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Background: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disease with no effective treatment. Altered microbiota composition seems implicated in disease etiology and therefore fecal microbial transplantation (FMT) has emerged as a possible treatment therapy. To clarify the clinical parameters impacting FMT efficacy, we conducted a systematic review with subgroup analysis. Methods: A literature search was performed identifying randomized controlled trials (RCTs) comparing FMT with placebo in IBS adult patients (8-week follow-up) with a reported improvement in global IBS symptoms. Results: Seven RCTs (489 participants) met the eligibility requirements. Although FMT seems not to be effective in global improvement of IBS symptoms, subgroup analysis shows that FMT through gastroscopy or nasojejunal tube are effective IBS treatments (RR 3.03; 95% CI 1.94–4.73; I2 = 10%, p < 0.00001). When considering non-oral ingestion routes, IBS patients with constipation symptoms are more likely to benefit from FMT administration (p = 0.003 for the difference between IBS subtypes regarding constipation). Fresh fecal transplant and bowel preparation seem also to have impact on FMT efficacy (p = 0.03 and p = 0.01, respectively). Conclusion: Our meta-analysis revealed a set of critical steps that could affect the efficacy of FMT as clinical procedure to treat IBS, nevertheless more RCTs are needed. [ABSTRACT FROM AUTHOR]

Water is a scarce resource in the Mediterranean region where adverse climatic conditions promoting water shortages tend to increase with climate change. Under water scarcity conditions and high atmosphere evaporative demand, the risks of decreased water quality, and land salinization are major threats to the sustainability of irrigated agriculture in this region. The assessment of the quality of irrigation water is increasingly important to ensure the maintenance of long-term salt balance at a crop, farm, and regional scale. This study is focused on the spatial and temporal variability of water quality for irrigation in the Alqueva reservoir (Southern Portugal). The assessment was performed every 2 months during a distinctive drought year (2017) and included inorganic ions (Na+, Ca2+, Mg2+, K+, NH4+, Cl−, F−, SO42−, NO3−, and NO2−), pH, and electric conductivity (ECW) of water. Sodium adsorption ratio (SAR) was calculated, and potential soil permeability problems were estimated. The assessment showed significantly higher values of the physicochemical parameters in the most upstream sites, located near tributaries inflows, and an upward trend in ion concentrations throughout the year, with significantly higher concentrations of Na+, Mg2+, Cl−, and SO42, registered through May to November, reflecting the severe drought felt in the summer, autumn, and winter. The evaluation of water quality for irrigation indicated a slight to moderate risk of reduced infiltration rates, which should be considered whenever sprinkler irrigation is used, mainly in fine-textured soils, which are prevalent in the irrigated area. The multivariate statistical approach, using principal component analysis and factor analysis, identified two principal components related to salinity and nutrient concentrations. The cluster analysis revealed three groups of similarity between samples pointing to a more time- than space-controlled pattern. Overall, the temporal dynamics of the water physicochemical parameters could indicate that an abnormal annual distribution of precipitation and temperature may distort seasonal differences. To prevent water and soil degradation, a more frequent assessment of the water quality should be considered, allowing for the selection of appropriate soil and water management measures in irrigated areas. [ABSTRACT FROM AUTHOR]

Nowadays, the Mediterranean freshwater systems face the threat of water scarcity, along with multiple other stressors (e.g., organic and inorganic contamination, geomorphological alterations, invasive species), leading to the impairment of their ecosystem services. All these stressors have been speeding up, due to climate variability and land cover/land use changes, turning them into a big challenge for the water management plans. The present study analyses the physicochemical and phytoplankton biomass (chlorophyll-a) dynamics of a large reservoir, in the Mediterranean region (Alqueva reservoir, Southern Portugal), under diverse meteorological conditions and land cover/land use real scenarios (2017 and 2018). The most important stressors were identified and the necessary tools and information for a more effective management plan were provided. Changes in these parameters were further related to the observed variations in the meteorological conditions and in the land cover/land use. The increase in nutrients and ions in the water column, and of potentially toxic metals in the sediment, were more obvious in periods of severe drought. Further, the enhancement of nutrients concentrations, potentially caused by the intensification of agricultural activities, may indicate an increased risk of water eutrophication. The results highlight that a holistic approach is essential for a better water resources management strategy. [ABSTRACT FROM AUTHOR]

Salinization and sodification are important processes of soil degradation affecting irrigated lands. A large proportion of the global irrigated area is affected by some degree of soil salinity or sodicity caused by the intensification of irrigation. The increase of the frequency of adverse climatic conditions, like high temperatures and variations in precipitation patterns caused by climate change, will potentially amplify these processes in arid, semi-arid, and Mediterranean areas. The use of integrated approaches for the spatial and temporal prediction of the risk of salinization and sodification in irrigated areas is of great value, helping in the decision-making regarding land uses and choice of more suitable agricultural practices. In this study, based on key criteria for the assessment of irrigation-related salinization processes (e.g., climate, topography, soil drainage, water quality for irrigation, and crop irrigation method), we developed a methodology for the prediction of soil salinity and sodicity risk in irrigated lands, using two composite indices, the Salinization Risk (RSA) index and the Sodification Risk (RSO) index. The application of these indices to a real scenario (a Mediterranean area in Southern Portugal) showed that 67% of the potentially irrigated area presented a low risk of salinity development, 68% had a moderate risk of sodification, and 16% was of high risk of sodicity development. Areas under moderate risk of salinization (26%) were mostly characterized by low slopes and fine-textured soils, like Luvisols and Vertisols, with limited drainage conditions. Areas with high risk of soil sodification presented a large incidence of low slope terrain, moderate-to-restricted soil drainage, in high clay content Luvisols, Vertisols and Cambisols, and land use dominated by annual crops irrigated with surface or sprinkler systems. These risk prediction tools have the potential to be used for resource use planning by policymakers and on-farm management decision by farmers, contributing to the sustainability of irrigated agriculture in Mediterranean regions. [ABSTRACT FROM AUTHOR]

Four streams in the Guadiana watershed were followed up to assess hydrogeomorphological and physicochemical characteristics, and to analyze its correlation with land use/land cover (LULC), analyzing their possible influence in reservoir water quality and possible influence in the reservoir water quality. The highest amounts of organic descriptors and nutrients were quantified in streams with the major percentage of olive groves and vineyards and urban land cover classes. Streams more influenced by agro-silvo-pastoral class presented better water quality, as this type of LULC acts as a buffer of the contamination runoff. The results highlighted that the hydrogeomorphology of the streams may influence the transfer of pollutants loads to reservoirs. Hence, in intermittent streams characterized by coarse particles in the sediment, high amounts of pollutants are accumulated when the flow ceases, and are further transported to the reservoirs when the flow retakes. On the contrary, streams with sediments characterized by a great percentage of fine particles and organic matter do not induce so much stress in reservoirs, since these allow the adsorption of nutrients and trace elements, without their transfer to reservoirs. [ABSTRACT FROM AUTHOR]