Consolidating Medical Education in Sudan During War

Background: Providing quality medical education in Sudan faces challenges due to armed conflicts. This short communication explores practical solutions for ensuring the continuity of medical education during the conflict in the Sudanese context. Methods: A comprehensive literature review covered relevant articles published from 1915 to 2023. Four major databases (PubMed, Scopus, Web of Science, and Google Scholar) were searched using keywords related to medical education, war, armed conflict, and affected countries. Data synthesis identified common themes, challenges, and trends and suggested solutions for medical education in conflict zones. Case studies from Ukraine, Liberia, and Iraq were included for a comprehensive understanding. Results: Collaborative alliances among medical schools facilitate resource sharing and support. Engaging the Sudanese diaspora through virtual collaborations, mentorship programs, and faculty exchanges enhance educational experiences. Stable regions as educational hubs ensure uninterrupted academic progress for students from conflict-affected areas. Online and remote education, including asynchronous learning and social media platforms, overcome access barriers and fosters knowledge sharing. Ambulatory teaching provides practical experience and adaptability. Prioritizing faculty well-being and professional development through training and support is crucial. Emphasizing resilience and adaptability in student education prepare them for healthcare delivery in resource-limited settings. Research and innovation contribute to evidence-based strategies. International collaboration and support offer opportunities for knowledge exchange and infrastructure improvement. Conclusion: Implementing collaborative strategies and innovative approaches helps Sudanese medical schools overcome challenges during armed conflicts and maintain quality medical education. These solutions empower students and faculty, enhance resilience, and contribute to improving healthcare systems in post-war Sudan

The response of benthic foraminifer, ostracod and mollusc assemblages to environmental conditions: a case study from the Camalti Saltpan (Izmir-Western Turkey)

The subject of this report is benthic foraminifer populations preserved in the saltpan of Camalti in the Province of Izmir. High salinity in certain habitats of Ammonia tepida Cushman may be the primary cause of the high rate of twins and triplets as well as other morphological abnormalities recorded within this species (50 % as compared to an anomaly rate of 1 % in normal marine waters). Thicker cyst membrane developing in extremely saline environments may encourage twins and other morphological deformities by denying free movement of the offspring. Ecological factors such as heavy metal contamination of ambient waters as well as contamination by other wastes are also not ruled out as leading to such developmental anomalies. Of the 27 collected samples, Number 5 (that is closest to the sea) includes the typical marine foraminifers. Nonion depressulum (Walker & Jacob), Ammonia tepida Cushman and Porosononion subgronosum(Egger) are the dominant species in other samples. A total of 63 abnormal individuals (8 triplets, 24 twins, and 31 morphological anomalies) was found within seven of the 27 samples collected. Ten samples contained freshwater ostracods: Darwinula stevensoni(Brady and Robertson), Leptocythere lacertosa Hirschmann, Cyprideis torasa (Jones), Cyprideis (C.) anatolica Bassiouni, and Loxochoncha elliptica Brady. Among these samples (some of which contained only a few species of ostracods - and those limited in number of offspring), one had an unusually high ratio of healthy foraminifers vs those with anomalies. Worthy of note in another sample was a high abundance of molluscs. Among pelecypods, were found Ostrea edulis Linné, Lucinella divaricata (Linné), Pseudocama gryphina Lamarck,Cerastoderma edule (Linné), and Scrobicularia plana da Costa; and among gastropods were identified Hydrobi (Hydrobia) acuta(Draparnaud), Rissoa labiosa (Montagu), R. parva (da Costa), R. violacea Desmarest, Pirenella conica (Blainville), Bittium desayesi(Cerulli and Irelli), B. lacteum Philippi and B. reticulatum Philippi

