Search Results (250)

Background: Early identification of liver transplant (LT) recipients at risk of graft failure is crucial to allow timely retransplantation. Lactate levels have been proposed as markers of graft dysfunction, although their optimal timing and predictive value remain uncertain. This study aimed to investigate the prognostic role of early postoperative lactate measurements for predicting 90-day graft loss after LT and compare their performance with established early allograft dysfunction scores. Methods: This retrospective observational study included adult patients undergoing their first LT at the Sapienza University of Rome (Italy) between 2013 and 2021, with external validation in an independent cohort from Zagreb University (Croatia) between 2022 and 2025. Lactate levels were evaluated at declamping, at the end of transplantation, and as the peak value within the first postoperative day. Their predictive ability for 90-day graft loss was compared with Early Allograft Dysfunction (EAD) and the Model for Early Allograft Function (MEAF) score using receiver operating characteristic (ROC) analysis. Results: A total of 268 LT recipients were analyzed (178 Sapienza and 90 Zagreb). Ninety-day graft loss occurred in 25 (14.0%) patients in Sapienza and 10 patients (11.1%) in Zagreb. A lactate peak within the first postoperative day showed the highest discriminative ability for predicting graft loss in both cohorts (Sapienza: AUC 0.87, 95%CI 0.77–0.98, p < 0.001; Zagreb: AUC 0.79, 95%CI 0.62–0.97, p = 0.003). This outperformed EAD and MEAF. A lactate peak cutoff of 5.0 mmol/L (75th percentile) resulted in 80.0% sensitivity and 86.3% specificity in Sapienza and 80.0% sensitivity and 68.7% specificity in Zagreb. Higher thresholds increased specificity, reaching 98.7% and 95.0% at 8.4 mmol/L in the Sapienza and Zagreb cohorts, respectively. Patients with a lactate peak ≥ 5.0 mmol/L showed significantly higher 90-day graft loss compared with those below the threshold in both cohorts (Sapienza: 47.6% vs. 4.7%, p < 0.001; Zagreb: 25.0% vs. 5.0%, p = 0.004). Conclusions: The peak lactate value during the first postoperative day represents a simple and accurate biomarker for predicting early graft loss after LT. Its superior predictive performance compared with commonly used EAD-related scores suggests that the lactate peak may represent a valuable tool for early postoperative risk stratification. Full article

A Jeffersonian model of civic education supports robust civic engagement while differing in important respects from prevailing paradigms of community-embedded learning that prioritize activism. Rather than emphasizing participation alone, Jefferson’s approach to the development of civic awareness foregrounds reasoned speech, civil discourse, and the cultivation of practical judgment informed by theoretical understanding. Central to this model is Jefferson’s insistence that civic education is primarily a local and state responsibility, grounded in a broader commitment to self-government. Jefferson’s account reflects an appreciation for human reason as a universal capacity that makes consent and civic deliberation possible. Reason, so understood, provides the foundation for political equality and for an account of human flourishing articulated most clearly in the Declaration of Independence and consistent with core claims of the natural law tradition. This framework supports a conception grounded in metaphysical equality and civic friendship, best expressed within a federal political order, and capable of sustaining what classic sources and contemporary initiatives describe as a “pervasive commitment to diversity—as well as unity”. Further contributing to the novelty of our argument, we show that Jeffersonian natural-law-inflected civic engagement resonates well into the 20th century. Important judicial decisions, educational initiatives, and policy recommendations—including Cook v. McKee, Education for American Democracy (EAD), and the Truman Commission Report—draw upon related concepts of civic formation, consent, and reasoned participation. Jefferson’s emphasis on “reasons in speech,” understood as an essential element of self-government, thus remains a necessary and underappreciated contribution to contemporary debates over civic education and engagement. Full article

