The use of plants in the traditional management of diabetes in Nigeria: Pharmacological and toxicological considerations

Ethnopharmacological relevance: The prevalence of diabetes is on a steady increase worldwide and it is now identified as one of the main threats to human health in the 21st century. In Nigeria, the use of herbal medicine alone or alongside prescription drugs for its management is quite common. We hereby carry out a review of medicinal plants traditionally used for diabetes management in Nigeria. Based on the available evidence on the species׳ pharmacology and safety, we highlight ways in which their therapeutic potential can be properly harnessed for possible integration into the country׳s healthcare system. Materials and methods: Ethnobotanical information was obtained from a literature search of electronic databases such as Google Scholar, Pubmed and Scopus up to 2013 for publications on medicinal plants used in diabetes management, in which the place of use and/or sample collection was identified as Nigeria. ‘Diabetes’ and ‘Nigeria’ were used as keywords for the primary searches; and then ‘Plant name – accepted or synonyms’, ‘Constituents’, ‘Drug interaction’ and/or ‘Toxicity’ for the secondary searches. Results: The hypoglycemic effect of over a hundred out of the 115 plants reviewed in this paper is backed by preclinical experimental evidence, either in vivo or in vitro. One-third of the plants have been studied for their mechanism of action, while isolation of the bioactive constituent(s) has been accomplished for twenty three plants. Some plants showed specific organ toxicity, mostly nephrotoxic or hepatotoxic, with direct effects on the levels of some liver function enzymes. Twenty eight plants have been identified as in vitro modulators of P-glycoprotein and/or one or more of the cytochrome P450 enzymes, while eleven plants altered the levels of phase 2 metabolic enzymes, chiefly glutathione, with the potential to alter the pharmacokinetics of co-administered drugs. Conclusion: This review, therefore, provides a useful resource to enable a thorough assessment of the profile of plants used in diabetes management so as to ensure a more rational use. By anticipating potential toxicities or possible herb–drug interactions, significant risks which would otherwise represent a burden on the country׳s healthcare system can be avoided

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Neighbors and extension agents in Ethiopia: who matters more for technology adoption?

The increased adoption of fertilizer and improved seeds are two key aspects to raising the level of land productivity in Ethiopian agriculture. However, the adoption and diffusion of such technologies has been slow. We use data from Ethiopia between 1999–2009 to examine the role of learning from extension agents versus learning from neighbors for both improved seeds and fertilizer adoption. We combine farmers' spatial networks with panel data to identify these influences, and find that while the initial impact of extension agents was high, the effect wore off after some time, in contrast to learning from neighbors

Attention and saliency on the internet: Evidence from an online recommendation system

Using high-frequency product-level data from an online retail store, we examine whether consumer choices on the internet are consistent with models of limited attention. We test whether consumers are more likely to buy products that receive a saliency shock when they are recommended by new products. We find a sharp and robust 6% increase in the aggregate sales of existing products after they are recommended by a new product. We also establish that the spillover effects of saliency on products further away in the recommendation network are small, suggesting that returns to search via the recommendation network diminish swiftly. Using a structural model we find that saliency has large effects on consumer consideration but a smaller effect on their subsequent choice, conditional on consideration. Counterfactuals suggest that limited attention disproportionately harms top-selling products but recommendation systems can alleviate these search frictions

Centralized stochastic energy management framework of an aggregator in active distribution network

This paper develops a detailed and sequential procedure for short term operation of an aggregator to minimize the cost of the consumer and risk of the aggregator, which includes day-ahead (DA) and real-time (RT) operation. DA operation has two stages: consumer load scheduling and risk-based energy procurement. Consumer load scheduling implemented over a radial distribution network by a cost minimization objective function which considers electricity price and solar photovoltaic (PV) uncertainty, peak-to-average ratio, and phase unbalance. This model is formulated as a mixed integer nonlinear program. In the second stage, a risk-based energy procurement is formulated. Here, the aggregator has the choice of energy procurement from wholesale market, either in DA market or RT market, to meet the scheduled power. In RT operation, the aggregator takes a decision on share of RT purchases and battery schedules to minimize the cost of scheduled load power deviations. In order to realize this, a rolling window optimization is implemented, which is modeled as a mixed integer problem. The framework is demonstrated with a detailed case study of 15-node radial active distribution network consisting of 420 residential customers.by Bala Sai Kiran Patnam and Naran M. Pindoriy

A Novel Mutation in the Transglutaminase-1 Gene in an Autosomal Recessive Congenital Ichthyosis Patient

Structure-function implication on a novel homozygous Trp250/Gly mutation of transglutaminase-1 (TGM1) observed in a patient of autosomal recessive congenital ichthyosis is invoked from a bioinformatics analysis. Structural consequences of this mutation are hypothesized in comparison to homologous enzyme human factor XIIIA accepted as valid in similar structural analysis and are projected as guidelines for future studies at an experimental level on TGM1 thus mutated