Ozone and fine particulate matter association with CVD and COPD emergency room visits in Harris County, Texas: Spatiotemporal analysis

This study represents a secondary analysis of the merging of emergency room visits and daily ozone and PM2.5. Although the adverse health effects of ozone and fine particulate matter have been documented in the literature, evidence regarding the health risks of these two pollutants in Harris County, Texas, is limited. Harris County (Houston) has sufficiently unique characteristics that analysis of these relationships in this setting and with the ozone and industry issues in Houston is informative. The objective of this study was to investigate the association between the joint exposure to ozone and fine particulate matter, and emergency room diagnoses of chronic obstructive pulmonary disease and cardiovascular disease in Harris County, Texas, from 2004 to 2009, with zero and one day lags. ^ The study variables were daily emergency room visits for Harris County, Texas, from 2004 to 2009, temperature, relative humidity, east wind component, north wind component, ozone, and fine particulate matter. Information about each patient's age, race, and gender was also included. The two dichotomous outcomes were emergency room visits diagnoses for chronic obstructive pulmonary disease and cardiovascular disease. Estimates of ozone and PM2.5 were interpolated using kriging, in which estimates of the two pollutants were predicted from monitoring data for every case residence zip code for every day of the six years, over 3 million estimates (one of each pollutant for each case in the database). ^ Logistic regressions were conducted to estimate odds ratios of the two outcomes. Three analyses were conducted: one for all records, another for visits during the four months of April and September of 2005 and 2009, and a third one for visits from zip codes that are close to PM2.5 monitoring stations (east area of Harris County). The last two analyses were designed to investigate special temporal and spatial characteristics of the associations. ^ The dataset included all ER visits surveyed by Safety Net from 2004 to 2009, exceeding 3 million visits for all causes. There were 95,765 COPD and 96,596 CVD cases during this six year period. A 1-μg/m3 increase in PM2.5 on the same day was associated with a 1.0% increase in the odds of chronic obstructive pulmonary disease emergency room diagnoses, a 0.4% increase in the odds of cardiovascular disease emergency room diagnoses, and a 0.2% increase in the odds of cardiovascular disease emergency room diagnoses on the following day. A 1-ppb increase in ozone was associated with a 0.1% increase in the odds of chronic obstructive pulmonary disease emergency room diagnoses on the same day. These four percentages add up to 1.7% of ER visits. That is, over the period of six years, one unit increase for both ozone and PM2.5 (joint increase), resulted in about 55,286 (3,252,102 * 0.017) extra ER visits for CVD or COPD, or 9,214 extra ER visits per year. ^ After adjustment for age, race, gender, day of the week, temperature, relative humidity, east wind component, north wind component, and wind speed, there were statistically significant associations between emergency room chronic obstructive pulmonary disease diagnosis in Harris County, Texas, with joint exposure to ozone and fine particulate matter for the same day; and between emergency room cardiovascular disease diagnosis and exposure to PM2.5 of the same day and the previous day. ^ Despite the small association between the two air pollutants and the health outcomes, this study points to important findings. Namely, the need to identify reasons for the increase of CVD and COPD ER visits over the course of the project, the statistical association between humidity (or whatever other variables for which it may serve as a surrogate) and CVD and COPD cases, and the confirmatory finding that males and blacks have higher odds for the two outcomes, as consistent with other studies. ^ An important finding of this research suggests that the number and distribution of PM2.5 monitors in Harris County - although not evenly spaced geographically—are adequate to detect significant association between exposure and the two outcomes. In addition, this study points to other potential factors that contribute to the rising incidence rates of CVD and COPD ER visits in Harris County such as population increases, patient history, life style, and other pollutants. Finally, results of validation, using a subset of the data demonstrate the robustness of the models.^

