A policy-based framework for the determination of management options to protect vulnerable marine ecosystems under the EU deep-sea access regulations

Vulnerable marine ecosystems (VMEs) are particularly susceptible to bottom-fishing activity as they are easily disturbed and slow to recover. A data-driven approach was developed to provide management options for the protection of VMEs under the European Union “deep-sea access regulations.” A total of two options within two scenarios were developed. The first scenario defined VME closure areas without consideration of fishing activity. Option 1 proposed closures for the protection of VME habitats and likely habitat, while Option 2 also included areas where four types of VME geophysical elements were present. The second scenario additionally considered fishing. This scenario used VME biomass—fishing intensity relationships to identify a threshold where effort of mobile bottom-contact gears was low and unlikely to have caused significant adverse impacts. Achieving a high level of VME protection requires the creation of many closures (> 100), made up of many small (∼50 km2) and fewer larger closures (> 1000 km2). The greatest protection of VMEs will affect approximately 9% of the mobile fleet fishing effort, while closure scenarios that avoid highly fished areas reduce this to around 4–6%. The framework allows managers to choose the level of risk-aversion they wish to apply in protecting VMEs by comparing alternative strategies.En prensa2,27

Eosinophilic pneumonias. A clinical case of acute eosinophilic pneumonia associated with sertraline and literature review

Background: Acute eosinophilic pneumonia (AEP) is one of the heterogeneous group of disorders termed eosinophilic lung diseases showing an abnormal accumulation of eosinophils in distal airways, air spaces, and the interstitial compartment of the lung. AEP is characterized by acute febrile respiratory failure, a typical radiographic pattern similar to that of acute pulmonary edema, eosinophilia in bronchoalveolar lavage (BAL), a dramatic response to corticosteroid therapy with no relapse when tapering or withdrawing treatment in the absence of infection. It can be idiopathic o secondary to known causes such as drugs, or fungal and parasitic infections. Clinical case: We report a case of a 76-year-old woman who developed symptoms, respiratory signs, and radiological and histological findings compatible with secondary AEP, we assessed as being associated with sertraline assumption (second case in literature). Discussion: The AEP we detected could be related to a secondary hypersensitivity syndrome to drug exposure (DRESS syndrome: Drug Rush with Eosinophilia and Systemic Symptoms) characterized by 1) skin rush, 2) increased eosinophilia, and 3) systemic involvement. The presence of all three criteria confirmed our diagnosis

Pharmacologic Treatment of Mixed States

Despite the relatively high prevalence of mixed symptoms and features among patients with mood disorders, the current literature supporting the specific efficacy of second-generation antipsychotics and mood stabilizers for the treatment of mixed symptoms is limited. Several studies have demonstrated that acute affective episodes with mixed symptoms or features tend to respond unsatisfactory to treatments that are usually more effective for the management of other affective phases. There is clearly a need for clinical trials in order to determine the more adequate pharmacologic option for the treatment of individuals suffering from affective episodes with mixed features

Comparison of the tubercolin skin test and the ellispot blood test for the diagnosis of latent tuberculosis infection in pre-transplant dialysis patients

End stage renal disease (ESRD) is a known risk factor for progression to active tuberculosis (TB) from latent tuberculosis infection (LTBI). Kidney transplant and immunosuppressive therapy may increase the risk of TB recurrence. Patients with LTBI undergoing dialysis would therefore benefit from preventive treatment with isoniazid, which often has adverse side effects in this particular group of patients. Therefore it is important to accurately identify ESRD patients with LTBI, mainly if awaiting renal transplantation. The standard tool for diagnosing LTBI is the century-old tuberculin skin test (TST); however, patients with ESRD, as many other immunosuppressedpatients, often have falsely negative TST results. The Enzyme-Linked ImmunoSpot (ELISPOT) test is a new test which enumerates M. tuberculosis-specific T-cells in peripheral blood samples and has been already shown to be more specific and more sensitive than the TST for diagnosis of LTBI. We tested 84 ESRD patients on dialysis treatment with TST and ELISPOT: 26 were on peritoneal dialysis and 57 on hemodialysis; only 1 patient was on conservative treatment. Mean age was 48\ub114 years (range 23-75); 51 male and 33 female. Simultaneous RD1 Elispot and TST (5 UI PPD) were performed. According to current guidelines, the cut-off value for a positive TST using 5 UI of PPD is 10 mm; based upon previously published studies, the pre- defined positive cut-off for the ELISPOT is 20 spot forming cells per million peripheral blood mononuclear cells. In 64 patients (76%) TST and ELISPOT gave concordant results and in more than 90% were both negative. Only 2 patients tested TST-positive and ELISPOT-negative (one was an immigrant from a high-prevalence Country) while 18 (21%) were TST-negative, but ELISPOT positive. These preliminary results indicate that a significant proportion of ESRD patients on dialysis treatment may have hitherto unrecognised LTBI and an associated increased risk of progression to active disease, mainly after renal transplantation

