bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of the European Society of Hypertension guidelines for the management of arterial hypertension: comparison of the helpfulness of ESH 2013, 2018, and 2023 guidelines
Authors: Koller Akos , Járai Zoltán , Takács Johanna 
Published: February 2025

Objective:
Over the last decade, the European Society of Hypertension (ESH) published several guidelines (GLs) for the Management of Arterial Hypertension (2013, 2018, and 2023). We hypothesized that the GL has been improved because of the publications of new evidence. Thus, we aimed to examine the development of ESH guidelines (ESH GLs) by comparing their helpfulness regarding the diagnosis and treatment of hypertension.

Methods:
A novel mathematical analysis was used to compare ESH GLs. Not only the frequency of Classes of Recommendations (CLASS) and the Levels of Evidence (LEVEL) were examined but a newly developed certainty index (CI) was calculated. This CI allows the CLASS and LEVEL to be assessed together, providing a less biased assessment of GLs, than examining the CLASS and LEVEL independently or related to each other.

Results:
The number of recommendations showed continuous and significant increases from 2013 (N = 110) to 2018 (N = 169), and 2023 (N = 269). Examining the frequency of CLASS and/or LEVEL led to biased results, showing both improvements and/or worsening comparing years. However, based on the new analysis, a continuous improvement was shown in the percentage of certainty from 2013 to 2023 (2013: 60.5%, 2018: 72.1%, 2023: 75.3%). Accordingly, the CI was also significantly increased from 2013 (CI: 0.21), to 2018 (CI: 0.44), and to 2023 (CI: 0.51).

Conclusion:
The analysis shows that compared to previous GLs, the structure of the ESH 2023 GL has been rearranged and simplified. The higher number of Recommendations indicates a continuously accumulating knowledge regarding the mechanisms, clinical findings, and epidemiology of hypertension. Moreover, the ESH 2023 GL shows a higher degree of certainty and CI, corresponding to a higher level of helpfulness of the ESH 2023 GL for healthcare professionals to diagnose, prevent, and treat hypertension.
Cannabis and liver transplant in the era of legalization: Effects of pre-transplant cannabis use on postoperative opioid use and transplant outcomes
Authors: Runge Ava , Loeb Becca , Shui Amy M. , Fenton Cynthia , Lai Jennifer , Rubin Jessica 
Published: February 2025

Background:
Cannabis use is increasing in the United States, including among liver transplant candidates. Although the anesthesia literature suggests an association between cannabis use and increased post-operative pain, the impact of cannabis use on post-liver transplant (LT) opioid use remains unknown. This study investigates changes in cannabis use at a transplant center over time, as well as the impact of cannabis use on post-LT opioid use, healthcare utilization, and mortality.

Methods:
We included 4,236 patients evaluated for LT at our institution between January 2013 and July 2023. Our primary risk factor was cannabis use, defined as urine toxicology (UTox) positive for cannabis within 90 days of LT evaluation. Our primary outcome was post-LT opioid use, including oral morphine equivalents (OME) received during the LT hospitalization and discharge opioid prescriptions. We used multivariable logistic and quantile regression to compare post-LT opioid use, healthcare utilization outcomes, and mortality between cannabis users and nonusers.

Results:
Cannabis use was associated with higher OME use in the 48 hours post-LT (p=0.04). There were no statistically significant differences between groups in 72-hour (p=0.07) or 7-day cumulative OME (p=0.33), opioid prescriptions on discharge (p=0.25), hospital length of stay (LOS, p=0.69), intensive care unit LOS (p=0.94), 90-day readmission (p=0.66), or 90-day mortality (p=0.96).

