Ovarian Cancer in the Sudan - Identifying the Social and Clinical Factors that Prevent an Early Diagnosis

Ovarian cancer, because it often presents with vague symptoms, is a difficult disease to diagnose at the early stages, especially in developing countries. In Sudan, diagnosis is further complicated by additional factors and challenges. First, as in any developing country, access to treatment, facilities and medical staff is generally lacking. Secondly, Sudan is the second largest country in Africa: its very size presents difficulties for the implementation of a centralized health system. The two tertiary hospitals in or near the capital have long patient waiting lists.The lack of female education in sub-Saharan Africa, together with social and economic issues affecting women, is a further obstacle to disease diagnosis and management. Misdiagnosis, leading to inappropriate treatment, may result from the presence of comorbid diseases such as Tuberculosis (TB), which can mimic ovarian cancer and obstruct early detection. Most patients are identified at the later stages when the complications associated with invasive procedures and conventional chemotherapy make treatment much less effective. The early detection of biomarkers may prove to be a vital tool to indicate targets for immunotherapy treatment.Financial aid may help improve the outcomes for patients with ovarian cancer in the Sudan, assisting with diagnosing and management procedures including training medical staff. Research and development, documentation and updating the statistical register for the whole country are also important requirements for future improvements.Finally, there is a need to promote interdisciplinary work between surgeons and clinical oncologists to optimize international guidelines and protocols in accordance with the facilities available

Mental Disorder Recovery Correlated with Centralities and Interactions on an Online Social Network

Recent research has established both a theoretical basis and strong empirical evidence that effective social behavior plays a beneficial role in the maintenance of physical and psychological well-being of people. To test whether social behavior and well-being are also associated in online communities, we studied the correlations between the recovery of patients with mental disorders and their behaviors in online social media. As the source of the data related to the social behavior and progress of mental recovery, we used PatientsLikeMe (PLM), the world's first open-participation research platform for the development of patient-centered health outcome measures. We first constructed an online social network structure based on patient-to-patient ties among 200 patients obtained from PLM. We then characterized patients' online social activities by measuring the numbers of "posts and views" and "helpful marks" each patient obtained. The patients' recovery data were obtained from their self-reported status information that was also available on PLM. We found that some node properties (in-degree, eigenvector centrality and PageRank) and the two online social activity measures were significantly correlated with patients' recovery. Furthermore, we re-collected the patients' recovery data two months after the first data collection. We found significant correlations between the patients' social behaviors and the second recovery data, which were collected two months apart. Our results indicated that social interactions in online communities such as PLM were significantly associated with the current and future recoveries of patients with mental disorders.Comment: 20 pages, 5 figures, 5 tables; accepted for publication in Peer

Barbarians at the British Museum: Anglo-Saxon Art, Race and Religion

A critical historiographical overview of art historical approaches to early medieval material culture, with a focus on the British Museum collections and their connections to religion

Pathways to magnesium supplementation of drinking water: An overview of the saline water conversion corporation experience

Magnesium (Mg) in drinking water is essential for human health, with low concentrations in drinking water being reported to be correlated with poor cardiovascular health outcomes. Based on the literature and suggestions that the World Health Organization would soon announce guidelines for Mg content of drinking water, the Saline Water Conversion Corporation (SWCC) announced specifications in October 2020 targeting 15–25 ppm of Mg in product water. SWCC produces approximately 6 million m3 of potable water daily for domestic and industrial use in the Kingdom of Saudi Arabia, so meeting this Mg target will require the allocation of significant resources. In this report the different approaches to adding Mg in post-treatment of the product water from the SWCC's network of desalination plants are reviewed in order to optimise the additional capital investment and ongoing operational expenses. The most cost-effective option is to mix produced water with groundwater containing Mg, but where this is not feasible the next most cost-effective method for achieving a 15 ppm target was assessed to be treating desalination brine with nanofiltration (NF) to generate a magnesium-rich brine fraction that can be mixed with produced water. A one-stage NF process can meet the 15 ppm Mg target only with levels of chloride and total dissolved solids exceeding regulatory maximums in the produced water, so a multi-stage NF process with intermediate dilution was designed. While this has a significantly higher capital expenditure and energy requirement than one-stage NF, at the cost of energy in the Kingdom of Saudi Arabia it is still significantly less expensive than alternative approaches (0.009 USD/m3). This solution was implemented at an SWCC desalination plant on the Red Sea and has been delivering Mg-enriched water (∼15 ppm) to approximately 1.3 million people since May 2022 at an estimated additional operational cost of 0.007 USD per m3. For lower target levels of Mg supplementation (∼5 ppm), replacement of limestone with dolomite in post-treatment limestone contactors has been found to be a cost-effective process in plant-scale trials at another SWCC plant on the Red Sea