A STUDY OF INFLUENZA AND OF STATISTICAL METHODS USED TO REPORT INFLUENZA

This paper defines and compares several models for describing excess influenza pneumonia mortality in Houston. First, the methodology used by the Center for Disease Control is examined and several variations of this methodology are studied. All of the models examined emphasize the difficulty of omitting epidemic weeks.^ In an attempt to find a better method of describing expected and epidemic mortality, time series methods are examined. Grouping in four-week periods, truncating the data series to adjust epidemic periods, and seasonally-adjusting the series y(,t), by:^ (DIAGRAM, TABLE OR GRAPHIC OMITTED...PLEASE SEE DAI)^ is the best method examined. This new series w(,t) is stationary and a moving average model MA(1) gives a good fit for forecasting influenza and pneumonia mortality in Houston.^ Influenza morbidity, other causes of death, sex, race, age, climate variables, environmental factors, and school absenteeism are all examined in terms of their relationship to influenza and pneumonia mortality. Both influenza morbidity and ischemic heart disease mortality show a very high relationship that remains when seasonal trends are removed from the data. However, when jointly modeling the three series it is obvious that the simple time series MA(1) model of truncated, seasonally-adjusted four-week data gives a better forecast.^

A systematic review of the methods used to assess race and racial disparities in uterine fibroid research

Context: Black women are reported to have a higher prevalence of uterine fibroids, and a threefold higher incidence rate and relative risk for clinical uterine fibroid development as compared to women of other races. Uterine fibroid research has reported that black women experience greater uterine fibroid morbidity and disproportionate uterine fibroid disease burden. With increased interest in understanding uterine fibroid development, and race being a critical component of uterine fibroid assessment, it is imperative that the methods used to determine the race of research participants is defined and the operational definition of the use of race as a variable is reported for methodological guidance, and to enable the research community to compare statistical data and replicate studies. ^ Objectives: To systematically review and evaluate the methods used to assess race and racial disparities in uterine fibroid research. ^ Data Sources: Databases searched for this review include: OVID Medline, NML PubMed, Ebscohost Cumulative Index to Nursing and Allied Health Plus with Full Text, and Elsevier Scopus. ^ Review Methods: Articles published in English were retrieved from data sources between January 2011 and March 2011. Broad search terms, uterine fibroids and race, were employed to retrieve a comprehensive list of citations for review screening. The initial database yield included 947 articles, after duplicate extraction 485 articles remained. In addition, 771 bibliographic citations were reviewed to identify additional articles not found through the primary database search, of which 17 new articles were included. In the first screening, 502 titles and abstracts were screened against eligibility questions to determine citations of exclusion and to retrieve full text articles for review. In the second screening, 197 full texted articles were screened against eligibility questions to determine whether or not they met full inclusion/exclusion criteria. ^ Results: 100 articles met inclusion criteria and were used in the results of this systematic review. The evidence suggested that black women have a higher prevalence of uterine fibroids when compared to white women. None of the 14 studies reporting data on prevalence reported an operational definition or conceptual framework for the use of race. There were a limited number of studies reporting on the prevalence of risk factors among racial subgroups. Of the 3 studies, 2 studies reported prevalence of risk factors lower for black women than other races, which was contrary to hypothesis. And, of the three studies reporting on prevalence of risk factors among racial subgroups, none of them reported a conceptual framework for the use of race. ^ Conclusion: In the 100 uterine fibroid studies included in this review over half, 66%, reported a specific objective to assess and recruit study participants based upon their race and/or ethnicity, but most, 51%, failed to report a method of determining the actual race of the participants, and far fewer, 4% (only four South American studies), reported a conceptual framework and/or operational definition of race as a variable. However, most, 95%, of all studies reported race-based health outcomes. The inadequate methodological guidance on the use of race in uterine fibroid studies, purporting to assess race and racial disparities, may be a primary reason that uterine fibroid research continues to report racial disparities, but fails to understand the high prevalence and increased exposures among African-American women. A standardized method of assessing race throughout uterine fibroid research would appear to be helpful in elucidating what race is actually measuring, and the risk of exposures for that measurement. ^

