Assessment of patient-centered outcomes (PROs) in inflammatory bowel disease (IBD): a multicenter survey preceding a cross-disciplinary (functional) consensus.

BACKGROUND: With a shift in the healthcare paradigm towards a more patient-centered approach, data on inflammatory bowel disease (IBD) needs to be further explored. This study aimed to determine patient perspectives on the effect of IBD and features of patients with lower satisfaction level and compare patient and physician perception of IBD-related Quality of Care (QoC). METHODS: A previously developed pre-standardised set of questions regarding patient-centered outcome (PRO) measures for IBD, comprising 36 items, was administered in five centers, and a concomitant questionnaire for specialised physicians was adapted and administered. RESULTS: Overall, 1005 patients with IBD met the inclusion criteria. Sixty-five questionnaires were administered to specialised physicians. Both patients and physicians perceived the IBD-related QoC as being satisfactory. Furthermore, this study revealed areas of shortcomings where it comes to patient perceptions. Female sex and the presence of negatively impacting disease characteristics (presence of significant pain or discomfort, lack of energy, feeling fatigued most of the time, experiencing anxiety or depression in the last 2 weeks) were associated with lower satisfaction levels. CONCLUSIONS: Our findings can be used in establishing strategies aimed at improving patient QoC and defining strategic priorities. These data can aid in improving the communication of the pressing needs of IBD patients, to both the public payers and health authorities.

Comprehensive ecological risk assessment for semi-arid basin based on conceptual model of risk response and improved TOPSIS model-a case study of Wei River Basin, China.

Comprehensive ecological risk assessment is of great significance for the restoration of watershed ecosystem health, and the appropriate and effective assessment method is the premise of ecological risk assessment. In this study, the conceptual model of risk response was developed by identification of ecological risk sources, stressors, endpoints and the corresponding response mechanism as well as the improved TOPSIS model based on Canberra distance and the combinatorial weighting method based on AHP and Critic were combined for the assessment. According to the three aspects of agriculture, industrial and urbanization, the occurrence mechanism of comprehensive ecological risk of rivers in semi-arid areas was analyzed. Furthermore, twenty-four indexes were selected to establish the index system and the Wei River Basin was taken as an example to verify the model. The results of comprehensive ecological risk assessment and stressor analysis showed that the deterioration of water quality (enrichment of heavy metals) and the decrease of benthos integrity were the two main risk factors for the increase of comprehensive ecological risk in Wei River Basin. And the regulation of ecological risk for the Wei River Basin is improvement of water quality and biotic integrity.

Assessment of fish communities using environmental DNA: Effect of spatial sampling design in lentic systems of different sizes.

Freshwater fish biodiversity is quickly decreasing and requires effective monitoring and conservation. Environmental DNA (eDNA)-based methods have been shown to be highly sensitive and cost-efficient for aquatic biodiversity surveys, but few studies have systematically investigated how spatial sampling design affects eDNA-detected fish communities across lentic systems of different sizes. We compared the spatial patterns of fish diversity determined using eDNA in three lakes of small (SL; 3 ha), medium (ML; 122 ha) and large (LL; 4,343 ha) size using a spatially explicit grid sampling method. A total of 100 water samples (including nine, 17 and 18 shoreline samples and six, 14 and 36 interior samples from SL, ML and LL, respectively) were collected, and fish communities were analysed using eDNA metabarcoding of the mitochondrial 12S region. Together, 30, 35 and 41 fish taxa were detected in samples from SL, ML, and LL, respectively. We observed that eDNA from shoreline samples effectively captured the majority of the fish diversity of entire waterbodies, and pooled samples recovered fewer species than individually processed samples. Significant spatial autocorrelations between fish communities within 250 m and 2 km of each other were detected in ML and LL, respectively. Additionally, the relative sequence abundances of many fish species exhibited spatial distribution patterns that correlated with their typical habitat occupation. Overall, our results support the validity of a shoreline sampling strategy for eDNA-based fish community surveys in lentic systems but also suggest that a spatially comprehensive sampling design can reveal finer distribution patterns of individual species.