Conclusions:
While cannabis use pre-LT was associated with significantly higher opioid use in the immediate postoperative period, this did not translate to differences in opioid use beyond 48 hours post-LT, or short-term healthcare utilization or clinical outcomes. These findings should help set provider expectations for immediate post-LT pain control. Our findings support the growing body of literature that fails to identify an association between pre-LT cannabis use and post-LT outcomes.
Current situation of pediatric cystic fibrosis-related liver disease: results of a Spanish nationwide study
Authors: Vicente-Santamaría Saioa , Tabares-González Ana , Gascón-Galindo Celia , Tutau-Gómez Carlos , Álvarez-Beltrán Marina , Muñoz-Codoceo Rosa Ana , Rubio-Murillo María , De-Los-Santos Marianela , Salcedo-Lobato Enrique , Masip-Simó Etna , García-Romero Ruth , Fernández-Lorenzo Ana Estefanía , Moreno-Álvarez Ana , Serrano-Nieto Juliana , Hierro-Llanillo Loreto , Loverdos-Eseverri Inés , Crehuá-Gaudiza Elena , Juste-Ruiz Mercedes , Blitz-Castro Enrique , Morales-Tirado Ana , López-Cárdenes Concepción Marina , Bousoño-García Carlos , González-Jiménez David ,   on behalf of Cystic Fibrosis working group from Spanish Society of Gastroenterology, Hepatology and Pediatric Nutrition (SEGHNP)
Published: February 2025

Background
Cystic fibrosis-related liver disease (CFRLD) is a health problem that can affect as many as 30–40% of cystic fibrosis patients by the age of 12 years. We studied the epidemiology of CFRLD thanks to the first exclusively pediatric CFRLD patient registry to date.

Methods
Descriptive cross-sectional study. Information from medical records from January 2018 to December 2020 is collected. CFRLD was classified according to the European Society of Paediatric Gastroenterology, Hepatology and Nutrition 2017 criteria.

Results
Data were collected from 168 pediatric patients diagnosed with CFRLD (90.5% liver involvement without cirrhosis and 8.5% multinodular cirrhosis).

Conclusion
In this national registry, including exclusively pediatric population, liver disease is diagnosed around 7 years of age. Liver involvement without cirrhosis is the most frequent finding among our patients but about 9% of the patients already had cirrhosis. CFRLD is one of the challenges faced by pediatric gastroenterologists in the future and national registries give us the opportunity to further study and broaden our knowledge.
Plasma microRNA-30a expression in patients with chronic hepatitis B and its application value in the assessment of the severity of liver fibrosis
Authors: He Qiufeng , Chen Zhili , Deng Yang , Mao Chuangjie 
Published: February 2025

Objective
The severity of liver fibrosis (LF) in chronic hepatitis B (CHB) affects the outcome and treatment. We probed plasma miR-30a expression in CHB patients and its value in assessing LF severity.

Methods
This retrospective study included 160 CHB patients and another 98 controls. Levels of lipid parameters, liver function parameters, hemoglobin, and alpha-fetoprotein were quantified by ELISA and chemiluminescence immunoassay. White blood cell, platelet, and red blood cell counts were determined using an automatic hematology analyzer. Fibrosis index based on four factors (FIB-4) was calculated. miR-30a level was determined, followed by the analysis of correlations of miR-30a expression with LF classification or with FIB-4 in CHB patients. The diagnostic value of plasma miR-30a for mild-to-moderate and severe LF in CHB patients was analyzed by receiver operating characteristic (ROC) curve.

Results
Plasma miR-30a was poorly expressed in CHB patients and decreased dependently with LF aggravation. miR-30a was negatively interrelated with LF classification and FIB-4. Plasma miR-30a had high diagnostic value for mild-to-moderate LF in CHB patients [area under the ROC curve (AUC) = 0.775, cutoff value = 0.71, 95% confidence interval (CI) = 0.685–0.849]. Plasma miR-30a had high diagnostic value for severe LF in CHB patients (AUC = 0.873, cutoff value = 0.49, 95% CI = 0.804–0.924).

Conclusion
Plasma miR-30a was weakly expressed in CHB patients. miR-30a expression was negatively correlated with LF severity in CHB patients. miR-30a had high diagnostic value for mild-to-moderate and severe LF in CHB patients. miR-30a might serve as a promising target for LF treatment.
Leveraging the gut microbiome to understand the risk factor of cognitive impairment in patients with liver cirrhosis
Authors: Li Shuyao , Niu Xiao-Xia , Liu Jia-Liang , Su Min , Li Qian-Qian , Wang Chun-Yan , Wang Jian-Jun , Chen Hong-Yan , Ji Dong 
Published: February 2025

Objectives
The role of the gut-liver axis in liver cirrhosis is becoming increasingly recognized. We investigated the fecal microbiome in patients with liver cirrhosis and its potential function as a predictive biomarker of hepatic encephalopathy.