(Table 1) Gas tie points used to correlate NorthGRIP and Vostol records

North Atlantic sediment records (MD95-2042), Greenland (Greenland Ice Core Project (GRIP)) and Antarctica (Byrd and Vostok) ice core climate records have been synchronized over marine isotopic stage 3 (MIS 3) (64 to 24 kyr B.P.) (Shackleton et al., 2000). The resulting common timescale suggested that MD95-2042 d18Obenthic fluctuations were synchronous with temperature changes in Antarctica (dDice or d18Oice records). In order to assess the persistency of this result we have used here the recent Greenland NorthGRIP ice core covering the last glacial inception. We transfer the Antarctic Vostok GT4 timescale to NorthGRIP d18Oice and MD95-2042 d18Oplanktonic records and precisely quantify all the relative timing uncertainties. During the rapid warming of Dansgaard-Oeschger 24, MD95-2042 d18Obenthic decrease is in phase with d18Oplanktonic decrease and therefore with NorthGRIP temperature increase, but it takes place 1700 ± 1100 years after the Antarctic warming. Thus the present study reveals that the results obtained previously for MIS 3 cannot be generalized and demonstrates the need to improve common chronologies for marine and polar archives.

(Table 1) Gas tie points used to correlate the ice cores NGRIP and EDML

Water isotope records from the EPICA Dronning Maud Land (EDML) and the NorthGRIP ice cores have revealed a one to one coupling between Antarctic Isotope Maxima (AIM) and Greenland Dansgaard-Oeschger (DO) events back to 50 kyr. In order to explore if this north-south coupling is persistent over Marine Isotopic Stage 5 (MIS 5), a common timescale must first be constructed. Here, we present new records of d18O of O2 (d18Oatm) and methane (CH4) measured in the air trapped in ice from the EDML (68-147 kyr) and NorthGRIP (70-123 kyr) ice cores. We demonstrate that, through the period of interest, CH4 records alone are not sufficient to construct a common gas timescale between the two cores. Millennial-scale variations of d18Oatm are evidenced over MIS 5 both on the Antarctic and Greenland ice cores and are coupled to CH4 profiles to synchronise the NorthGRIP and EDML records. They are shown to be a precious tool for ice core synchronisation. With this new dating strategy, we produce the first continuous and accurate sequence of the north-south climatic dynamics on a common ice timescale for the last glacial inception and the first DO events of MIS 5, reducing relative dating uncertainties to an accuracy of a few centuries at the onset of DO events 24 to 20. This EDML-NorthGRIP synchronisation provides new firm evidence that the bipolar seesaw is a pervasive pattern from the beginning of the glacial period. The relationship between Antarctic warming amplitudes and their concurrent Greenland stadial duration highlights the particularity of DO event 21 and its Antarctic counterpart. Our results suggest a smaller Southern Ocean warming rate for this long DO event compared to DO events of MIS 3.

(Table 2) Age controls used to derive a time scale for DSDP Site 73-522

The stratotype section for the base of the Miocene is at a reversed (below) to normal (above) magnetic transition that is claimed to represent magnetic chron C6Cn.2n (o). Deep Sea Drilling Project (DSDP) Site 522 is the only location we are aware of that unambiguously records the three normal events of C6Cn. We have quantitatively determined the range of the short-lived nannofossil Sphenolithus delphix and the lower limit of S. disbelemnos in DSDP Holes 522 and 522A in order to calibrate their precise relationship to the magnetostratigraphy and to confirm the completeness of the record at this site. Astronomical tuning of Ocean Drilling Program (ODP) Sites 926, 928, and 929 shows that S. disbelemnos appears at 22.67 Ma and that the entire range of S. delphix is from about 22.98 Ma to 23.24 Ma. Using these ages, linear interpolation in DSDP Site 522 suggests that the age of C6Cn.2n (o) and of the Oligocene-Miocene boundary is 22.92+/-0.04 Ma. Our value, conservatively expressed as 22.9+/-0.1 Ma, is 0.9 m.y. younger than the currently accepted age of the Oligocene-Miocene boundary and of C6Cn.2n (o), which was assigned an age of 23.8 Ma, based on an estimate of 23.8+/-1 Ma for the Oligocene-Miocene boundary. The bulk-sediment carbon isotope data from DSDP Site 522 is correlated to the record from benthic foraminifera at ODP Site 929 to refine the calibration of magnetic reversals from C6Cn.1n (o) to C7n.2n (o) at DSDP Site 522 on the astronomical time scale.