Search Results (249)

The occurrence of haze pollution significantly deteriorates air quality and threatens human health, yet persistent knowledge gaps in real-time source apportionment of fine particulate matter (PM_2.5) hinder sustained improvements in atmospheric pollution conditions. Thus, this study employed single-particle aerosol mass spectrometry (SPAMS) to investigate PM_2.5 sources and dynamics during winter haze episodes in Yinchuan, Northwest China. Results showed that the average PM_2.5 concentration was 57 μg·m⁻³, peaking at 218 μg·m⁻³. PM_2.5 was dominated by organic carbon (OC, 17.3%), mixed carbonaceous particles (ECOC, 17.0%), and elemental carbon (EC, 14.3%). The primary sources were coal combustion (26.4%), fugitive dust (25.8%), and vehicle emissions (19.1%). Residential coal burning dominated coal emissions (80.9%), highlighting inefficient decentralized heating. Source contributions showed distinct diurnal patterns: coal combustion peaked nocturnally (29.3% at 09:00) due to heating and inversions, fugitive dust rose at night (28.6% at 19:00) from construction and low winds, and vehicle emissions aligned with traffic (17.5% at 07:00). Haze episodes were driven by synergistic increases in local coal (+4.0%), dust (+2.7%), and vehicle (+2.1%) emissions, compounded by regional transport (10.1–36.7%) of aged particles from northwestern zones. Fugitive dust correlated with sulfur dioxide (SO₂) and ozone (O₃) (p < 0.01), suggesting roles as carriers and reactive interfaces. Findings confirm local emission dominance with spatiotemporal heterogeneity and regional transport influence. SPAMS effectively resolved short-term pollution dynamics, providing critical insights for targeted air quality management in arid regions. Full article

Halifax Harbour, a major seaport in Nova Scotia that is approximately 100 km southeast of the Bay of Fundy, comprises a deep inner region called Bedford Basin, connected to the adjacent ocean by a shallow channel called The Narrows. A study of sea level and currents reveals the presence of episodic oscillations in The Narrows, with a period of approximately 2 h. The oscillation strength varies from day to day and, to some extent, through the seasons. The median amplitude of the associated sea level variation is $18\%$ that of the de-tided signal, rising to $32\%$ at the 95-th percentile. Values this large may be of concern for the transit of deep-draft vessels through shallow parts of the harbour and for the clearance of tall vessels under the two bridges that span The Narrows. Another concerning issue is the matter of oscillations being superimposed on storm surges. In addition to such direct effects of sea level variation, shear associated with the oscillations may increase the turbulent mixing in the region, affecting the overall state of this estuarine system. We explore the nature of the oscillations as a first step towards the improvement of prediction schemes for sea level and currents in the region. This involves an analysis of the oscillations in the context of seiche and Helmholtz resonance theories and the use of a 2D numerical model to handle realistic bathymetric conditions and other complications that the simpler theories cannot address. We conclude that the predictions of Helmholtz resonance theory are in reasonable agreement with both the observations and the predictions of the numerical model. Full article

This study focused on the carbonate system dynamics and air–sea CO₂ fluxes in the open-ocean waters of the Madeira–Tore Seamount Complex during August 2024. Surface water properties revealed pronounced latitudinal gradients in sea surface temperature (21.9–23.1 °C), salinity (36.2–36.7), and dissolved oxygen (228–251 µmol Kg⁻¹), influenced by mesoscale eddies and topographically driven upwelling. Despite oligotrophic conditions, distinct phytoplankton assemblages were observed, with coccolithophores dominating southern seamounts and open-ocean stations, and green algae and diatoms indicating episodic nutrient input. Surface total alkalinity (TA: 2236–2467 µmol Kg⁻¹), dissolved inorganic carbon (DIC: 2006–2183 µmol Kg⁻¹), and pCO₂ (467–515 µatm) showed spatial variability aligned with water mass characteristics and biological activity. All stations exhibited positive air–sea CO₂ fluxes (2.8–11.5 mmol m⁻² d⁻¹), indicating the region is a CO₂ source during summer. Calcite and aragonite saturation states were highest in stratified, warmer waters. Principal Component Analysis highlighted the role of physical mixing, carbonate chemistry, and biological uptake in structuring regional variability. Our findings emphasize and contribute to the complex interplay of physical and biogeochemical drivers in modulating carbon cycling and ecosystem structure across Atlantic seamounts. Full article

