Advancing ethnobiology for the ecological transition and a more inclusive and just world: a comprehensive framework for the next 20 years.

This opinion piece, written by ethnobiologists from different parts of the world, emphasizes the importance of ethnobiology research in advancing contemporary biology, natural resource management, biodiversity conservation, sustainable development, and, especially, contributing to the ecological transition and more just and inclusive world. To achieve these goals, it is essential to develop research and collaborate with social groups that live in close relationship with nature in research activities, such as Indigenous Peoples and Local Communities (IPLC), as well as Afro-descendants and other Marginalized, Minority or Minoritized Communities (AMMC). Ethnobiology can identify and provide locally appropriate solutions to local problems, enabling sustainable resource management at the landscape level. The text explores important aspects that need to be considered to guide the future of ethnobiology in the next 20 years, aiming to integrate and amplify previous discussions held in the discipline and identify points that demand ongoing attention. This paper highlights reflections from diverse researchers, emphasizing how ethnobiology can embrace different perspectives and employ rigorous analysis of complex phenomena toward effective policies and practices. This approach holds the potential to address the challenges the planet is currently facing in the coming decades.

East meets west: using ethnobotany in ethnic urban markets of Barcelona metropolitan area (Catalonia) as a tool for biocultural exchange.

BACKGROUND: Ethnobotanical studies in metropolitan areas and urban ethnic markets have grown considerably in recent years as large cities have demonstrated to be significantly rich in biocultural diversity and in driving its evolution, as human populations migrate from one region to another. Urban spaces also represent important places of rich multicultural and multilingual interaction and exchange, where ethnobotany can act as a bridge between research and action. The purpose of this study is to present a case study on how to use ethnobotany in multicultural urban settings by studying people-plant interactions and the larger implications and applications to promote biocultural learning in these areas. METHODS: We inventoried the botanical composition of fresh and dry products sold in most food stores owned by Chinese immigrants in Fondo, a neighbourhood of Barcelona's metropolitan area, in Santa Coloma de Gramenet municipality (Barcelonès county, Catalonia, Iberian Peninsula), pharmacologically validating the obtained list with the Chinese Pharmacopoeia. We also participated in multiple dissemination activities and materials (non-academic and academic), along with exchanges with the broader community in relation to this research. RESULTS: In total, 103 plants were identified at the species level, pertaining to 88 genera and 46 botanical families. Including the infraspecific level, a total of 113 plant taxa were inventoried. One algal and six fungal species were also recorded, but not included in the analyses. Brassicaceae (12.4%) and Fabaceae (10.6%) were the most predominant families inventoried, followed by Cucurbitaceae (7.1%) and Poaceae (7.1%). Over three-quarters of all the taxa have an Asian origin (76.11%), indicating a high conservation of the use of Asian taxa. Over one-third (36.89%) of the plant parts pertain to species contained in the Chinese Pharmacopoeia, showing the relevance of medicinal plants in local stores and the preponderance of Eastern Asian food-medicine continuums. To promote ethnobotanical education programmes, over 50 dissemination activities and educational materials were produced from this study and shared with the local urban community in different fora. CONCLUSIONS: Further research in these and similar settings can provide significant ethnographic information to better understand anthropological processes and phenomena underlying migration and transculturation that can be used in an umbrella of applications, from adequate nomenclature and labelling of foreign products in local languages to multicultural integration and social cohesion programmes along with educational activities on biocultural topics.

Traditional knowledge 10 min far from Barcelona: ethnobotanical study in the Llobregat river delta (Catalonia, NE Iberian Peninsula), a heavily anthropized agricultural area.