Background and Objectives: Early allograft dysfunction (EAD) after liver transplantation (LT) is associated with adverse graft and patient outcomes. However, its effects on kidney outcomes remain unclear. We retrospectively investigated the association between EAD and various kidney events following LT. Materials and Methods: We included 92 LT recipients. EAD was defined by the presence of ≥1 of the following: total bilirubin level ≥ 10 mg/dL or international normalized ratio ≥ 1.6 on postoperative day 7, or aspartate aminotransferase or alanine aminotransferase level > 2000 U/L within the first 7 days post-LT. Kidney outcomes included acute kidney injury (AKI), acute kidney disease (AKD), kidney replacement therapy (KRT) performance, and changes in estimated glomerular filtration rate (eGFR). Results: AKI incidence was comparable between the non-EAD and EAD groups; however, stage 3 AKI incidence was higher in the EAD group (65.0% vs. 22.2%; p = 0.001). AKD occurred more frequently in the EAD group (75.0% vs. 30.6%, p = 0.001). KRT was required more frequently within 7 days of LT in the EAD group (70.0%) than in the non-EAD group (15.3%) (p < 0.001). Multivariate analysis identified EAD as an independent predictor of KRT requirement (p < 0.001). EAD was associated with prolonged (≥7 days) KRT requirement (p = 0.025). In the receiver operating characteristic curves, all EAD components were associated with KRT requirement following LT. The baseline and 3-month eGFR levels were comparable; however, a trend toward a steeper decline was noted in eGFR in the EAD group than that in the non-EAD group (p = 0.090). The burden of hospitalization and calcineurin inhibitor exposure were similar between the groups. Conclusions: EAD appears to be independently associated with adverse kidney outcomes following LT. Preventive strategies targeting EAD are required to improve post-transplant prognosis and mitigate kidney-related complications. Full article

The adsorption and activation of CO₂ on Cu_xSc_y nanoclusters with x + y equal to 4 were analyzed using DFT and PDOS and TDOS signatures. The geometries of Cu₃Sc, Cu₂Sc₂, and CuSc₃ were optimized in the gas phase, and the minima were verified by frequencies in ORCA using M06-2X/def2-TZVP. Multiplicities 1, 3, and 5, temperatures between 298 and 400 K, and four CO₂ coordination modes R1 to R4 were evaluated. Naked and complex cluster comparison panels were constructed, and two energy windows, −18 to −10 eV and −8 to 6 eV around the Fermi level, were analyzed, complemented by frontier orbitals and charge maps. Thermodynamics indicated that mode and multiplicity control the adsorption energy, with ANOVA p-values of 0.002 and 0.008, while temperature was not significant (p = 0.682). In Cu₃Sc–C₂v(1), the R1 singlet at 298 K showed E_ads −33.43 kcal·mol⁻¹ with spin contamination, while alternative modes in the singlet were unfavorable. In PDOS and TDOS, the bare cluster exhibits a Cu d band at −11 to −10 eV and a valley around −5 eV. The exergonic complexes show CO₂ signals near the Fermi level, superimposed on Cu and Sc states, with state filling and broadening. Transferable indicators based on CO₂ intensity in the −8 to 6 eV range and metal–adsorbate overlap are proposed as predictors of exergonic adsorption. Full article

Background/Objectives: Physical exercise has emerged as a promising non-pharmacological intervention for cognitive dysfunction; however, the most effective mode of exercise remains unclear. This study aimed to investigate the acute effects of two cycling exercise protocols, (a) continuous aerobic/moderate-intensity (CA) and (b) high-velocity/low-resistance (high-cadence) interval (HVI), on cognitive and executive performance in patients with mild cognitive impairment (MCI). Methods: Seventeen patients (10 females and 7 males, age: 65.5 ± 8.85 years) diagnosed with MCI or early-stage Alzheimer’s disease (13 MCI and 4 eAD) participated in a random order in three different conditions: CA, HVI, and control/no exercise (CON). Cognitive parameters were assessed acutely before and after the completion of each condition. Results: Significant condition × time interactions were observed for both Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB) (p < 0.01). Higher scores (p < 0.01) for MoCA and FAB post-intervention were found compared to baseline in both exercise bouts, whereas no changes occurred in CON. Interestingly, when post-intervention scores were compared between conditions, cognitive performance was improved only in HVΙ compared to CON in MoCA (p < 0.01) and FAB (p < 0.001), revealing a stronger acute effect of HVI. Conclusions: A single bout of high-velocity, low-resistance (high-cadence) interval cycling acutely enhanced global cognition and executive function in individuals with MCI, exerting greater improvement compared to continuous aerobic exercise or control condition. These findings emphasize the potential utilization of HVI as an effective non-pharmacological intervention to acutely enhance cognitive performance in older adults with MCI. Full article