Background/Objectives: Patients diagnosed with decompensated congestive heart failure (HF) often have elevated CA-125 levels, attributed to systemic congestion. However, a subgroup of patients presents with normal CA-125 levels. The primary objective of this study was to characterize the clinical, analytical, and echocardiographic profiles of patients admitted for decompensated congestive HF according to their CA-125 levels. The secondary objective was to analyze mortality after discharge. Methods: We conducted a retrospective study of patients hospitalized for a decompensated congestive HF episode. Recruitment was consecutive over more than 4 years (December 2019–June 2024), with 3151 patients recruited. Scheduled admissions, transfers from other hospitals, pulmonary congestion patterns, mixed patterns, and low output were the exclusion criteria. The final number of patients included was 166, all with an isolated systemic congestion pattern: CA-125 ≤ 50 U/mL: 38, and CA-125 > 50 U/mL: 128. Results: The comparative analysis between the groups showed that patients with CA-125 ≤ 50 U/mL were more often women (p < 0.05). They also had lower bilirubin and GOT/AST levels (p < 0.05). The percentage of patients with a preserved left ventricular ejection fraction (≥50%) was higher in the CA-125 ≤ 50 U/mL group (p < 0.05). The right ventricular (RV) size and inferior vena cava (IVC) were enlarged in both groups but with no significant differences (p < 0.05). However, the degree of RV dysfunction was greater in the CA-125 > 50 U/mL group, while the proportion of patients with inspiratory collapse of the IVC was higher in the CA-125 ≤ 50 U/mL group (p < 0.05). Survival curves differed from the first month and throughout the follow-up, with higher mortality in the CA-125 > 50 U/mL group. Thus, the probability of being alive at the end of the follow-up was over 50% in the CA-125 ≤ 50 U/mL group, while in the CA-125 > 50 U/mL group, it was around 25% (p < 0.05). Conclusions: The proportion of patients with decompensated congestive HF and systemic congestion who present with a low CA-125 level is close to 25%. These patients are mostly women with a preserved ejection fraction and inspiratory collapse of the IVC of >50%. Moreover, they have a higher survival rate, so a low CA-125 could help identify a subgroup of patients with a better prognosis. Full article

We present coordinated observations from ozone Differential Absorption lidar (DIAL), aerosol lidar, and Doppler wind lidar at the City College of New York (CCNY) in northern Manhattan during the summer 2023 AGES+ campaigns across the New York City (NYC) region and Long Island Sound (LIS) areas. The results highlight significant ozone formation within the planetary boundary layer (PBL) and the concurrent transport of ozone/aerosol plumes aloft and mixing into the PBL during 26–28 July 2023. Especially, 26 July experienced the highest ozone concentration within the PBL during the three-day ozone episode despite having a lower temperature than the following two days. In addition, the onset of the afternoon sea breeze contributed to increased ozone levels in the PBL. A mobile ozone DIAL was also deployed at Columbia University’s Lamont–Doherty Earth Observatory (LDEO) in Palisades, NY, 29 km north of NYC, from 11 August to 8 September 2023. A notable high-ozone episode was observed by both ozone DIALs at the CCNY and the LDEO site during an unusual heatwave event in early September. On 7 September, the peak ozone concentration at the LDEO reached 120 ppb, exceeding the ozone levels observed in NYC. This enhancement was associated with urban plume transport, as indicated by wind lidar measurements, the HRRR (High-Resolution Rapid Refresh) model, and the Copernicus Sentinel-5 TROPOMI (TROPOspheric Monitoring Instrument) tropospheric column NO₂ product. The results also show that, during both heatwave events, those days with slow southeast to southwest winds experienced significantly higher ozone pollution. Full article

