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21st Jun 2019

Introduction: Life-course approaches to determine risk factor exposure are increasingly favoured over traditional ‘once-only’ epidemiological determination. One is latent class trajectory modelling (LCTM), which clusters individuals’ changes in exposure over time and can be used as a tool for identifying early divergent adverse trajectories. There is increasing use of LCTMs in mainstream epidemiology, but often with poor model description, and an over-reliance on BIC for model selection. Here, we aimed to explore methods in deriving and validating LCTMs from multiple cohorts to ensure that they properly represent observed patterns across different populations.
Methods: We interrogated three cohorts, AARP (N: 321,827), PLCO (N: 147,488) and WHI (N: 151,363), with longitudinal BMI as the exposure and cancer incidence as the endpoint of interest. We extended our previous work (https://bmjopen.bmj.com/content/8/7/e020683) to (i) testing multiple start points to obtain the global maximums; (ii) facilitating model choice with alternative metrics to BIC; (iii) developing visual model assessment tools.
Results: We illustrate a number of examples where deviation from model assumptions yield very different classifications. After arriving at preferred models, we show that LCTM improve the performance characteristics of BMI exposure, compared with once only BMI measures, however, this improvement is clinically modest. LCTM might best identify specific sub-populations that have very high risk for cancer incidence.
Conclusions: The study highlights that model selection needs to be undertaken with care and not based solely determined by lowest BIC. We emphasise that multiple start points should be tested when using these models.


06th Jun 2019

INTRODUCTION: Clinical tooth eruption is defined as the first evidence of tooth emergence of the crown through the gingiva into the mouth. Studies report it to be earlier in African groups to others with different ethnic background or origin. Assessing eruption from radiographs presents clearer and more detailed reference points, such as the alveolar crest and roots, and is thought to be less variable compared to clinical emergence. No studies describe alveolar eruption from Africa.
AIM: To describe alveolar ridge attainment for children from Sudan and compare them to other groups with different ancestry.
METHODS Alveolar ridge attainment, of all mandibular and maxillary teeth on the left side, was assessed from dental radiographs, in teeth and 782 children (452 males, 330 females), from a dental practice in Khartoum. The children were equally distributed across age (3-23 years). The left maxillary and mandibular permanent teeth scored in relation to alveolar ridge bone. Mean age was calculated using probit regression analysis. Males and females were compared using student t-test.
RESULTS: Mean ages at entry of alveolar eruption were similar males and females (p>0.05). Only males were compared in this study. Alveolar eruption was similar between males from Sudan and children from London. Mean alveolar times are presented for all teeth.
Discussion AND CONCLUSIONS: This is the first study to present data from African groups and shows that eruption is similar in 2 geographically distinct regions. No studies on alveolar eruption exist from African to enable comparison. Further studies are required to investigate why Africans are advanced in clinical emergence but not radiographic alveolar crest attainment.


21st May 2019

Second Abstract Proposal
Human Genetics code(Unmasked).
My Research works consist of these: 1) Y chromosomes confirmation both found and exist inside the human female egg cells and male sperm cells with X chromosome inside. 2) early detection of infertility and fertility, menopause and stress (Male/Female). 3) Detection of DNA’s Child links – connected to his/her original parents (Father/Mother). 4) Early detection of gender fetus/embryos either first Baby, 2nd Baby, 3rd Baby…etc.. within 24 hours – 3 days after the sperm cells enter into the egg cells of female mammals. 5) Early detection’s of future Gender of embryos twins, triplets, quadruplets …etc.. 6) Early detection to all future gender of embryos or next baby gender of embryos even if the mother is not yet pregnant. 7) Single male/ married/single father will have a chance an opportunity to know all his future sons and daughter’s 1st future baby gender, 2nd, 3rd…etc.. All Human Male mammals will have the opportunity to know if he has a future twin gender, triplets, and quadruplets baby gender..etc… these are detectable and real. 8) X and Y chromosomes natural cycles using helix function inside the sperm cells of male mammals and egg cells of female mammals – It can detect and divulge the exact time of cycles, month and exact year of cycles. 9) Early detection of Human clone Personnel or Person by tracing and detecting his/her Unseen Genetic engineering codes that my technology only can detect it. 10) Unseen Individual Identity of person – aside from the thumb mark example identical twin, triplets, quadruplets identity. 11) Pro-Life manufacture and producing correct future gender selection or sex selection is real and possible


