Adjustment Policies and the Current Account Balance: Empirical Evidence from Sudan

The paper seeks to assess the impact of adjustment reforms on Sudan taking the current account balance as policy performance indicator. The paper shows that the government own reforms were more effective than those imposed by the IMF or the World Bank. It further illustrates that both policy and non-factors are responsible to the same degree in deriving current account deficit in the long run specifically inefficiency in exchange rate policy and structural and demographic factors.Political Economy,

The need for UN climate change policy reformation

This paper endeavours to understand the climate change phenomenon and identify measures taken to contain it. It discusses global warming causes and consequences and assesses effectiveness of the United Nations (UN) polices following failure of the Kyoto Protocol to reduce greenhouse gas emissions. In pursuing this course of action, this paper utilizes data collected from East Africa region. Key issues discussed in the paper include findings of the Intergovernmental Panel on Climate Change and the role of urbanization in global warming as cities emit most of greenhouse gases. Special reference is made to developing cities which are growing extremely fast and will consume more energy in future. They are becoming economic engines and adopting industrialization as an economic model while developed cities are experiencing de-industrialization. Developing cities have neither the ability to adopt green technology nor the capacity to establish large capacity public transport systems to reduce carbon dioxide (CO2) emissions. It is evident that UN efforts to combat climate change are not effective because past experience shows that CO2 generation cuts weren’t near enough. The recent Paris Agreement may restore a faith in UN process if implemented but doesn’t reduce temperatures as needed unless all drivers of climate variability are considered, particularly the abortive role of developing cities. The UN Programme appears to be focusing on attaining urban resilience rather than targeting grassroots causes. Urbane-bias global policies drive the rural population to leave their land and flood cities while over-usage of natural resources by the rich is left unchecked. A new UN strategy making the countryside a more appealing place to live in and work whilst normalising urban growth is needed as well as mobilizing local leaders who enjoy more autonomy to enact regulations. It should also alleviate poverty, deter excessive practices and put science and technology under community control

How bad is bile acid diarrhoea: an online survey of patient-reported symptoms and outcomes.

OBJECTIVES: Bile acid diarrhoea (BAD) is an underdiagnosed condition producing diarrhoea, urgency and fear of faecal incontinence. How patients experience these symptoms has not previously been studied. Bile Acid Malabsorption (BAM) Support UK was established in 2015 as a national charity with objectives including to provide details regarding how BAD affects patients, to improve earlier recognition and clinical management. DESIGN SETTING AND MAIN OUTCOME: A questionnaire was collected anonymously by BAM Support UK and the Bile Salt Malabsorption Facebook group over 4 weeks at the end of 2015. It comprised 56 questions and aimed to inform patients and clinicians about how BAD affects the respondents. RESULTS: The first 100 responses were analysed. 91% of the respondents reported a diagnosis of BAD. 58% of total respondents diagnosed following a Selenium-homocholic acid taurine scan, 69% were diagnosed by a gastroenterologist, with type 2 and 3 BAD comprising 38% and 37%, respectively, of total respondents. Symptoms had been experienced for more than 5 years before diagnosis in 44% of respondents. Following treatment, usually with bile acid sequestrants, 60% of participants reported improvement of diarrhoea and most reported their mental health has been positively impacted. Just over half of the cohort felt as though their symptoms had been dismissed during clinical consultations and 28% felt their GPs were unaware of BAD. CONCLUSIONS: BAD requires more recognition by clinicians to address the current delays in diagnosis. Treatment improves physical and mental symptoms in the majority of participants

Revitalization of Greater Khartoum Urban Transportation System

Khartoum metropolis depends on a single-modal transport – vehicular road system. Mass transport modes are completely absent making Khartoum unable to meet citizens’ mobility demand. Thus passengers facing long time delays in transport stations. Slow traffic speeds and severe traffic jams result in long trip periods, high traffic accidents rates and high suspended particulate concentrations accumulating in the air. This situation is attributed to: Use of small-sized vehicles running on limited paved road network. • Adoption of extensive grid iron planning patterns lacking multi-grade intersections. • Eroded public transport fleet and extremely overcrowded urban centres. Negligence of public transport systems integration into landuse plans and urban structure restructuring difficulty crippled public transport revitalisation for no space is left for mass transport infrastructure construction. Moreover, transport systems’ operation mismanagement and focus on economic development increased pressure on transport systems. This paper endeavours to point out the deficiencies in public transport services and proposes the areas of reformation. To revitalize urban transport, Khartoum main transport infrastructures must be efficiently operated by establishment of a talented transport authority supported by strong legislations and popular authorization and able to adopt sustainable mobility solutions to meet current and future traffic demands by: Rehabilitating and expanding the existing infrastructures. • Deploying large-capacity multimodal transport systems including river transport, bus rapid transit systems, tramways and metropolitan railways to connect Khartoum polycentric and its sprawling outward growth. • Mitigating environmental pollution and enforcing stringent road safety measures. • Reviewing traffic laws to tighten traffic regulations and control traffic flows. Investment priority should be given to river transport. It is economically feasible, has large carrying capacity and safe and almost accident free. Furthermore, Nile Rivers dominate the metropolis, dictate urban configuration, direct urban growth, impose urban expansions patterns and influence spatial organization