Background: Splenectomy remains necessary in selected oncologic and hematologic indications but is associated with significant postoperative morbidity and mortality. The data on outcomes in this high-risk population remain limited, particularly in mixed cohorts. Methods: We conducted a retrospective cohort study including all patients undergoing splenectomy for oncologic or hematologic causes between 2009 and 2022 at a cancer referral center. The primary outcomes were the occurrence of major complications at day 90 and the 1-year all-cause mortality. Multivariate logistic regression was used to identify independent predictors. Results: Among the 8503 ICU admissions from surgical wards, 204 splenectomies were performed; 179 patients were analyzed. The median age was 64 years, and 100 patients (55.9%) were female. Splenectomy was performed for hematologic malignancies in 76 cases (42.5%) and for oncologic causes in 103 cases (57.5%). Laparotomy was used in 154 cases (86.0%), and metastasectomy was performed in 54 patients (30.2%). At day 90, 86 patients (48.0%) developed a major complication: 12 deaths (6.7%), 44 surgical complications (24.6%), and 71 episodes of sepsis (39.7%). In a multivariate analysis, weight loss (OR 3.39, 95% CI [1.32–8.70], p = 0.011), laparotomy (OR 4.38 [1.09–17.60], p = 0.038), and a higher SAPS II score (OR 1.08 per point [1.03–1.13], p = 0.003) were associated with complications, while metastasectomy was protective (OR 0.23 [0.08–0.67], p = 0.007). At one year, the mortality reached 22.4%. Independent predictors of death were sepsis at one year (OR 5.04, 95% CI [1.30–25.96], p = 0.029), the Charlson Comorbidity Index (OR 1.30 per point, 95% CI [1.04–1.68], p = 0.030), invasive mechanical ventilation (OR 14.94, 95% CI [2.83–118.93], p = 0.003), and a performance status >1 (OR 7.84, 95% CI [2.38–27.75], p < 0.001). Encapsulated bacteria were not isolated; sepsis was mainly due to Gram-negative and enterococcal organisms. Conclusions: Splenectomy in onco-hematologic patients is associated with high rates of sepsis and mortality. In addition to surgical factors, frailty, immune status, and infection independently contribute to the patients’ outcomes. These results support risk-adapted perioperative strategies and long-term infectious surveillance in immunocompromised patients. Full article

Unusual Ag-(Ni-Co-Sb-As-Hg ± Bi)-bearing fault-fill vein ore shoot mineralization set in a gangue of quartz, fluorite, and barite has been identified in Morocco’s Aouli deposit. The Paleozoic host rocks consist of a succession of Cambrian to Ordovician-aged folded and low- to medium-grade metasediments and metavolcaniclastic rocks with tuff interbeds and amphibolite sills, locally intruded by late Visean calc-alkaline to alkaline granitoid intrusions. Paragenetic relationships indicate that the sequence of ore precipitation comprises a succession of Ni-Co-Fe arsenides, followed by Pb-Sb-As-Ag-Hg sulfarsenides/sulfosalts and then Zn-Pb-Fe sulfides. Results indicate that the ore shoot mineralization formed from episodic stages of fracturing and subsequent fluid migration. Precipitation of ore phases is thought to have occurred as a result of isothermal mixing and subsequent fluid–rock interactions. The timing of mineralization is thought to have occurred between Late Triassic and Late Miocene, coinciding with major crustal extension and Middle Jurassic–Upper Cretaceous alkaline magmatism. Thermal convection and seismic pumping are proposed as the main driving force for the large-scale migration of the ore-forming brines. This research bears directly upon the potential for new exploration targets in Pb-Zn ± fluorite ± barite deposits hosted in Variscan inliers throughout North Africa. Full article