Methods
Patients were divided into either a high plasma ammonia (HPA) group or a low plasma ammonia (LPA) group according to the upper limit of normal of plasma ammonia concentration. 16S rRNA sequencing of fecal samples was performed to study how the microbiota affects the clinical symptoms of liver cirrhosis. The Stroop test was used to assess the ability of the brain to inhibit habitual behaviors.

Results
Totally, 21 subjects were enrolled. Among the 18 patients with liver cirrhosis, 14 were male, the age range was 42–56 years, and the plasma ammonia level range was 20–125.9 μmol/l. The Stroop test showed more severe cognitive impairment in HPA than in LPA individuals. At the same time, there were significant differences in fecal microbiome characteristics between the two groups, characterized by a further increase in the abundance of the Proteobacteria phylum in the gut (especially aerobic Enterobacteriaceae). Function predictions of Phylogenetic Investigation of Communities by Reconstruction of Unobserved States in the microbiome further explained the increase in the Enterobacteriaceae-dominated polyamine synthesis pathway in the gut microbiome of HPA groups.

Conclusion
Cirrhotic patients with hyperammonemia have a specific fecal bacterial composition (characterized via expansion of Enterobacteriaceae). The ability to bio-synthesize polyamines that Enterobacteriaceae possesses is likely to be a key factor in the elevation of plasma ammonia.
Preschool children with insufficient physiological hyperopia experience accelerated myopic drift
Authors: Bian Shimeng , Pu Jianing , Chen Wei , Zhou Zhen , Zhang Ranran , Wang Dan , Mi Xuejing , Yang Yanyan , Peng Chuzhi , Xu Huaying , Jin Mingrui , Jiao Yonghong 
Published: February 2025

SIGNIFICANCE
This study reveals that preschool children with insufficient physiological hyperopia experience accelerated myopic drift and axial length elongation. Regular monitoring can serve as an early warning for impending myopia during early childhood, highlighting its critical role in future myopia prevention strategies.

PURPOSE
This study examines the patterns of spherical equivalent and biometric parameters if physiological hyperopia has shown an accelerated tendency to regress by preschool age and whether the early onset of physiological hyperopia regression accelerates myopia onset.

METHODS
This kindergarten-based longitudinal observational study included 1308 children between 3 and 6 years old from kindergartens in Haidian District, Beijing, China. Comprehensive eye examinations were performed on all participants.

RESULTS
Two grouping methods were used for all children. The first was based on their baseline age and divided into four groups of 3 to 6 years. The second was based on spherical equivalent, with spherical equivalent >0.75 D designated as the physiological hyperopia group and spherical equivalent ≤+0.75 D designated as the pre-myopia or myopia group. Physiological hyperopia and the proportion of children with physiological hyperopia displayed a declining trend over time in all age groups (p<0.001), with the older the baseline age, the more pronounced the decline (p<0.001), and the rate increased year by year (p<0.001). In contrast, axial length, anterior chamber depth, and axial length/corneal curvature radius displayed an increasing trend (p<0.001), and the rate of increase of axial length and anterior chamber depth accelerated over time (p<0.001). Female children have more physiological hyperopia and a higher proportion of children with physiological hyperopia compared with males (p<0.001) but displayed a more rapid decline (p<0.001). The axial length, anterior chamber depth, and the axial length/curvature radius were found to be elevated in the pre-myopia or myopia group in comparison to the physiological hyperopia group (p<0.001). Furthermore, the magnitude of the rate increase in myopic drift and axial length was found to be greater in the aforementioned group.

