Search

BACKGROUND & AIMS: The Primary Biliary Cholangitis (PBC) Obeticholic Acid (OCA) International Study of Efficacy (POISE) randomized, double-blind, placebo-controlled trial demonstrated that OCA reduced biomarkers associated with adverse clinical outcomes (ie, alkaline phosphatase, bilirubin, aspartate aminotransferase, and alanine aminotransferase) in patients with PBC. The objective of this study was to evaluate time to first occurrence of liver transplantation or death in patients with OCA in the POISE trial and open-label extension vs comparable non-OCA-treated external controls. METHODS: Propensity scores were generated for external control patients meeting POISE eligibility criteria from 2 registry studies (Global PBC and UK-PBC) using an index date selected randomly between the first and last date (inclusive) on which eligibility criteria were met. Cox proportional hazards models weighted by inverse probability of treatment assessed time to death or liver transplantation. Additional analyses (Global PBC only) added hepatic decompensation to the composite end point and assessed efficacy in patients with or without cirrhosis. RESULTS: During the 6-year follow-up, there were 5 deaths or liver transplantations in 209 subjects in the POISE cohort (2.4%), 135 of 1381 patients in the Global PBC control (10.0%), and 281 of 2135 patients in the UK-PBC control (13.2%). The hazard ratios (HRs) for the primary outcome were 0.29 (95% CI, 0.10-0.83) for POISE vs Global PBC and 0.30 (95% CI, 0.12-0.75) for POISE vs UK-PBC. In the Global PBC study, HR was 0.20 (95% CI, 0.03-1.22) for patients with cirrhosis and 0.31 (95% CI, 0.09-1.04) for those without cirrhosis; HR was 0.42 (95% CI, 0.21-0.85) including hepatic decompensation. CONCLUSIONS: Patients treated with OCA in a trial setting had significantly greater transplant-free survival than comparable external control patients. ispartof: Gastroenterology vol:163 issue:6 pages:1630-1642.e3 ispartof: location:United States status: published

© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way, Introduction: Primary biliary cholangitis (PBC) is an infrequent, immune-mediated cholestatic liver disease, which can lead to liver fibrosis, cirrhosis and complications of end-stage liver disease. The established goals of treatment of PBC are prevention of end-stage liver disease and amelioration of associated symptoms. The European Association for the Study of the Liver (EASL) management guidelines provide extensive recommendations on the diagnosis and management of PBC. Areas covered: This article describes the development by expert consensus of a 'PBC Integrated Patient Care Pathway' to simplify and standardize the management of PBC for clinicians based on current practice. Expert opinion: Guideline adoption is potentially poor in practice since most patients with PBC in the community are seen by general gastroenterologists or hepatologists without a special interest in autoimmune liver disease. The PBC Integrated Patient Care Pathway is a best practice tool for clinicians designed to complement the EASL Clinical Practice Guidelines for the diagnosis and management of PBC patients. It gives clinicians a practical decision tree of the key steps in PBC management, thereby providing a simplified framework and an opportunity for more uniform practice that supports the safe and timely adoption of varied models of care provision to patients with PBC.

Nanoscience and nanotechnology are currently undergoing several developments that will impact several industries across the global in due season. The wide applications of nanoparticles in biomedicine, pharmacy, phytochemistry, research institute, catalysis, textile, waste water management, chemistry, food preservatives, and paint have led to new area of discoveries for many researchers and industries. The biological method of synthesizing silver nanoparticles (AgNPs) had tremendously gained wide popularity due to its environmental friendly conditions of synthesis. Numerous biological entities namely; plants, bacteria, essential oil, fungi, algae, and yeasts had been used as reducing and capping agent for the synthesis of AgNPs. All scientific investigations have ascertained the uniqueness of AgNPs as therapeutic agent against cancer, virus, bacterial, and fungal infections. This review provides detailed scientific information about the various methods of synthesis, optimization conditions, mechanism, and characterization techniques for the synthesis of AgNPs with efficient yield and morphological properties. Furthermore, concise advancement in the antibacterial, antiviral, antifungal, antioxidant, and anticancer activities of AgNPs mediated from plant sources from recently published articles were enumerated.