Background: Delirium is a frequent yet pathophysiologically still poorly understood complication in the intensive care unit (ICU) and is associated with adverse outcomes for the patients. Currently, guidelines give several recommendations for treating delirium in the ICU, but to date no sufficient drug treatment exists. Dexmedetomidine, primarily used for anesthesia and sedation in ICUs has shown a preventive effect of delirium compared to other sedatives, such as propofol. We hypothesize that overnight administration of dexmedetomidine may prevent and/or shorten the duration of delirium in ICU patients. Methods: The Basel propofol dexmedetomidine (BaProDex) Study was a single-center, prospective, randomized controlled trial. We included adult ICU patients with hyperactive or mixed delirium. Patients with delirium prior to ICU admission, advanced heart block, uncontrolled hypotension, or status epilepticus were excluded. The participants were randomly assigned 1:1 to either receive dexmedetomidine (study group) or propofol (control group) as a continuous infusion overnight. The Intensive Care Delirium Screening Checklist (ICDSC) was applied at least three times per day. Delirium was defined as an ICDSC ≥ 4. The study drug was administered until the end of delirium or ICU discharge. The primary endpoint was the time to delirium episode end, which was analyzed using cumulative incidence curves and a cause specific Cox proportional hazards regression with death as a competing risk. Secondary endpoints included recurrence of delirium until 28 days after ICU discharge, death until day 28, severity of ICU delirium, number of ventilation days, ICU length of stay (LOS) in hours, hospital length of stay in days and survival after three and twelve months after ICU discharge. Due to insufficient recruitment the trial needed to be stopped prematurely. Results: In total, 38 patients were enrolled and randomized in the two groups. The median duration of delirium was shorter in the dexmedetomidine group as compared to the propofol group (ITT: 34 vs. 66 h; PP: 31 vs. 66 h), resulting in a hazard ratio of 1.92 (95% CI 0.89–4.15, p = 0.097) in the ITT and 2.95 (95% CI 1.27–6.86, p = 0.012) in the PP analysis. In the PP analysis, the 28-day mortality was lower in the dexmedetomidine group (1 vs. 5 deaths) and fewer patients needed ventilation (7 vs. 15 patients). Both ICU and hospital LOS were shorter in the dexmedetomidine group (ICU LOS: median 43 vs. 128 h; hospital LOS: median 12 vs. 22 days). Further, mortality up to three and twelve months was lower in the dexmedetomidine group compared to the propofol group (PP: 2 vs. 8 patients died within twelve months, 2 vs. 7 patients died within three months). The recurrence of delirium until 28 days after ICU discharge and severity of delirium were similar in both groups. Conclusions: Despite premature termination, BaProDex provides preliminary evidence for a reduction in the duration of delirium by nocturnal infusion of dexmedetomidine compared to propofol. Therefore, dexmedetomidine may be considered an option to treat hyperactive or mixed delirium in ICU patients. However, due to the small sample size, the study is rather of exploratory nature due to the premature termination, and we cannot rule out that the observed treatment effect is overly optimistic or by chance. Full article

Background and Clinical Significance: Chronic nonbacterial osteomyelitis (CNO) of the jaw is a rare autoinflammatory bone disorder that primarily affects children and adolescents. Diagnosing CNO of the mandible can be challenging due to its rarity, and the clinical and radiographic findings overlap with those of other bone disorders. Case Presentation: This case series retrospectively presents four female pediatric patients (9–12 years old) diagnosed with mandibular CNO. The patients were treated at King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia, between 2018 and 2024. Clinical features and radiographic and histopathological findings were evaluated. All cases had mandibular swelling and pain. Radiographic features consistently revealed mixed sclerotic and radiolucent lesions with bone expansion and periosteal reactions. Histopathological findings revealed viable bone interspersed with varying degrees of fibrous tissue. No evidence of bacterial colonies or inflammation was observed. This case series highlights the radiographic and histopathological features of CNO in the mandible of pediatric patients. The mixed radiographic features and variability of histopathological findings combined with the refractory nature of the lesions contribute to diagnostic complexity. Diagnostic challenges include differentiating CNO from other inflammatory and fibro-osseous conditions. The presence of recurrent episodes of pain, the formation of subperiosteal bone, periostitis, lysis of the cortical layer, expansion of the mandibular canal, and sterile bone biopsies with nonspecific inflammatory changes were related mainly to CNO. Conclusions: These findings underscore the need for increased awareness and a multidisciplinary approach for accurate diagnosis and management of CNO. Conservative management, particularly in dental cases, avoids prolonged unnecessary use of antibiotics, and the prescription of nonsteroidal anti-inflammatory drugs should be followed. Full article

