"Lucky, I can handle myself then." Snatching the soap shaped stone back, she flashed her boyfriend a smug smirk as she shoved it into the back pocket of her denim shorts.

"Di—"

"She's my friend." And with that, she sent Mason a look that he couldn't argue with.

But, he still tried, "She's a vampire. You can't trust her, baby. If it benefits her, she'll stab you in the back the first chance she gets." He urged with his girlfriend to see sense.

Dianna sighed, "Do you trust me?"

Mason's features softened once more, "Of course I do." He moved closer, reaching out to caress her cheek. "You've always been there for me. Through every transition, every full moon, every moment in between. I love you. You came into my life when I needed someone the most and you haven't left my side since."

A smile graced Dianna's face at his kind words, "And I never will, 'cause despite my better judgement, I love you too, Mason Lockwood," she confessed, letting out an amusement chuckle. "Who would of thought, Dianna Claire, falling in love with a werewolf."

Mason let out a breathless chuckle, "It's not your fault I'm completely irresistible."

Oh, how Dianna wanted to wipe that smug smirk off his face, but damn it, she really did love this man, even though her mother never approved. She said it was because of their ten year age gap, but Dianna knew it was in fact due to Mason being a werewolf.

"Dream on," she teased, sticking her nose up in fake disgust.

"Shut up." Before Dianna could even open her mouth with a sarcastic remark, Mason had pulled her to his chest and brought her into an intoxicating—heart pounding—type of kiss.

Words: 2911

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xxdarkxwolfxxx · 4 months ago

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Any hiccups with the W.D.F.s new D.C.B. ?

Other than Bob losing a finger not at all!

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d-cat-b · 7 years ago

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He decidido morirme unos dias...

-D.C.B-

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silentreadersposts · 4 years ago

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To that guy D.C.B - kahit babae ako, I am better than you! Kahit naagaw mo yung taong pinakamamahal ko, one things for sure, I AM REALLY BETTER THAN YOU! IPAGMAMALAKI KONG MAY UTAK AKO KESA SAYO! You bitch yung galit ko sayo dadalhin ko hanggang hukay!

TANGINANG YAN BAKIT NASASAKTAN PA RIN TALAGA AKO NALULUNOD AKO SA SAKIT

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beeezie · 5 years ago

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I think you're mostly writing for Victoire right now but I just wanted to let you know how much I love your D.C.B. storyline and your take on Lavender! So. There it is, haha. Her mental health issues and how she navigates them spoke a lot to me, and I really like how you portrayed that. And the D.C.B. is just a really good take on the magical creatures and the wizardling world. It just makes sense for magical creatures to become a huge issue sometime!

ohhh thank you so much! 💖

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abatelunare · 8 years ago

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Istituzioni interiori

Ogni tanto, le mie caselle antispam mi regalano qualche variazione sul tema. Oggi ho addirittura trovato una mail proveniente, se ben traduco, dal Ministero dell'Interno spagnolo.

Ministerio del Interior y Hacienda. Calle de Alcalб 5, Madrid 28802. Espaсa.

Good Day, We are writing you from the office of the European anti-fraud/internet scam and money laundry, Investigative department of Europol to inform you that we have commenced an investigation into the alleged fraud. After the investigation by the Investigation Department, we discovered that you make some payment of some amount of money and you never receive any fund. According to the Art.254 Sec.14.7 of 1996 of the laws the agent has the sole right to transfer such a fund to the beneficiary whom the criminal act carried out in this process was the subsequent payment made by the beneficiary, which is against the laws of sect. 247.14 of Art 261 of 1996. During these processes the total amount has to be returned. As mentioned above we are having a date in court by Nest week for the hearing/Proceeding into the case, for this reason you are advise to send the payment receipt as a proof to present in the court for your refund. Contact us with the contact Information below E-mail [email protected] Do not hesitate to reply me should there be any questions Hope to hear from you soon. Yours Faithfully, Best regards, Don.Varquero Gomez Dominguez. (M.E.H. Director) FORM D.C.B NO 382200 SCS Tel/Fax:+34-611-213-069 E-mail [email protected]

Secondo un sedicente ufficio europeo che si occuperebbe di combattere le frodi telematiche e il riciclaggio di denaro sporco, io avrei pagato una somma per Dio sa cosa e non avrei ricevuto in cambio quello che mi spettava. Peccato che io non abbia tirato fuori proprio niente. Per cui, anziché contattare questa gente, io la sputtano. Non servirà a fermarla, ma a impedire che qualcuno ci caschi secondo me sì.

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creativemorningswro · 6 years ago

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Ostatnie w 2018 roku spotkanie było niezwykłe z dwóch powodów. Spotkaliśmy się w miejscu, którego mury pełne są tradycji i historii - Synagodze pod Biały Bocianem. Nie był to przypadek, gdyż to właśnie serce żydowskiej społeczności Wrocławia, z którą nasza prelegentka Bente Kahan jest ściśle związana. Norweska piosenkarka i aktorka żydowskiego pochodzenia działa w Fundacji Bente Kahan, której głównym celem jest przybliżanie szerszej publiczności żydowskiej kultury i historii. By tradycji stało się zadość, rozpoczęliśmy spotkanie pysznym koszernym śniadaniem. Dzięki życzliwości Rebecyn D.C.B., na stole znalazły się takie specjały jak: Jachnun, Rugelach czy Kugel. Mogliśmy również skosztować Kawoszki w wersji koszernej - z rodzynkami nasączonymi w rumie.

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12endigital · 5 years ago

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La plantilla de la Policía Local de El Campello se incrementa con la incorporación de dos nuevos agentes, a los que seguirán otros dos en 2021

La policía Local de El Campello crece en efectivos incorporados en calidad de interinos. Ya forman parte del cuerpo dos nuevos agentes (D.C.B. y A.O.S.) que días atrás juraron sus cargos ante el alcalde, Juanjo Berenguer; el secretario municipal, Carlos del Nero; el concejal de Seguridad, Rafa Galváñ, y la responsable política de Recursos Humanos, Lourdes Llopis, ambos del PP. Los dos agentes…

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#El Campello #Policía Local

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cr00kedalien-blog · 6 years ago

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What would I write when all my thought and energy is discouraged by my own train of thought, there are times where I catch myself in the worst thought or not in thought at all is so confusing for me to put down what I’m currently feeling or yearning for especially in the moment it’s almost like I dream all day and when it comes to it I question or doubt myself. My self confidence has grown, but there are those glitches where my mood or feelings disappear, and I’m left with this odd feeling of being empty. I can have the most amazing moment with myself then it snatched out of my inner soul and just left me like it was never there in the first place. Its that self doubt and it gets to me so much and I would love to feel the absence of self doubt to be free from your own fear and lack of understanding. What a world it would be if I were to be free of all those demons that haunt my self love and worth, but to my guess that is what makes us the most human of all to have conflictions, terrifying, gut wrenching feelings that seem to drag you along the road. Its terrifyingly beautiful to be alive, to exist, to breath and love. -D.C.B.

#loveyou

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d-cat-b · 8 years ago

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Después de estar tan alejada de todo, llegaste tú y me volví tan apegada a ti que ahora me da miedo que me abandones.

D.C.B

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aster-sunshine · 7 years ago

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D.C.B

10-7-18, 12:44 am

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beeezie · 8 years ago

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Countdown: 50 days, part one (Devil in the Details C1)

James was very glad that he was so sure about what he wanted to do with his life.

It seemed like everyone else in his year was on the verge of a nervous breakdown because they were rapidly running out of time to figure it out.

He, on the other hand, was more relaxed than he’d ever been.

Well, all right, he was on the outs with his girlfriend again, and that was certainly a little stressful, but all in all, he was feeling good about their upcoming N.E.W.T.s and life after Hogwarts. If Marion Thomas was a part of it, that would be nice, but if she wasn’t, he didn’t plan to mope about it.

He was sure that they’d stay friends, at any rate, even if they broke it off for good. Who ended a seven-year long friendship over what basically just amounted to some philosophical differences?

When he entered the Great Hall, it was still fairly quiet. Apparently, the boys he shared his dormitory with were not the only ones taking advantage of the weekend and sleeping in.

Most of the Gryffindors had not yet ventured down to breakfast. However, he did see his brother eating breakfast with their cousin Rose about halfway down the table.