BACKGROUND: The right floodplain at the Llobregat river delta (Catalonia, NE Iberian Peninsula) constitutes an agricultural periurban area adjacent to Barcelona, which has remained ethnobotanically unexplored until now. This area comprises a very heavily anthropized mosaic of soil uses-urban, industrial, natural, agricultural-including the Agricultural Park of Baix Llobregat. The main aim of this work has been to collect and analyze the ethnoflora of this area in order to fill a gap in the ethnobotanical knowledge in industrialized areas. METHODS: The followed methodology has been based on semi-structured interviews. The obtained data have been qualitatively and quantitatively analyzed and compared with other studies. RESULTS: Data have been gathered from 83 informants. The interviewed informants referred 1965 use reports from 292 taxa, including both non-cultivated and cultivated species, from 85 botanical families. Among those, 451 were referred to medicinal uses, 1247 to food uses and 267 to other uses. In the present study, 779 vernacular names have been reported for 287 taxa. In addition to medicinal and food uses, this study significantly enhances our understanding of some agrosilvopastoral uses of plants, artistic use of plants and insights into folk functional foods. In this regard, we propose a novel quantitative ethnobotany index (the folk functional food index) to assess the relative significance of taxa employed as folk functional foods. CONCLUSIONS: The findings of this study highlight the enduring presence of ethnobotanical knowledge in this periurban agricultural region and underscore the significance of its preservation.

Parallel anagenetic patterns in endemic Artemisia species from three Macaronesian archipelagos.

Anagenetic speciation is an important mode of evolution in oceanic islands, yet relatively understudied compared to adaptive radiation. In the Macaronesian region, three closely related species of Artemisia (i.e. A. argentea, A. thuscula and A. gorgonum) are each endemic from a single archipelago (i.e. Madeira, Canary Islands and Cape Verde, respectively), representing a perfect opportunity to study three similar but independent anagenetic speciation processes. By analysing plastid and nuclear DNA sequences, as well as nuclear DNA amount data, generated from a comprehensive sampling in all the islands and archipelagos where these species are currently distributed, we intend to find common evolutionary patterns that help us explain the limited taxonomic diversification experienced by endemic Macaronesian Artemisia. Our time-calibrated phylogenetic reconstruction suggested that divergence among the three lineages occurred in a coincidental short period of time during the Pleistocene. Haplotype and genetic differentiation analyses showed similar diversity values among A. argentea, A. thuscula and A. gorgonum. Clear phylogeographic patterns-showing comparable genetic structuring among groups of islands-were also found within the three archipelagos. Even from the cytogenetic point of view, the three species presented similarly lower genome size values compared to the mainland closely related species A. arborescens. We hypothesize that the limited speciation experienced by the endemic Artemisia in Madeira, Canary Islands and Cape Verde archipelagos could be related to their recent parallel evolutionary histories as independent lineages, combined with certain shared characteristics of seed dispersal, pollen transport and type of habitat.

Rapid Reduction of HbA1c and Early Worsening of Diabetic Retinopathy: A Real-world Population-Based Study in Subjects With Type 2 Diabetes.

OBJECTIVE: Early worsening of diabetic retinopathy (EWDR) due to the rapid decrease of blood glucose levels is a concern in diabetes treatment. The aim of the current study is to evaluate whether this is an important issue in subjects with type 2 diabetes with mild or moderate nonproliferative DR (NPDR), who represent the vast majority of subjects with DR attended in primary care. RESEARCH DESIGN AND METHODS: This is a retrospective nested case-control study of subjects with type 2 diabetes and previous mild or moderate NPDR. Using the SIDIAP ("Sistema d'informació pel Desenvolupament de la Recerca a Atenció Primària") database, we selected 1,150 individuals with EWDR and 1,150 matched control subjects (DR without EWDR). The main variable analyzed was the magnitude of the reduction of HbA1c in the previous 12 months. The reduction of HbA1c was categorized as rapid (>1.5% reduction in <12 months) or very rapid (>2% in <6 months). RESULTS: We did not find any significant difference in HbA1c reduction between case and control subjects (0.13 ± 1.21 vs. 0.21 ± 1.18; P = 0.12). HbA1c reduction did not show significant association with worsening of DR, neither in the unadjusted analyses nor in adjusted statistical models that included the main confounding variables: duration of diabetes, baseline HbA1c, presence of hypertension, and antidiabetic drugs. In addition, when stratification by baseline HbA1c was performed, we did not find that those patients with higher levels of HbA1c presented a higher risk to EWDR. CONCLUSIONS: Our results suggest that the rapid reduction of HbA1c is not associated with progression of mild or moderate NPDR.

Value contribution of cenobamate for the treatment of Focal-Onset Seizures (FOS) in patients with drug-resistant epilepsy (DRE) in Spain through reflective Multi-Criteria Decision Analysis (MCDA).