The conviction that herbal drugs have enormous health benefits has led to increase the rate of their consumption by Nigerians. The aim of this study was to assess the carcinogenic property of some popularly consumed anti-diarrheal herbal drugs via polycyclic aromatic hydrocarbons (PAHs) quantification. Three prevalent anti-diarrhea herbal drugs , Odunmo herbal drug (Hibiscus rosa-sinensis and Bacopamonnieri), Orogun herbal mixture (Hibiscus sabdariffaI and Hedera helix), and Alora herbal syrup (Aloe vera and Hibiscus sabdariffaI) were bought for the purpose of this study and they were coded as samples A, B, and C, respectively. The ultrasonic extraction of the herbal drugs was carried out using standard procedures. The crude extracts obtained were purified using a chromatographic method. The concentrations of PAHs were quantified using gas chromatography flame ionization detector (GCFID). The diagnostic indices, group distribution, toxicity equivalence and exposure dosage were estimated. The cancer risk values were theoretically speculated based on concentrations of PAHs in the tested herbal drugs, associated with the published estimates of each concentration to cause cancer and the calculated exposure doses of the anti-diarrhea herbal drug samples were within three age groups (children, Preteen and adult). The highest concentration of total PAHs was observed in sample A (58.2815mg/kg) and the lowest concentration in sample B (44.1898mg/kg), but the concentration of total PAHs in sample C was 47.4169 mg/kg. The highest percentage of carcinogenic PAHs in the anti-diarrheal herbal drugs was found in sample C (48.66%) and the lowest in sample B (38.17%). The diagnostic indices confirmed a pyrogenic source of PAHs. Group distribution of PAHs showed that the herbal drugs are weakly carcinogenic due to high concentrations of low and moderate molecular weight PAHs. The cancer risk estimated for all the age groups where below the limit established by the United State Environmental Protection Agency (USEPA) for cancer (1 x 10-6). This ascertained that the use of these herbal drugs cannot cause cancer. However, consumers of these herbal drugs should take necessary precautions as excessive intake can lead to dangerous health implications.

The study examined the marketing and uses of two species of Giant African Land Snails (Archachatina marginata and Achatina achatina) in four (4) different market locations in Ibadan Oyo state, Nigeria. The data were collected using a structured and validated questionnaire administered interpersonally to 160 snail marketers in four randomly selected markets in selected Local Government Area (LGA) situated in Ibadan. Data collected were analysed using descriptive and inferential statistical tools; these include frequencies, mean, median, mode and multiple regression. Findings from the socioeconomic characteristics revealed that majority (98.1 %) of the respondents were female and only 1.9 % were male. Majority (91.9 %) of marketers were married with 27.5 % in the 31–40 years age group. Majority (89.4 %) raised their capital through personal savings and had over 16 years of marketing experience. All respondents (100 %) were involved in wholesale marketing of different species of snail whereas 65 % of them were into both wholesale and retail marketing. Also, 88.8 % were engaged in marketing of both species only. Most (70 %) of the respondents’ generated income per year was between ₦10,000–₦49,999 ($26–$130). All marketers ascertained that the major purpose of snail is for consumption. Also, the budgetary analysis (costs and returns) revealed that marketing of Archachatina marginata and Achatina achatina is a profitable business among the marketers with a high rate of return on investment. The most efficient market for both snail species was Sango market with efficiency values 1.77 and 1.82 for A. achatina and A. marginata, respectively. The coefficient of multiple determination, R2 value of 0.689 indicated that 68.9 % of the variation in the marketing price of snail is explained by transportation cost, cost price of snail and market tariff. The marketing efficiency was greater than one in all markets which showed that the markets were efficient in the marketing of Archachatina marginata and Achatina achatina. The study concluded that snail marketing is profitable given the market efficiencies and rate of returns on investment. Policy recommendation towards reduction in cost of transportation and market tariff is suggested as this would bring about improved market efficiencies and more returns.

The aim of this study was to investigate the cancer risk that could be incurred from the use of some anti-cholera herbal drugs sold in Southwest Nigeria. Three most popular anti-cholera herbal drugs were studied. The cancer risk estimation for the drugs at studied population ranges from 7.119 to 0.338 x 10-8 in children, 9.563 to 0.129 x 10-8 in preteen and 9.541 to 5.196 x 10-8 in adult. The cancer risk estimated values are below the USEPA set value 1 x 10-6. This established that the use of these herbal drugs might not lead to cancer if consumed at low dosage.

The aim of this study was to assess the safety level of some bottled water produced in Okitipupa, Ondo State Nigeria. Several packs of bottled water were obtained from three different manufacturers. Some physicochemical parameters and heavy metals were investigated to assess the quality of the bottle water using standard methods. The results from the physicochemical parameters and heavy metals were in with World Health Organization (WHO) standard for drinking water when compared. This study confirmed that the analyzed bottled water has good quality. Therefore, these bottled water are said to be safe for drinking.