“Hi, James,” Albus said when he joined them. His hair, a more muted shade of red than Rose’s, drooped across his forehead. It didn’t, however, distract from the dark circles under his eyes or the creases in his forehead. Rose looked a little better, but James suspected that that was more due to having a boyfriend than how she was actually handling the workload; both she and Albus had had a hard time adjusting to N.E.W.T. classes that year, and he knew that they were both looking forward to the summer holiday even more than usual.

Rose jerked her head toward Marion and their cousin Roxanne, who were chatting with each other further down the table. “Avoiding your problems?” she asked dryly. “Or did you not notice her glaring at you all through practice yesterday?”

James shrugged and served himself some food. “Not particularly.”

His brother exchanged a look with Rose. “What was it this time?”

“Oh, she just overreacted about something.” He shoveled a forkful of potatoes into his mouth. “I mean, all I was doing was talking about the last letter I got from Vic about how there have been a few sightings of what might have been quintapeds off the Scottish coast.”

Albus’s eyes widened. “You’re joking,” he said incredulously. “But they’ve never—” He stopped himself - if James wanted to distract his brother from prying into his relationship, he was clearly going to have to do better than that. “I think I can see where this is going, but tell me anyway.”

“Well, V said that they were going to have to investigate it, and I expressed some slight envy to Marion, and she completely overreacted. I mean, of course I know how dangerous they are.” He grinned. “That’s part of the fun.”

“I hear that.” Rose raised her goblet. James clinked it with his and turned to his brother.

“Are you sure you don’t want to reconsider the whole Auror thing?”

Albus shook his head. “No, I’m good, thanks. And anyway, even if I decided not to be an Auror, I definitely wouldn’t go into Dangerous Creatures—I might have to deal with you two every day for the rest of my life.”

James reached over and ruffled his brother’s hair. “You seem to do okay.”

“My sanity is hanging on by a thread,” Albus said dryly. “So you voiced a desire to face off against some very dangerous creatures, and your girlfriend got a little tense?”

“You’re no fun,” James muttered. His brother could be like a dog with a bone when he wanted to be. “I really don’t understand why, it’s not like it should be news to her. She knows what I want to do.”

“Yes,” his brother said patiently, “but James, there’s a difference between ‘I want to join the D.C.B.’ and ‘I heard there were some highly dangerous monsters running around and my cousin Victoire is probably going to go fight them. What? Oh, no, I’m not worried about her, I’m just jealous because nothing would please me better than to rush headlong into danger!”

“Well, when you put it like that… Oh, come on, Al, don’t tell me you’re taking her side.”

Albus groaned. “I’m not taking her side. I just think that sooner or later, you’re actually going to have to deal with the fact that she’s uncomfortable rather than charming her out of being angry.”

“She’ll come around or she won’t. There’s nothing I can do about it.”

“Why am I the one without a girlfriend, again?” Albus asked.

“They’ve forgotten that you are the sane one,” Rose commented distractedly. When James and Albus had started talking about his difficulties with Marion, she’d buried herself in her copy of the Daily Prophet. James could see just enough of the page to know that she was looking up Quidditch results.

“Clearly.” Albus leaned over to examine the page.

“Also, you keep turning girls down because they’re not good enough for you,” James pointed out.

Rather than acknowledge what James had said, Albus changed the subject. “Oh, good, the Harpies did beat Portree! I was worried – our form has been awful lately.”

Rose threw the paper down, looking disgusted. “Less good news for us,” she told James. “Hammered by the Falcons.”

He groaned. “Roxanne is going to rub our noses in that.” He glanced up the table, and then lowered his voice to ask, “How did Puddlemere United do?”

Albus rolled his eyes as Rose looked back down at the paper. “They beat the Tornados. Why?”

“No reason,” James said airily, glancing out a window. “Good flying conditions today.”

“Do you have a practice scheduled?” Albus had taken the paper from Rose and was scanning the current league table.

He shook his head. “No, tomorrow. Practice yesterday afternoon was hard, especially with the rain, so I’m giving them today off.”

“Thanks ever so, fearless leader,” Rose murmured. He rolled his eyes at her, and she stuck out her tongue.

After they had finished eating, Albus said, “James, you should talk to Marion.”

James looked up from his empty plate, forcing an expression of innocence onto his face. “What do you mean?”

“You keep sneaking glances at her.” His brother laughed. “Come on. I’m not stupid, and I know you. Go patch things up with Marion. I need your help with Goldstein’s assignment later and you’re just going to be distracted if you don’t.”

James jerked back. “Will not!”

Albus gave him a sceptical look. “Just go.”

“Later.” He pushed his plate away. It hadn’t even been a day yet, and he was damned if he was going to go running to her to patch things up that quickly. If she wanted to, she could come to him.

It wasn’t that he didn’t care about her or about patching things up. He did. He just wasn’t the type to go crawling around begging anyone to forgive him, especially when he hadn’t done anything wrong.

And that was really the crux of it. He didn’t feel like he had done anything wrong. He probably could have been a little more tactful, but at the same time, Marion was one of his best friends, and they’d been going out for over a year. James didn’t see why he should have to be tactful about what he wanted to do with his life. The end of their seventh year was fast approaching, and if she couldn’t deal with him talking about fighting dangerous creatures, how on earth did she expect to deal with him doing it? She had to know that he wasn’t about to change his mind.

James sighed and ran a hand through his hair.

“Knut for your thoughts?” He looked up and saw both Rose and Albus looking at him quizzically.

“They’re worth at least a sickle,” he told them. “Since there are two of you, maybe even a galleon.”

“One sickle plus one sickle equals a galleon, now?” Albus asked.

“I said at least a sickle. The price went up.”

“Sickle for your thoughts, then?” Rose amended. “And I’m not going to pay you.”

He grinned. “If I could get my family to pay me every time I shared a thought with them—”

“We’d be poor, and you’d talk too much,” Albus said, cutting him off. “Spill.”

James glanced down the table, where Marion and Roxanne were still sitting, and lowered his voice. “It’s just that I don’t know if it’s worth patching up.”

His brother’s eyebrows shot up. “What?”

Rose’s reaction, however, was much more measured. “Yeah, I was wondering whether you were starting to think that.”

Albus looked from James to her to James again. “Are you joking?”

James shrugged. “Not particularly.”

“But you adore Marion,” Albus said.

“Sure.”

“And you’re just going to throw that away because she doesn’t like your career choice?” Al asked incredulously.

“Albus, that’s not a minor concern,” Rose said impatiently. “If she can’t deal with what he wants to do, how is she going to deal with it when he’s doing it? It doesn’t matter how much he likes her, if she can’t cope then they won’t be happy.” James raised his eyebrows at her, and she gave him a sheepish grin. “You’re not the only one who’s been thinking about that.”

Albus gave a disgusted snort. “Do I have to make myself available to my best friend because you have imminent plans to break his heart?” he asked.

“No,” Rose said calmly. “It’s just something I’ve been thinking about. And it’s something I’ve talked about with him,” she said pointedly, and Albus sighed.

“You’re both insane,” he said. “All of you are. If you’re with someone you care about, you find a way to make it work.”

“It’s not that easy,” James and Rose said at the same time.

Albus sighed. “You’re all insane,” he repeated. “It’s no wonder I can’t find anyone.”

“Right, it has nothing to do with the fact that you keep turning down girls who ask you out because they aren’t good enough for you,” James said again.

His brother didn’t acknowledge the comment this time, either. “James, just talk to her.”

“I will. Eventually.”

#harry potter fanfiction #james sirius potter #james potter ii #james sirius x oc #next gen

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dnbrdn · 8 years ago

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Damn love

My love, my deepest why

Your face on my mind, keeps on passing by

I love you so much that it makes me cry

Willing to do anything for you, even die

-D.C.B

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jamestaylorjrmusic · 8 years ago

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D.C.B., Friday at the Crystal Bar! Come on out! (at Crystal Bar)

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dailyquack5896 · 8 years ago

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Dental amalgam restorations and children's neuropsychological function: the New England children's Amalgam Trial.