INTRODUCTION: Epilepsy is one of the most common neurological conditions worldwide. The main goal of its treatment is to achieve seizure freedom without intolerable adverse effects. However, despite the availability of many anti-seizure medications, including the latest options, called third-generation anti-seizure medications (ASMs), approximately 40% of people with epilepsy present drug-resistant epilepsy (DRE). Cenobamate is the first ASM approved in Spain for the adjunctive treatment of Focal-Onset Seizures (FOS) in adult patients with DRE. In a chronic disease with a portfolio of available ASMs, the decision to introduce a new therapeutic alternative must follow a holistic evaluation of value provided. Reflective Multi-Criteria Decision Analysis (MCDA) methodology allows to determine the value contribution of a treatment in a given indication considering all relevant criteria for healthcare decision-making in a transparent and systematic manner from the perspective of relevant stakeholders. PURPOSE: The aim of this study was to determine the relative value contribution of cenobamate in the treatment of FOS in patients with DRE compared with third-generation ASMs using reflective MCDA-based methodology. METHODS: A systematic literature review (combining biomedical databases and grey literature sources) was performed to populate the Evidence and Value: Impact on DEcisionMaking (EVIDEM) MCDA framework adapted to determine what represents value in the management of FOS in patients with DRE in Spain. The study was conducted in two phases. The first took place in 2021 with a multi-stakeholder group of eight participants. The second phase was conducted in 2022 with a multi-stakeholder group of 32 participants. Participants were trained in MCDA methodology and scored four evidence matrices (cenobamate vs. brivaracetam, vs. perampanel, vs. lacosamide and vs. eslicarbazepine acetate). Results were analyzed and discussed in a group meeting through reflective MCDA discussion methodology. RESULTS: DRE is considered a very severe condition associated with many important unmet needs, mainly with regard to the lack of more effective treatments to achieve the ultimate goal of treatment. Compared to third-generation ASMs, cenobamate is perceived to have a better efficacy profile based on improvements in responder rate and seizure freedom. Regarding safety, it is considered to have a similar profile to alternatives and a positive quality-of-life profile. Cenobamate results in lower direct medical costs (excluding pharmacological) and indirect costs. Overall, cenobamate is regarded as providing a high therapeutic impact and supported by high-quality evidence. CONCLUSIONS: Based on reflective MCDA methodology and stakeholders' experience in clinical management of epilepsy in Spain, cenobamate is perceived as a value-added option for the treatment of patients with DRE when compared with third-generation ASMs.

Phylogenomics and morphological evolution of the mega-diverse genus Artemisia (Asteraceae: Anthemideae): implications for its circumscription and infrageneric taxonomy.

BACKGROUND AND AIMS: Artemisia is a mega-diverse genus consisting of ~400 species. Despite its medicinal importance and ecological significance, a well-resolved phylogeny for global Artemisia, a natural generic delimitation and infrageneric taxonomy remain missing, owing to the obstructions from limited taxon sampling and insufficient information on DNA markers. Its morphological characters, such as capitulum, life form and leaf, show marked variations and are widely used in its infrageneric taxonomy. However, their evolution within Artemisia is poorly understood. Here, we aimed to reconstruct a well-resolved phylogeny for global Artemisia via a phylogenomic approach, to infer the evolutionary patterns of its key morphological characters and to update its circumscription and infrageneric taxonomy. METHODS: We sampled 228 species (258 samples) of Artemisia and its allies from both fresh and herbarium collections, covering all the subgenera and its main geographical areas, and conducted a phylogenomic analysis based on nuclear single nucleotide polymorphisms (SNPs) obtained from genome skimming data. Based on the phylogenetic framework, we inferred the possible evolutionary patterns of six key morphological characters widely used in its previous taxonomy. KEY RESULTS: The genus Kaschgaria was revealed to be nested in Artemisia with strong support. A well-resolved phylogeny of Artemisia consisting of eight highly supported clades was recovered, two of which were identified for the first time. Most of the previously recognized subgenera were not supported as monophyletic. Evolutionary inferences based on the six morphological characters showed that different states of these characters originated independently more than once. CONCLUSIONS: The circumscription of Artemisia is enlarged to include the genus Kaschgaria. The morphological characters traditionally used for the infrageneric taxonomy of Artemisia do not match the new phylogenetic tree. They experienced a more complex evolutionary history than previously thought. We propose a revised infrageneric taxonomy of the newly circumscribed Artemisia, with eight recognized subgenera to accommodate the new results.

