Journals
2025 EN
Rasheed Faiza · Kayani Waqas Khan · Asghar Muhammad Usama
+4 more
Abstract Global solid waste generation is expected to double by 2050 from the present annual level of 2.01 metric ton. Traditional biowaste treatment methods, such as landfilling and incineration, cannot meet the need to deal with gigantic amounts of waste and reduce environmental harm. This review critically evaluates existing sustainable waste management strategies highlighting their role in transitioning to a “reuse and recovery” paradigm. Sustainable waste management refers to conserving resources and protecting human health, society, and the environment. In this context, this review examines the current advancements and potential trends in using widely available biowaste in novel applications to produce key biofuels (such as biogas and biodiesel) and resources such as corrosion inhibitors, asbestos‐free brake pads, nutrient‐rich functional foods, bio‐cement, bio‐based fertilizer, and biodegradable plastic. Among these, biowaste‐to‐energy conversion (e.g., biogas production) and biodegradable plastic synthesis emerge as particularly impactful strategies due to their scalability and potential to address both waste reduction and resource recovery goals. The strategic utilization of biowaste resources into novel products holds significant promise in mitigating sustainability problems, offering renewable alternatives that are biodegradable and free of harmful additives.
Journals
2025 EN
Yamaguchi Shukuro · Miyamoto Kazutaka · Jones Xaviar M.
+11 more
ABSTRACT All approved RNA therapeutics require parenteral delivery. Here, we demonstrate an orally bioavailable formulation wherein synthetic noncoding (nc) RNA, packaged into lipid nanoparticles, is loaded into casein‐chitosan (C2) micelles. We used the C2 formulation to deliver TY1, a 24‐nucleotide synthetic ncRNA, which targets DNA damage and attenuates inflammation in macrophages. C2‐formulated TY1 (TY1 C2 ) efficiently packages and protects TY1 against degradative enzymes. In healthy mice, oral TY1 C2 was well‐tolerated and nontoxic. Oral TY1 C2 exhibited disease‐modifying bioactivity in two models of tissue injury: (1) rat myocardial infarction, where a single oral dose of TY1 C2 was cardioprotective, on par with intravenously‐delivered TY1; and (2) mouse acute lung injury, where a single dose of TY1 C2 attenuated pulmonary inflammation. Mechanistic dissection revealed that TY1 C2 is taken up by intestinal macrophages, namely those of the lamina propria and Peyer's patches. Afterwards, TY1 could be detected in circulating monocytes for up to 72 h post‐ingestion. Unlike TY1, which acts on macrophages, an antisense oligonucleotide against Factor VII, which acts on hepatocytes, is not effective when administered in the C2 formulation. Thus, not all ncRNA drugs are bioactive when delivered by mouth. Oral delivery of macrophage‐active RNA opens up a wide range of potential new therapeutic opportunities.
Journals
2025 EN
Alkan Bulbul Gul · Kirtis Emine · Kandemir Hulya
+4 more
Abstract The purpose of this study was to assess the additional contribution of karyotyping compared with genome‐wide non‐invasive prenatal testing (NIPT) for pregnancies at intermediate risk for trisomy 21 (T21), calculated using the maternal serum screening without major structural anomalies detected through sonography. Karyotype results of all pregnancies undergoing invasive prenatal diagnostic testing between January 2013 and March 2022 were obtained from a large hospital‐based laboratory. Pregnancies with no major structural anomalies on ultrasound (including soft markers) and an intermediate risk for T21 on maternal serum screening were included in this study. The additional contribution of karyotyping for abnormal karyotype results was calculated after excluding results that could theoretically be identified with genome‐wide NIPT. Among the 511 pregnancies analyzed, 13 (2.54%) were found to have abnormal karyotype results, 9 (1.76%) of which could theoretically have been detected with genome‐wide NIPT. Within the cohort, 6/263 (2.28%) of women aged 35 years and older, and 3/248 (1.20%) of women younger than 35 years had results that could have been detected with genome‐wide NIPT. After excluding results detectable using genome‐wide NIPT, the additional contribution of karyotyping was found as 4/502 (0.79%) for the entire cohort, 2/257 (0.77%) for women aged 35 years and older, 2/245 (0.81%) for women younger than 35 years. Of the 511 examined pregnancies at intermediate risk for T21 by maternal serum screening, genome‐wide NIPT would have failed to detect 4 of 13 abnormal karyotype results. The findings hold importance in guiding couples' informed decision‐making processes regarding their choice of genetic screening and diagnostic testing in case of intermediate risk for T21.
