University of Gezira, or U of G, is a public university located in Wad Medani, Sudan.It is a member of the Federation of the Universities of the Islamic World.
Pancreatic cancer remains one of the most lethal malignancies globally. In Africa, the burden is poorly characterized due to fragmented data and limited resources. This scoping review aimed to map published data on pancreatic cancer across the continent, identify reporting gaps, and highlight implications for research and policy. A systematic search was conducted across PubMed, OVID Medline, CINAHL, ERIC, and Scopus for articles published between January 1995 and June 2025. Inclusion criteria focused on clinical data, treatment modalities, and survival outcomes of pancreatic cancer in African populations. Twenty studies spanning 1995–2023,representing 26,850 patients, were identified. Research output was geographically uneven, concentrated in South Africa, Egypt, Morocco. The weighted mean age at diagnosis was 59.2 years. Primary symptoms included Jaundice, abdominal pain, and weight loss. Advanced-stage presentation dominated, with stage III–IV accounting for > 70
Hydrogen is increasingly recognized as a promising carbon-free fuel for internal combustion engines (ICEs) due to its high diffusivity, wide flammability range, and fast flame speed, which together enable efficient and clean combustion. It represents a critical pathway toward achieving the 60-80% greenhouse gas (GHG) reduction targets by 2050. This review assesses the role of hydrogen enrichment in both compression-ignition (CI) and spark-ignition (SI) engines, with emphasis on performance, emissions, and mitigation strategies. In heavy-duty diesel-biodiesel CI dual-fuel engines, moderate hydrogen enrichment (similar to 10-30% hydrogen energy share, HES) increases in-cylinder pressure and heat release by 5-15%, improves brake thermal efficiency (BTE) by 4-10%, and reduces brake-specific fuel consumption (BSFC) by 5-12%, while lowering CO2 (up to 40%), CO (up to 65%), and soot (up to 58). However, NOx emissions can rise significantly at higher substitution levels. A near-zero carbon pathway is demonstrated with ammonia-hydrogen-diesel-biodiesel pilot strategies, where 30% H-2 with ammonia ensures stable ignition and low carbon intensity. In gasoline-alcohol SI engines, hydrogen enrichment improves combustion stability and efficiency, reducing cyclic variation by up to 60%, raising indicated thermal efficiency (ITE) by approximate to 13%, and lowering fuel consumption by approximate to 15%. Emissions improve markedly, with reductions of 33% in CO2, 60% in CO, and 60% in HC, although NOx increases by up to 60%. For hydrogen-ammonia SI operation, efficiency improvements reach approximate to 36%, as hydrogen accelerates ignition and shortens combustion duration. Advanced approaches such as stratified fueling and pre-chamber turbulent jet ignition (TJI) reduce NH3 slip by up to 99%, enhance flame propagation, and support stable lean operation. Nonetheless, NOx emissions increase by 70%, requiring effective countermeasures such as optimized injection phasing, spark retard, lean boosting, and selective catalytic reduction (SCR). Overall, hydrogen enrichment across CI and SI engines delivers significant efficiency gains and sharp reductions in carbonaceous emissions, but the control of NOx emissions remains the central challenge. Mitigation strategies including EGR, stratified fueling, water injection, and advanced ignition control are essential to unlock hydrogen's full potential as a pathway to sustainable zero-carbon ICE operation.
Armed conflicts pose severe challenges to healthcare workforce pipelines, with specialized surgical training being particularly vulnerable. The war in Sudan, which began in April 2023, has led to a complex humanitarian crisis, damaging health infrastructure and displacing medical professionals. The impact on postgraduate urological surgical training requires detailed assessment. A national, descriptive quantitative cross-sectional study was conducted from September to December 2024. A structured online questionnaire was distributed to the complete national cohort of urology specialty trainees (n = 40, 100
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.
Cancer care in conflict-affected settings represents a growing yet underrecognized global health crisis, disproportionately affecting populations in low- and middle-income countries, particularly in Africa. With over 130 million people forcibly displaced worldwide, conflict-driven disruptions to health systems have created profound gaps across the cancer care continuum, from prevention and diagnosis to treatment and palliative care. In these settings, cancer is often deprioritized in favor of acute and communicable diseases, resulting in delayed diagnosis, treatment interruptions, and poor outcomes. This review examines the impact of conflict on cancer care delivery, highlighting structural disruptions, including infrastructure destruction, workforce displacement, and supply chain collapse. Drawing on case studies from Sudan, Somalia, Burkina Faso, and Kenya, it presents exploratory, field-informed strategies to sustain care. In Sudan, telehealth, primarily through WhatsApp and mobile communication, has enabled continuity of care, real-time triage, and cross-border clinical collaboration despite severe connectivity challenges, supported by emerging hybrid digital platforms. In Burkina Faso, the collapse of surgical oncology capacity has led to predominantly late-stage, palliative interventions; however, adaptive responses such as mobile clinics, tele-oncology, and decentralized service delivery have partially mitigated these gaps. The manuscript further emphasizes the potential role of mobile oncology units in delivering cancer medicines, basic surgical care, and palliative services, alongside context-adapted training for health care workers in crisis settings. It highlights the need for coordinated safe cross-border referral systems, interoperable digital health platforms, and the establishment of safe humanitarian corridors for patient transfer. Addressing cancer care in conflict settings requires integrating oncology into humanitarian responses, strengthening decentralized and resilient systems, and fostering regional collaboration to ensure equitable access for vulnerable populations.