Water use strategies reflect the ability of plants to adapt to drought caused by climate change. However, how these strategies change with stand development and seasonal drought is not fully understood. This study used stable isotope techniques (δD, δ¹⁸O, and δ¹³C) combined with the MixSIAR model to quantify the seasonal changes in water use sources and water use efficiency (WUE) of Eucalyptus urophylla S.T.Blake × E. grandis (E. urophylla × E. grandis) at four stand ages (2-, 4-, 9- and 14-year-old) and to identify their influencing factors. Our results showed that the young (2-year-old) and middle-aged (4-year-old) stands primarily relied on shallow soil water throughout the growing season due to the limitations of a shallow root system. In contrast, the mature (9-year-old) and overmature (14-year-old) stands, influenced by the synergistic effects of larger and deeper root systems and relative extractable water (REW), exhibited more flexibility in water use, mainly relying on shallow soil water in wet months, but shifting to using middle and deep soil layer water in dry months, and quickly returning to mainly using shallow soil water in the episodic wet month of the dry season. The WUE of E. urophylla × E. grandis was affected by the combined effect of air temperature (T), vapor pressure deficit (VPD), and REW. WUE was consistent across the stand ages in the wet season but decreased significantly with stand age in the dry season. This suggests that mature and overmature stands depend more on shifting their water source, while young and middle-aged stands rely more on enhanced WUE to cope with seasonal drought stress, resulting in young and middle-aged stands being more vulnerable to drought stress. These findings offer valuable insights for managing water resources in eucalyptus plantations, particularly as drought frequency and intensity continue to rise. Full article

Background/Objectives: Cariprazine, a D3/D2 partial agonist, is one of the few recommended treatment options for bipolar 1 disorder (BP1D) in Southeast Asia. This study aims to generate insights from leading experts on the safe and effective use of cariprazine for BP1D, specifically by formulating practical recommendations not thoroughly covered in the existing literature. Methods: A formal consensus methodology using the modified RAND/UCLA Appropriateness Method was employed to develop consensus recommendations. The methodology included a targeted literature search, creation of clinical scenarios, two rounds of rating of the appropriateness of each scenario on a nine-point Likert scale by an expert panel of psychiatrists from Southeast Asia (n = 13), and a face-to-face discussion among the expert panel between the two rounds of rating. In the absence of disagreement, scenarios were classified as appropriate (7–9), equivocal (4–6), or inappropriate (1–3) based on median scores. Clinical scenarios were subsequently converted to consensus recommendations upon approval by the expert panel. Results: Most experts recommended a 4–8-week trial of cariprazine for bipolar depression (85%) and 3–4 weeks for acute mania/mixed (71%). For longer treatment, 61.5% and 69% recommended >1 year for acute mania/mixed and bipolar depression, respectively. Cariprazine was also considered suitable as first-line therapy, including for first-episode bipolar depression (Mdn: 8, IQR: 7–9) and first-episode mania (Mdn: 8; IQR: 8–9). Conclusions: The consensus recommendations may serve as practical guidance for clinicians to make informed decisions regarding the management of adult patients with BP1D, while considering the preferences and circumstances of individual patients. Full article