20th May 2019

2001, I started my human codes experiment research alone after I accidentally discovered new combined elements that can interpret the messages using teleportation subatomic wave particles an applied into the human DNA’s. Using Quantum biology theory to detect 100% function of the human genome unseen codes, like quantum computer codes is a new interesting discovery that I discovered since 2001. I develop and invented a new super advanced technology and it’s called ‘Stellar Technology’ fit to validate the owner’s DNA’s from the human Male mammals or Female mammal’s chromosomes like the identification of chromosomes inside the human female mammal’s egg cells and also in male mammal’s sperm cells. Stellar Technology is the one responsible to separate the formation of the chromosomes inside the egg cells of female mammals and sperm cells of male mammals. It can detect and confirmed the existence of Y chromosomes inside the human female mamma’s egg cells with X chromosomes inside by translating the unseen codes into Y and X chromosomes using the slope and pi formulas. Stellar Technology can validate also the surrogacy, human cloning, sperm donation, DNA testing in an external approach, early detection of the human clone, infertility and stress, menopause, helix role, and natural function cycle in terms of gender selection, early detection of future baby gender either girl or boy gender, early of twin gender, triplets gender, quadruplets gender even before pregnancy occurs. and identification of identical twin, triplets, quadruplets identity.


2001, I started my human codes experiment research alone after I accidentally discovered new combined elements that can interpret the messages using teleportation subatomic wave particles an applied into the human DNA’s. Using Quantum biology theory to detect 100% function of the human genome unseen codes, like quantum computer codes is a new interesting discovery that I discovered since 2001. I develop and invented a new super advanced technology and it’s called ‘Stellar Technology’ fit to validate the owner’s DNA’s from the human Male mammals or Female mammal’s chromosomes like the identification of chromosomes inside the human female mammal’s egg cells and also in male mammal’s sperm cells. Stellar Technology is the one responsible to separate the formation of the chromosomes inside the egg cells of female mammals and sperm cells of male mammals. It can detect and confirmed the existence of Y chromosomes inside the human female mamma’s egg cells with X chromosomes inside by translating the unseen codes into Y and X chromosomes using the slope and pi formulas. Stellar Technology can validate also the surrogacy, human cloning, sperm donation, DNA testing in an external approach, early detection of the human clone, infertility and stress, menopause, helix role, and natural function cycle in terms of gender selection, early detection of future baby gender either girl or boy gender, early of twin gender, triplets gender, quadruplets gender even before pregnancy occurs. and identification of identical twin, triplets, quadruplets identity.

I’m looking forward to your reply.

Ranel


15th May 2019

The CRoatian Islands Birth Cohort Study (CRIBS) was the first Croatian birth cohort study and the first birth cohort study ever conducted in Southeastern Europe, designed to prospectively follow a sample of 500 pregnant women and their children up to two years of age. The aim was to assess the prevalence of risk factors (biological, environmental and behavioural) for the development of metabolic syndrome (MetS) and other NCDs, in two Croatian islands (islands Hvar and Brač) and one mainland subpopulation (city of Split). Although birth cohorts and life course designs offer a wealth of opportunities, their implementation is uniquely challenging. Being the first birth cohort in Croatia, CRIBS faced certain methodological, logistical, and sociocultural challenges – including small sample size, incomplete data, problems with participant retention and lack of logistic support on the national level. The presentation will discuss such methodological shortcomings and highlight efforts of the CRIBS researchers to address them. Although limited in sample size, the success of the study lies in the wealth of collected data generating a great potential for cross-cohort collaborations and inclusion into larger consortia. However, this would not have been possible without a personal contact with the participants, making it a challenge and opportunity at the same time.


03rd May 2019

The Developmental Origins of Health and Disease hypothesis purports that early life factors determine long-term risks of death and disease. Prospective birth cohorts and more recently genetic studies consistently indicate that the rapid weight gain trajectory to later obesity starts in the first months of life, even from birth. Rapid infant weight gain and childhood overweight lead to earlier pubertal maturation in boys and girls, and in turn these adolescent traits are predictive for obesity, diabetes, hypertension and cardiovascular disease events in later life. Understanding of the nutritional, parental and wider determinants of rapid infant weight gain are informing the development of obesity prevention strategies starting in early life. These are important efforts in light the observed high levels of nutrition and weight in UK infants. However, many questions remain. Does rapid growth in infancy length ameliorate effects of rapid infancy weight gain on obesity risk? Conversely, do rapid gains in infancy adiposity exacerbate such effects and predict even worse metabolic health? As more accurate markers of infancy body composition and metabolism emerge and are incorporated into new cohort studies, do we have to wait for follow-up time to elapse before inferring their relevance to later obesity and disease risks? This paper will review what is currently known and consider how genetic epidemiological approaches might be used more widely to infer long-term relationships between early life growth and later outcomes.