TIME SERIES ANALYSIS AS INPUT FOR PREDICTIVE MODELING: PREDICTING CARDIAC ARREST IN A PEDIATRIC INTENSIVE CARE UNIT

The first manuscript, entitled "Time-Series Analysis as Input for Clinical Predictive Modeling: Modeling Cardiac Arrest in a Pediatric ICU" lays out the theoretical background for the project. There are several core concepts presented in this paper. First, traditional multivariate models (where each variable is represented by only one value) provide single point-in-time snapshots of patient status: they are incapable of characterizing deterioration. Since deterioration is consistently identified as a precursor to cardiac arrests, we maintain that the traditional multivariate paradigm is insufficient for predicting arrests. We identify time series analysis as a method capable of characterizing deterioration in an objective, mathematical fashion, and describe how to build a general foundation for predictive modeling using time series analysis results as latent variables. Building a solid foundation for any given modeling task involves addressing a number of issues during the design phase. These include selecting the proper candidate features on which to base the model, and selecting the most appropriate tool to measure them. We also identified several unique design issues that are introduced when time series data elements are added to the set of candidate features. One such issue is in defining the duration and resolution of time series elements required to sufficiently characterize the time series phenomena being considered as candidate features for the predictive model. Once the duration and resolution are established, there must also be explicit mathematical or statistical operations that produce the time series analysis result to be used as a latent candidate feature. In synthesizing the comprehensive framework for building a predictive model based on time series data elements, we identified at least four classes of data that can be used in the model design. The first two classes are shared with traditional multivariate models: multivariate data and clinical latent features. Multivariate data is represented by the standard one value per variable paradigm and is widely employed in a host of clinical models and tools. These are often represented by a number present in a given cell of a table. Clinical latent features derived, rather than directly measured, data elements that more accurately represent a particular clinical phenomenon than any of the directly measured data elements in isolation. The second two classes are unique to the time series data elements. The first of these is the raw data elements. These are represented by multiple values per variable, and constitute the measured observations that are typically available to end users when they review time series data. These are often represented as dots on a graph. The final class of data results from performing time series analysis. This class of data represents the fundamental concept on which our hypothesis is based. The specific statistical or mathematical operations are up to the modeler to determine, but we generally recommend that a variety of analyses be performed in order to maximize the likelihood that a representation of the time series data elements is produced that is able to distinguish between two or more classes of outcomes. The second manuscript, entitled "Building Clinical Prediction Models Using Time Series Data: Modeling Cardiac Arrest in a Pediatric ICU" provides a detailed description, start to finish, of the methods required to prepare the data, build, and validate a predictive model that uses the time series data elements determined in the first paper. One of the fundamental tenets of the second paper is that manual implementations of time series based models are unfeasible due to the relatively large number of data elements and the complexity of preprocessing that must occur before data can be presented to the model. Each of the seventeen steps is analyzed from the perspective of how it may be automated, when necessary. We identify the general objectives and available strategies of each of the steps, and we present our rationale for choosing a specific strategy for each step in the case of predicting cardiac arrest in a pediatric intensive care unit. Another issue brought to light by the second paper is that the individual steps required to use time series data for predictive modeling are more numerous and more complex than those used for modeling with traditional multivariate data. Even after complexities attributable to the design phase (addressed in our first paper) have been accounted for, the management and manipulation of the time series elements (the preprocessing steps in particular) are issues that are not present in a traditional multivariate modeling paradigm. In our methods, we present the issues that arise from the time series data elements: defining a reference time; imputing and reducing time series data in order to conform to a predefined structure that was specified during the design phase; and normalizing variable families rather than individual variable instances. The final manuscript, entitled: "Using Time-Series Analysis to Predict Cardiac Arrest in a Pediatric Intensive Care Unit" presents the results that were obtained by applying the theoretical construct and its associated methods (detailed in the first two papers) to the case of cardiac arrest prediction in a pediatric intensive care unit. Our results showed that utilizing the trend analysis from the time series data elements reduced the number of classification errors by 73%. The area under the Receiver Operating Characteristic curve increased from a baseline of 87% to 98% by including the trend analysis. In addition to the performance measures, we were also able to demonstrate that adding raw time series data elements without their associated trend analyses improved classification accuracy as compared to the baseline multivariate model, but diminished classification accuracy as compared to when just the trend analysis features were added (ie, without adding the raw time series data elements). We believe this phenomenon was largely attributable to overfitting, which is known to increase as the ratio of candidate features to class examples rises. Furthermore, although we employed several feature reduction strategies to counteract the overfitting problem, they failed to improve the performance beyond that which was achieved by exclusion of the raw time series elements. Finally, our data demonstrated that pulse oximetry and systolic blood pressure readings tend to start diminishing about 10-20 minutes before an arrest, whereas heart rates tend to diminish rapidly less than 5 minutes before an arrest.

Stable isotope analysis and temperature reconstruction data from DSDP Hole 94-609B and ODP Hole 162-984B

The Greenland ice sheet is accepted as a key factor controlling the Quaternary glacial scenario. However, the origin and mechanisms of major Arctic glaciation starting at 3.15 Ma and culminating at 2.74 Ma are still controversial. For this phase of intense cooling Ravelo et al. proposed a complex gradual forcing mechanism. In contrast, our new submillennial-scale paleoceanographic records from the Pliocene North Atlantic suggest a far more precise timing and forcing for the initiation of northern hemisphere glaciation (NHG), since it was linked to a 2-3 °C surface water warming during warm stages from 2.95 to 2.82 Ma. These records support previous models, claiming that the final closure of the Panama Isthmus (3.0- ~2.5 Ma induced an increased poleward salt and heat transport. Associated strengthening of North Atlantic Thermohaline Circulation and in turn, an intensified moisture supply to northern high latitudes resulted in the build-up of NHG, finally culminating in the great, irreversible climate crash at marine isotope stage G6 (2.74 Ma). In summary, there was a two-step threshold mechanism that marked the onset of NHG with glacial-to-interglacial cycles quasi-persistent until today.

