The distal suture line during aortic dissection repair can be performed by a closed technique or by an open technique. This study presents a retrospective comparison of both methods regarding their postoperative outcomes. 120 patients who underwent surgery for acute aortic dissection type A were divided into two groups. In group A (n = 81), open distal anastomosis was performed under hypothermic circulatory arrest and selective cerebral perfusion. In group B (n = 39), distal anastomosis was performed with the aorta cross-clamped under mildly hypothermic cardiopulmonary bypass. Primary outcomes were operative mortality, neurologic morbidity, and long-term survival. Hospital mortality (17.3% for the open group vs. 12.8% for the closed group, p = 0.53), permanent neurologic dysfunction (8.7% vs. 8.3%, p = 1.0), and temporary neurologic dysfunction (31.9% vs. 22.2%, p = 0.298) were not significantly different between groups. No significant difference in actuarial 5- and 10-year survival was observed (88% vs. 86% and 53 vs. 73%, respectively, p = 0.396). After propensity-score adjustment, the technique of distal aortic repair was not found to be a predictor of the primary outcomes. We conclude that the open repair can be used in most if not all cases of surgical repair of type A acute aortic dissection.

The current research presents an approach to the improvement of the librarian infrastructure via the integration of advanced technology and solutions aiming at an immediate, smooth, and continuous adaptation of the libraries in line with 21st-century needs. In particular, this article discusses the design and development of an innovative library environment ensuring descriptive cataloging, subject indexing, intelligent data searching, curation, and collection development aiming to meet the functional needs related to the increasingly growing users’ expectations. The effectiveness of the approach has been validated in the Regional Library “Peyo Yavorov”–Burgas, Bulgaria, an associated content provider in the Bulgarian National Interdisciplinary Research E-Infrastructure for Bulgarian Language and Cultural Heritage Resources and Technologies (CLaDA-BG). Testing of the system was made to assure its stability and reliability.

The vacuum residue hydrocracker naphtha (VRHN) is a chemically unstable product that during storage changes its colour and forms sediments after two weeks. It cannot be directly exported from the refinery without improving its chemical stability. In this research, the hydrotreatment of H-Oil naphtha with straight run naphtha in a commercial hydrotreater, its co-processing with fluid catalytic cracking (FCC) gasoline in a commercial Prime-G+ post-treater, and its co-processing with vacuum gas oil (VGO) in a commercial FCC unit were discussed. The hydrotreatment improves the chemical stability of H-Oil naphtha and reduces its sulphur content to 3 ppm. The Prime-G+ co-hydrotreating increases the H-Oil naphtha blending research octane number (RON) by 6 points and motor octane number (MON) by 9 points. The FCC co-cracking with VGO enhances the blending RON by 11.5 points and blending MON by 17.6 points. H-Oil naphtha conversion to gaseous products (C1–C4 hydrocarbons) in the commercial FCC unit was found to be 50%. The use of ZSM 5 containing catalyst additive during processing H-Oil naphtha showed to lead to FCC gasoline blending octane enhancement by 2 points. This enabled an increment of low octane number naphtha in the commodity premium near zero sulphur automotive gasoline by 2.4 vol.% and substantial improvement of refinery margin. The processing of H-Oil naphtha in the FCC unit leads also to energy saving as a result of an equivalent lift steam substitution in the FCC riser.

The article explores the different meanings behind the narratives of “family,” “childcare,” and “child protection” in public discourses against the National Strategy for the Child (NSC) 2019–2030 in Bulgaria. These meanings are seen as reflecting the intertwining and cumulative effects of transnational and local influences in the anti-gender movement. Using frame analysis as an approach in social movement studies, the aim is to analyse the main ideas of NSC opponents—conservative far-right non-governmental organizations (NGOs) and citizens who joined the discussion during the public debate on the Strategy in January 2019. We differentiate between the discourses of the NGOs and the critical citizens, paying attention to the way they use the narrative of return—return to traditional family forms and child-rearing models. The conservative NGOs declared themselves to be defenders of Bulgarian children and families against the liberal policies of the European Union (EU) and the lesbian, gay, bisexual, and transgender (LGBT) lobbies. The citizens’ discourse is directed against the child-centred philosophy of the Strategy, seen as a threat to both the children themselves and parents’ rights, but it rarely mentions LGBT and gendering as a danger. The discussion revealed the deep distrust of citizens and parents towards the state and its institutions, which was amplified and instrumentalized by the far-right NGOs who mobilized and organized a mass social movement against the Strategy.