Journals
2025 EN
Hodrob Tamer · Abusalameh Alaaeddin · Ismail Ibrahim
+6 more
Abstract Preconception care (PCC), particularly genetic testing, is essential for improving reproductive health outcomes in high‐risk families, including those with consanguineous marriages. Whole‐exome sequencing (WES) has shown promise in identifying autosomal recessive disorders, yet its use in preconception screening (PCS) has not been extensively studied in regions with high consanguinity, such as Palestine. This retrospective cross‐sectional study aimed to assess the diagnostic yield of WES in identifying autosomal recessive genetic disorders in consanguineous Palestinian couples, particularly those with previously undiagnosed conditions. Forty consanguineous couples were recruited from outpatient genetic clinics across Palestine between 2021 and 2024. Recruitment was conducted through referrals from primary care physicians due to a history of consanguinity, recurrent pregnancy losses or a relative with confirmed or suspected genetic disorder. The results revealed that 72.5% (29/40, 95% CI: 56.1%–85.4%) of couples carried pathogenic/likely pathogenic (P/LP) variants, with 86.2% (25/29, 95% CI: 68.3%–96.1%) being carriers of autosomal recessive conditions not previously identified within their families. Of those with positive results, 48.3% (14/29, 95% CI: 29.4%–67.5%) carried more than one P/LP variant. Incidental or secondary findings (ISFs) were observed in 7.5% (3/40, 95% CI: 1.6%–20.4%) of the couples. These findings emphasize the value of WES as a comprehensive genetic screening tool, particularly in populations with high consanguinity, and its potential to enhance preconception care and reduce the burden of genetic disorders.
Journals
2025 EN
Nziku Eliada B. · Mkwizu Elifuraha W. · Sadiq Abid M.
+9 more
ABSTRACT Aims Due to the expensiveness and unavailability of endoscopy management in Tanzania, the management outcomes of variceal bleeding are unknown. The objective of this study was to assess the management outcomes of patients with variceal bleeding. Methods This was a retrospective study conducted between April 2012 and April 2022. The study enrolled all patients diagnosed with variceal bleeding aged 18 years and older. Socio‐demographic and clinic characteristics, treatment modalities, and outcomes were collected. Statistical analysis was done using a chi‐square test. Multivariable logistic regression was used to determine factors associated with rebleeding and mortality. A p ‐value of ≤ 0.05 was considered statistically significant. Results A total of 534 patients were enrolled based on diagnostic endoscopy findings. Esophageal varices were identified in 88.9% of patients, gastric varices in 0.9%, and 10.1% had both. Conservative treatment was given to 77.5% of patients, and endoscopic treatment was performed in 22.5%: endoscopic variceal ligation (17.6%), endoscopic injection sclerotherapy (4.3%), and both (0.6%). Rebleeding occurred in 40.1%, and factors associated with rebleeding were patients without insurance ( p = 0.037), without comorbidities ( p = 0.042), with non‐communicable diseases ( p = 0.039), and with chronic infections ( p = 0.035). In‐hospital mortality was 8.1%, and factors associated with mortality were a shorter length of stay ( p = 0.045), patients without comorbidities ( p = 0.041), and grade II esophageal varices ( p = 0.043). Conclusion This study shows a high rate of variceal bleeding among patients treated conservatively. Mortality and rebleeding rates in our setting remain high, which appears to be due to the expensiveness and unavailability of endoscopic treatment. Available endoscopic interventions will be vital in improving the outcomes of patients with variceal bleeding.