BACKGROUND: A concern persists that children's exposure to mercury vapor from dental amalgams produces neurotoxicity. OBJECTIVE: Our goal was to compare the neuropsychological function of children, without prior exposure to dental amalgam, whose caries were repaired using either dental amalgam or mercuryfree composite materials. METHODS: We conducted a randomized controlled trial involving 534 6- to 10-year-old urban and rural children who were assessed yearly for 5 years using a battery of tests of intelligence, achievement, language, memory, learning, visual-spatial skills, verbal fluency, fine motor function, problem solving, attention, and executive function. RESULTS: Although the mean urinary mercury concentration was greater among children in the amalgam group than the composite group (0.9 vs. 0.6 [micro]g/g creatinine), few significant differences were found between the test scores of children in the two groups. The differences found were inconsistent in direction. Analyses using two cumulative exposure indices--surface years of amalgam and urinary mercury concentration--produced similar results. CONCLUSIONS: Exposure to elemental mercury in amalgam at the levels experienced by the children who participated in the trial did not result in significant effects on neuropsychological function within the 5-year follow-up period. KEY WORDS: children, dental amalgam, elemental mercury, neuropsychology, randomized controlled trial. Environ Health Perspect 115:440-446 (2007). doi:10.1289/ehp.9497 available via http://dx.doi.org/ [Online 30 October 2006] ********** We previously reported on a randomized clinical trial, the New England Children's Amalgam Trial (NECAT), in which no significant differences were found, over a 5-year follow-up interval, between the neuropsychological scores of children for whom dental amalgam was used to repair caries and the scores of children for whom mercury-free composite materials were used (Bellinger et al. 2006). The Full-Scale IQ score on the Wechsler Intelligence Scale for Children-Third Edition (WISC-III; Wechsler 1991) was the primary end point, and the General Memory Index (GMI) on the Wide Range Assessment of Memory and Learning (WRAML; Sheslow and Adams 1990), and the Visual Motor Composite (VMC) on the Wide Range Assessment of Visual-Motor Ability (WRAVMA; Adams and Sheslow 1995) were the two secondary end points. Each of these is a global score, derived by combining a child's performance on tasks that assess somewhat different abilities. The additional analyses reported in this article address three issues. First, if mercury vapor liberated from dental amalgams produces specific rather than general neuropsychological effects and are most likely to be evident on tests that assess specific cognitive domains, global scores such as Full-Scale IQ, GMI, and VMC might be relatively insensitive to important treatment-group differences. Even in the absence of treatment-group differences on global test scores, differences in specific cognitive domains could, depending on their nature and severity, represent morbidities with important consequences for children's health and well-being. Therefore, here we report comparisons of the scores of the amalgam and composite groups on the subscales that contribute to Full-Scale IQ, the GMI, and the VMC, as well as scores on a battery of additional, domain-focused, neuropsychological and educational tests. Second, the exposure index used in the primary analyses of the trial was treatment-group assignment. This could have introduced a form of exposure misclassification insofar as the variability in the treatment needs of the children in the amalgam group resulted in the receipt of variable amounts of amalgam and thus in their potential exposure to mercury. Therefore, we repeated the analyses replacing treatment-group assignment with two continuously distributed indices of exposure: surface-years of amalgam and urinary mercury concentration. Third, it is possible that only a subset of children experienced adverse neuropsychological effects as the result of exposure to amalgam, either because of behaviors, such as bruxism or frequent gum chewing, that cause enhanced release of mercury (Barregard 2005; Barregard et al. 1995) or because of enhanced sensitivity to mercury. Two recent studies of dental professionals suggest that polymorphisms for brain-derived neurotrophic factor (Echeverria et al. 2005; Heyer et al. 2004) and the coproporphyrinogen oxidase gene (Echeverria et al. 2006) modify the neurotoxicity of elemental mercury. If the prevalence of such enhanced vulnerability to elemental mercury is low or the associated increase in neuropsychological toxicity is modest in magnitude, its impact on the mean scores of children in the amalgam group might not have been sufficiently large to produce significant treatment-group differences. In an attempt to identify the presence of a subgroup of children who are particularly sensitive to amalgam, we compared the distributional characteristics of the scores within the treatment groups. Methods Study design and participants. Children were eligible if they were 6-10 years of age, fluent in English, had no known prior or existing amalgam restorations, had two or more posterior teeth with dental caries, and did not have a physician-diagnosed psychological, behavioral, neurological, immunosuppressive, or renal disorder (Children's Amalgam Trial Study Group 2003). Children were recruited from several community dental clinics in the Boston/Cambridge area of Massachusetts, an urban setting, and from a dental clinic in Farmington, Maine, a rural area. A total of 5,116 children were screened for eligibility. Eligibility was confirmed for 598 children. At baseline visits, children received a dental examination by a study dentist, X rays, and standard preventive dental care (e.g., cleaning, application of sealants). Other baseline visit activities included the collection of blood and urine samples, anthropometric measurements of height, weight, and body fat, neuropsychological testing of the child, a health interview with the child's guardian, and neuropsychological testing of the guardian. After completion of baseline visits, children were randomized to a study treatment arm. Randomization was stratified by geographic location (Boston/Cambridge vs. Farmington) and number of teeth with caries (two to four vs. five or more), using randomly permuted blocks within each of the four strata. The NECAT was conducted in accordance with all applicable requirements for the protection of human subjects. All children provided assent and parents provided informed consent. The study protocol was approved by the institutional review boards of the New England Research Institutes, the Forsyth Institute, and the clinics from which children were recruited. Interventions and follow-up. All children had semiannual dental examinations as well as additional visits required to meet treatment needs. For children in the amalgam arm, a dispersed-phase amalgam was used to restore all posterior teeth with caries at baseline and to repair incident caries during the 5-year trial period. For children in the composite arm, composite material (white filling) was used for all restorations. Following standard clinical practice, for both groups, composite material was used to repair caries in the front teeth, and stainless steel crowns were used to restore primary teeth with extensive lesions that could not otherwise be restored. The choices of dental materials and techniques were standardized across sites and dentists. Urine samples were collected annually and analyzed for elemental mercury using cold vapor atomic absorption. Values were expressed as micrograms per gram creatinine. The analyses reported use only urinary mercury concentrations in samples collected at 3, 4, and 5 years of follow-up. After 1 February 2000, the detection limit, which had been 1.5 ng/mL, was reduced to 0.45 ng/mL as a result of increasing the volume of sample analyzed for each child. Samples with a mercury concentration below the detection limit were assigned a value of 0.45/[square root of 2] (Bellinger et al. 2006). Participants and dentists could not be blinded to treatment assignment, but all individuals who collected outcome data (e.g., neuropsychological tests) or analyzed specimens (e.g., for mercury) were blinded to children's treatment assignments. Neuropsychological assessments. At baseline, before randomization and the receipt of any dental