The delinquent peril of bacterial infections affecting human kind is becoming unbearable. This study was embarked on to investigate the antimicrobial activity of biosynthesized silver nanoparticles (AgNPs) using Garcinia kola bark extract against some bacteria strains. Fresh barks of Garcinia kola were obtained from the “Gbeleju” farm land in Irele town in Ondo state region of Nigeria. Exactly 0.4 g of previously pulverized bark of Garcinia kola was immersed into 20 mL of distilled water and heated at 60–70°C for 10 minutes yielding the extract. The biosynthesized nanoparticle was characterized with UV spectroscope, Fourier infrared spectroscope (FTIR), transmission electron microscope (TEM), and energy dispersive X-Ray analyzer (EDX). Then, 0.2 g of the silver nanoparticles was dissolved in 2 ml of water to yield 100 mg/ml of the stock solution which was further diluted for the antibacterial analysis via the disc diffusion method. The result obtained from the analytical characterization of the biosynthesized silver nanoparticles revealed a spherical particle shape, particle size in the range of 12.23 to 27.90 nm with an average size of 20.07 nm via TEM analysis. The FTIR analysis confirmed the presence of -OH functional group for the stabilization of the silver nanoparticles formed due to the broad peak at wavelength 3324.52 and 3344.21 cm−1. The EDX analysis revealed carbon, nitrogen, oxygen, aluminum, potassium, copper, and silver as the elements present in the nanoparticles. Results obtained from the antibacterial screening of the biosynthesized AgNPs showed inhibitory potential that are capable of obstructing the growth of the test bacteria. This investigation ascertained the biosynthesized AgNPs as a remedy for curing bacterial infections and also a promising source for novel antibacterial agent.

Research into alternative natural products with health potential such as herbal soap has become very important to curb the disastrous effects of mercury-based soap on healthy living and so enhance women’s productive activities of the rural peasantry. The study examines the factors affecting herbal soap small enterprises development and marketing. In identifying the factors affecting the small enterprises, five hundred and two (502) herbal soap processors and marketers were surveyed from South West, Nigeria comprising 65 villages in the sampled 16 Local Government Areas. A close-ended questionnaire was used to gather data for the study. The data collected from herbal soap entrepreneurs was fitted into three regression functional forms. The functional forms were linear, semi-log and double log functions. The double log function was selected as the lead equation based on the significance of the individual coefficients and their signs, the magnitude of the coefficient of the multiple determinations (R2) and the magnitude of the standard error (SE) which was 0.80 and F- statistics of 2.35. The R2 of 0.829 indicated that 82.9% of the variation in the gross profit of herbal soap production (Y) was accounted for by the regressors/explanatory variables. Regression analysis result revealed that, household size and labour were significant at 10% while extension contact was significant at 5%. It is therefore recommended that, extension contact should be encouraged among the herbal soap processors in other to generate more income, also, awareness should be created for existing and prospective entrepreneurs about business opportunities in Natural resources utilising agricultural-wastes.

This research centred on the evaluation of the antifungal potency of gold nanoparticles (AuNPs) synthesized from Garcinia kola leaves. The leaves of Garcinia kola obtained were thoroughly rinsed, air dried, pulverized and extracted. The extract obtained was mixed with aqueous solution of gold chloride to form gold nanoparticle and were characterized. The antifungal screening of the synthesized gold nanoparticles was carried out via the Agar disc diffusion method. The ultraviolet (UV) analysis showed an absorption wavelength at 536.12 nm. The scanning electron microscopic (SEM) image confirmed uniform distribution of the synthesized gold nanoparticles. The transmission electron microscope (TEM) analysis confirmed that the particle size are in the range of 8.21 to 19.00 nm. The broad inhibitory zones against test fungi displayed by the synthesized nanoparticles confirmed the synthesized gold nanoparticles as a good antifungal source. This study establish a simple, easy and environmental friendly approach of synthesizing gold nanoparticles.

Charcoal producers are becoming more important and increasing in number among the population in Southwest, Nigeria. This study examined poverty status among charcoal producers in Ogun and Oyo States, Nigeria. Multistage Random Sampling technique was used to select three hundred (300) respondents comprising 120 and 180 charcoal producers in Ogun and Oyo States respectively. Structured questionnaire was used to elicit information. Descriptive statistics summarised the socio-economic characteristics of the respondents. Poverty line was determined with Foster, Greer and Thorbecke method. Poverty incidence (P0) and poverty depth (P1) were also evaluated. Logit regression was used to examine factors influencing poverty among the respondents in the study areas. The socio-economic characteristics revealed that the respondents were predominantly male, mean age of 43.5years, married, 46.7%, average household size of 6 persons. Primary education was predominant (33.7%), mean years of experience -12years and mean household annual income of N827,702.80. Method of production was earthen only, 73% and 27% operated on full time and part time respectively. Percentage of those below the poverty line (P0) was 49.67%. An average charcoal producer requires N6,086.36, (P1) to get to the Poverty line of N86, 453.92 annually. The Logit analysis revealed that marital status had a positive significant relationship with poverty status (p < 0.05). Years of experience, technical and allocative efficiencies had inverse significant relationship with poverty status (p < 0.05). The Likelihood ratio was 128.713, significantly different from zero. Also, R2 was 0.465 while F statistics was significant (p < 0.01). Suggestions include fiscal policy intervention to accommodate producers with minimum collateral for loan facility and forest policy to promote conservation through extension services.