Our genetic background has not changed over the past century, but chronic diseases are on the rise globally. In addition to the genetic component, among the critical factors for many diseases are inhabitants of our intestines (gut microbiota) as a crucial environmental factor. Dysbiosis has been described in liver diseases with different etiologies like non-alcoholic fatty liver disease (NAFLD), alcohol-related liver disease (ALD), viral hepatitis, autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC), cirrhosis, hepatocellular carcinoma (HCC). On the other hand, new technologies have increased our understanding of liver disease genetics and treatment options. Genome-wide association studies (GWAS) identify unknown genetic risk factors, positional cloning of unknown genes associated with different diseases, gene tests for single nucleotide variations (SNVs), and next-generation sequencing (NGS) of selected genes or the complete genome. NGS also allowed studying the microbiome and its role in various liver diseases has begun. These genes have proven their effect on microbiome composition in host genome–microbiome association studies. We focus on altering the intestinal microbiota, and supplementing some bacterial metabolites could be considered a potential therapeutic strategy. The literature data promote probiotics/synbiotics role in reducing proinflammatory cytokines such as TNF-α and the interleukins (IL-1, IL-6, IL-8), therefore improving transaminase levels, hepatic steatosis, and NAFLD activity score. However, even though microbial therapy appears to be risk-free, evaluating side effects related to probiotics or synbiotics is imperative. In addition, safety profiles for long-term usage should be researched. Thus, this review focuses on the human microbiome and liver diseases, recent GWASs on liver disease, the gut-liver axis, and the associations with the microbiome and microbiome during/after liver disease therapy.

This paper explores the institutional mainstreaming of nature-based solutions (NBS) to advance a process-based understanding about how to strategically develop the governance capacities needed for systemic, localised and inclusive NBS. To this end, it reports how policy officers in ten European cities have started to mainstream NBS by interacting with and changing incumbent governance arrangements when experimenting with novel governance processes and mechanisms to plan, deliver and steward NBS. Based on these activities of the policy officers, the analysis identifies three strategies, associated stepping stones and changes in governance conditions, to mainstream NBS in governance capacities: institutionalising (a) a systems’ approach to link NBS to policies, regulations, and departments across goals and sectors, (b) inclusive collaborations for localised and inclusive interventions, and (c) reflexivity and learning about how NBS interact with the (institutional, ecological, social, etc.) contexts and create impacts. The strategies illustrate institutional entrepreneurship in interacting with incumbent governance contexts, and how starting from NBS as a type of systemic innovation can promote broader shifts in urban governance arrangements.

Ebullated bed vacuum residue hydrocracking and fluid catalytic cracking (FCC) are among the most profitable processes in modern refining. Their optimal performance is vital for petroleum refining profitability. That is why a better understanding of their combined action and the interrelations between these two heavy oil conversion processes in a real-world refinery could provide valuable information for further performance optimization. Nine distinct petroleum crudes belonging to the extra light, light, and medium petroleum crude types were processed in the LUKOIL Neftohim Burgas refinery to study the combined performance of two processes: FCC of vacuum gas oil and ebullated bed vacuum residue H-Oil hydrocracking. The operating conditions along with the characterization data of the feeds and products of both processes were evaluated through the employment of intercriteria analysis to define the variables with statistically significant relationships. Maple 2023 Academic Edition mathematics software was used to develop models to predict the vacuum residue conversion level under different operating conditions. The plug flow reactor model with an activation energy of 215 kJ/mol and a reaction order of 1.59 was found to provide the highest accuracy of vacuum residue conversion, with an average absolute deviation of 2.2%. H-Oil yields were found to correlate with the vacuum residue conversion level and the content of FCC slurry oil (SLO), the recycling of partially blended fuel oil, a material boiling point below 360 °C, and the vacuum gas oil (VGO) in the H-Oil feed. FCC conversion was found to depend on the H-Oil VGO content in the FCC feed and the content of FCC SLO in the H-Oil feed.

The emergence of Industry 4.0 has brought about remarkable technological progressions, leading to substantial transformations in work environments. This has created a globally shared vision that the educational and training systems should be improved to offer high-quality, inclusive, and accessible digital education to develop essential skills and abilities that guarantee job readiness and assimilation into the current labour metamorphoses of era 4.0. In Europe, the reform of education at all levels in response to the concepts of University 4.0 and Education 4.0 is outlined as a key priority. In this regard, outlining the factors for successful inclusive digital education, as well as the barriers to its implementation, is crucial. This paper presents some of the main results of a survey conducted in Bulgaria, Greece, Italy and Latvia, aiming to determine the readiness of universities to provide inclusive Industry 4.0 education.