This study investigates the feasibility of treating acidic gases produced in oilfields using a novel method that combines cavitation-jet reactor (CJR) technology with electric arc discharge (EAD). The integration of these two approaches enhances the ionization process by converting neutral gas molecules into chemically reactive ion-radical and radical fragments. These highly reactive species eventually recombine, creating new chemical compounds and simpler molecules from incoming acid gas and water vapor. Theoretical validation and experimental demonstration have revealed possible mechanisms and pathways of low-temperature plasma-chemical processes resulting from the synergistic effects of cavitating-jet flow and arc discharge on the molecular degradation of neutral gaseous molecules, such as hydrogen sulfide and carbon dioxide in water vapor, which lead to the generation of new compounds. Research indicates that the most effective method for processing associated petroleum gas (APG) involves minimizing the sequential nature of chemical reactions in low-temperature non-equilibrium plasma environments, thus eliminating the need for costly and complex catalysts. Additionally, studies have shown that the cavitation-jet flow of a gas–vapor–liquid mixture, when combined with an electric arc discharge in the truncated region of the low-temperature plasma of CJR, results in the synthesis of hydrogen, two forms of S₈ (S₈^I and S₈^II), crystalline carbon, and its organic derivatives containing oxygen and nitrogen, specifically methanol, ethanol, acetone, and acetonitrile. The data obtained suggest that the generation of low-temperature plasma in the cavitation-jet chamber, induced by an electric discharge, is essential for the production of reaction products, such as hydrogen, sulfur, and oxygen- and nitrogen-containing derivatives of organic carbon, when water vapor and acid gas molecules traverse the reactor. Full article

The development of lightweight materials with high and reversible hydrogen storage capacity remains a key materials design challenge. Here, we investigate pristine and Ti-decorated C₃B₂ quantum dots using DFT, DLPNO-CCSD(T), and statistical thermodynamics. Pristine C₃B₂ strongly chemisorbs H₂ (E_ads = −0.93 eV), while Ti decoration moderates the interaction to a reversible regime (E_ads = −0.39 eV) through a balanced Kubas-type mechanism. Structural analysis shows that the Ti center becomes saturated at approximately five H₂ molecules via Kubas-type coordination, while additional hydrogen molecules are stabilized in the vicinity of the Ti–C₃B₂ framework through cooperative interactions. Sequential adsorption shows that up to 20 H₂ molecules can be stored per Ti–C₃B₂ unit. Thermodynamic and kinetic analyses reveal moderate desorption temperatures (≈322–366 K) and ultrafast release times, ensuring efficient cycling. Under realistic operating conditions (30/3 atm; 298/373 K), Ti–C₃B₂ achieves a reversible capacity of 20.10 wt%, surpassing DOE targets. These results highlight Ti-decorated C₃B₂ quantum dots as a promising, design-tunable platform for next-generation solid-state hydrogen storage. Full article

Plutella xylostella (L.) (Lepidoptera: Plutellidae), the diamondback moth (DBM), is a cosmopolitan pest of brassicas. To validate and compare the performance of yeast-derived sex pheromone components with chemically synthesized ones, we studied the behavioral and electrophysiological responses (EAGs) of male DBM adults. In addition, using gas chromatography coupled with electroantennographic detection (GC-EAD), we examined whether any residual impurities present in yeast-derived pheromone components can be perceived by the insects’ antennae and are thus capable of interfering with normal behavior. Furthermore, we assessed the performance of the yeast-derived pheromones under field conditions through monitoring trials conducted in cabbage crops in Greece. Electrophysiological and behavioral assays revealed equivalent responses from the insects to both the yeast-derived (BIO) and chemically synthesized (CHEM) pheromone blends. Consistent with this, GC-EAD results showed no significant differences in antennal response to minor impurities present in the BIO blend compared to the CHEM blend. Finally, it was demonstrated that the binary pheromone blend—comprising (Z)-11-hexadecenal and (Z)-11-hexadecenyl acetate derived from (Z)-11-hexadecen-1-ol produced by yeast cell-factories—was as efficient and specific for trapping male moths in cabbage fields as the conventional ternary synthetic blend [(Z)-11-hexadecenal and (Z)-11-hexadecenyl acetate and (Z)-11-hexadecen-1-ol]. The yeast-derived mixture contained small amounts of unoxidized (Z)-11-hexadecen-1-ol due to incomplete oxidation. Full article