Naso-Maxillary extramedullary plasmacytoma: A case report

We report an early case of extramedullary, right maxillary sinus and nasal, plasmacytoma. The patient was a 27 years old female who presented with nasal bleeding and a nasal mass. Imaging studies showed opacities in the nasal cavity and the maxillary sinus but there was no bone involvement.  A biopsy from the nasal mass showed a plasmacytoma. She was investigated to rule out systemic disease. The investigations included; serum electrophoresis, urine analysis for Bence Jones proteins, bone marrow aspirates study and radiological skeletal survey. The results of all investigations were negative. After complete excision of the tumour endoscopically the patient was treated with adjuvant radiotherapy. She remained well, without recurrence or spread of the tumour at 4 years follow up. CTscans pre and postoperatively as well as H&E and Immunohistochemistry slides are presented. To our knowledge, this is the first case to be reported in Sudan.                                                                   &nbsp

Seasonal Effect on Biomarkers of Exposure to Petroleum Hydrocarbons in the Coasts of North Western Suez Gulf, Egypt

Petroleum hydrocarbons of surface water were collected from eight locations of from the coasts of north western Suez Gulf, Egypt. The extracted petroleum hydrocarbons were determined by gas chromatography–flame ionization detector and quantified by integrating the areas of both the resolved and unresolved components. The results confirm that the concentration is relatively higher than the recommended in the regulations of the Egyptian low of Environment of No.4/1994 of petroleum products. At various locations, The dissolved petroleum hydrocarbons ranged from 5.639 to 74.8 and 1.868 to 65.698 mg/ml for summer and winter seasons, respectively. This indicates that chronic oil pollution, in addition to hydrocarbon concentrations, the diagnostic indices used shows that the hydrocarbons in the area were comes from biogenic, petrogenic and anthropogenic sources. FT-IR spectrometric analysis confirms the petrogenic nature of pollutants

Global wood fuel production estimates and implications

Global wood fuel production can indicate opportunities and also challenges in sustainable development, forest management, and energy access. Estimates of wood fuel removals and charcoal production are essential for tracking global goals yet reliable measurements are rare. We synthesize existing understanding through a mechanistic, conceptual model and build on it to develop statistical models from official statistics and over 2000 newly identified data points. For 2019, we estimate 2525.7 million m3 of wood fuel removals globally, approximately 30% higher than previously understood. Our estimates are 50% higher in Africa and 40% higher in Asia, 10% lower in the Americas and 20% lower in Europe. Global production of wood charcoal is estimated at 70.5 million tonnes, approximately 50% higher than previous values; our estimates are 20% higher in Africa and 200% higher in Asia. These estimates describe global shifts in wood fuel removals and charcoal production and improve our understanding of the forest sector; they will likely underlie global models used to forecast future trends

First-line ovulation induction for polycystic ovary syndrome : an individual participant data meta-analysis

Acknowledgements We would like to thank Mr M. Draper from Barr Smith Library, University of Adelaide, for his assistance in developing the search strategies and Dr M. H. Zafarmand from University of Amsterdam for assisting with the translation. We would like to acknowledge all the investigators and participants of the primary trials. The investigators of individual trials are listed in Supplementary Table SIV. We would like to acknowledge the assistance of NICHD, the Reproductive Medicine Network (RMN) and the Protocol Subcommittee, in making the database for PPCOS I and II available. +The authors of the Reproductive Medicine Network are R.S.L., R.G. Brzyski, M.P. Diamond, C. Coutifaris, W.D. Schlaff, P. Casson, G.M. Christman, H. Huang, Q. Yan, R. Alvero, D.J. Haisenleder, K.T. Barnhart, G.W. Bates, R. Usadi, S. Lucidi, V. Baker, J.C. Trussell, S.A. Krawetz, P. Snyder, D. Ohl, N. Santoro, H.X. Barnhart, B.R. Carr, S.A. Carson, M.P. Steinkampf, P.G. McGovern, N.A. Cataldo, G.G. Gosman, J.E. Nestler, L.C. Giudice, P.C. Leppert, E.R. Myers, E. Eisenberg and H. Zhang. The details of their affiliations and NIH Grants are listed in Supplementary Table SV. Funding An Australian government research training programme scholarship (to R.W.); Australian National Health and Medical Research Council-funded Centre for Research Excellence in Polycystic Ovary Syndrome (APP1078444). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.Peer reviewedPostprin

Hydrology in the Sea of Marmara during the last 23 ka : implications for timing of Black Sea connections and sapropel deposition

