Achieving Sustainability of the Seafood Sector in the European Atlantic Area by Addressing Eco-Social Challenges: The NEPTUNUS Project

Fisheries and aquaculture are becoming a focus of societal concern driven by globalization and increasing environmental degradation, mainly caused by climate change and marine litter. In response to this problem, the European Atlantic Area NEPTUNUS project aims to support and inform about the sustainability of the seafood sector, boosting the transition towards a circular economy through defining eco-innovation approaches and a steady methodology for eco-labelling products. This timely trans-regional European project proposes key corrective actions for positively influencing resource efficiency by addressing a life cycle thinking and involving all stakeholders in decisionmaking processes, harnessing the water-energy-seafood nexus. This paper presents inter-related objectives, methodologies and cues to action that will potentially meet these challenges that are aligned with many of the United Nations Sustainable Development Goals and European policy frameworks (e.g., Farm to Fork, European Green Deal). © 2022 by the authors. Licensee MDPI, Basel, Switzerland

Achieving Sustainability of the Seafood Sector in the European Atlantic Area by Addressing Eco-Social Challenges: The NEPTUNUS Project

Fisheries and aquaculture are becoming a focus of societal concern driven by globalization and increasing environmental degradation, mainly caused by climate change and marine litter. In response to this problem, the European Atlantic Area NEPTUNUS project aims to support and inform about the sustainability of the seafood sector, boosting the transition towards a circular economy through defining eco-innovation approaches and a steady methodology for eco-labelling products. This timely trans-regional European project proposes key corrective actions for positively influencing resource efficiency by addressing a life cycle thinking and involving all stakeholders in decision-making processes, harnessing the water-energy-seafood nexus. This paper presents inter-related objectives, methodologies and cues to action that will potentially meet these challenges that are aligned with many of the United Nations Sustainable Development Goals and European policy frameworks (e.g., Farm to Fork, European Green Deal)

Early treatment with anti-tumor necrosis factor agents improves long-term effectiveness in symptomatic stricturing Crohn's disease.

There is limited evidence on the effectiveness of biological therapy in stricturing complications in patients with Crohn's disease. The study aims to determine the effectiveness of anti-tumor necrosis factor (TNF) agents in Crohn's disease complicated with symptomatic strictures. In this multicentric and retrospective study, we included adult patients with symptomatic stricturing Crohn's disease receiving their first anti-TNF therapy, with no previous history of biological, endoscopic or surgical therapy. The effectiveness of the anti-TNF agent was defined as a composite outcome combining steroid-free drug persistence with no use of new biologics or immunomodulators, hospital admission, surgery or endoscopic therapy during follow-up. Overall, 262 patients with Crohn's disease were included (53% male; median disease duration, 35 months, 15% active smokers), who received either infliximab (N = 141, 54%) or adalimumab (N = 121, 46%). The treatment was effective in 87% and 73% of patients after 6 and 12 months, respectively, and continued to be effective in 26% after a median follow-up of 40 months (IQR, 19-85). Nonetheless, 15% and 21% of individuals required surgery after 1 and 2 years, respectively, with an overall surgery rate of 32%. Postoperative complications were identified in 15% of patients, with surgical site infection as the most common. Starting anti-TNF therapy in the first 18 months after the diagnosis of Crohn's disease or the identification of stricturing complications was associated with a higher effectiveness (HR 1.62, 95% CI 1.18-2.22; and HR 1.55, 95% CI 1.1-2.23; respectively). Younger age, lower albumin levels, strictures located in the descending colon, concomitant aminosalicylates use or presence of lymphadenopathy were associated with lower effectiveness. Anti-TNF agents are effective in approximately a quarter of patients with Crohn's disease and symptomatic intestinal strictures, and 68% of patients are free of surgery after a median of 40 months of follow-up. Early treatment and some potential predictors of response were associated with treatment success in this setting

Clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in patients with ulcerative colitis treated with two consecutive anti-TNF agents: data from the ENEIDA registry

Background: Infliximab seems to be the most efficacious of the three available anti-TNF agents for ulcerative colitis (UC) but little is known when it is used as the second anti-TNF. Objectives: To compare the clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in UC patients. Design: Retrospective observational study. Methods: Patients from the ENEIDA registry treated consecutively with infliximab and a subcutaneous anti-TNF (or vice versa), naïve to other biological agents, were identified and grouped according to the administration route of the first anti-TNF into IVi (intravenous initially) or SCi (subcutaneous initially). Results: Overall, 473 UC patients were included (330 IVi and 143 SCi). Clinical response at week 14 was 42.7% and 48.3% in the IVi and SCi groups (non-statistically significant), respectively. Clinical remission rates at week 52 were 32.8% and 31.4% in the IVi and SCi groups (nonsignificant differences), respectively. A propensity-matched score analysis showed a higher clinical response rate at week 14 in the SCi group and higher treatment persistence in the IVi group. Regarding long-term outcomes, dose escalation and discontinuation due to the primary failure of the first anti-TNF and more severe disease activity at the beginning of the second anti-TNF were inversely associated with clinical remission. Conclusion: The use of a second anti-TNF for UC seems to be reasonable in terms of efficacy, although it is particularly reduced in the case of the primary failure of the first anti-TNF. Whether the second anti-TNF is infliximab or subcutaneous does not seem to affect efficacy