CONCLUSIONS
The regression of physiological hyperopia accelerates in preschool-age children, with older children showing faster regression and lower levels of physiological hyperopia. This premature decline correlates with an increased rate of myopic drift and accelerated biometric growth. Therefore, regular monitoring of physiological hyperopia should begin at preschool age, as the rate of regression serves as a more reliable predictor of future myopia than refraction alone.
Decoding non-human mammalian adaptive signatures of 2.3.4.4b H5N1 to assess its human adaptive potential
Authors: Nataraj Ranjana , Ashok Avinash Karkada , Dey Ayushi Amin , Kesavardhana Sannula 
Published: February 2025

ABSTRACT
The recent panzootic 2.3.4.4b clade H5N1 infected diverse non-human mammalian species globally, showed mammal-to-mammal transmission among them and caused sporadic human infections. However, whether 2.3.4.4b H5N1 circulating in non-human mammals can establish human infections and spread among humans is unclear. Gain-of-function research restrictions preclude assessing human adapting mutations of 2.3.4.4b H5N1. Here, we tracked the evolution of 2.3.4.4b H5N1 that infected non-human mammals and evaluated their ability to gain human adaptations. The non-human mammal 2.3.4.4b H5N1 partly acquired classical human adapting mutations, which are identical to the residues of H1N1pdm09 and seasonal human H3N2 infections while showing a few species-specific adaptations that might be potential barriers for successful human adaptations. Despite minimal changes in Hemagglutinin (HA), A160T and T199I mutations near the receptor binding site of HA in dairy cattle viruses indicate the rapid HA glycan surface evolution affecting virus entry and immune evasion. The quantitative assessment indicated that 2.3.4.4b H5N1 circulating in bears, cattle, dolphins, and foxes show higher human adaptive potential than other hosts. Also, H5N1 infections in mammals across time showed a unique set of adaptations in the 2.3.4.4b clade compared to previously circulating strains, especially the acquisition of Q591 adaptation in PB2 that enables human adaptation. Thus, 2.3.4.4b H5N1 acquires human adaptations due to natural selection pressure in non-human mammals. Overall, our study delineates human adaptation and infection risk of specific non-human mammalian circulating HPAI 2.3.4.4b H5N1 strains.Abstract FigureGRAPHICAL ABSTRACT
Women’s empowerment and life stage: assessing intersectional differences in contraceptive method mix in sub-Saharan Africa
Authors: Hellwig Franciele , Wado Yohannes Dibaba , Faye Cheikh M , Requejo Jennifer , Alkema Leontine , Kananura Rornald Muhumuza , Boerma Ties , Barros Aluísio JD 
Published: February 2025

AbstractBackgroundWomen’s empowerment positively impacts family planning in sub-Saharan Africa, but little is known about its relationship with contraceptive method mix. Considering that contraceptive needs vary across life stages, we aimed to explore the intersectional differences in contraceptive method mix according to age and level of empowerment in sub-Saharan Africa.MethodsWe analyzed data from Demographic and Health Surveys conducted from 2015 to 2022 across 28 countries in West & Central and Eastern & Southern Africa. Within each region, we calculated pooled estimates of demand for family planning satisfied by any method (DFPS) and contraceptive method mix, stratifying by women’s age and empowerment level according to the SWPER Global index.ResultsOur sample included 138,374 married women of reproductive age. Across both regions, DFPS increased with empowerment, especially among women older than 19. Among adolescents, a substantial increase was only identified in terms of decision-making. Contraceptive method mix was skewed towards injectables and implants, but their shares dropped as empowerment increased. This trend appeared across all age groups and empowerment domains, with the largest declines observed for social independence. High-empowered women had a more diversified method mix, with adolescents and young women showing increased use of condoms, pills, and fertility-awareness methods, while women over 34 relied more on IUDs and sterilization.ConclusionOur findings reveal that age, empowerment, and contraceptive method mix intersect in diverse ways. Tailoring family planning policies and counseling while addressing empowerment drivers could enhance informed contraceptive choices and better meet women’s reproductive health goals.
Random patterns of medicinal plants on a phylogeny do not imply random selections of medicinal plants
Authors: Yessoufou Kowiyou , Yaradua Samaila Samaila , Gaoue Orou G. 
Published: February 2025