Author Posting. © American Geophysical Union, 2010. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Paleoceanography 25 (2010): PA1205, doi:10.1029/2009PA001735.Sediments deposited under lacustrine and marine conditions in the Sea of Marmara hold a Late Quaternary record for water exchange between the Black Sea and the Mediterranean Sea. Here we report a multiproxy data set based on oxygen and strontium isotope results obtained from carbonate shells, major and trace elements, and specific organic biomarker measurements, as well as a micropaleontological study from a 14C-dated sediment core retrieved from the Sea of Marmara. Pronounced changes occurred in δ18O and 87Sr/86Sr values at the fresh and marine water transition, providing additional information in relation to micropaleontological data. Organic biomarker concentrations documented the marine origin of the sapropelic layer while changes in n-alkane concentrations clearly indicated an enhanced contribution for organic matter of terrestrial origin before and after the event. When compared with the Black Sea record, the results suggest that the Black Sea was outflowing to the Sea of Marmara from the Last Glacial Maximum until the warmer Bølling-Allerød. The first marine incursion in the Sea of Marmara occurred at 14.7 cal ka B.P. However, salinification of the basin was gradual, indicating that Black Sea freshwaters were still contributing to the Marmara seawater budget. After the Younger Dryas (which is associated with a high input of organic matter of terrestrial origin) both basins were disconnected, resulting in a salinity increase in the Sea of Marmara. The deposition of organic-rich sapropel that followed was mainly related to enhanced primary productivity characterized by a reorganization of the phytoplankton population.We acknowledge support from INSU and the French Polar Institute IPEV

Characterization of the association between 8q24 and colon cancer: gene-environment exploration and meta-analysis

<p>Abstract</p> <p>Background</p> <p>Genome-wide association studies and subsequent replication studies have shown that single nucleotide polymorphisms (SNPs) in the chromosomal region 8q24 are associated with colorectal cancer susceptibility.</p> <p>Methods</p> <p>We examined 11 SNP markers in the 8q24 region between 128.47 and 128.54 Mb, using a total of 1,987 colon cases and 2,339 controls who self-reported as white from two independent, well-characterized study populations. Analysis was performed separately within each study, and combined using random effects meta-analysis. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) and to test for effect modification by known colon cancer risk factors. We also performed a meta-analysis combining our results with previous studies.</p> <p>Results</p> <p>We observed evidence of association for four SNPs in low to high linkage disequilibrium (r²ranging from 0.18 to 0.93) localized in a 16.2 kb region defined by rs10505477 and rs1056368. The combined results for our two studies of colon cancer showed an OR of 1.10 (95% CI: 1.01-1.20, P_trend= 0.023), and a meta-analysis of our results with previously reported studies of colon and colorectal cancer strongly support the association for this SNP (combined OR for rs6983267 = 1.21, 95% CI: 1.18-1.24, p = 5.5 × 10^-44). We did not observe any notable evidence of effect modification by known colon cancer risk factors, and risk did not differ significantly by tumor site or stage.</p> <p>Conclusions</p> <p>Our study confirms the association between polymorphisms on chromosome 8q24 and colon cancer risk and suggests that the susceptibility locus in region 8q24 is not strongly modified by various lifestyle, environmental, and demographic risk factors for colon cancer.</p

Prevalence and etiology of community-acquired pneumonia in immunocompromised patients

Background. The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. Methods. We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. Results. At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CAP) pathogens were the most frequently identified, and prevalences did not differ from those in immunocompetent patients. Risk factors for immunocompromise were independently associated with neither Pseudomonas aeruginosa nor non\u2013community-acquired bacteria. Specific risk factors were independently associated with fungal infections (odds ratio for AIDS and hematological cancer, 15.10 and 4.65, respectively; both P = .001), mycobacterial infections (AIDS; P = .006), and viral infections other than influenza (hematological cancer, 5.49; P < .001). Conclusions. Our findings could be considered by clinicians in prescribing empiric antibiotic therapy for CAP in immunocompromised patients. Patients with AIDS and hematological cancer admitted with CAP may have higher prevalences of fungi, mycobacteria, and noninfluenza viruses