Facies analysis on sediment core CRP-3 from the Ross Sea, Antarctica

Cape Roberts Project drill core 3 (CRP-3) was obtained from Roberts ridge, a sea-floor high located at 77°S, 12 km offshore from Cape Roberts in western McMurdo Sound, Antarctica. The recovered core is about 939 m long and comprises strata dated as being early Oligocene (possibly latest Eocene) in age, resting unconformably on ~116 m of basement rocks consisting of Palaeozoic Beacon Supergroup sediments. The core includes ten facies commonly occurring in five major associations that are repeated in particular sequences throughout the core and which are interpreted as representing different depositional environments through time. Depositional systems inferred to be represented in the succession include: outer shelf, inner shelf, nearshore to shoreface each under iceberg influence, deltaic and/or grounding-line fan, and ice proximal-ice marginal-subglacial (mass flow/rainout diamictite/subglacial till) singly or in combination. The record is taken to represent the initial talus/alluvial fan setting of a glaciated rift margin adjacent to the block-uplifted Transantarctic Mountains. Development of a deltaic succession upcore was probably associated with the formation of palaeo-Mackay valley with temperate glaciers in its headwaters. At that stage glaciation was intense enough to support glaciers ending in the sea elsewhere along the coast, but a local glacier was fluctuating down to the sea by the time the youngest part of CRP-3 was being deposited. Changes in palaeoenvironmental interpretations in this youngest part of the core are used to estimate relative glacial proximity to the drillsite through time. These inferred glacial fluctuations are compared with the global d180 and Mg/Ca curves to evaluate the potential of glacial fluctuations on Antarctica for influencing these records of global change. Although the comparisons are tentative at present, the records do have similarities, but there are also some differences that require further evaluation.

Grain size analysis on CRP sediment cores from the Ross Sea, Antarctica

The upper 1200 m of pre-Pliocene sediment recovered by Cape Roberts Project (CRP) drilling off the Victoria Land coast of Antarctica between 1997-1999 has been subdivided into 54 unconformity-bound stratigraphic sequences, spanning the period c. 32 to 17 Ma. The sequences are recognised on the basis of the cyclical vertical stacking of their constituent lithofacies, which are enclosed by erosion surfaces produced during the grounding of the advancing ice margin onto the sea floor. Each sequence represents deposition in a range of offshore shelf to coastal glacimarine sedimentary environments during oscillations in the ice margin across the Western Ross Sea shelf, and coeval fluctuations in water depth. This paper applies spectral analysis techniques to depth- and time-series of sediment grain size (500 samples) for intervals of the core with adequate chronological data. Time series analysis of 0.5-l.0m-spaced grainsize data spanning sequences 9-11 (CRP-2/2A) and sequences 1-7 (CRP-3) suggests that the length of individual sequences correspond to Milankovitch frequencies, probably 41 k.y., but possibly as low as 100 k.y. Higher frequency periodic components at 23 k.y. (orbital precession) and 15-10 k.y. (sub-orbital) are recognised at the intrasequence-scale, and may represent climatic cycles akin to the ice rafting episodes described in the North Atlantic Ocean during the Quaternary. The cyclicity recorded by glacimarine sequences in CRP core provides direct evidence from the periphery of Antarctica for orbital oscillations in the size of the Oligocene-Early Miocene East Antarctic Ice Sheet.

Grain size analysis of sediment core CRP-3 from the Ross Sea, Antarctica

Grain-size analyses by sieve and Sedigraph are presented for 115 samples of core from CRP-3, 12 km off the coast of south Victoria Land. The data provide a useful check on visual core descriptions. The geographic setting for the strata sampled, some 790 m of early Oligocene nearshore marine sediments with a persistent glacial influence, is reviewed, and sediment textures interpreted in that context. Sand textures from the CRP-3 samples in the lower part of the core suggest that deposition was initially primarily wave-dominated, but that at times the influence of the waves was over-ridden by episodes of rapid sedimentation. Sedimentary cycles, recognised in the visual description of the core above 485 mbsf, show an increasing proportion of mudstone in the middle of each cycle above 330 mbsf that is interpreted to record periodic sedimentation in deeper water. Sandstone textures in the lower and upper parts of each cycle are interpreted to record departure from and return to shoreface deposition with changes in sea level. Mudstone textures above 176 mbsf indicate sedimentation below wave base. Many of the textures in both sand and mud samples show the coarse 'tail' characteristic of ice-rafted debris, but others do not, indicating ice-free periods. Many sandstones below c. 200 mbsf have virtually no silt, but significant amounts of clay (6 to 17%) that is thought to be of post-depositional origin.