treatments, children participated in two 3-hr neuropsychological test sessions. At the first session, the WISC-III (Wechsler 1991) and the Wechsler Individual Achievement Test (WIAT) (Psychological Corporation 1992) were administered. These tests were again administered at 3 and 5 years after baseline. The second baseline session consisted of a battery of domain-focused tests. This test battery, which was again administered at 1, 2, and 4 years after baseline, included the WRAML (Sheslow and Adams 1990), the WRAVMA (Adams and Sheslow 1995), the Trail-Making Test (Spreen and Strauss 1991), finger tapping (the WPS Electronic Tapping Test; Western Psychological Services, Los Angeles, CA), ordered and unordered verbal cancellation (Mesulam 1985), category fluency (McCarthy 1972), the Controlled Oral Word Association Test (letter fluency) (Spreen and Strauss 1991), simple visual reaction time (the Standard Reaction Timer; Software Science, Cincinnati, OH), the Stroop Color-Word Interference Test (Trenerry et al. 1989), and the Wisconsin Card Sorting Test (Heaton et al. 1993). A total of 14 testers were used at the Boston/Cambridge site and five testers at the Farmington site. Quality control of the assessments was assured by having all examiners trained and certified by one supervising psychologist (D.C.B.) before conducting assessments of children enrolled in the trial, and monitored over the course of data collection. Each testing session was completely rescored by a second individual and errors were corrected. A variety of computerized algorithms were used to check the entered data for internal consistency. Sample size determination. The trial was designed to achieve 80% power to detect a 3-point difference between treatment arms in 5-year change in Full-Scale IQ score, adjusted for baseline IQ score and randomization stratum. Assuming a retention rate of 75% over the 5-year follow-up period, the recruitment goal was 250 children per treatment arm, for a total sample size of 500 children. Statistical analysis. We used intention-to-treat analyses, using analysis of covariance, to compare the amalgam and composite groups in terms of the changes, over 5 years, in scores on the WISC-III and WIAT and the changes, over 4 years, in scores on the domain-focused tests. These analyses thus indicated whether the central tendencies of the distributions of change scores differed in the amalgam and composite groups. Adjustments were made for baseline covariates: test score, randomization stratum, age, sex, socioeconomic status, hair mercury, and blood lead level. We calculated socioeconomic status using the method developed by Green (1970). Hair mercury was included to control for methylmercury, a form of mercury that is known to be a developmental neurotoxicant (Weiss 2006) but acquired primarily by consumption of contaminated seafood. Elevated blood lead level is a well-known developmental risk factor, with an increased prevalence among children who are socioeconomically disadvantaged (Bellinger 2006). We evaluated children's neuropsychological test scores in relation to two continuously distributed indices of exposure. The first index was surface-years of amalgam (number of amalgam surfaces weighted by number of years present), calculated from the information contained in dental clinic records regarding dates of amalgam placement, the number of tooth surfaces involved in the restoration, the timing of loss of primary teeth containing amalgam restorations, and the like. The second index was urinary mercury concentration. Scores on the WISC-III and WIAT, both of which were administered at year 5 of follow-up, were evaluated in relation to the mean of available urinary mercury concentrations at years 3, 4, and 5. Scores on the other tests, which were administered for the final time at year 4 of follow-up, were evaluated in relation to the mean of available urinary mercury concentrations at years 3 and 4 of follow-up. We evaluated the associations between these indices of exposure and children's neuropsychological test scores using analysis of covariance, adjusting for the same set of baseline covariates used in the intention-to-treat analyses. We conducted the analyses using the Kolmogorov-Smirnov test (Stuart and Ord 1991) to compare characteristics other than the central tendency of the distributions of the change scores in the treatment groups. When the results indicated that the change scores of children in the two groups did not come from the same distribution, we determined whether this was attributed to differences between treatment groups in the percentages of children with change scores indicating substantial deterioration of performance over the follow-up interval. Of particular interest was whether, in the absence of a treatment-group difference in mean change score, a greater percentage of children in the amalgam group than in the composite group demonstrated such deterioration. To evaluate the impact of interexaminer variability on the results, we repeated the intention-to-treat analyses including adjustment for a set of indicator variables representing the neuropsychological examiners. Results Table 1 shows that the treatment groups did not differ significantly in terms of age, race, household income, education of primary caregiver, Full-Scale IQ, hair and urinary mercury concentrations, blood lead level, and number of decayed tooth surfaces. Females outnumbered males in the composite arm. Children were primarily non-Hispanic white (62%), with non-Hispanic blacks making up an additional 19% of the sample. The mean number of total decayed tooth surfaces at baseline was 9.5, with 1.7 of the surfaces being in permanent teeth. Slightly more than half of the children (54%) had five or more teeth with caries that required restoration, with the rest having two to four carious teeth. Children from the Boston/Cambridge area tended to have more caries than did children from Farmington (10.3 vs. 8.6 carious surfaces, respectively). Children continued to have dental treatment needs over the course of the 5-year follow-up period, averaging approximately one new filled surface per year. The treatment needs were similar in the treatment groups (Table 2). At the end of the follow-up period, the number of restored surfaces in place ranged from 0 to 36 in both treatment groups, and the mean values did not differ significantly (p = 0.16). The amalgam and composite groups also did not differ significantly in the cumulative number of restored surfaces over the trial (p = 0.10). In the amalgam group, 79% of the surfaces had been restored with amalgam. At the end of the 5-year follow-up period, the mean urinary mercury concentration was significantly greater among children in the amalgam group (0.9; range, 0.1-5.7 [micro]g/g creatinine) than among children in the composite group (0.6; range, 0.1-2.9 [micro]g/g creatinine) (p < 0.001). Table 3 shows the change scores over the follow-up interval for each test score. Of all the change scores evaluated, only two differed significantly between the amalgam and composite treatment groups. On the Number-Letter Memory subtest of the WRAML, the 4-year change score of the amalgam group was significantly more positive than was the change score of the composite group, indicating greater improvement over time in the amalgam group. The 4-year change in the time required to complete Part B of the Trail-Making Test was significantly more negative in the composite group than in the amalgam group, indicating greater improvement over time in the composite group. The results of analyses using surface-years of amalgam or urinary mercury concentration as the exposure metric were consistent with those of the intention-to-treat analyses, providing no evidence of a detrimental effect of amalgam on children's test scores. The coefficient for surface-years of amalgam was significant for three scores (Picture Memory and Number-Letter Memory of the WRAML and letter fluency), but for all three scores, the sign was positive, indicating that the score improved with increasing exposure to amalgam (Table 4). Urinary mercury concentration was not significantly associated with any of the test scores (Table 5). The results of the Kolmogorov-Smirnov tests indicated that the only two scores for which the distributions of changes scores in the amalgam and composite groups differed significantly were two subtests of the WRAML: Finger Windows and Number-Letter Memory (Table 3). On both tests, however, children in the