Background/Objectives: Autoimmune hepatitis (AIH) often coexists with extrahepatic autoimmune diseases (EADs); however, the clinical significance of EAD comorbidity and its subtypes remains incompletely understood. In addition, an increasing proportion of AIH without EAD (NEAD-AIH) has been suggested but not systematically evaluated. Methods: We retrospectively analyzed 46 patients diagnosed with AIH between 2014 and 2023. Clinical features were compared between EAD-associated AIH (EAD-AIH) and NEAD-AIH. Analyses were performed focusing on major EAD subtypes, including Sjögren’s syndrome (SS), autoimmune thyroid disease (AITD), and systemic sclerosis (SSc). Steroid-treated cases were further evaluated for treatment response and renal outcomes. Results: Among the 46 patients (median age, 63 years; 89% female), 61% had concomitant EADs. Compared with EAD-AIH, NEAD-AIH showed significantly higher AST, ALT, IgG, and bilirubin levels, together with lower albumin and prothrombin activity. Acute-onset hepatitis and corticosteroid use were more frequent in NEAD-AIH, and all cases of liver failure occurred in this group. The proportion of NEAD-AIH increased over time (from 21% to 54%). A small number of recent NEAD-AIH cases occurred after COVID-19 vaccination or immune checkpoint inhibitor therapy, although causality could not be established. Among EAD subtypes, SSc-AIH was characterized by relatively low IgG levels, whereas SS-AIH showed favorable biochemical profiles with low relapse rates. No excess renal deterioration was observed in SSc-AIH after steroid therapy. Conclusions: AIH exhibits substantial clinical heterogeneity according to EAD status and subtype. NEAD-AIH tends to present with a more acute and severe phenotype and appears to be increasing, whereas EAD-AIH shows distinct immunologic characteristics. These findings underscore the importance of considering autoimmune background in the clinical evaluation of AIH. Full article

Background/Objectives: Laparoscopic living donor hepatectomy may compromise hepatic microcirculation and exacerbate ischemia–reperfusion injury. Evidence regarding the effects of dexmedetomidine on donor liver injury and graft outcomes in laparoscopic living donor liver transplantation (LDLT) remains limited. Methods: We conducted a retrospective cohort study of adult donor–recipient pairs undergoing purely laparoscopic living donor hepatectomy with the Pringle maneuver, categorized by intraoperative dexmedetomidine administration. Primary outcomes were postoperative donor liver function and lactate dynamics. Secondary outcomes included recipient postoperative liver function, perioperative lactate dynamics, early allograft dysfunction (EAD), and graft failure. A 1:1 propensity score matching was performed, and longitudinal laboratory trends were analyzed using linear mixed-effects models. Results: Among 395 donor–recipient pairs, 168 matched pairs (84 per group) were analyzed after PSM. Donors receiving dexmedetomidine had significantly lower postoperative peak aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels (both p < 0.01), with significant group-by-time interactions (AST p < 0.001; ALT p = 0.013). Lactate trajectories differed significantly between groups in both donors and recipients (p for interaction < 0.001). In recipients, there were no significant differences between the two groups in EAD (2.4% vs. 8.3%; OR, 0.31; 95% CI, 0.07–1.35; p = 0.168) and one-year graft survival (1.2% vs. 4.8%; HR, 0.36; 95% CI, 0.04–7.20; p = 0.251). Conclusions: Intraoperative dexmedetomidine administration in living liver donors was associated with reduced biochemical evidence of hepatocellular injury and improved perioperative metabolic profiles. These findings suggest a potential donor-level protective effect without demonstrable early clinical benefit in recipients, supporting the need for prospective studies to clarify its clinical significance. Full article

The current investigation examined the effect of inclusion of Black soldier fly (Hermetia illucens; BSF) dry larvae in hens’ diet on egg quality and hen performance. A total of 260 brown egg-laying hens (RIR × RIW) were divided into four groups (65 hens/group; 5 pens/group) and fed with control and experimental diets (inclusion rates 3%, 6%, 9%). Although the four-week feeding period did not influence production parameters, yolk color responded positively to the test diets, showing a linear increase with the percentage of BSF inclusion rate (p < 0.001). This was reaffirmed by the increased levels of yolk carotenoids (astaxanthin and β-carotene) and α-tocopherol, with notable differences in 6% and 9% BSF-fed groups (p ≤ 0.003). Lipids are an important factor in carotenoid absorption and assimilation, and the combination of fat content and carotenoids in BSF suggests the potential of this system for egg enrichment. Along with the increased antioxidant levels, a novel finding is the positive correlation between BSF inclusion rates and hens’ egg yolk levels of C:15 and C:17 fatty acids, key players in the core mechanisms of cell health and longevity. Altogether, the results provide evidence of the potential of BSF for enrichment of eggs with carotenoids and vitamins with strong antioxidant activity, which would have a positive effect on human health. Full article