The Bundelkhand granite (BG) constitutes the bulk of the granitoid complex in the Bundelkhand Craton and preserves imprints of its evolution from the magmatic to a protracted hydrothermal stage as deduced from the petrography. In order to reconstruct such a path of evolution in this study, thermobarometric calculations were attempted on the mineral chemistry of the major (hornblende, plagioclase, biotite) and minor (epidote, apatite) magmatic phases. They yielded magmatic temperatures and pressures (in excess of 700 °C and ~5 kbar), although not consistently, and indicate mid-crustal conditions at the onset of crystallization. Temperatures in the hydrothermal regime within the BG are better constrained by the chemistry of the chlorite and epidote minerals (340 to 160 °C) that conform with the ranges of homogenization temperatures of aqueous–biphase inclusions in matrix quartz in the BG and subordinate quartz veins. These reconstructions indicate that fluid within the BG evolved down to lower temperatures and towards the deposition of quartz and, more importantly, bears a striking similarity to the temperature–salinity characteristics of fluid in the giant quartz reef system. Scanty mixed aqueous–carbonic inclusions in the BG are indicative of the CO₂-poor nature of the BG magma and the exsolution of CO₂ at lower pressure (~2.6 kbar). The dominant mechanism of fluid evolution in the BG appears to be the incursion of meteoric fluid, which caused fluid dilution. Laser Raman microspectrometry reveals many types of solid phases in aqueous–carbonic inclusions in the BG domain. The occurrence of unusual, effervescent-type inclusions, though infrequent, bears a striking similarity to that reported in the giant quartz reef domain. Thus, the highlight of the present work is the convincing fluid inclusion evidence that genetically links the BG with the giant quartz reef system, although many cited discrepancies arise from the radiometric dates. We visualize the episodic release of silica-transporting fluid to the major fracture system (now occupied by the giant reef) from the BG, thus making the fluid in the two domains virtually indistinguishable. Full article

Background: Sepsis remains a significant cause of morbidity and mortality in preterm and low birth weight (LBW) neonates, especially in low- and middle-income countries (LMICs). Lactoferrin, a glycoprotein present in breast milk with antimicrobial activity, is a low-cost, readily available, and promising intervention currently under investigation. The available literature presents conflicting results on the impact of lactoferrin on the risk of late-onset sepsis (LOS). This study evaluated the effectiveness of two doses of bovine lactoferrin (bLF) supplementation in preventing LOS and necrotizing enterocolitis (NEC) in preterm and LBW neonates in Pakistan. Methods: A three-arm, double-blind, placebo-controlled, randomized clinical trial in the neonatal intensive care unit of Aga Khan University was conducted from July 2019 to August 2020. Preterm (28 to 36 + 5 weeks gestational age) and low birth weight (≥1000 g to <2500 g) neonates who established enteral feeding by 72 h were eligible. The exclusion criteria included sepsis before randomization, maternal history of chorioamnionitis or group B streptococcus colonization, and congenital anomalies. Enrolled neonates were randomly assigned in a 1:1:1 ratio using a computer-generated random allocation sequence to receive placebo (D-glucose), 150 mg bLF, or 300 mg bLF mixed with breast milk once daily for 28 days. The study staff, parents, and outcome assessors were blinded to the allocation. The primary outcome was late-onset sepsis from the trial entry to 28 days. The secondary outcome was NEC from the trial entry to 28 days. Neonates were followed weekly for 28 ± 2 days, and episodes of LOS and NEC were recorded. Results: Of 305 neonates enrolled, 102, 102, and 101, respectively, were randomized to receive a placebo (arm A), 150 mg bLF (arm B), and 300 mg bLF (arm C), respectively. Outcome data of 291 participants (99 in arm A, 95 in arm B, and 97 in arm C) were available for inclusion in the intention-to-treat analysis. The frequency of culture-proven sepsis was 8/102 (7.8%) in arm A compared to 1/102 (0.98%) (p = 0.020) in arm B and 5/101 (4.9%) in arm C (p = 0.390). We did not find any difference in episodes of NEC between arms A (n = 3, 3%) and B (n = 0, 0%) (p = 0.087) or between arms A and C (n = 2, 2%) (p = 0.650). We reported compliance rates of 79 (79.79%) in arm A, 78 (82.1%) in arm B, and 82 (84.53%) in arm C for investigational products. Arm C recorded two deaths, but neither was attributed to the intervention. Conclusions: Bovine lactoferrin supplementation did not prevent late-onset sepsis in neonates of preterm and low birth weight in our trial. However, given the small sample size, further trials with larger sample sizes are required to investigate its efficacy in these at-risk groups. Full article

