Shendi University is a public university that was established in 1994, located in Shendi, Sudan.It is a member of the Federation of the Universities of the Islamic World.
BackgroundEmapalumab, an interferon-γ (interferon-gamma)–blocking monoclonal antibody, has emerged as a targeted therapy for refractory hemophagocytic lymphohistiocytosis (HLH). This scoping review summarizes real-world evidence of its clinical use across HLH subtypes.MethodsA comprehensive search of PubMed, Scopus, and Web of Science through September 2025 identified studies reporting emapalumab use outside clinical trials. Case reports, series, and observational studies describing clinical outcomes were included.ResultsThirty-one publications comprising 86 patients were analyzed. Disease contexts included familial/genetic HLH (n = 11), rheumatology-associated macrophage activation syndrome (MAS; n = 12), malignancy-associated HLH (n = 25), infection-associated HLH (n = 22), CAR-T/IEC-HS or cytokine-release-syndrome–related HLH (chimeric antigen receptor T-cell/immune effector cell–associated hemophagocytic syndrome; n = 11), and other secondary HLH (n = 5). Across all categories, emapalumab achieved rapid suppression of hyperinflammation, typically within 1–2 weeks. Clinical response rates were 100% in familial HLH, 91.7% in rheumatology-associated MAS, 72.7% in infection-associated HLH, 90.9% in CAR-T/IEC-HS–related HLH, and 80% in other secondary HLH. In contrast, only 6 of 25 patients with malignancy-associated HLH (24%) showed partial or complete responses, reflecting inferior outcomes due to underlying disease progression. Overall survival was highest in familial and infection-associated subgroups. The reported adverse events were generally infrequent and mild in the published cases, but causality cannot be reliably established given the complexity of the underlying disease and concurrent therapies.ConclusionReal-world evidence demonstrates that emapalumab induces rapid and durable disease control across diverse HLH subtypes, with a favorable tolerability profile. However, outcomes remain markedly inferior in malignancy-associated HLH, where response rates are limited to approximately 24%, primarily due to the impact of underlying malignancy. Its role as rescue or bridging therapy to hematopoietic stem-cell transplantation (HSCT) is increasingly supported in both pediatric and adult populations.
A new series of pyrazolo[3,4-d]pyrimidine scaffolds, namely, 4a-l, were designed, synthesized, and tested for anti-inflammatory and anti-proliferative activities. Compounds 4f and 4g displayed advanced COX-2 selectivity (SI = 4.95 and 16.22) in comparison to celecoxib (SI = 7.61). In addition, all compounds were evaluated for their cytotoxic activity against three cancer cells using a reference drug (staurosporine). Compounds 4f and 4g showed the most potent anti-proliferative activity against MCF-7 (IC50 = 0.259 and 0.292 µM, respectively), MDA-MB-231 (IC50 = 0.258 and 0.327 µM, respectively), and Caco-2 (IC50 = 0.228 and 0.178 µM, respectively) cell lines and were more potent than staurosporine (IC50 = 0.401, 0.411, and 0.224 µM, respectively). Moreover, both derivatives were less toxic with comparable selectivity to the normal breast cell line (MCF-10) (SI values of 1.13-4.43) compared to staurosporine (SI values of 1.10-2.02). Further assessment of the CDK2 inhibitory activity of the most cytotoxic candidates 4f and 4g revealed their higher potency (IC50 = 0.324 and 0.215 µM, respectively) than that of the reference drug ribociclib (IC50 = 0.496 µM). Additionally, compound 4g revealed cell cycle arrest at the G2/M phase in Caco-2 cells, resulting in cell apoptosis. Furthermore, molecular docking and dynamics simulations revealed that derivatives 4f and 4g form stable and tighter complexes with the CDK2 kinase domain, as confirmed by their lower RMSD values, superior interaction stability, and stronger hinge and catalytic site binding. Finally, ADME profiling demonstrated that compound 4f satisfies all major drug-likeness criteria without any violations, while compound 4g fully adheres to the Veber's, Lipinski's, Egan's, and Ghose's drug-likeness guidelines. Consequently, these compounds represent promising starting candidates for the development of future CDK2 kinase and COX-2 inhibitors.
Ephedra foeminea Forssk., an East Mediterranean shrub with numerous traditional medicinal applications, represents an abundant source of bioactive phytochemicals. As a non-ephedrine Ephedra species lacking a dominant alkaloid marker, E. foeminea cannot be standardized by monitoring a single compound, thereby necessitating a multi-response extraction strategy. This study aimed to optimize ultrasonic-assisted extraction (UAE) conditions to maximize extraction yield (Y%), total phenolic content (TPC), and radical scavenging activity (RSA%) from E. foeminea aerial parts. Extraction conditions were structured using a circumscribed central composite design (CCCD) to evaluate the interactive effects of extraction volume, ethanol percentage, sonication time, and temperature. The CCCD-generated data were modeled using response surface methodology (RSM), yielding robust quadratic predictive models with non-significant lack-of-fit (p > 0.05). The selected extraction conditions resulted in a yield of 11.93 ± 0.09%, a TPC of 3.06 ± 0.06 mg GAE/g, and an RSA% of 90.63 ± 1.08%. Principal component analysis (PCA), applied post hoc, revealed a strong positive correlation between TPC and antioxidant activity. Furthermore, HPLC-DAD validation confirmed enrichment of key polyphenolic compounds under the selected conditions, identifying gallic acid as the most abundant (0.82 mg/g). Overall, this study establishes a statistically validated and reproducible green extraction framework for this phytochemically complex species. The findings highlight the potential for the valorization of Ephedra foeminea, provide guidance for similar multi-response extraction strategies in other plant species, and support further investigation of its phytochemical composition toward future large-scale extraction applications.
Medical students face a significant burden of depressive symptoms and social isolation, particularly in conflict-affected regions like Sudan, where access to formal mental health services is severely restricted. While AI chatbots are increasingly adopted for academic and emotional assistance, their relationship with psychological outcomes in such unstable, resource-constrained environments remains poorly characterized. This study aimed to evaluate the association between conversational AI utilization, depressive symptoms, and social isolation among Sudanese medical students to guide evidence-based policy and the responsible development of digital support tools. A large-scale, cross-sectional survey was conducted between November 2025 and March 2026. Data were collected from 2,507 medical students using validated instruments, including the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Revised UCLA Loneliness Scale-6 (RULS-6) for social isolation. Structured questionnaires assessed sociodemographic characteristics, chatbot usage patterns, and perceived psychological benefits. Chatbot adoption was nearly universal, with 41.9
Breast cancer (BC) remains the leading cause of cancer-related mortality and a major contributor to disease burden among women worldwide. Although PD‑1/PD‑L1‑targeting immune checkpoint inhibitors have become a standard treatment for certain triple‑negative breast cancer subgroups, their use across the broaderBCb population is limited by intrinsic resistance, an immunosuppressive tumor microenvironment (TME), and treatment‑related adverse effects. The present review offers a comprehensive synthesis of the immunotherapeutic paradigm in BC, spanning ICIs, adoptive cellular therapies (CAR-T, CAR-NK, CAR-M, TIL, TCR-T, and CIK cells), and emerging immune modulators. We critically evaluate pivotal clinical trials, discuss cross-cutting challenges—including biomarker development, therapy resistance, and the practical limitations of cellular products—and highlight rational combinatorial strategies. By contrasting the translational readiness of diverse modalities and outlining a framework for personalized therapy, this review aims to inform future research and clinical practice in harnessing immunity against BC.