amalgam group showed greater improvement over time than the children in the composite group, with the difference being significant for Number-Letter Memory. The distributions of change scores were not significantly different on the Trail-Making Test Part B (time to complete), the test on which the composite group showed significantly more improvement than the amalgam group. Adjustment for neuropsychological examiner did not produce results that were appreciably different (data not shown). Discussion These analyses revealed an absence of consistent differences between the scores of children in the amalgam and composite treatment groups on a battery of neuropsychological tests that assessed a wide range of domains, including intelligence, achievement, language, memory, learning, visual-spatial skills, verbal fluency, fine motor function, problem solving, attention, and executive function. The findings were similar when the dichotomous variable treatment-group assignment was replaced by two continuously distributed indices of exposure, one that combined the amount and duration of amalgam a child received and one that was a biomarker, urinary mercury concentration. Furthermore, no evidence was found to support the hypothesis that a subset of children in the amalgam group suffered substantial harm. The number of significant differences observed was similar to that which might have been expected to occur by chance. Although neuropsychological deficits associated with amalgam exposure have been reported in several studies of dental professionals (Bittner et al. 1998; Echeverria et al. 1995, 1998; Ngim et al. 1992) and others exposed occupationally to mercury (Rohling and Demakis 2006), our findings are similar to those involving mercury exposure in cohorts drawn from the general population of adults and children (Brownawell et al. 2005). In a cross-sectional study of 550 30- to 49-year-old healthy employed adults, scores on tests of verbal memory, nonverbal memory, attention, psychomotor speed, and fine motor coordination were not significantly associated with any of several exposure indices considered (number of visible amalgam surfaces, number of visible occlusal amalgam surfaces, urinary mercury concentration) (Factor-Litvak et al. 2003). The mean urinary mercury concentration in that cohort of adults, 1.7 [micro]g/g creatinine, was higher than the mean concentration of 0.9 [micro]g/g creatinine among the children in the amalgam treatment group in our trial 5 years after placement of their first amalgam restorations. In a study of 1,663 Vietnam-era veterans, the total number of tooth surfaces with amalgam fillings was unrelated to clinical neurological signs (e.g., tremor, coordination, station, gait, strength, sensation, muscle stretch reflexes, or indices of peripheral neuropathy), although it was associated with vibrotacile sensation in nondiabetic participants (Kingman et al. 2005). In a study of 384 German 6-year-olds, 24-hr urinary excretion of mercury, which averaged 0.16 [micro]g, was not significantly related to scores on a variety of tests, including the Vocabulary and Block Design subtests of the WISC and five tests of the computerized Neurobehavioral Evaluation System 2 (pattern comparison, pattern memory, tapping, simple reaction time, continuous performance test) (Walkowiak et al. 1998). In this cohort, some indices of visual contrast sensitivity did decline with increasing urinary mercury excretion, however (Altman et al. 1998). Over the course of the follow-up interval, the scores of children in both treatment groups tended to change in the direction of improved performance, even on tests for which scores are standardized for age. Several factors might have contributed to improved performance over time. First, this could represent a type of sampling bias, reflecting the characteristics of families who are motivated to enroll in such a trial and to participate for its full duration. Second, all tests except the WISC-III and WIAT were administered yearly, so the general improvement in scores might reflect the familiarity that children developed with the test materials and expectations. Particularly large improvements tended to be on performance-based tests, such as the WRAVMA pegboard and the Processing Speed composite of the WISC-III, one component of which is Symbol Search, a timed task that involves matching symbols and digits. A substantial improvement was also noted on the WRAML Learning Index, which reflects the rapidity with which a child learns new material, such as sound-symbol pairs, a word list, and the locations of hidden designs. Repeated administration of these tasks, even at yearly intervals, might be expected to result in an increased rate of acquisition of the material. As noted, the dental treatment needs of the children enrolled in the trial were substantial and exceeded those typical of the general population of U.S. children. For example, among 6- to 11-year-old children who participated in the National Health and Nutrition Examination Survey (NHANES) 1999-2002, the prevalence of dental caries in primary teeth was 22%, and the mean numbers of decayed or filled primary teeth and surfaces were 1.7 and 3.7, respectively (Beltran-Aguilar et al. 2005). The prevalence of dental caries in permanent teeth was 20% (mean number of decayed, missing, and filled teeth and surfaces in permanent teeth were 0.1 and 0.4, respectively) (Beltran-Aguilar et al. 2005). Therefore, children assigned to the amalgam group in the NECAT are likely to have experienced greater exposures to mercury vapor from amalgams than do most children in the United States. Given our failure to detect significant differences between the amalgam and composite groups in neuropsychological function, these results provide reassurance that the use of dental amalgam to repair caries is not producing substantial neuropsychological morbidity in the general population of children in the United States. The conclusions must be tempered, first, by a recognition that the follow-up interval of 4-5 years might have been too short to allow for the expression of such deficits. Second, the critical window of children's greatest vulnerability to elemental mercury might already have passed by the time the children were enrolled in the trial ([greater than or equal to] 6 years of age). Given the heightened sensitivity of the fetus to methylmercury, prenatal exposure to mercury vapor, which is known to cross the placenta, warrants increased attention. In the NHANES 1999-2000 survey, among women of child-bearing age, an increase of 10 dental surfaces restored with amalgam was associated with an estimated increase of 1.8 [micro]g/L in urinary mercury concentration (Dye et al. 2005). Mercury level in amniotic fluid is weakly associated with number of amalgam fillings (Luglie et al. 2005). A recent case-control study did not, however, find an increased risk of delivering a low-birth-weight infant among women who had up to 11 amalgam restorations placed during pregnancy (Hujoel et al. 2005). The results of studies of the reproductive outcomes of women with dental workplace exposures have been mixed (Dahl et al. 1999; Elghany et al. 1997; Ericson and Kallen 1989). In some of these studies, distinguishing the potential impact of mercury exposure from the impacts of other workplace exposures, such as to disinfectants containing ethanol and benzene, is difficult. Third, the prevalence of children with enhanced sensitivity to elemental mercury might be too low among the children enrolled in the NECAT for us to have been able to detect their effects on the distribution of responses. Fourth, children with preexisting neuropsychological or behavioral disorders were not eligible for enrollment. Our findings therefore do not provide any information about the possibility that amalgam-related exposure to mercury vapor might exacerbate such disorders. Nevertheless, our results indicate that even among children with substantial dental needs, an increased risk of neuropsychological deficits could not be detected among children whose dental restorations contained elemental mercury. REFERENCES Adams W, Sheslow D. 1995. WRAVMA: Wide Range Assessment of Visual Motor Abilities. Wilmington, DE:Wide Range, Inc. Altmann L, Sveinsson K, Kramer U, Weishoff-Houben M, Turfield M, Winneke G, et al. 1998. Visual functions in 6-year-old children in relation to lead and mercury levels. Neurotoxicol Teratol 20:9-17. Barregard L. 2005. Mercury from dental amalgam: looking beyond the average. Occup Environ Med 62:352-353. Barregard L, Sallsten G, Jarvholm B. 1995. People with high mercury uptake from their own dental amalgam fillings. Occup Environ Med 52:124-128. Bellinger DC. 2006. Lead neurotoxicity in children: knowledge gaps and research needs. In: Human Developmental Neurotoxicology (Bellinger DC, ed). New York:Taylor & Francis, 67-82. Bellinger DC, Trachtenberg F, Barregard L, Tavares M, Cernichiari E, Daniel D, et al. 2006. Neuropsychological and renal effects of dental amalgam in children: a randomized clinical trial. JAMA 295:1775-1783. Beltran-Aguilar ED, Barker LK, Canto MT, Gooch BF, Griffin SO, Hyman J, et al. 2005. Surveillance for dental caries, dental sealants, retention, edentulism, and enamel fluorosis United States, 1988-1994 and 1999-2002. Morb Mortal Wkly Rep Surveill Summ 54(03):1-44. Bittner AC, Echeverria D, Woods JS, Aposhian HV, Naleway C, Martin MD, et al. 1998. Behavioral effects of low-level exposure to Hg[degrees] among dental professionals: a cross-study evaluation of psychomotor effects. Neurotoxicol Teratol 20:429-439. Brownawell AM, Berent S, Brent RL, Bruckner JV, Doull J, Gershwin EM, et al. 2005. The potential adverse health effects of dental amalgam. Toxicol Rev 24:1-10. Children's Amalgam Trial Study Group. 2003. The Children's Amalgam Trial: design and methods. Control Clin Trials 24:795-814. Dahl JE, Sundby J, Hensten-Pettersen A, Jacobsen N. 1999. Dental workplace exposure and effect on fertility. Scand J Work Environ Health 25:285-290. Dye BA, Schober SE, Dillon CF, Jones RL, Fryar C, McDowell M, et al. 2005. Urinary mercury concentrations associated with dental restorations in adult women aged 16-49 years: United States, 1999-2000. Occup Environ Med 62:368-375. Echeverria D, Aposhian HV, Woods JS, Heyer AJ, Aposhian MM, Bittner AC, et al. 1998. Neurobehavioral effects from exposure to dental amalgam Hg[degrees]: new distinctions between recent exposure and Hg body burdens. FASEB J 12:971-980. Echeverria D, Heyer NJ, Martin MD, Naleway CA, Woods JS, Bittner AC. 1995. Behavioral effects of low-level exposure to Hg[degrees] among dentists. Neurotoxicol Teratol 17:161-168. Echeverria D, Woods JS, Heyer NJ, Rohlman DS, Farin FM, Bittner AC, et al. 2005. 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Heaton RK, Chelune GJ, Talley JL, Kay GG, Curtiss G. 1993. Wisconsin Card Sorting Test. Manual. Odessa, FL:Psychological Assessment Resources. Heyer NJ, Echeverria D, Bittner AC, Farin FM, Garabedian CC, Woods JS. 2004. Chronic low-level mercury exposure, BDNF polymorphism, and associations with self-reported symptoms and mood. Toxicol Sci 81:354-363. Hujoel PP, Lydon-Rochelle M, Bollen AM, Woods JS, Geurtsen W, del Aguila MA. 2005. Mercury exposure from dental filling placement during pregnancy and low birth weight risk. Am J Epidemiol 161:734-740. Kingman A, Albers JW, Arezzo JC, Garabrant DH, Michalek JE. 2005. Amalgam exposure and neurological function. Neurotoxicology 26:241-255. Luglie PF, Campus G, Chessa G, Spano G, Capobianco G, Fadda GM, et al. 2005. Effect of amalgam fillings on the mercury concentrations in human amniotic gluid. Arch Gynecol Obstet 271:138-142. McCarthy D. 1972. McCarthy Scales of Children's Abilities. Manual. New York:Psychological Corporation. Mesulam MM. 1985. Principles of Behavioral Neurology. Philadelphia:F.A. Davis. Ngim CH, Foo SC, Boey KW, Jeyaratnam J, 1992. Chronic neurobehavioral effects of elemental mercury in dentists. Br J Ind Med 49:782-790. Psychological Corporation. 1992. Wechsler Individual Achievement Test. San Antonio, TX:Psychological Corporation. Rohling ML, Demakis GJ. 2006. A meta-analysis of the neuropsychological effects of occupational exposure to mercury. Clin Neuropsychol 20:108-132. Sheslow D, Adams W. 1990. WRAML. Wide Range Assessment of Memory and Learning. Wilmington, DE:Wide Range. Inc. Spreen O, Strauss E. 1991. A Compendium http://www.smileusa.com/full-mouth-reconstruction/ of Neuropsychological Tests. New York:Oxford University Press. Stuart A, Ord JK. 1991. Kendall's Advanced Theory of Statistics. Vol 2. New York:Oxford University Press. Trenerry MR, Crosson B, DeBoe J, Leber WR. 1989. Stroop Neuropsychological Screening Test Manual. Odessa, FL:Psychological Assessment Resources. Walkowiak J, Altmann L, Kramer U, Sveinsson K, Turfeld M, Weishoff-Houben M, et al. 1998. Cognitive and sensorimotor functions in 6-year-old children in relation to lead and mercury levels: adjustment for intelligence and contrast sensitivity in computerized testing. Neurotoxicol Teratol 20:511-521. Wechsler D. 1991. Wechsler Intelligence Scale for Children. 3rd ed. San Antonio, TX:Psychological Corporation. Weiss B. 2006. Methylmercury: a model neurotoxicant and risk assessment dilemma. In: Human Developmental Neurotoxicology (Bellinger DC, ed). New York:Taylor & Francis, 1-23. David C. Bellinger, (1,2) David Daniel, (3) Felicia Trachtenberg, (4) Mary Tavares, (5) and Sonja McKinlay (4) (1) Department of Neurology, Children's Hospital Boston and Harvard Medical School, and (2) Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA; (3) Department of Psychology, University of Maine at Farmington, Farmington, Maine, USA; (4) New England Research Institutes, Watertown, Massachusetts, USA; (5) The Forsyth Institute, Boston, Massachusetts, USA Address correspondence to S. McKinlay, New England Research Institutes, 9 Galen St., Watertown, MA 02472 USA. Telephone: (617) 923-7747. Fax: (617) 926-0144. E-mail: [email protected] A. Zhang provided assistance with statistical analyses. This research was supported by a cooperative agreement, U01 DE11886, between the New England Research Institutes and the National Institute of Dental and Craniofacial Research. The authors declare they have no competing financial interests. Received 8 July 2006; accepted 30 October 2006. Table 1. Baseline characteristics of trial participants, by treatment group. Composite Characteristic Amalgam (n = 267) (n = 267) Site [no. (%)] Boston/Cambridge 144 (53.9) 147 (55.1) Farmington 123 (46.1) 120 (44.9) No. of carious surfaces [mean 9.8 [+ or -] 9.3 [+ or -] [+ or -] SD (range)] 6.9 (2-39) 6.2 (2-36) Age (years) [mean [+ or -] SD 7.9 [+ or -] 7.9 [+ or -] (range)] 1.3 (5.9-11.4) 1.4 (5.9-11.5) Sex [no. (%)] Female 131 (49.1) 156 (58.4) Male 136 (50.9) 111 (41.6) Race [no. (%)] (a) Non-Hispanic white 165 (64.0) 158 (60.3) Non-Hispanic black 49 (19.0) 49 (18.7) Hispanic 15 (5.8) 23 (8.8) Other 29 (11.2) 32 (12.2) Household income [no. (%)] [less than or equal to] $20,000 74 (29.2) 86 (33.1) $20,000-$40,000 113 (44.7) 109 (41.9) > $40,000 66 (26.1) 65 (25.0) Education of primary caretaker [no. (%)] < High school 34 (13.2) 38 (14.6) High school graduate 197 (76.4) 194 (74.3) College graduate 18 (7.9) 17 (6.5) Postgraduate degree 9 (3.5) 12 (4.6) WISC-III Full-Scale IQ [mean 95.1 [+ or -] 96.1 [+ or -] [+ or -] SD (range)] 14.5 (65-141) 12.1 (62-123) Urinary mercury 21 (8.4) 11 (4.5) [greater than or equal to] 1.5 ng/mL [no. (%)] Hair mercury ([micro]g/g) [mean 0.4 [+ or -] 0.4 [+ or -] [+ or -] SD (range)] 0.5 (0.1-4.4) 0.5 (0.1-4.5) Blood lead ([micro]g/dL) [mean 2.4 [+ or -] 2.3 [+ or -] [+ or -] SD (range)] 1.9 (1-13) 1.5 (1-11) (a) Race was self-reported by parents. Table 2. Dental treatment and amalgam exposure at the end of the 5-year follow-up period, by treatment group [mean [+ or -] SD (range)]. Dental treatment Amalgam Composite No. of restored 5.3 [+ or -] 5.2 (0-36)* 6.1 [+ or -] 6.0 (0-36)* surfaces in mouth No. of restored 4.0 [+ or -] 4.0 (0-21) 0.05 [+ or -] 0.6 (0-9) amalgam surfaces (a) Cumulative no. 14.8 [+ or -] 9.5 (2-55)** 16.0 [+ or -] 9.8 (2-51)** of surfaces restored (over 5 years) (b) Cumulative no. 11.7 [+ or -] 7.0 (0-35) 0.05 [+ or -] 0.6 (0-9) of surfaces restored with amalgam (b) (a) Two children in the composite group received amalgam restorations from an out-of-study dentist. (b) Cumulative numbers do not include children who withdrew from the study. *p = 0.16 for difference between amalgam and composite groups. **p = 0.10 for the difference between amalgam and composite groups. Table 3. Changes in test scores between baseline and 4- or 5-year follow-up, by treatment group [adjusted coefficient [+ or -] SE (n)]. Test score Amalgam Composite WISC-III Factor Verbal Comprehension 2.2 [+ or -] 1.5 [+ or -] 0.6 (219) 0.6 (217) Perceptual Organization 3.6 [+ or -] 3.1 [+ or -] 0.7 (219) 0.7 (216) Freedom from Distractibility 3.9 [+ or -] 2.4 [+ or -] 0.7 (219) 0.7 (216) Processing Speed 