Grain size analysis of sediment coring site CRP-2 from the Ross Sea, Antarctica

The purpose of this note is to present results of grain size analyses from 118 samples of the CRP-2/2A core using sieve and Sedigraph techniques. The samples were selected to represent the range of facies encountered, and tend to become more widely spaced with depth. Fifteen came from the upper 27 m of Quaternary and Pliocene sediments, 62 from the early Miocene-late Oligocene strata (27 to 307 mbsf), and 41 from the early Oligocene strata beneath (307 to 624 mbsf). The results are intended to provide reference data for lithological descriptions in the core logs (Cape Roberts Science Team, 1999), and to help with facies interpretation. The analytical technique used for determining size frequency of the sand fraction in our samples (sieving) is simple, physical and widely practised for over a century. Thus it provides a useful reference point for analyses produced by other faster and more sophisticated techniques, such as the Malvern laser particle size analysis system (Woolfe et al., 2000), and estimates derived from measurements taken with down-hole logging tools (Bücker, pers. com., 1999).

Deuterium analysis of ice core GISP2

The Greenland Ice Sheet Project 2 (GISP2) core can enhance our understanding of the relationship between parameters measured in the ice in central Greenland and variability in the ocean, atmosphere, and cryosphere of the North Atlantic Ocean and adjacent land masses. Seasonal (summer, winter) to annual responses of dD and deuterium excess isotopic signals in the GISP2 core to the seesaw in winter temperatures between West Greenland and northern Europe from A.D. 1840 to 1970 are investigated. This seesaw represents extreme modes of the North Atlantic Oscillation, which also influences sea surface temperatures (SSTs), atmospheric pressures, geostrophic wind strength, and sea ice extents beyond the winter season. Temperature excursions inferred from the dD record during seesaw/extreme NAO mode years move in the same direction as the West Greenland side of the seesaw. Symmetry with the West Greenland side of the seesaw suggests a possible mechanism for damping in the ice core record of the lowest decadal temperatures experienced in Europe from A.D. 1500 to 1700. Seasonal and annual deuterium excess excursions during seesaw years show negative correlation with dD. This suggests an isotopic response to a SST/ land temperature seesaw. The isotopic record from GISP2 may therefore give information on both ice sheet and sea surface temperature variability. Cross-plots of dD and d show a tendency for data to be grouped according to the prevailing mode of the seesaw, but do not provide unambiguous identification of individual seesaw years. A combination of ice core and tree ring data sets may allow more confident identification of GA and GB (extreme NAO mode) years prior to 1840.

40Ar/39Ar analysis for incremental heating experiments at DSDP Holes 77-537 and 77-538A

Drilling penetrated pre-Mesozoic crystalline basement beneath abbreviated sedimentary sequences overlying fault blocks in the southeastern Gulf of Mexico. At Hole 538A, located on Catoche Knoll, a foliated, regional metamorphic association of variably mylonitic felsic gneisses and interlayered amphibolite is intruded by post-tectonic diabase dikes. Hornblende from the amphibolite displays internally discordant 40Ar/39Ar age spectra, suggesting initial post-metamorphic cooling at about 500 Ma followed by a mild thermal disturbance at about 200 Ma. Biotite from the gneiss yields a plateau age of 348 Ma, which is interpreted to result from incorporation of extraneous argon components when the biotite system was opened during the about 200 Ma thermal overprint. A whole-rich diabase sample from Hole 538A records a crystallization age of 190.4 ± 3.4 Ma. A lower grade phyllitic metasedimentary sequence was penetrated at Hole 537, drilled about 30 km northwest of Catoche Knoll. Whole-rock phyllite samples display internally discordant 40Ar/39Ar age spectra, but plateau segments clearly document an early Paleozoic metamorphism at about 500 Ma. The age and lithologic character of the basement terrane penetrated at Holes 537 and 538A suggest that the drilled fault blocks are underlain by attenuated fragments of continental crust of "Pan-African" affinity. This supports pre-Mesozoic tectonic reconstructions that locate Yucatan in the present Gulf recess during the amalgamation of Pangea.