Novel Insights into the Nature of Intraspecific Genome Size Diversity in Cannabis sativa L.

Cannabis sativa has been used for millennia in traditional medicine for ritual purposes and for the production of food and fibres, thus, providing important and versatile services to humans. The species, which currently has a worldwide distribution, strikes out for displaying a huge morphological and chemical diversity. Differences in Cannabis genome size have also been found, suggesting it could be a useful character to differentiate between accessions. We used flow cytometry to investigate the extent of genome size diversity across 483 individuals belonging to 84 accessions, with a wide range of wild/feral, landrace, and cultivated accessions. We also carried out sex determination using the MADC2 marker and investigated the potential of flow cytometry as a method for early sex determination. All individuals were diploid, with genome sizes ranging from 1.810 up to 2.152 pg/2C (1.189-fold variation), apart from a triploid, with 2.884 pg/2C. Our results suggest that the geographical expansion of Cannabis and its domestication had little impact on its overall genome size. We found significant differences between the genome size of male and female individuals. Unfortunately, differences were, however, too small to be discriminated using flow cytometry through the direct processing of combined male and female individuals.

Gastrointestinal, metabolic, and nutritional disorders: A plant-based ethnoveterinary meta-analysis in the Catalan linguistic area.

Veterinary care is fundamental for animal wellbeing, and so is achieving a comprehensive understanding of traditional ethnoveterinary applications. However, little attention has been paid to it so far in industrialized countries, and in particular in Western Europe. In this context, the present work aims to make a contribution to this issue in the Catalan linguistic area, focusing on the study of plants used, at a popular level, to treat and deal with gastrointestinal, metabolic, and nutritional disorders, which are among the most important issues that affect animals. Data obtained in this study come from the popular knowledge about plants for veterinary purposes from 599 informants, who jointly provided 1,405 reports of use from 148 plant taxa. The most cited species have been Tanacetum parthenium (L.) Sch.Bip. (9.04%), Olea europaea L. subsp. europaea var. europaea (6.26%), and Euphorbia lathyris L. (6.26%). At higher taxonomic levels, the botanical families with more ethnoveterinary applications were Asteraceae (24.48%), Euphorbiaceae (8.33%), and Oleaceae (7.12%). Among the total use reports, 95.02% refer to disorders of the gastrointestinal system, 4.34% to nutritional disorders, and 0.64% to metabolic disorders. Antidiarrheal (18.01%), digestive (16.51%), and laxative (15.80%) have been the most reported veterinary uses. The most used plant parts have been the aerial part (40.50%), the fruit or the infructescence (18.65%), and the flower or inflorescence (16.01%). The main preparation and administration forms reported were tisane (58.69%), followed by direct use (without any specific pharmaceutical form; 21.77%). The global corpus of ethnoveterinary knowledge for the gastrointestinal system disorders in the territory of study is diverse, with some species having a very high cultural value, as indicated by an informant consensus factor very close to 1. Some reported uses were also confirmed after consultation of encyclopedic pharmacological works, although few of these works are specifically devoted to veterinary uses. The results of this study are relevant to preserve the ethnoveterinary knowledge, but also represent an important contribution to be taken into account in research for future development of new plant-based drugs for animals.

Genome Size Variation Assessment in Vitis vinifera L. Landraces in Ibiza and Formentera (Balearic Islands).