Densification of biomass is often required to combat the negative handling characteristics of these low bulk density materials. A high-quality densified product is strongly desired, binding agents are usually added to comminuted biomass material to improve the quality of the resulting briquettes. Many materials naturally possess such binding agents; however, they may not be enough or available in a form that can contribute to product binding. The briquettes were prepared from groundnut shell with different cassava starch as binder in varying percentage (5, 10, 15 and 20%) by weight. The prepared briquettes after sun drying for 21 days were subjected to water boiling test for assessing the quality and suitability of briquetted fuel as domestic fuel. The groundnut shell briquettes burnt with good flame and observed 14.47 to 18.46% thermal efficiency while that of wood is 10.31%. The average burning rate of the briquettes ranges between 0.587 and 0.881 kg/hr while that of wood (V) is 1.166 kg/hr. The average specific fuel consumption of the briquettes ranges between 0.067 and 0.267 J/g while that of wood is 0.332 J/g. The boiling time for briquettes is between 14.80 to 23.15 minutes and 13.05 to 19.08 minutes for cold and hot start respectively while for wood are 28.05 and 19.20 minutes for cold and hot starting respectively. Comparatively briquette with 20% binder performs better.

Climate change is currently the greatest environmental challenge of the st nbsp century This study evaluated selected agroforestry practices and farmers rsquo perception of climate change in Ogun state Multistage sampling technique was used to select respondents involved in Agroforestry practices from four agricultural zones in Ogun State Abeokuta Ilaro Ikenne and Ijebu Ode Data were collected with the aid of structured and pre tested questionnaire administered interpersonally to the respondents The data were analyzed using descriptive statistics Likert scale and Chi square analyses Seven agroforestry practices were identified in the study area out of which lsquo scattered trees on farmland rsquo was predominantly practiced when prioritized Likert scale analysis showed that agreed that there have been changes in climatic variables such as rainfall and temperature in the last five years The Chi square analysis revealed a significant association p lt between the perception of respondents rsquo need to mitigate the effect of climate change and their socio economic variables such as age The major problem associated with agroforestry practices was insufficient capital to run the farms

To develop a 'close to patient' peripatetic intravenous service (PIVS) for delivery of specialist osteoporosis care in a community setting without increasing cost and with a reduced carbon footprint.Cost and feasibility of a PIVS for intravenous (i.v.) bisphosphonate treatment were modelled using UK National Health Service costings and then tested in the field for 1 year. Average patient mileage to peripatetic sites was compared with mileage travelled if treated at the base hospital (current practice). The method of travel to hospital (current practice) or peripatetic sites (new study) was ascertained together with patients' preference for the new or the current system. Peripatetic sites were researched and those with suitable facilities selected. Data for fuel consumption were based on a usage of 1 litre per 14.5 km.The main outcome measure was cost comparison between hospital and peripatetic services. Others included patient satisfaction, miles saved, method of travel to the clinic and changes in CO(2) emissions.Cost per patient, including drugs, lies between pound557 and pound622 annually for 1000 and 500 patients, respectively which is cost-neutral compared with hospital attendance. PIVS was rated more convenient by 98% of patients. Hospital transport was significantly reduced and the total monthly saving of 2000 miles has reduced CO(2) emission by 6072 kg p.a. No medical emergency occurred in 410 infusions.PIVS is cost neutral compared with a conventional service, leads to a better patient experience, a significant cutback in hospital transport costs and a reduction of the NHS carbon footprint. However not all drugs may be suitable for this service: the area served was rural with large distances and poor public transport and mileage savings may not accrue in urban areas. Insurance was not included in the calculation of costs.

The marketing of forest tree barks used for medicinal purposes were investigated in some markets in Abeokuta metropolis. This was to provide the much needed information on the sellers, buyers and producers of these products for sustainable production and maximum socio-economic benefits. This study identified 43 species being sold in the market places sampled namely Kuto, Omida, Itoku, Lafenwa, Iberekodo and Elega. Almost the same species were traded in all the markets sampled. This study further revealed that the trade of forest tree barks is pre-dominated by women accounting for 93.3% of the total respondent. Fifty one percent of the respondents were recorded among the youths between the ages of 15 and 20 years old. Forest tree bark sales were found to contribute to the monthly income of the respondents. For instance more than half of them earned between N7,500 and N10,000 as monthly incomes from bark sales. A total of 62 or 41.33% or the total respondents were found to earn more than the State Government minimum wage of N4,600 monthly. The Chi-square statistical analysis showed that there was a relationship between income earned by the respondents and the location of the markets. African Research Review Vol. 1 (1) 2007: pp. 65-76