Environmental analysis on sediment core CRP-2 from the Ross Sea, Antarctica

Cape Roberts Project drill core 2/2A was obtained from Roberts Ridge, a sea-floor high located at 77° S, 16 km offshore from Cape Roberts in western McMurdo Sound, Antarctica. The recovered core is about 624 m long and includes strata dated as being Quaternary, Pliocene, Miocene and Oligocene in age. The core includes twelve facies commonly occurring in associations that are repeated in particular sequences throughout the core and which are interpreted as representing different depositional environments through time. Depositional systems inferred to be represented in the succession include: outer shelf with minor iceberg influence, outer shelf-inner shelf-nearshore to shoreface under iceberg influence, deltaic and/or grounding-line fan, and ice proximal-ice marginal-subglacial (mass flow/rainout diamictite/subglacial till) singly or in combination. Changes in palaeoenvironmental interpretations up the core are used to estimate relative glacial proximity to the site through time. These inferred glacial fluctuations are then compared with the global eustatic sea level and d18O curves to evaluate the potential of glacial fluctuations on Antarctica influencing these records of global change. Although the comparisons are tentative at present, the records do have similarities, but there are also some differences especially in possible number (and perhaps magnitude) of glacial fluctuations that require further evaluation.

Assamblages and cluster analysis from DSDP Hole 22-214 of the eastern Indian Ocean

Multivariate analyses of latest Pliocene through Holocene benthic foraminifera from 61 samples from Deep-Sea Drilling Project (DSDP) Site 214, eastem Indian Ocean were carried out. The 46 highest ranked species were used in R-mode factor analysis which has enabled to the identification of three environmentally significant assemblages at Site 214. Assemblage 1 is characterized by Uvigerina hispido-costata, Osangularia culter , Gavelinopsis lobatulus, Cibicides wuellerstorfi and Karreriella baccata as principal species. This assemblage is inferred to reflect high-energy, well-oxygenated and probably low-organic carbon deep-sea environment at Site 214. Assemblage 2 is defined principally by Globocassidulina pacifica and U. proboscidea and is considered to indicate an organic carbon-rich environment which resulted from high surface productivity irrespective of dissolved oxygen content. Assemblage 3 is marked by Oridorsalis umbonatus, Textularia lythostrota, Hoeglundina elegans, Pyrgo murrhina, and Pullenia quinqueloba as principal species. This assemblage is inferred to indicate a low-organic carbon environment with high pore water oxygen concentration leading to better preservation of deep-sea sediments.

Territorial assemblages and Governance : The example of the Taonaba project [Town of Abymes, Guadeloupe]

This article reports on an action research to support the urban community of Cap Excellence in Guadaloupe in its local sustainable development project. After summarizing the terms of the debate around sustainable development, and presenting the region, the search will be put back into the context of a more general approach of territorial* intelligence (TI). The limits of a local Agenda 21 in the form of a 'programmed action plan' is the chance to enhance the concept of TI with that of territorial assemblage. Our study area is the natural reserve of the Grand Cul-de-Sac Marin of Guadeloupe, the second largest biosphere reserve designated by UNESCO in the archipelago of the Petites Antilles, more specifically the implementation of the Taonaba project, whose goal is to launch an ecotourism visitors' centre, operational at the end of 2012. Based on the analysis of a large amount of data, the article describes an evaluation tool for territorial assemblages for participative territorial governance. Our results were presented to local government officials in the Urban Sustainable Development Forum, which our group organised from 2 to 4 April 2012, in the district of Abymes/Pointe-à-Pitre

Territorial assemblages and Governance : The example of the Taonaba project [Town of Abymes, Guadeloupe]

This article reports on an action research to support the urban community of Cap Excellence in Guadaloupe in its local sustainable development project. After summarizing the terms of the debate around sustainable development, and presenting the region, the search will be put back into the context of a more general approach of territorial* intelligence (TI). The limits of a local Agenda 21 in the form of a 'programmed action plan' is the chance to enhance the concept of TI with that of territorial assemblage. Our study area is the natural reserve of the Grand Cul-de-Sac Marin of Guadeloupe, the second largest biosphere reserve designated by UNESCO in the archipelago of the Petites Antilles, more specifically the implementation of the Taonaba project, whose goal is to launch an ecotourism visitors' centre, operational at the end of 2012. Based on the analysis of a large amount of data, the article describes an evaluation tool for territorial assemblages for participative territorial governance. Our results were presented to local government officials in the Urban Sustainable Development Forum, which our group organised from 2 to 4 April 2012, in the district of Abymes/Pointe-à-Pitre