Plant genome size has many applications in different biological fields including ecology and plant breeding. The 2C value for Vitis vinifera L. has not been widely studied; furthermore, to date, no data from local landraces in the Pityusic Islands (the two smaller inhabited Balearic Islands, Ibiza, and Formentera) have been reported. This research aims to contribute to this knowledge and investigate whether there are variations between different grape landraces cultivated in Ibiza and Formentera and also among the same landraces on each island. To this end, 36 accessions of 15 cultivars and 6 landraces, identified with SSR markers, were assessed using flow cytometry. The results revealed that 2C values ranged from 1.09 pg to 1.28 pg. There were statistically significant differences in 'AG1' and 'AG2' landraces and 'Santa Magdalena', 'Garnatxa', 'Danugue', and 'Valencí tinto/Grumier' cultivars. No statistically significant differences were found in terms of the genome size content between islands. Statistically significant differences were found in accessions within 'AG2' landrace group and 'Beba' cultivar. The results presented here constitute the first-ever reported information on genome size in the genus Vitis vinifera in Pityusic, Balearic, and, in general, Spanish accessions, and they are one of the largest prospections in this field for this species anywhere. Further research should be conducted to explain the differences in nuclear DNA content found between landraces and cultivars studied here with others cultivated in different islands or countries to understand whether genome size varies in modern cultivars compared with local landraces. Additionally, it would be interesting to investigate whether there is a relationship between genome size and adaptations to diverse climatology conditions, crop management, and ripening characteristics.

Cancer and Traditional Plant Knowledge, an Interesting Field to Explore: Data from the Catalan Linguistic Area.

Cancer is the second cause of death in the world and is foreseen to be responsible for about 16 million deaths in 2040. Approximately, 60% of the drugs used to treat cancer are of natural origin. Besides the extensive use of some of these drugs in therapies, such as those derived from the genus Taxus, a significant number of plants have revealed themselves as useful against cancer in recent years. The field of ethnobotany focuses on documenting traditional knowledge associated with plants, constituting a starting point to uncover the potential of new plant-based drugs to treat or prevent, in this case, tumour diseases and side effects of chemotherapy and radiotherapy. From a series of extensive ethnobotanical prospections across the Catalan linguistic area (CLA), we have recorded uses for 41 taxa with antitumour effects. The two most quoted botanical families are Asteraceae and Ranunculaceae, and the most frequently reported species is Ranunculus parnassifolius, a high-mountain species, which is widely collected for this purpose. The reported species have been used to treat an important number of cancer types, focusing on preventive, palliative, and curative uses, as well as to deal with the side effects of conventional treatments. Comparing our results in CLA with previous data available in the most comprehensive databases of pharmacology and a review of cytotoxicity assays revealed that for the several species reported here, there was no previous evidence of traditional uses against cancer. Despite the need for further analyses to experimentally validate the information presented here, combining traditional uses and phylogenetically-informed strategies to phytochemical and pharmacological research would represent new avenues to establish more integrative approaches, hence improving the ability to select new candidate taxa in cancer research.

Compliance with the DPP-4 inhibitors dose adjustment recommendations based on renal function in a population database.

OBJECTIVE: To examine the prescription pattern of the different dipeptidyl peptidase-4 inhibitors (DPP4is), depending on the estimated glomerular filtration rate (eGFR) under real-world clinical practice conditions. METHOD: This was a descriptive, observational study using a population database (SIDIAP Catalonia). Subjects diagnosed with T2DM with kidney function assessed and on active treatment with DPP4is were enrolled. Patients were included at the time of the measurement of eGFR (CKD-epi) and were monitored for 6 months after enrolment. For each subject, the prescribed daily dose (PDD) of DPP4i, the theoretical dose according to the degree of renal failure established by the recommendations in the summary of product characteristics (DDD-adj), and the PDR ratio (PDD/DDD-adj) were estimated. A subject was considered overtreated if his/her RDR was greater than 1.2 (>20%). RESULTS: The study sample consisted of 72,135 subjects with a mean age of 69.7 (±11.6) years and 55.9% males. The proportion of patients overtreated varied depending on the type of DPP4i and the renal function stage. Overall, overdosage was recorded in 7.15% of all DPP4i treatments. In advanced stages (IIIb, IV, and V), overdosage was much higher (36.8% for all DPP4is, and 58.7% if linagliptin is excluded). DISCUSSION: Under real-world clinical practice conditions, more than one third of T2DM patients with advanced renal failure were overdosed with DPP4is because the doses were not adequately adjusted to the glomerular filtration rate of each patient.

The Use of Cannabis sativa L. for Pest Control: From the Ethnobotanical Knowledge to a Systematic Review of Experimental Studies.