Empoyment of the ELISPOT blood test for the diagnosis of latent tuberculosis infection in dialysis patients awaiting renal transplantation

Abstract COngresso Internazional

A policy-based framework for the determination of management options to protect vulnerable marine ecosystems under the EU deep-sea access regulations

Vulnerable marine ecosystems (VMEs) are particularly susceptible to bottom-fishing activity as they are easily disturbed and slow to recover. A data-driven approach was developed to provide management options for the protection of VMEs under the European Union “deep-sea access regulations.” A total of two options within two scenarios were developed. The first scenario defined VME closure areas without consideration of fishing activity. Option 1 proposed closures for the protection of VME habitats and likely habitat, while Option 2 also included areas where four types of VME geophysical elements were present. The second scenario additionally considered fishing. This scenario used VME biomass—fishing intensity relationships to identify a threshold where effort of mobile bottom-contact gears was low and unlikely to have caused significant adverse impacts. Achieving a high level of VME protection requires the creation of many closures (> 100), made up of many small (∼50 km2) and fewer larger closures (> 1000 km2). The greatest protection of VMEs will affect approximately 9% of the mobile fleet fishing effort, while closure scenarios that avoid highly fished areas reduce this to around 4–6%. The framework allows managers to choose the level of risk-aversion they wish to apply in protecting VMEs by comparing alternative strategies

ICES Scientific Reports. 2:114. 237 pp.

Under regulation (EU) 2016/2336, the EU fleet will be banned from bottom fishing in all waters between 400 and 800m in depth, apart from within the existing fishing footprint. Within the fishing footprint, EU vessels will be prohibited from bottom fishing in any closed areas that might be introduced to protect VMEs. To meet these regulatory requirements, ICES was requested by the European Commission to provide “advice on the list of areas where VMEs are known to occur or are likely to occur and on the existing deep-sea fishing areas (ref. (EU)2016/2336)”. The ICES workshop WKEUVME was tasked to produce the technical evidence base for producing a set of regulatory area options, building on 2019 work (Technical Service and WKREG workshop), as well as previous ICES advice (ICES 2018a) and technical services (ICES 2018b). The work drew upon the most recent fishing activity and vulnerable marine ecosystem (VME) distribution data at ICES, which has been quality assured following the respective annual ICES data calls for VMS/logbook (link) and VMEs (link). The assessment procedure herein is fully documented, with the respective scripts to run the assessment available on an open source platform (WKEUVME GitHub site). Two “assessment sheets” with respective regulatory area options for two larger ecoregions (Bay of Biscay and Iberian Coast, and the Celtic Seas) were produced. These assessment sheets served as the basis for dissemination documents for managers – stakeholders meeting of WKEUVME in September 2020, and could be incorporated into their respective annual ICES Ecosystem and Fisheries Overviews in future. There are also strong links to shallower water assessment procedures developed by WGFBIT (Working Group on Fisheries Benthic Impact and Trade-offs) that have been developed for the ICES Ecosystem Overview advice in the context of Descriptor 6 seafloor integrity of the EC’s marine strategy framework directive (MSFD). WKEUVME used a data-driven approach to provide management options for this request. Two broad scenarios were provided, each with two options. For each option a set of rules was defined for producing the outcomes. The first scenario defined VME closure polygons without any modification by known fishing activity. The first option under this scenario focused on VME habitats and areas with a High or Medium VME Index score (a multi-criteria assessment method developed by WGDEC). The second option included areas identified in option 1 and added in areas where four types of VME elements were present (areas where VMEs are likely to occur: seamounts, banks, coral mounds, and mud volcanoes); allowing managers to choose the level of precaution they wish to apply in protecting VMEs. The second scenario identified areas where the fishing footprint overlapped with VMEs and then used VME biomass/fishing intensity relationships to identify a threshold (swept-area ratio (SAR) < 0.43) for areas where effort was low and unlikely to have caused Significant Adverse Impacts to the VMEs (at C-square resolution). Two options for closing areas under this scenario were presented: the first where VME habitats and areas with a High or Medium VME Index score (irrespective of fishing effort) and only Low VME Index score with low fishing effort were closed; the other where all areas of VME presence (habitats and Low, Medium and High VME Index values) were closed, but only in areas of low fishing effort, on the basis that any VME habitat in heavily fished C-squares would be degraded