This study investigates the prospects for implementing hydrogen mobility in Bulgaria within the broader context of transport decarbonization. Using a three-dimensional framework—policy, technology, and geography—it combines analysis of European and national strategic documents, technological feasibility assessment, and a pilot case study in the city of Ruse. The pilot scenario includes a regional hydrogen ecosystem with a photovoltaic-powered electrolyzer, two refueling stations, deployment of 20 hydrogen buses, and retrofitting of a river vessel with fuel cell propulsion. Results indicate that hydrogen technologies can significantly reduce transport-related emissions, particularly where battery-electric solutions face operational constraints. Total Cost of Ownership (TCO) analysis shows that hydrogen buses remain more expensive than diesel or battery-electric alternatives under current conditions, even with locally produced green hydrogen. Sensitivity analysis demonstrates that cost competitiveness may be achieved after 2030 with large-scale investments, policy support, and reduced hydrogen prices. The study highlights the importance of coherent national strategies, public–private partnerships, and targeted financial instruments to enable sustainable integration of hydrogen in urban and river transport systems. Full article

Graphene-like 2D ZnO (g-ZnO), a wide-bandgap semiconductor, shows great potential for gas sensing, owing to its high surface area and carrier mobility. However, the practical use of it is hampered by its intrinsic chemical inertness. In this study, density functional theory was first used to study the effects of zinc vacancies (V_Zn), oxygen vacancies (V_O), and Au doping on formaldehyde (CH₂O) sensing. The results show that engineering of the defects and the Au doping both significantly improve the reactivity of the material. Specifically, the V_Zn system promotes dissociative chemisorption (E_ads = −5.55 eV) of CH₂O to CO and H atoms. Charge compensation effectively passivates the vacancy states and returns the direct bandgap semiconducting nature of the system. Furthermore, Au doping raises the conduction band and enlarges the bandgap, while the charge accumulation around Au atoms activates the surrounding sites, causing the adsorption mechanism to change from physisorption to chemisorption. Overall, the introduction of V_Zn and Au doping is an efficient way to overcome the surface inertness and improve sensing sensitivity, offering a theoretical framework for the design of high-performance 2D gas sensors. Full article

Sandwich panels with trapezoidal (corrugated) cores combine low weight, high specific stiffness, and energy absorption capability. This study analyzes four configurations with different core heights by means of microstructural analyses (optical microscopy, SEM/EDS, XRD) and quasi-static compression tests. The tests yield stress–strain curves with an initial linear stage, a peak, a plateau, and a densification stage. Peak stresses range from 0.5 MPa for the thickest core (P1) to 6.2 MPa for the thinnest core (P4), while the energy absorbed density (EAD) increases with strain: at ε = 30% it varies from 0.031 to 0.670 J/cm³, and at ε = 50% the thin-core configuration reaches ≈1.113 J/cm³. The face sheets and the core are both manufactured from AA 3000 series (Al–Mn) aluminum alloy; widespread micro-porosity and Fe/Mn-rich phases are observed by SEM/EDS. XRD confirms aluminum with different peak intensities ascribable to the manufacturing texture. Increasing the core height promotes earlier local/global instabilities and reduces the peak stress; the thinnest core displays higher stiffness and peak loads. These findings support the use of trapezoidal corrugation where low weight and progressive strain are required. Full article

The article explores the current challenges and prospects for the electrification of the bus fleet in urban passenger transport, with a particular focus on the municipal operator Municipal Transport Ruse EAD. The study is motivated by the growing importance of sustainable mobility and the European Union’s policy framework aimed at decarbonization of urban transport systems. A mixed-integer linear programming (MILP) model is developed to optimize the investment and operational strategies for the gradual replacement of diesel buses with electric ones, taking into account capital expenditures, operational costs, charging infrastructure, and environmental benefits. Scenario analysis is employed to compare six different pathways of fleet electrification, ranging from partial to full transition within a defined planning horizon. The results highlight significant trade-offs between financial feasibility and ecological impact, illustrating that an accelerated electrification strategy yields the largest emission reductions but requires substantial upfront investment. Conversely, gradual transition scenarios demonstrate better budget alignment but achieve lower environmental benefits. The discussion emphasizes the practical applicability of the model for municipal decision-makers, offering a tool for strategic planning under economic and ecological constraints. The paper concludes that sustainable electrification of municipal bus fleets requires a balanced approach that aligns environmental objectives with financial and operational capacities. Full article