Background: Despite the benefits that synthetic pesticides have provided in terms of pest and disease control, they cause serious long-term consequences for both the environment and living organisms. Interest in eco-friendly products has subsequently increased in recent years. Methods: This article briefly analyzes the available ethnobotanical evidence regarding the use of Cannabis sativa as a pesticide and offers a systematic review of experimental studies. Results: Our findings indicate that both ethnobotanical and experimental procedures support the use of C. sativa as a pesticide, as remarkable toxicity has been observed against pest organisms. The results included in the systematic review of experimental studies (n=30) show a high degree of heterogeneity, but certain conclusions can be extracted to guide further research. For instance, promising pesticide properties were reported for most of the groups of species tested, especially Arachnida and Insecta; the efficacy of C. sativa as a pesticide can be derived from a wide variety of compounds that it contains and possible synergistic effects; it is crucial to standardize the phytochemical profile of C. sativa plants used as well as to obtain easily reproducible results; appropriate extraction methods should be explored; and upper inflorescences of the plant may be preferred for the production of the essential oil, but further studies should explore better other parts of the plant. Conclusion: In the coming years, as new findings are produced, the promising potential of C. sativa as a pesticide will be elucidated, and reviews such as the present one constitute useful basic tools to make these processes easier.

The Role of Traditional Plant Knowledge in the Fight Against Infectious Diseases: A Meta-Analytic Study in the Catalan Linguistic Area.

Infectious diseases represent, as a group, the main cause of mortality in the world. The most important reasons are multidrug-resistant pathogens, the rapid spread of emerging diseases aggravated by globalization, and the extended reach of tropical and vector-borne diseases resulting from continued climate change. Given the increase in these diseases and the limited effectiveness of antibiotics, traditional knowledge can constitute a useful tool to address these new health challenges. The aim of this work is to analyze extensively the available ethnobotanical data linked to infections and infestations in the Catalan linguistic area, with the intention of depicting the panorama of the folk use of herbal products to address the quoted ailments, preserving the popular plant knowledge and management data. The meta-analytic work performed in the present study covers 29 research studies belonging to different regions throughout the Catalan linguistic area. The medicinal ethnoflora to treat infections and infestations in the Catalan linguistic area includes 326 taxa belonging to 78 botanical families of vascular plants. The informant consensus factor (FIC) was 0.92, and the ethnobotanicity index (EI) was 7.26%. Artemisia absinthium (10.98%; 0.37) and Thymus vulgaris (8.06%; 0.27) are the most quoted taxa and have the highest values of the cultural importance index. The most reported use was antihelminthic (30.15%), followed by internal antiseptic (19.43%) and antipyretic (13.69%). The medicinal importance index shows the relevance of the antihelminthic use (14.23) and also the use against measles (10.19). The information is coincidental with at least one of the comprehensive pharmacological literature sources checked for 47.42% of ethnobotanical uses. These results, centered on the plants used to treat infection and infestation diseases, are the first step toward selecting some of the most interesting species to develop phytochemical and pharmacological studies and suggesting an alternative regarding how to face the health emergency involving the expansion of infectious diseases, based on local and traditional knowledge.

Detecting Introgressed Populations in the Iberian Endemic Centaurea podospermifolia through Genome Size.

Based on results from previous studies, populations of the Iberian endemic Centaurea podospermifolia north of the Ebro River are considered genetically pure, while those southward are introgressed, with genetic input from C. cephalariifolia. This phenomenon is particularly relevant, especially given both the endangered and protected status for the species, which can have consequences in how to best apply conservation strategies to maintain genetic resources in the species. The main goal of this study was to evaluate whether genome size assessments using flow cytometry can help distinguishing between pure, hybrid and introgressed populations, and hence become a powerful and cost-effective tool to complement comprehensive population genetic surveys. The results indicate that there are significant genome size differences between populations of C. podospermifolia, which are coincident with previous considerations of pure and introgressed populations. Given the simplicity and reproducibility of this technique, flow cytometry could become an effective tool for monitoring pure populations of this species and, indeed, become an integral part of the management plans that are mandatory for listed taxa.

Cardiovascular and mortality benefits of sodium-glucose co-transporter-2 inhibitors in patients with type 2 diabetes mellitus: CVD-Real Catalonia.