7.2 [+ or -] 5.1 [+ or -] 0.9 (216) 0.9 (217) Subtest Verbal Information 0.3 [+ or -] 0.4 [+ or -] 0.2 (219) 0.2 (217) Similarities 0.8 [+ or -] 0.7 [+ or -] 0.1 (219) 0.2 (217) Vocabulary 0.4 [+ or -] 0.2 [+ or -] 0.1 (219) 0.1 (217) Comprehension 0.2 [+ or -] -0.1 [+ or -] 0.2 (219) 0.2 (217) Digit Span 0.7 [+ or -] 0.5 [+ or -] 0.2 (219) 0.2 (216) Performance Picture Completion 1.2 [+ or -] 1.2 [+ or -] 0.2 (219) 0.2 (217) Coding 0.2 [+ or -] -0.1 [+ or -] 0.2 (218) 0.2 (217) Picture Arrangement 0.5 [+ or -] 0.6 [+ or -] 0.2 (219) 0.2 (216) Block Design 0.3 [+ or -] 0.1 [+ or -] 0.2 (219) 0.2 (217) Object Assembly 0.3 [+ or -] 0.3 [+ or -] 0.2 (219) 0.2 (216) Symbol Search 2.5 [+ or -] 2.2 [+ or -] 0.2 (216) 0.2 (217) Mazes 0.8 [+ or -] 0.7 [+ or -] 0.2 (218) 0.2 (217) WIAT Composite Reading -1.0 [+ or -] -1.7 [+ or -] 0.7 (217) 0.7 (215) Mathematics -1.9 [+ or -] -3.0 [+ or -] 0.7 (216) 0.8 (207) Scale Basic Reading -0.6 [+ or -] -1.3 [+ or -] 0.6 (219) 0.6 (216) Reading Comprehension 0.7 [+ or -] 0.2 [+ or -] 0.7 (217) 0.7 (215) Numerical Operations -5.2 [+ or -] -6.7 [+ or -] 0.8 (216) 0.9 (207) Math Reasoning 1.5 [+ or -] 1.3 [+ or -] 0.7 (219) 0.7 (216) Spelling -1.7 [+ or -] -3.1 [+ or -] 0.7 (219) 0.7 (215) Listening Comprehension -5.5 [+ or -] -4.5 [+ or -] 0.7 (212) 0.7 (205) WRAML Index Verbal Memory 2.9 [+ or -] 2.2 [+ or -] 0.6 (212) 0.6 (202) Visual Memory 6.3 [+ or -] 5.0 [+ or -] 0.8 (212) 0.8 (204) Learning 10.2 [+ or -] 10.3 [+ or -] 0.8 (212) 0.8 (203) Scale Picture Memory 0.8 [+ or -] 0.6 [+ or -] 2.2 (212) 0.2 (204) Design Memory 1.0 [+ or -] 1.2 [+ or -] 0.2 (212) 0.2 (204) Story Memory 0.7 [+ or -] 0.9 [+ or -] 0.2 (212) 0.2 (203) Verbal learning 1.4 [+ or -] 1.4 [+ or -] 0.2 (212) 0.2 (203) Finger Windows 0.8 [+ or -] 0.4 [+ or -] 0.2 (212) 0.2 (204) Sound Symbol 2.8 [+ or -] 2.7 [+ or -] 0.2 (212) 0.2 (203) Sentence Memory 0.3 [+ or -] 0.3 [+ or -] 0.1 (212) 0.1 (204) Visual Learning 0.4 [+ or -] 0.6 [+ or -] 0.2 (212) 0.2 (203) Number--Letter Memory 0.3 [+ or -] -0.3 [+ or -] 0.1 (212) 0.1 (203) WRAVMA Drawing -3.8 [+ or -] -3.1 [+ or -] 0.9 (211) 0.9 (203) Matching 3.0 [+ or -] 3.5 [+ or -] 0.8 (211) 0.8 (203) Pegboard 9.3 [+ or -] 8.4 [+ or -] 0.9 (211) 1.0 (203) Trail-Making Test Part A: time to complete -15.5 [+ or -] -16.1 [+ or -] 0.3 (203) 0.3 (200) Part A: no. of errors -0.2 [+ or -] -0.1 [+ or -] 0.03 (203) 0.04 (200) Part B: time to complete -45.6 [+ or -] -50.4 [+ or -] 1.0 (201) 1.1 (193) Part B: no. of errors -0.6 [+ or -] -0.7 [+ or -] 0.1 (201) 0.1 (193) Finger Tapping Right hand (mean of 5 trials) 5.7 [+ or -] 5.1 [+ or -] 0.4 (208) 0.4 (202) Left hand (mean of 5 trials) 6.4 [+ or -] 5.7 [+ or -] 0.3 (208) 0.3 (202) Verbal Cancellation Ordered trial: no. of errors -19.3 [+ or -] -19.4 [+ or -] 0.2 (200) 0.2 (198) Unordered trial: no. of errors -15.0 [+ or -] -14.9 [+ or -] 0.1 (200) 0.2 (198) Verbal Fluency Category fluency (sum of 4 trials) 9.7 [+ or -] 9.5 [+ or -] 0.4 (210) 0.4 (201) Letter fluency (sum of 3 trials) 13.3 [+ or -] 12.4 [+ or -] 0.5 (210) 0.6 (201) Reaction Time Mean response time (msec) -0.1 [+ or -] -0.1 [+ or -] 0.0 (181) 0.0 (180) Response time SD -0.1 [+ or -] -0.1 [+ or -] 0.0 (181) 0.0 (180) Stroop Color--Word Interference Test Color 19.7 [+ or -] 18.0 [+ or -] 0.7 (165) 0.7 (164) Word 26.1 [+ or -] 25.0 [+ or -] 0.8 (165) 0.8 (163) Color--Word 12.8 [+ or -] 12.8 [+ or -] 0.6 (165) 0.6 (164) Wisconsin Card Sorting Test No. of categories achieved 1.1 [+ or -] 1.1 [+ or -] 0.1 (200) 0.1 (194) No. of trials to first category -5.8 [+ or -] -5.6 [+ or -] 0.3 (200) 0.3 (194) Total errors (b) 15.6 [+ or -] 17.2 [+ or -] 0.9 (199) 1.0 (191) Total perseverative errors (b) 17.6 [+ or -] 19.3 [+ or -] 0.9 (199) 1.0 (191) Percent conceptual level responses 15.7 [+ or -] 17.3 [+ or -] 1.0 (199) 1.0 (191) p-Value Intention- Kolmogorov- Test score to-treat (a) Smirnov Test WISC-III Factor Verbal Comprehension 0.46 0.69 Perceptual Organization 0.58 0.72 Freedom from Distractibility 0.57 0.71 Processing Speed 0.08 0.09 Subtest Verbal Information 0.61 0.97 Similarities 0.56 1.00 Vocabulary 0.26 0.41 Comprehension 0.22 0.98 Digit Span 0.26 1.00 Performance Picture Completion 0.84 0.57 Coding 0.19 0.81 Picture Arrangement 0.79 0.77 Block Design 0.43 0.63 Object Assembly 0.96 0.99 Symbol Search 0.21 0.73 Mazes 0.85 0.79 WIAT Composite Reading 0.44 0.34 Mathematics 0.33 0.57 Scale Basic Reading 0.37 0.53 Reading Comprehension 0.70 0.26 Numerical Operations 0.20 0.72 Math Reasoning 0.85 1.00 Spelling 0.14 0.81 Listening Comprehension 0.27 0.63 WRAML Index Verbal Memory 0.47 0.57 Visual Memory 0.23 0.42 Learning 0.91 0.28 Scale Picture Memory 0.28 0.98 Design Memory 0.53 0.95 Story Memory 0.46 0.96 Verbal learning 0.92 0.84 Finger Windows 0.09 0.05 Sound Symbol 0.55 0.12 Sentence Memory 0.80 0.56 Visual Learning 0.29 0.82 Number--Letter Memory 0.002 0.04 WRAVMA Drawing 0.63 0.78 Matching 0.62 0.96 Pegboard 0.50 0.82 Trail-Making Test Part A: time to complete 0.25 0.68 Part A: no. of errors 0.07 0.95 Part B: time to complete 0.002 0.36 Part B: no. of errors 0.09 0.88 Finger Tapping Right hand (mean of 5 trials) 0.28 0.42 Left hand (mean of 5 trials) 0.10 0.54 Verbal Cancellation Ordered trial: no. of errors 0.57 0.59 Unordered trial: no. of errors 0.83 0.99 Verbal Fluency Category fluency (sum of 4 trials) 0.70 0.91 Letter fluency (sum of 3 trials) 0.25 0.77 Reaction Time Mean response time (msec) 0.67 0.79 Response time SD 0.74 0.91 Stroop Color--Word Interference Test Color 0.09 0.17 Word 0.35 0.89 Color--Word 0.96 0.75 Wisconsin Card Sorting Test No. of categories achieved 0.94 0.97 No. of trials to first category 0.69 0.96 Total errors (b) 0.25 0.14 Total perseverative errors (b) 0.19 0.59 Percent conceptual level responses 0.26 0.20 (a) Adjusted for baseline score, randomization stratum, baseline age, sex, baseline family socioeconomic status, baseline hair mercury concentration, and baseline blood lead concentration. (b) Standard score. Table 4. Associations between neuropsychological test scores and surface-years of exposure to amalgam restorations [adjusted coefficient [+ or -] SE (n)]. Test score Surface-years of amalgam p-Value (a) WISC-III Factor Verbal Comprehension 0.01 [+ or -] 0.02 (434) (b) 0.48 Perceptual Organization 0.00 [+ or -] 0.02 (433) 0.94 Freedom from 0.02 [+ or -] 0.02 (433) 0.50 Distractibility Processing Speed 0.03 [+ or -] 0.03 (431) 0.28 Subtest Verbal Information -0.00 [+ or -] 0.01 (434) 0.74 Similarities 0.00 [+ or -] 0.01 (434) 0.83 Vocabulary 0.01 [+ or -] 0.00 (434) 0.19 Comprehension 0.01 [+ or -] 0.01 (434) 0.33 Digit Span 0.01 [+ or -] 0.01 (433) 0.26 Performance Picture Completion 0.01 [+ or -] 0.01 (434) 0.41 Coding 0.00 [+ or -] 0.01 (433) 0.47 Picture Arrangement -0.00 [+ or -] 0.01 (433) 0.46 Block Design 0.00 [+ or -] 0.01 (434) 0.58 Object Assembly -0.00 [+ or -] 0.01 (433) 0.66 Symbol Search 0.01 [+ or -] 0.01 (431) 0.29 Mazes 0.01 [+ or -] 0.01 (433) 0.35 WIAT Composite Reading 0.03 [+ or -] 0.02 (430) 0.20 Mathematics 0.03 [+ or -] 0.03 (421) 0.33 Scale Basic Reading 0.03 [+ or -] 0.02 (433) 0.16 Reading Comprehension 0.02 [+ or -] 0.02 (430) 0.41 Numerical Operations 0.03 [+ or -] 0.03 (421) 0.29 Math Reasoning 0.01 [+ or -] 0.02 (433) 0.75 Spelling 0.03 [+ or -] 0.02 (432) 0.21 Listening Comprehension -0.03 [+ or -] 0.02 (415) 0.19 WRAML Index Verbal Memory 0.01 [+ or -] 0.03 (406) 0.73 Visual Memory 0.05 [+ or -] 0.03 (408) 0.10 Learning 0.02 [+ or -] 0.03 (407) 0.64 Scale Picture Memory 0.02 [+ or -] 0.01 (408) 0.008 Design Memory -0.01 [+ or -] 0.01 (408) 0.48 Story Memory -0.00 [+ or -] 0.01 (407) 0.57 Verbal Learning 0.00 [+ or -] 0.01 (407) 0.99 Finger Windows 0.01 [+ or -] 0.01 (408) 0.14 Sound Symbol 0.01 [+ or -] 0.01 (407) 0.26 Sentence Memory -0.00 [+ or -] 0.01 (408) 0.52 Visual Learning -0.00 [+ or -] 0.01 (407) 0.67 Number-Letter Memory 0.01 [+ or -] 0.01 (407) 0.01 WRAVMA Drawing -0.02 [+ or -] 0.04 (406) 0.56 Matching -0.04 [+ or -] 0.03 (406) 0.27 Pegboard 0.03 [+ or -] 0.04 (406) 0.45 Trail-Making Test Part A: time to complete 0.02 [+ or -] 0.01 (395) 0.22 Part A: no. of errors -0.00 [+ or -] 0.00 (395) 0.26 Part B: time to complete 0.06 [+ or -] 0.04 (387) 0.15 Part B: no. of errors 0.00 [+ or -] 0.00 (387) 0.38 Finger Tapping Right hand (mean of 5 0.01 [+ or -] 0.01 (402) 0.53 trials) Left hand (mean of 5 0.01 [+ or -] 0.01 (402) 0.42 trials) Verbal Cancellation Ordered trial: no. of 0.00 [+ or -] 0.01 (367) 0.88 errors Unordered trial: no. of 0.00 [+ or -] 0.01 (367) 0.77 errors