This research focuses on current photojournalism practices in the media representation of the climate crisis, exploring how images published by Spain’s leading digital newspapers contribute to shaping public perception of the phenomenon. Through a mixed-methods approach, this study examines eco-visual reporting in 2023—a year characterized by unprecedented global temperatures—alongside an examination of the initial month of coverage of the 2024 DANA floods. The main objective of this study is to evaluate whether the visual depiction of climate change in mainstream media aligns with or deviates from the established visual patterns associated with stereotyped iconography and alarmist narratives. This research provides a taxonomy of the predominant thematic elements and their frequency, addressing key issues such as the persistence of worn-out visual tropes, the reliance on stock images, and the episodic nature of its news treatment. The inclusion of the most catastrophic climate disaster of the 21st century in Spain allows for an exploration of how the media pressure inherent to crisis situations intensifies the risk of errors in image attribution and contextualization. Finally, we offer practical recommendations to guide visual coverage toward comprehensive, accurate, and human-centered approaches, aiming to foster public trust and maximize the potential of photojournalism as a key tool in collective mobilization against the climate emergency. Full article

Background: Acute rejection (AR) in kidney transplant (KT) recipients remains a significant challenge for short- and long-term graft survival even in the most recent years characterized by extended criteria donors and older and more comorbid recipients. Methods: We analyzed risk factors and outcomes of AR in 339 KT recipients treated at St. Orsola-Malpighi Hospital, Bologna (Italy), between 1 January 2019 and 31 December 2021. Demographic, immunological, and transplant data (type, cold ischemia time, complications) were recorded with a follow-up period of up to 24 months. Key outcomes included estimated glomerular filtration rate (eGFR), 24 h proteinuria, delayed graft function (DGF), biopsy-proven AR, and graft loss. Results: During the first year after transplant, 57 AR episodes occurred: 19 antibody-mediated rejections (AMR), 18 borderline T cell-mediated rejections (TCMR), 18 TCMR, 2 mixed AMR/TCMR, and 11 graft losses. AR was linked to older donor age (59.9 ± 12.8 vs. 55.5 ± 15.1, p = 0.040), longer cold ischemia time (690 vs. 570 min, p = 0.044), higher DGF rates (61.40% vs. 39.57%, p = 0.002), and lower eGFR (39 vs. 52 mL/min, p = 0.003). AR was consistently prevalent in patients who underwent an AB0-incompatible (AB0-i) transplant (8.8% vs. 2.5%, p = 0.020). HLA matching was strongly associated with a reduced risk of AMR (HLA-DR: OR 0.35, HLA-A: OR 0.33, HLA-C: OR 0.35), while DGF was linked to a higher risk (OR 4.04). TCMR risk was associated with donor age (OR 1.05). The development of post-transplant donor-specific antibodies (DSAs) at 24 months showed no significant association with AR (AMR: p = 0.769; TCMR: p = 0.938). The decline in eGFR over time (24 months) did not differ between patients with and without AR (difference, −0.69 mL/min/year; Standard Error, 0.92; p = 0.452). Similarly, 24 h proteinuria change over time did not differ between patients with and without AR (difference, −0.12 g/24 h; Standard Error, 0.28; p = 0.657). Conclusions: Understanding the risk factors of AR is crucial to identifying KTs at more risk of rejection and to guiding targeted therapeutic decisions. In the most recent era of extended criteria donors and more vulnerable recipients, early diagnosis and prompt and tailored treatment of AR play a critical role in stabilizing renal function over time. Full article