SummaryExisting studies report that medicinal plants are either phylogenetically clustered or that plant medicinal property is phylogenetically conserved. Each scenario is traditionally interpreted as evidence of non-random selection, by humans, of medicinal plants. Here, we argue that this interpretation is misleading arguing that both scenarios are simultaneously required for a correct interpretation of human selection of medicinal plants, and we propose a framework to illustrate all possible scenarios of phylogenetic patterns and human selection options.To demonstrate the use of this framework, we conducted a survey across Katsina State in northern Nigeria, West Africa, to record plants used to treat various ailments and then employed phylogenetic comparative methods to investigate the basis for integrating a given plant in the regional pharmacopoeia.First, we found a mixed selection pattern in organs used for medicine, perhaps mirroring the within-plants heterogeneous distribution of secondary compounds as predicted in the optimal defense theory. Second, medicinal plants used to treat most diseases follow a random distribution on the phylogeny whereas their medicinal property is convergent on the phylogeny. This pattern is plausible only when humans select preferentially less-related species for medicinal uses.That we found a random phylogenetic structure for species used to treat most diseases would, traditionally, have been interpreted as random selections of medicinal plants. We therefore call for caution and the use of the framework we propose while interpreting phylogenetic patterns in ethnobiology.Societal Impact StatementPlants are sources of modern drugs, and traditionally used plants for medicine are the first target in bio-screening. Early discussions suggest that humans randomly select plants that they use medicinally. However, recent studies demonstrate a rather nonrandom selection pattern. Here, we argue that the conclusion of nonrandom selection is grounded on less accurate interpretation of phylogenetic patterns. We consequently propose a framework with which to interpret medicinal plant selection by human and demonstrate, using data from Nigeria in West Africa, how this framework can be used.
Effects of Pesticide Exposure on Neuroinflammation and Microglial Gene Expression: Relevance to Mechanisms of Alzheimer’s Disease Risk
Authors: Mhatre-Winters Isha , Eid Aseel , Blum Nicole , Han Yoonhee , Sammoura Ferass M. , Wu Long-Jun , Richardson Jason R. 
Published: February 2025

AbstractBackgroundAlzheimer’s disease (AD) is characterized by the presence of amyloid-β plaques, neurofibrillary tangles, and neuroinflammation. Previously, we reported serum levels of dichlorodiphenyldichloroethylene (DDE), the primary metabolite of the pesticide dichlorodiphenyltrichloroethane (DDT), were significantly higher in AD patients compared to age-matched controls and that DDT exposure worsened AD pathology in animal models.ObjectiveHere, we investigated the effect of DDT on neuroinflammation in primary mouse microglia (PMG) and C57BL/6J mice.MethodsEffects of DDT on inflammation and disease-associated microglia were determined in primary mouse microglia and C57BL/6J mice.ResultsPMG exposed to DDT (0.5-5.0 µM) elicited a ∼2-3-fold increase inIl-1bmRNA levels, with similar concentration-dependent upregulation inIl-6, Nos2,andTnfa. These effects were blocked by the sodium channel antagonist tetrodotoxin, demonstrating the role of DDT-microglial sodium channel interactions in mediating this response. Additionally, NOS2 protein levels increased by ∼1.5-2-fold, while TNFa was elevated by 2-4-fold. C57BL/6J male and female mice exposed to DDT (30 mg/kg) demonstrated significantly increased mRNA levels ofNos2,Il-1b, andIl-6in the frontal cortex (1.5-2.3-fold), andNos2,Il-1b,andTnfa(1.5-1.8-fold) in the hippocampus. Furthermore, microglial homeostatic genes,Cx3cr1,P2ry12,andTmem119, were downregulated, while stage 1 disease-associated microglia genes were upregulated bothin vitroandin vivo. Notably,ApoeandTrem2were only upregulated in the frontal cortex and hippocampus of females.ConclusionThese data indicate that DDT increases neuroinflammation, which may result from direct actions of DDT on microglia, providing a novel pathway by which DDT may contribute to AD risk.