01st May 2019

Introduction: Most tooth formation reference data are based on radiographs taken in the course of diagnosis and dental treatment; however, re-analysis of a historical longitudinal radiographic study allows a more reliable description of the timing, variation in timing and the duration of consecutive tooth stages. One of the early longitudinal dental studies was by Carmen Nolla, who detailed permanent tooth formation in 25 boys and 25 girls from annual dental radiographs. The aim of our study was to reconstruct Nolla’s longitudinal data and calculate the timing of permanent tooth stages.
Methods: The material for this study was data reconstructed from plots showing individual tooth stage curves from dental radiographs of 25 boys and 25 girls in Nolla’s thesis (1952). These were assessed from annual radiographs taken from the ages of 2 to 18. We transcribed the data and calculated mean age of attainment of mandibular tooth stages in two ways. Firstly, data were treated as cross sectional and mean age calculated by probit regression. Secondly, data were analysed longitudinally by transition analysis using auglag in R. First results were compared to results from 946 dental radiographs of contemporary children aged 3-16.
Results: Our results show the timing of most tooth stages was similar to contemporary children. Some results of the longitudinal analyses could be compared to recently published reanalysis of longitudinal radiographic data and similarities were noted.
Conclusion: These findings suggest that the timing of permanent teeth is broadly similar between groups with little evidence of a secular trend.


29th Apr 2019

Introduction:Completion of the full series of childhood vaccines on-time is crucial to ensuring protection against vaccine-preventable diseases. Health effects of the potential “non-specific effects” of vaccines are linked to vaccines timeliness. We examines determinants of complete and on-time vaccination and evaluates the relationship between vaccination patterns and severe morbidity outcomes
Methods:The paper uses data from maternal and child health survey which recruited and followed up a cohort of children born in the Nairobi Urban Health and Demographic Surveillance System between 2007 and 2014. Vaccination information were collected from child health cards. Logistic regression was used to identify determinants of vaccination completion and timeliness. Cox regression model was used to evaluate the relationship between vaccination statuses and subsequent severe morbidity. Several children reported more than one hospitalization episodes – a typical recurrent survival outcome. A frailty parametric cox model was fitted to account for the heterogeneity
Results:Maternal age, post-natal care, parity, ethnicity and residence place were identified as determinants of vaccination completion. Institutional deliveries and residence place were identified as the determinant of on-time vaccination. A significant 58% (CI: 15-79%) (p=0.017) lower mortality was observed among fully immunized children compared with not fully immunized. Lower mortality observed among on-time immunized children, 64% (CI: 20-84%) compared to those with delays
Conclusions:Improving vaccination timeliness and completion schedule is critical for protection against vaccines preventable diseases, and may potentially provide protection beyond these targets


Introduction: The DOHaD hypothesis contends that exposures early in life can impact on lifelong health, especially in contexts where there is a ‘mismatch’ between the early and later life environment. Much of the evidence in support of DOHaD comes from studies in high-income countries using retrospective records, with less data from low-income countries. Here, I describe how we have used longitudinal data from rural sub-Saharan Africa to contribute to explore nutrition and human health interactions.
Methods: Using demographic records initiated in 1947 in rural Gambia, coupled with records on maternal and child health, we have explored; (i) the impact of the early-life nutritional environment on later health in a rural African population, and (ii) secular trends in childhood growth, with a focus on factors contributing to growth faltering.
Results: Firstly, building on epidemiological associations between season of birth and infection-related mortality, we have shown that the human immune system is sensitive to nutritional exposures early in life, adding a novel dimension to the DOHaD field. Secondly, using routine data on childhood anthropometry, we observe that, despite a significant decline in child undernutrition, rates remain unacceptably high, likely reflecting the very high socio-economic threshold required to eliminate undernutrition.
Conclusions: The foresight to establish demographic data collection over 7 decades ago, has provided longitudinal data enabling novel research within a traditional African context. The addition of detailed clinical records on maternal and child health is helping us to understand the factors driving child undernutrition in rural Africa, and to identify targets for intervention.


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