Wiley Publishing Asia Pty Ltd
Journals
2025 EN
Zafar Yousaf · Sohail Muhammad Umer · Ibrahim Zainab Siddiqua
+10 more
ABSTRACT Background Walled‐off necrosis (WON) is a potentially fatal condition best treated endoscopically with metal or plastic stents. This study compares the clinical outcomes of these stents. Methods PubMed and Cochrane were searched for trials comparing metal and plastic stents for WON. Primary outcomes were clinical and technical success. Results Seven studies with 230 metal stent patients and 226 plastic stent patients were included. Metal stents showed significantly shorter procedure times (SMD ‐0.80, 95% CI: ‐1.25 to −0.34), better 4‐week clinical success (OR 1.94, 95% CI: 1.00 to 3.77), and higher procedure costs (SMD 1.38, 95% CI: 0.56 to 2.20). No significant differences were observed in hospital stay (SMD ‐0.05, 95% CI: ‐0.35 to 0.25), technical success (OR 1.45, 95% CI: 0.22 to 9.43), clinical success (OR 1.13, 95% CI: 0.54 to 2.39), interventions (SMD ‐0.02, 95% CI: ‐0.34 to 0.29), need for necrosectomy (RR 1.10, 95% CI: 0.59 to 2.04), necrosectomy sessions (SMD 0.35, 95% CI: ‐0.42 to 1.11), need for percutaneous drainage (RR 0.82, 95% CI: 0.36 to 1.85), stent migration (RR 0.88, 95% CI: 0.29 to 2.66), bleeding (RR 0.97, 95% CI: 0.53 to 1.75), WON recurrence (RR 1.66, 95% CI: 0.70 to 3.92), treatment failure (death) (RR 0.75, 95% CI: 0.37 to 1.53), disconnected pancreatic duct (RR 0.93, 95% CI: 0.79 to 1.11), and total cost (SMD ‐0.02, 95% CI: ‐0.29 to 0.26). Conclusion Metal stents offer shorter procedure time and better 4‐week clinical success, although at a higher cost, with most clinical outcomes showing no significant differences between stent types.
Wiley Publishing Asia Pty Ltd
Journals
2025 EN
Abuelazm Mohamed · Alsakarneh Saqr · Tanashat Mohammad
+5 more
ABSTRACT Background and Objective Seladelpar is an oral, once‐daily medication that improves cholestasis through its selective peroxisome proliferator‐activated receptor (PPAR‐δ) agonism. It shows promising efficacy in treating primary biliary cholangitis (PBC) patients. Methods A systematic review and meta‐analysis synthesizing evidence from randomized controlled trials (RCTs) obtained from PubMed, Cochrane, Scopus, and WOS until July 19th, 2025. Dichotomous outcomes were reported using risk ratio (RR) and continuous outcomes using mean difference (MD), with a 95% confidence interval (CI). Results Three RCTs with 499 patients were included. Seladelpar was significantly associated with an increased ALP normalization (RR: 21.12 with 95% CI [4.14, 107.58], p < 0.01), biochemical response (RR: 3.06 with 95% CI [2.00, 4.70], p < 0.01), and decreased pruritus NRS score change (MD: −1.47 with 95% CI [−2.73, −0.21], p = 0.02). Seladelpar was also significantly associated with a decreased incidence of pruritus (RR: 0.54 with 95% CI [0.31, 0.94], p = 0.03) but with an increased incidence of headache (RR: 3.37 with 95% CI [1.11, 10.23], p = 0.03). However, there was no significant difference between seladelpar and placebo regarding the incidence of any adverse events (RR: 0.96 with 95% CI [0.87, 1.06], p = 0.43). Conclusion Seladelpar improved liver biomarkers of cholestasis and reduced pruritus in patients with PBC without significantly increasing the adverse effects. This makes seladelpar a promising addition to the treatments available for PBC. Trial Registration: PROSPERO: CRD42024521208
Wiley Publishing Asia Pty Ltd
Journals
2025 EN
Khalid Ayan · Tabish Sabula · Burhan Muhammad
+8 more