Exploration of urine and plasma biomarkers in liver fibrosis and hepatocellular carcinoma

Liver fibrosis is a major risk factor for development of hepatocellular carcinoma. Both liver fibrosis and hepatocellular carcinoma are associated with molecular pathogenic mechanisms involving alterations in the hepatocellular proteome, metabolome, and genome. Both liver fibrosis and hepatocellular carcinoma lack suitable biological predictive biomarkers in clinical practice. Therefore, to aid in identifying suitable biomarkers, three approaches were employed in patients with liver fibrosis and hepatocellular carcinoma. Firstly, proteomic analysis was applied to identify post-translational enzymatic protein modifications peripherally present in the urine. Secondly, metabolic profiling was applied to characterise small volatile organic compounds present in the urine. Thirdly, DNA methylation detection technology was applied, to identify methylated SEPTIN9 patterns among the circulating hepatocellular carcinoma DNA molecules within the cell-free DNA pool present peripherally in the plasma. Urinary proteomic analysis identified novel specific peptides for liver fibrosis and hepatocellular carcinoma. Additionally, proteases potentially involved in liver fibrosis and hepatocellular carcinoma were predicted from the peptides sequence with further demonstration of these proteases by immunohistochemistry in human normal liver tissue, liver fibrosis and hepatocellular carcinoma. The identified urinary peptides showed good diagnostic and prognostic performance in liver fibrosis and hepatocellular carcinoma. Urinary metabolic profiling technologies demonstrated that volatile organic compounds patterns can be used noninvasively to detect hepatocellular carcinoma and they also revealed chemical composition of novel volatile organic compounds related to liver fibrosis and hepatocellular carcinoma. DNA methylation analysis showed that methylated SEPTIN9 has good sensitivity and specificity for hepatocellular carcinoma. It was also a prognostic indicator in patients with liver disease and hepatocellular carcinoma. The methylated SEPTIN9 was also associated with other surrogate biomarkers for liver function, liver fibrosis and inflammation. Additionally, methylated SEPTIN9 was noted to incrementally increase in various stages of liver disease. The researched biomarkers in this work provided some insight into the pathogenic mechanisms of liver fibrosis and hepatocellular carcinoma. If further validated, the identified biomarkers in this work could offer cost-effective tools for screening, diagnosis, prognosis and/or surveillance, particularly in low resource settings where access to advanced imaging and invasive biopsy is not feasible

Exploratory study using urinary volatile organic compounds for the detection of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) biomarkers are lacking in clinical practice. We therefore explored the pattern and composition of urinary volatile organic compounds (VOCs) in HCC patients. This was done in order to assess the feasibility of a potential non-invasive test for HCC, and to enhance our understanding of the disease. This pilot study recruited 58 participants, of whom 20 were HCC cases and 38 were non-HCC cases. The non-HCC cases included healthy individuals and patients with various stages of non-alcoholic fatty liver disease (NAFLD), including those with and without fibrosis. Urine was analysed using gas chromatography–ion mobility spectrometry (GC–IMS) and gas chromatography–time-of-flight mass spectrometry (GC–TOF-MS). GC–IMS was able to separate HCC from fibrotic cases with an area under the curve (AUC) of 0.97 (0.91–1.00), and from non-fibrotic cases with an AUC of 0.62 (0.48–0.76). For GC-TOF-MS, a subset of samples was analysed in which seven chemicals were identified and tentatively linked with HCC. These include 4-methyl-2,4-bis(p-hydroxyphenyl)pent-1-ene (2TMS derivative), 2-butanone, 2-hexanone, benzene, 1-ethyl-2-methyl-, 3-butene-1,2-diol, 1-(2-furanyl)-, bicyclo(4.1.0)heptane, 3,7,7-trimethyl-, [1S-(1a,3β,6a)]-, and sulpiride. Urinary VOC analysis using both GC–IMS and GC-TOF-MS proved to be a feasible method of identifying HCC cases, and was also able to enhance our understanding of HCC pathogenesis

Non-invasive detection and staging of colorectal cancer using a portable electronic nose

