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

Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data

There is a need to develop and validate biomarkers for treatment response and survival in tubo-ovarian high-grade serous carcinoma (HGSC). The chemotherapy response score (CRS) stratifies patients into complete/near-complete (CRS3), partial (CRS2), and no/minimal (CRS1) response after neoadjuvant chemotherapy (NACT). Our aim was to review current evidence to determine whether the CRS is prognostic in women with tubo-ovarian HGSC treated with NACT.This article is freely available via Open Access. Click on the Publisher URL to access the full-text via the publisher's site

Long-term vertical alliances and supplier performance

In recent years, cooperative buyer-supplier relationships, fashioned after the Japanese management style, have become popular in industrial markets. While buyers have explicitly benefited (from these relationships) in terms of better end-product performance and lower costs, it is not clear if suppliers have also gained. Researchers wonder if the buyers\u27 success has come at the expense of their suppliers. To this end, this dissertation attempts to study the effect of the structural attributes of long-term vertical relations on supplier performance. Given that a long-term vertical relationship (that warrants transaction specific investments—TSIs) is the focus of analysis, the dissertation draws on two related fields of study—Transaction Cost Economics (TCE) and Theory of Incomplete Contracts. The former theory stipulates that TSIs need to be accompanied by safeguard mechanisms to serve efficiency interests of both parties. It further characterizes governance structures (for exchange relationships) along the dimensions of incentive intensity and adaptive ability. Among other factors, the latter theory focuses on “verifiability of contractual provisions” as a key source of incompleteness and rigidity in long term contracts. This dissertation synthesizes these two contributions to distinguish between “enforceable contracts” that require verifiable provisions and “self-enforcing contracts” that are supported by symbiotic, but non-verifiable mechanisms. The study argues that these two governance modes would vary systematically in terms of their safeguards, incentive intensity and adaptive features, and would therefore impact supplier performance differently. A total of nine hypotheses, all concerning supplier performance, are developed. These propositions are tested in the context of data collected from the Home Appliance Industry. Results from the study suggest that supplier management characterized by reciprocal investments, mutual dependence, and information sharing is a value enhancing capability. Results also indicate that merely increasing contract duration is not sufficient to serve supplier interests. Interestingly, this is not the approach taken by most American OEMs in their dealings with suppliers. In this context, this dissertation should add to our understanding of how to structure long-term OEM-Supplier relationships in ways that lead to improved performance for suppliers and sustainable advantage for OEMs