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Background: The optimal antithrombotic (antiplatelet or anticoagulant) treatment of patients undergoing extracranial carotid artery interventions is a subject of debate. The aim of this multidisciplinary document was to critically review the recommendations of current guidelines, taking into consideration the results of recendy published studies. Methods:The various antithrombotic strategies reported were evaluated for asymptomatic and symptomatic patients undergoing extracranial carotid artery interventions (endarterectomy, transfemoral carotid artery stenting [CAS] or transcarotid artery revascularization [TCAR]). Based on a critical review, a series of recommendations were formulated by an international expert panel. Results: For asymptomatic patients, we recommend low-dose aspirin (75-100 ing/day) or dopidogrel (75 mg/day) with the primary goal to reduce the risk of myocardial infarction and cardiovascular event rates rather than to reduce the risk of stroke. For symptomatic patients, we recommend dual antiplatelet treatment (DAFT) initiated within 24 h of the index event to reduce the risk of recurrent events. We suggest that following transfemoral CAS or TCAR, patients continue DAFT for 1 month after which a single antiplatelet agent is used. High level of evidence to support anticoagulant treatment for patients with carotid artery disease is lacking. Condusions: The antithrombotic treatment offered to carotid patients should be individualized, taking into account the presence of symptoms, the type of intervention and the goal of the treatment. The duration and type of DAFr (ticagrelor instead of dopidogrel) should be evaluated in future trials. [ABSTRACT FROM AUTHOR]

International guidelines strongly recommend statins alone or in combination with other lipid-lowering agents to lower low-density lipoprotein cholesterol (LDL-C) levels for patients with asymptomatic/symptomatic carotid stenosis (AsxCS/SCS). Lowering LDL-C levels is associated with significant reductions in transient ischemic attack, stroke, cardiovascular (CV) event and death rates. The aim of this multi-disciplinary overview is to summarize the benefits and risks associated with lowering LDL-C with statins or non-statin medications for Asx/SCS patients. The cerebrovascular and CV beneficial effects associated with statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and other non-statin lipid-lowering agents (e.g. fibrates, ezetimibe) are reviewed. The use of statins and PCSK9 inhibitors is associated with several beneficial effects for Asx/SCS patients, including carotid plaque stabilization and reduction of stroke rates. Ezetimibe and fibrates are associated with smaller reductions in stroke rates. The side-effects resulting from statin and PCSK9 inhibitor use are also highlighted. The benefits associated with lowering LDL-C with statins or non-statin lipid lowering agents (e.g. PCSK9 inhibitors) outweigh the risks and potential side-effects. Irrespective of their LDL-C levels, all Asx/SCS patients should receive high-dose statin treatment±ezetimibe or PCSK9 inhibitors for reduction not only of LDL-C levels, but also of stroke, cardiovascular mortality and coronary event rates. [ABSTRACT FROM AUTHOR]

Fishery monitoring programs are essential for effective management of marine resources, as they provide scientists and managers with the necessary data for both the preparation of scientific advice and fisheries control and surveillance. The monitoring is generally done by human observers, both in port and onboard, with a high cost involved. Consequently, some Regional Fisheries Management Organizations (RFMO) are opting for electronic monitoring (EM) as an alternative or complement to human observers in certain fisheries. This is the case of the tropical tuna purse seine fishery operating in the Indian and Atlantic oceans, which started an EM program on a voluntary basis in 2017. However, even when the monitoring is conducted though EM, the image analysis is a tedious task manually performed by experts. In this paper, we propose a cost-effective methodology for the automatic processing of the images already being collected by cameras onboard tropical tuna purse seiners. Firstly, the images are preprocessed to homogenize them across all vessels and facilitate subsequent steps. Secondly, the fish are individually segmented using a deep neural network (Mask R-CNN). Then, all segments are passed through other deep neural network (ResNet50V2) to classify them by species and estimate their size distribution. For the classification of fish, we achieved an accuracy for all species of over 70%, i.e., about 3 out of 4 individuals are correctly classified to their corresponding species. The size distribution estimates are aligned with official port measurements but calculated using a larger number of individuals. Finally, we also propose improvements to the current image capture systems which can facilitate the work of the proposed automation methodology. [ABSTRACT FROM AUTHOR]

The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement is to reconcile the conflicting views on the topic. A literature review was performed with a focus on data from recent studies. Several clinical and imaging high-risk features have been identified that are associated with an increased long-term ipsilateral ischemic stroke risk in patients with ACS. Such high-risk clinical/imaging features include intraplaque hemorrhage, impaired cerebrovascular reserve, carotid plaque echolucency/ulceration/ neovascularization, a lipid-rich necrotic core, a thin or ruptured fibrous cap, silent brain infarction, a contralateral transient ischemic attack/stroke episode, male patients < 75 years and microembolic signals on transcranial Doppler. There is growing evidence that 80–99% ACS indicate a higher stroke risk than 50–79% stenoses. Although aggressive risk factor control and BMT should be implemented in all ACS patients, several high-risk features that may increase the risk of a future cerebrovascular event are now documented. Consequently, some guidelines recommend a prophylactic carotid intervention in high-risk patients to prevent future cerebrovascular events. Until the results of the much-anticipated randomized controlled trials emerge, the jury is still out regarding the optimal management of ACS patients. [ABSTRACT FROM AUTHOR]