ABSTRACT Rising antibiotic resistance has challenged empirical regimens for Helicobacter pylori eradication. While concomitant therapy is widely used, its effectiveness is reduced in resistant settings. Tailored therapy, guided by antimicrobial susceptibility testing, may improve outcomes. We performed a meta‐analysis of randomized controlled trials (RCTs) comparing tailored versus concomitant therapy as a first‐line treatment. We searched PubMed, Google Scholar, Cochrane, and ClinicalTrials.gov through April 2025 for RCTs enrolling treatment‐naïve adults with confirmed H. pylori infection. The primary outcome was the eradication rate by intention‐to‐treat (ITT) and per‐protocol (PP) analyses, with adverse events as a secondary outcome. We included eight RCTs with 2524 patients (1332 tailored, 1192 concomitant). Tailored therapy achieved higher eradication rates than concomitant therapy in the ITT analysis (87.4% vs. 83.2%; RR = 1.05; 95% CI: 1.00–1.10; p = 0.05) and the PP analysis (92.6% vs. 89.1%; RR = 1.04; 95% CI: 1.00–1.07; p = 0.03). Furthermore, tailored therapy was associated with a significantly lower incidence of adverse events (35.6% vs. 45.6%; RR = 0.71; 95% CI: 0.58–0.86; p = 0.0007). In conclusion, tailored therapy provides modestly higher H. pylori eradication rates and significantly fewer adverse events compared to empirical concomitant therapy. These findings support using tailored therapy as the preferred first‐line option, particularly in regions with high antibiotic resistance and as access to rapid molecular testing expands.
Wiley Publishing Asia Pty Ltd
Journals
2025 EN
ElMoaty Heba Ibrahim Abd · Doghish Ahmed S. · Mansour Reda M.
+13 more
ABSTRACT Moyamoya disease (MMD) is a rare degenerative stenosis and occlusive cerebrovascular illness. It is characterized by cerebral ischemia and/or cerebral hemorrhage as the two main clinical signs. It is a common cause of stroke in both children and adults. Several recent studies illustrated the crucial role of microRNAs (miRNAs) in the pathophysiology of MMD via the regulation of endothelial cells and smooth muscle cells. Furthermore, other studies highlighted the decisive role of miRNAs in the underlying molecular pathophysiological mechanisms in MMD via regulation of cellular proliferation, angiogenesis, extracellular matrix remodeling, and vascular inflammation. This review aims to explore the involvement of miRNAs in MMD pathogenesis and to assess their potential use as biomarkers for stroke risk and their utility as therapeutic targets for the treatment of MMD.
Journals
2025 EN
Mohammadzadeh Omid · Fahimzadeh Nafise · Elhami Fateme
+1 more
ABSTRACT Various neurological disorders have been linked to the presence of serum antibodies targeting glutamic acid decarboxylase (GAD), a key enzyme in the production of γ‐aminobutyric acid (GABA). Associated conditions include stiff‐person syndrome (SPS) (classic and variant forms), cerebellar ataxia, limbic or extra‐limbic encephalitis, nystagmus issues, drug‐resistant epilepsy, paraneoplastic SPS, and progressive encephalopathy with rigidity and myoclonus (PERM). Although PERM and paraneoplastic SPS are mainly associated with antibodies targeting glycine receptors and amphiphysin, GAD antibodies might also be detected. Despite evidence of autoimmune activity and GABAergic dysfunction in some cases, the direct pathological role of GAD antibodies remains uncertain and debated. Diagnosis relies on clinical evaluation combined with detecting GAD antibodies in serum and cerebrospinal fluid (CSF), alongside confirmation of intrathecal antibody production. While GAD antibodies are not always required for diagnoses like SPS, they are essential for confirming cerebellar ataxia, encephalitis, or epilepsy. Treatment typically involves immunotherapy, with first‐line options including intravenous immunoglobulins, steroids, or plasma exchange to induce remission. Long‐term immunosuppression is often necessary. Symptomatic therapies (e.g., for muscle spasms, seizures, or delirium) are also recommended. The prognosis can differ, but it is typically positioned at an intermediate level between neurological syndromes associated with antibodies that target neural membrane antigens and those linked to onconeural antibodies. This review aims to further investigate the pathogenic role of these antibodies to improve predictions and select more appropriate treatment strategies.