BACKGROUND: Evidence from prospective cardiovascular (CV) outcome trials in type 2 diabetes (T2DM) patients supports the use of sodium-glucose co-transporter-2 inhibitors (SGLT2i) to reduce the risk of CV events. In this study, we compared the risk of several CV outcomes between new users of SGLT2i and other glucose-lowering drugs (oGLDs) in Catalonia, Spain. METHODS: CVD-REAL Catalonia was a retrospective cohort study using real-world data routinely collected between 2013 and 2016. The cohorts of new users of SGLT2i and oGLDs were matched by propensity score on a 1:1 ratio. We compared the incidence rates and hazard ratio (HR) for all-cause death, hospitalization for heart failure, chronic kidney disease, and modified major adverse CV event (MACE; all-cause mortality, myocardial infarction, or stroke). RESULTS: After propensity score matching, 12,917 new users were included in each group. About 27% of users had a previous history of CV disease. In the SGLT2i group, the exposure time was 60% for dapagliflozin, 26% for empagliflozin and 14% for canagliflozin. The use of SGLT2i was associated with a lower risk of heart failure (HR: 0.59; 95% confidence interval [CI] 0.47-0.74; p < 0.001), all-cause death (HR = 0.41; 95% CI 0.31-0.54; p < 0.001), all-cause death or heart failure (HR = 0.55; 95% CI 0.47-0.63; p < 0.001), modified MACE (HR = 0.62; 95% CI 0.52-0.74; p < 0.001), and chronic kidney disease (HR = 0.66; 95% CI 0.54-0.80; p < 0.001). CONCLUSIONS: In this large, retrospective observational study of patients with T2DM from a Catalonia, initiation of SGLT-2i was associated with lower risk of mortality, as well as heart failure and CKD.

Compliance with the DPP-4 inhibitors dose adjustment recommendations based on renal function in a population database. / Cumplimiento de las recomendaciones de ajuste de la dosis de inhibidores DPP4 según la función renal en una base de datos poblacional.

OBJECTIVE: To examine the prescription pattern of the different dipeptidyl peptidase-4 inhibitors (DPP4is), depending on the estimated glomerular filtration rate (eGFR) under real-world clinical practice conditions. METHOD: This was a descriptive, observational study using a population database (SIDIAP Catalonia). Subjects diagnosed with T2DM with kidney function assessed and on active treatment with DPP4is were enrolled. Patients were included at the time of the measurement of eGFR (CKD-EPI) and were monitored for 6 months after enrolment. For each subject, the prescribed daily dose (PDD) of DPP4i, the theoretical dose according to the degree of renal failure established by the recommendations in the summary of product characteristics (DDD-adj), and the PDR ratio (PDD/DDD-adj) were estimated. A subject was considered overtreated if his/her RDR was greater than 1.2 (>20%). RESULTS: The study sample consisted of 72,135 subjects with a mean age of 69.7 (±11.6) years and 55.9% males. The proportion of patients overtreated varied depending on the type of DPP4i and the renal function stage. Overall, overdosage was recorded in 7.15% of all DPP4i treatments. In advanced stages (IIIb, IV and V), overdosage was much higher (36.8% for all DPP4is, and 58.7% if linagliptin is excluded). DISCUSSION: Under real-world clinical practice conditions, more than one third of T2DM patients with advanced renal failure were overdosed with DPP4is because the doses were not adequately adjusted to the glomerular filtration rate of each patient.

Traditional uses of Cannabis: An analysis of the CANNUSE database.