Verbal Fluency Category fluency (sum of 4 0.00 [+ or -] 0.02 (404) 0.84 trials) Letter fluency (sum of 3 0.04 [+ or -] 0.02 (404) 0.05 trials) Reaction Time Mean response time (msec) -0.00 [+ or -] 0.00 (356) 0.62 Response time SD 0.00 [+ or -] 0.00 (356) 0.46 Stroop Color-Word Interference Test Color 0.01 [+ or -] 0.03 (323) 0.70 Word 0.00 [+ or -] 0.03 (322) 0.97 Color-Word -0.00 [+ or -] 0.02 (323) 0.87 Wisconsin Card Sorting Test No. of categories achieved -0.00 [+ or -] 0.00 (387) 0.50 No. of trials to first -0.00 [+ or -] 0.01 (387) 0.92 category Total errors (c) -0.04 [+ or -] 0.04 (383) 0.24 Total perseverative -0.05 [+ or -] 0.04 (383) 0.20 errors (c) Percent conceptual level -0.04 [+ or -] 0.04 (383) 0.29 responses (a) Adjusted for baseline score, randomization stratum, baseline age, sex, baseline family socioeconomic status, baseline hair mercury concentration, and baseline blood lead concentration. (b) Coefficient represents the change in test score for each unit increase in surface- years of amalgam. (c) Standard score. Table 5. Associations between neuropsychological test scores and urinary mercury concentration [adjusted coefficient [+ or -] SE (n)]. Test score Urinary mercury p-Value (a) WISC-III Factor Verbal Comprehension 0.40 [+ or -] 0.58 (433) (b) 0.50 Perceptual Organization 0.65 [+ or -] 0.64 (432) 0.31 Freedom from -0.37 [+ or -] 0.69 (432) 0.60 Distractibility Processing Speed 0.01 [+ or -] 0.80 (430) 0.99 Subtest Verbal Information 0.02 [+ or -] 0.16 (433) 0.89 Similarities -0.02 [+ or -] 0.13 (433) 0.91 Vocabulary 0.17 [+ or -] 0.13 (433) 0.19 Comprehension -0.00 [+ or -] 0.18 (433) 0.99 Digit Span 0.04 [+ or -] 0.15 (432) 0.80 Performance Picture Completion 0.01 [+ or -] 0.18 (433) 0.94 Coding -0.01 [+ or -] 0.19 (432) 0.97 Picture Arrangement -0.01 [+ or -] 0.18 (432) 0.97 Block Design 0.07 [+ or -] 0.16 (433) 0.66 Object Assembly 0.29 [+ or -] 0.17 (432) 0.08 Symbol Search 0.04 [+ or -] 0.19 (430) 0.83 Mazes -0.11 [+ or -] 0.19 (432) 0.55 WIAT Composite Reading 0.17 [+ or -] 0.63 (429) 0.79 Mathematics 0.57 [+ or -] 0.70 (420) 0.42 Scale Basic Reading 0.23 [+ or -] 0.58 (432) 0.69 Reading Comprehension 0.32 [+ or -] 0.66 (429) 0.63 Numerical Operations 0.20 [+ or -] 0.78 (420) 0.79 Math Reasoning 0.58 [+ or -] 0.67 (432) 0.39 Spelling 0.38 [+ or -] 0.63 (431) 0.54 Listening Comprehension -0.52 [+ or -] 0.62 (414) 0.40 WRAML Index Verbal Memory 0.31 [+ or -] 0.53 (400) 0.56 Visual Memory 0.79 [+ or -] 0.65 (402) 0.23 Learning 0.57 [+ or -] 0.68 (401) 0.40 Scale Picture Memory 0.08 [+ or -] 0.13 (402) 0.52 Design Memory 0.01 [+ or -] 0.16 (402) 0.96 Story Memory 0.10 [+ or -] 0.15 (401) 0.52 Verbal Learning 0.11 [+ or -] 0.15 (401) 0.49 Finger Windows 0.18 [+ or -] 0.14 (402) 0.21 Sound Symbol 0.05 [+ or -] 0.15 (401) 0.74 Sentence Memory 0.04 [+ or -] 0.12 (402) 0.77 Visual Learning 0.06 [+ or -] 0.15 (401) 0.67 Number-Letter Memory -0.03 [+ or -] 0.12 (401) 0.82 WRAVMA Drawing 0.33 [+ or -] 0.76 (400) 0.66 Matching -0.25 [+ or -] 0.68 (400) 0.71 Pegboard 0.23 [+ or -] 0.79 (400) 0.77 Trail-Making Test Part A: time to complete 0.07 [+ or -] 0.30 (390) 0.83 Part A: no. of errors -0.03 [+ or -] 0.03 (390) 0.37 Part B: time to complete -0.26 [+ or -] 0.94 (382) 0.78 Part B: no. of errors 0.03 [+ or -] 0.05 (382) 0.51 Finger Tapping Right hand (mean of 5 -0.42 [+ or -] 0.31 (396) 0.17 trials) Left hand (mean of 5 -0.22 [+ or -] 0.27 (396) 0.41 trials) Verbal Cancellation Ordered trial: no. of 0.01 [+ or -] 0.19 (387) 0.98 errors Unordered trial: no. of -0.08 [+ or -] 0.13 (387) 0.52 errors Verbal Fluency Category fluency (sum of 4 -0.17 [+ or -] 0.36 (398) 0.63 trials) Letter fluency (sum of 3 0.12 [+ or -] 0.45 (398) 0.80 trials) Reaction Time Mean response time (msec) 0.00 [+ or -] 0.00 (352) 0.27 Response time SD -0.00 [+ or -] 0.01 (352) 0.91 Stroop Color-Word Interference Test Color -0.90 [+ or -] 0.62 (318) 0.14 Word -0.82 [+ or -] 0.72 (317) 0.26 Color-Word -0.04 [+ or -] 0.50 (318) 0.94 Wisconsin Card Sorting Test No. of categories achieved -0.07 [+ or -] 0.05 (383) 0.15 No. of trials to first -0.02 [+ or -] 0.26 (383) 0.93 category Total errors (c) -0.63 [+ or -] 0.77 (379) 0.41 Total perseverative -0.16 [+ or -] 0.76 (379) 0.84 errors (c) Percent conceptual level -0.45 [+ or -] 0.81 (379) 0.58 responses (a) Adjusted for baseline score, randomization stratum, baseline age, sex, baseline family socioeconomic status, baseline hair mercury concentration, and baseline blood lead concentration. (b) Coefficient represents the change in test score for each unit increase in urinary mercury concentration. (c) Standard score.

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