Objectives: The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement is to reconcile the conflicting views on the topic.Materials and Methods: A literature review was performed with a focus on data from recent studies.Results: Several clinical and imaging high-risk features have been identified that are associated with an increased long-term ipsilateral ischemic stroke risk in patients with ACS. Such high-risk clinical/imaging features include intraplaque hemorrhage, impaired cerebrovascular reserve, carotid plaque echolucency/ulceration/ neovascularization, a lipid-rich necrotic core, a thin or ruptured fibrous cap, silent brain infarction, a contralateral transient ischemic attack/stroke episode, male patients < 75 years and microembolic signals on transcranial Doppler. There is growing evidence that 80-99% ACS indicate a higher stroke risk than 50-79% stenoses.Conclusions: Although aggressive risk factor control and BMT should be implemented in all ACS patients, several high-risk features that may increase the risk of a future cerebrovascular event are now documented. Consequently, some guidelines recommend a prophylactic carotid intervention in high-risk patients to prevent future cerebrovascular events. Until the results of the much-anticipated randomized controlled trials emerge, the jury is still out regarding the optimal management of ACS patients. [ABSTRACT FROM AUTHOR]

[Display omitted] • A multi-chemical evaluation of 60 breast milk samples was performed. • 31 organic contaminants and 14 toxic and essential elements were determined. • Breastfed babies are exposed to a mixture of hazardous chemicals. • Maternal features (age, body mass index) and smoking are key exposure factors. • Breast milk from low-income mothers has higher levels of DDT and DDE. Breastfeeding is one of the most effective ways to ensure child health and survival, with several benefits for both the infants and their mothers. However, breast milk can contain environmental pollutants with endocrine disruption capacity, neurotoxicity and/or potential to alter microbiota. Monitoring breast milk provides information on the current chemical exposure of breastfed infants and, in addition, on the current and historical exposure of nursing mothers. In this study, the levels of a wide range of pollutants were measured in breast milk of Spanish nursing mothers. Target chemicals were dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB), oxy-chlordane, polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), per- and poly-fluoroalkyl substances (PFASs) (including perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA)), chlorpyrifos, bisphenol A (BPA), tetrabromobisphenol A (TBBPA), and a number of toxic and essential elements. Traces of most chemicals were found. A correlation between the levels of some persistent organic pollutants (POPs) and maternal characteristics (age and body mass index) was observed, while smoking was associated to higher concentrations of some toxic elements. Higher levels of PCBs were detected in samples from Spanish primiparous mothers compared to non-Spanish multiparous women. Breast milk from low-income mothers showed higher content of DDT and DDE than high-income mothers. Although breastfeeding is clearly beneficial for babies, the exposure to this mixture of hazardous substances, as well as their interaction and combined effects must not be disregarded. [ABSTRACT FROM AUTHOR]

Different fishing strategies have been adopted in the last decades by tropical tuna purse seiners fleet, including fish aggregating device (FAD) and free-swimming school (FSC) fishing strategies, which has raised issues about the different carbon footprint of those fishing modes. Here we show the activity and energy patterns of a Spanish tuna purse seiner operating in the tropical Indian Ocean, based on the monitoring of energy consumption over 10 consecutive fishing trips; and we also assess the fuel use intensity of FAD versus FSC fishing by analysing 14 further trips of different tropical tuna purse seiners. The average time of a fishing trip lasted 33.1 ± 11 days. The dominant activity during the fishing trip was cruising (with 68.5% of the time), followed by inactive period at sea (15.6%), fishing (7.7%), and in port (8.1%). The vessel consumed 381 ± 113 t fuel/trip, of which 90.4% was spent in cruising, 4.3% in fishing, 3.7% during the inactive period at night and 1.6% while staying in port. The main engine consumed 75% of the total fuel, while the auxiliary engines the remaining 25%. Furthermore, our results demonstrated that FAD fishing (543.6 L/t) is more fuel intensive, than FSC fishing (439.4 L/t). However, FADs fishing successful rates are higher, around 95.7 ± 3.8%, than FSC rates (around 80.6% ± 5.8). It is worth noting that the differences may be driven by seasonality and FSC availability, number of FADs in an area, vessel characteristics and equipment, and skipper skills rather than the adopted fishing strategy. Nonetheless both FAD and FSC fishing are more energy efficient than longline (1069 L/t), trolling (1107 L/t), or pole and line (1490 L/t) fisheries for Atlantic tuna, but similar or slightly less efficient than Maldivian pole and liners. [Display omitted] • Cruising is the most dominant activity in a fishing trip. • Main engine consumes the 75% of the total fuel consumption. • FSC fishing presents better FUI index than FAD fishing. • FAD fishing presents higher set success rate than FSC sets. [ABSTRACT FROM AUTHOR]

Route optimization methods offer an opportunity to the fisheries industry to enhance their efficiency, sustainability, and safety. However, the use of route optimization Decision Support Systems (DSS), which have been widely used in the shipping industry, is limited in the case of fisheries. In the first part, this work describes the fishing routing problems, reviews the state-of-the-art methods applied in the shipping industry, and introduces a general framework for fishing route optimization decision support systems (FRODSS). In the second part, we highlight the existing gap for the application of DSS in fisheries, and how to develop a FRODSS considering the different types of fishing fleets. Finally, and using the diverse Basque fishing fleet as a case study, we conclude that fishing fleets can be summarized into four main groups whose fishing routes could be optimized in a similar way. This characterization is based on their similarities, such us the target species, fishing gear, and the type and distance to the fishing grounds. These four groups are: (i) small-scale coastal fleet; (ii) large-scale pelagic fleet; (iii) large-scale demersal fleet; and (iv) the distant-water fleet. Distant-water vessels are currently the fleet that can more easily benefit from FRODSS, and they are used as an example here. However, the rest of the fleets could also benefit through adequate adaptation to their operation characteristics, driven by their specific fishing gear and target species. [ABSTRACT FROM AUTHOR]