ETHNOPHARMACOLOGICAL RELEVANCE: Cannabis is one of the most versatile genera in terms of plant use and has been exploited by humans for millennia. Nowadays, Cannabis is the centre of many scientific studies, most of them focusing on chemical composition and medicinal values. While new and varied applications are continuously being developed, the knowledge surrounding less common uses of the plant is slowly disappearing. AIM OF THE REVIEW: We have analysed diversity of global data of Cannabis traditional uses, to investigate if certain plant parts are significantly associated with particular Cannabis use. We wanted to uncover potential associations between the plant parts used for the treatment of different body systems and ailments. MATERIALS AND METHODS: We have analysed the extensive database of Cannabis traditional uses (CANNUSE). This database contains 2330 data entries of Cannabis ethnobotanical uses from over 40 countries across the world. The dataset was divided into five general groups based on the type of use: medicinal, alimentary, psychoactive, fibre and other uses. Given the abundance of human medicinal uses, detailed analysis was done on the subset of 1167 data entries. We analysed the relationship between 16 body system categories and ailments treated with Cannabis plant parts. We used a Pearson's chi-square and Fisher's exact test, to determine which Cannabis parts are characteristic of treatment for specific ailments. RESULTS: In this dataset, the majority of reports were represented by medicinal (75.41%), followed by psychoactive (8.35%) and alimentary (7.29%) use. The most commonly used plant parts were leaf (50.51%), seed (15.38%) and inflorescence (11.35%). We found that different Cannabis plant parts were significantly associated with different uses; the leaf was typically used for medicinal, seed for alimentary and inflorescence for psychoactive use. Regarding the human medicinal uses, most common were reports for treatments of the digestive system and nutritional disorders (17.66%), nervous system and mental disorders (16.24%), followed by pain and inflammations (12.21%). We found a significant relationship between the use of certain Cannabis parts and treatment of ailments and body systems categories; leaf was significantly associated with treatment of two categories: skin and subcutaneous tissue disorders and circulatory system and blood disorders; seed use was associated with musculoskeletal system disorders and traumas; while inflorescence use shows a statistical support for treatment of nervous system and mental disorders. CONCLUSION: Several pharmaceutical companies are intensely working on developing new drugs with isolated chemical compounds or crude extracts, almost exclusively from Cannabis inflorescences. However, our review revealed that use of leaf or seed in traditional medicine is often more important than use of inflorescence for the treatment of certain ailments. A review of traditional medicine provides a body of knowledge and an initial pathway to identify landraces and plant parts that could have an important role in future medicinal research. We are confident that traditional medicine still has a large potential for modern medicine. As more information on Cannabis diversity (genetics, biochemistry, and clinical studies) becomes available, ethnobotanical data are poised to be of much greater significance.

CANNUSE, a database of traditional Cannabis uses-an opportunity for new research.

Cannabis is one of the most versatile genera in terms of plant uses and has been exploited by humans for millennia due to its medicinal properties, strong fibres, nutritious seeds and psychoactive resin. Nowadays, Cannabis is the centre of many scientific studies, which mainly focus on its chemical composition and medicinal properties. Unfortunately, while new applications of this plant are continuously being developed, some of its traditional uses are becoming rare and even disappearing altogether. Information on traditional uses of Cannabis is vast, but it is scattered across many publication sources in different formats, so synthesis and standardization of these data are increasingly important. The CANNUSE database provides an organized information source for scientists and general public interested in different aspects of Cannabis use. It contains over 2300 entries from 649 publications related to medicinal, alimentary, fibre and other uses from different geographical areas and cultures around the world. We believe this database will serve as a starting point for new research and development strategies based on the traditional knowledge. Database URL: http://cannusedb.csic.es.

The Role of Botanical Families in Medicinal Ethnobotany: A Phylogenetic Perspective.

Studies suggesting that medicinal plants are not chosen at random are becoming more common. The goal of this work is to shed light on the role of botanical families in ethnobotany, depicting in a molecular phylogenetic frame the relationships between families and medicinal uses of vascular plants in several Catalan-speaking territories. The simple quantitative analyses for ailments categories and the construction of families and disorders matrix were carried out in this study. A Bayesian approach was used to estimate the over- and underused families in the medicinal flora. Phylogenetically informed analyses were carried out to identify lineages in which there is an overrepresentation of families in a given category of use, i.e., hot nodes. The ethnobotanicity index, at a specific level, was calculated and also adapted to the family level. Two diversity indices to measure the richness of reported taxa within each family were calculated. A total of 47,630 use reports were analysed. These uses are grouped in 120 botanical families. The ethnobotanicity index for this area is 14.44% and the ethnobotanicity index at the family level is 68.21%. The most-reported families are Lamiaceae and Asteraceae and the most reported troubles are disorders of the digestive and nutritional system. Based on the meta-analytic results, indicating hot nodes of useful plants at the phylogenetic level, specific ethnopharmacological research may be suggested, including a phytochemical approach of particularly interesting taxa.