Electronic noses (e-nose) offer potential for the detection of cancer in its early stages. The ability to analyse samples in real time, at a low cost, applying easy–to-use and portable equipment, gives e-noses advantages over other technologies, such as Gas Chromatography-Mass Spectrometry (GC-MS). For diseases such as cancer with a high mortality, a technology that can provide fast results for use in routine clinical applications is important. Colorectal cancer (CRC) is among the highest occurring cancers and has high mortality rates, if diagnosed late. In our study, we investigated the use of portable electronic nose (PEN3), with further analysis using GC-TOF-MS, for the analysis of gases and volatile organic compounds (VOCs) to profile the urinary metabolome of colorectal cancer. We also compared the different cancer stages with non-cancers using the PEN3 and GC-TOF-MS. Results obtained from PEN3, and GC-TOF-MS demonstrated high accuracy for the separation of CRC and non-cancer. PEN3 separated CRC from non-cancerous group with 0.81 AUC (Area Under the Curve). We used data from GC-TOF-MS to obtain a VOC profile for CRC, which identified 23 potential biomarker VOCs for CRC. Thus, the PEN3 and GC-TOF-MS were found to successfully separate the cancer group from the non-cancer group

Application of Knowledge Management in The Sudanese Universities: An Analytical Study

Knowledge management (KM) is becoming a very important issue in higher education, which drives the ability to collect and analyze information, transform knowledge and apply novelties. Therefore, this paper aimed at introducing a framework of thoughts for applying knowledge management in the Sudanese universities, depending on the analysis of the theoretical studies and the available literature related to the topic. In doing so, the researchers followed a qualitative and analytical type of research. To collect data, previous studies and papers, especially those related to higher education institutions are reviewed. The paper covered the basic concepts, definitions, justifications, and domains, besides the application of (KM) in the Sudanese universities. The main factors that can help in relieving difficulties facing (KM) are also discussed. The paper concluded that Sudanese Universities are considered the most suitable institutions to apply (KM), as they have a strong infrastructure that is favorable to the production and application of knowledge through the venues of investment in scientific research. The paper recommended the utmost necessity of adopting (KM) in the Sudanese universities as an approach to developing the individual and the official administrative to improve the level of outputs and to increase its capacity to adapt to all the prevalent changes and challenges. The use of knowledge management, according to this paper's inference, promotes staff members to advance both themselves and their universities by using this information to scientific research and studies

Percutaneous endoscopic colostomy: a useful technique when surgery is not an option

Percutaneous endoscopic colostomy (PEC) is a minimally invasive endoscopic procedure that offers an alternative treatment for high-risk patients with sigmoid volvulus or intestinal pseudoobstruction who have tried conventional treatment options without success or those who are unfit for surgery. The procedure acts as an irrigation or decompressing channel and provides colonic 'fixation' to the anterior abdominal wall. The risk of complications highlights the importance of informed consent for patients and relatives

Pathophysiological implications of urinary peptides in hepatocellular carcinoma

SIMPLE SUMMARY: In this study, the application of capillary electrophoresis mass spectrometry enabled identification of 31 urinary peptides significantly associated with hepatocellular carcinoma diagnosis and prognosis. Further assessment of these peptides lead to prediction of cellular proteases involved in their development namely Meprin A subunit α and Kallikrein-6. Subsequent identification of the proteases was verified by immunohistochemistry in normal liver, cirrhosis and hepatocellular carcinoma. Histopathological assessment of the proteases revealed numerical gradient staining signifying their involvement in liver fibrosis and hepatocellular carcinoma formation. The discovered urinary peptides offered a potential noninvasive tool for diagnosis and prognosis of hepatocellular carcinoma. ABSTRACT: Hepatocellular carcinoma (HCC) is known to be associated with protein alterations and extracellular fibrous deposition. We investigated the urinary proteomic profiles of HCC patients in this prospective cross sectional multicentre study. 195 patients were recruited from the UK (Coventry) and Germany (Hannover) between 1 January 2013 and 30 June 2019. Out of these, 57 were HCC patients with a background of liver cirrhosis (LC) and 138 were non-HCC controls; 72 patients with LC, 57 with non-cirrhotic liver disease and 9 with normal liver function. Analysis of the urine samples was performed by capillary electrophoresis (CE) coupled to mass spectrometry (MS). Peptide sequences were obtained and 31 specific peptide markers for HCC were identified and further integrated into a multivariate classification model. The peptide model demonstrated 79.5% sensitivity and 85.1% specificity (95% CI: 0.81–0.93, p < 0.0001) for HCC and 4.1-fold increased risk of death (95% CI: 1.7–9.8, p = 0.0005). Proteases potentially involved in HCC progression were mapped to the N- and C-terminal sequence motifs of the CE-MS peptide markers. In silico protease prediction revealed that kallikrein-6 (KLK6) elicits increased activity, whilst Meprin A subunit α (MEP1A) has reduced activity in HCC compared to the controls. Tissue expression of KLK6 and MEP1A was subsequently verified by immunohistochemistry