Search Results (58)

Background: Esophageal atresia (EA) is a rare congenital malformation of the foregut, most commonly presenting in association with tracheoesophageal fistula (TEF). Advances in neonatal surgical techniques and intensive care have significantly improved survival rates over recent decades. However, short- and long-term respiratory morbidity remains prevalent, substantially impacting patients’ quality of life. Methods: This is a retrospective single-center case series of pediatric patients with repaired EA, with emphasis on the spectrum of pulmonary complications and their clinical management. Six patients with repaired type C EA with TEF and associated respiratory complications were included. All patients were admitted between 2018 and 2026 to the Third Pediatric Clinic, Clinical Hospital for Pediatric Emergencies, Cluj-Napoca, Romania, for the management of respiratory pathology. Results: Tracheomalacia was identified in all six patients, and each had experienced at least one episode of lower respiratory tract infection. Reactive airway disease meeting diagnostic criteria for asthma was documented in two patients. One case raised clinical suspicion for a residual or recurrent tracheoesophageal fistula, warranting further diagnostic workup. Gastroesophageal reflux (GER) was present in all patients. Protein-energy malnutrition was identified in two patients (30% of the cohort). Conclusions: Surgically repaired EA is frequently associated with considerable chronic respiratory and gastrointestinal morbidity. A structured multidisciplinary approach, including pediatric pulmonology, gastroenterology, surgery and nutrition, alongside systematic long-term follow-up, is essential to optimize outcomes and quality of life in this vulnerable patient population. Full article

Large volumes of solid waste are produced by the winemaking sector, which could be utilised as adsorbents to retain contaminants, providing a beneficial approach in terms of economic recovery and sustainability. The adsorption of nitrate onto biochar produced from grape pomace has not received enough attention, even though biochar-based materials have been thoroughly studied for water treatment applications. This study aims to fill the knowledge gap by assessing a low-cost mildly carbonized biochar derived from winery residues for nitrate retention and optimising the nitrate retention procedures by comprehensive physicochemical characterisation. The mildly carbonized biochar prepared from grape pomace collected from the Dealu Mare wine region (Romania) was characterized using scanning electron microscopy coupled with energy dispersive X-ray spectroscopy (SEM–EDX), Fourier transform infrared spectroscopy (FTIR), Brunauer–Emmett–Teller (BET), and thermogravimetric and derivative thermogravimetric (TGA/DTG) analyses. Results revealed a structure enriched with oxygen-containing functional groups that promote nitrate retention through combined physical adsorption and electrostatic interactions. Surface analyses after adsorption confirmed the successful immobilization of nitrate species on the biochar matrix. The adsorption performance was improved by Response Surface Methodology (RSM) method using a Central Composite Design (CCD), studying the influences of the following parameters: solution pH, adsorbent weight, nitrate concentration and time. Among all variables, pH was identified as the dominant factor controlling adsorption efficiency, reflecting the key role of surface charge interactions. The optimized conditions (175 mg/L nitrate, pH 6, 0.3 g adsorbent dosage, and 94 min contact time) resulted in a maximum nitrate removal efficiency (RE) of 86.69%, while the predictive model exhibited excellent accuracy (R²_adj = 0.985). The findings demonstrate that mildly carbonized grape pomace biochar can achieve competitive nitrate removal without chemical surface modification, offering a more sustainable and economically attractive alternative to conventionally biochars. The research highlights that selecting feedstock and utilizing intrinsic surface functionality can create efficient nitrate adsorbents from agro-industrial residues. Full article

Ukraine’s renewable electricity transition combines decarbonisation with wartime resilience and post-war reconstruction. This study examines the relationship between installed renewable capacity and realised electricity generation using a structured institutional diagnostic; a same-year 2023 benchmark with Poland, Romania, and Slovakia; the capacity-realisation index (CRI); the capacity-deficit ratio (CDR); and the exploratory k-means clustering of 42 European electricity systems. The clustering model uses four non-overlapping 2023 capacity variables—renewable hydropower, onshore wind, solar PV, and bioenergy—while treating pure pumped storage separately as a flexibility characteristic. Renewables accounted for 24.8% of Ukraine’s installed electricity capacity and 18% of generation in 2023, yielding a CRI of 0.73, compared with 0.59 in Poland, 0.76 in Romania, and 0.68 in Slovakia. Ukraine therefore does not exhibit uniquely weak capacity–generation alignment within the selected benchmark. Nevertheless, the summer 2024 CDR of 19.2% and Energy Community scores of 72% for decarbonisation, 56% for markets, and 26% for energy security document substantial system stress. In the exploratory k = 3 solution (silhouette = 0.645), Ukraine belongs to a 33-case cluster and lies 0.563 standardised units from its centroid. The combined evidence is consistent with, but does not prove, constraints related to settlement discipline, grid evacuation, balancing, project bankability, and wartime security. Policy priorities include audited arrears resolution, financeable auctions and PPAs, curtailment and war-risk provisions, targeted grid reinforcement, competitive flexibility procurement, and solar-plus-storage systems for critical facilities. Full article

Problem statement: Contaminated mixed plastic waste—bearing metallic, paper, cardboard and organic residues—remains largely excluded from mechanical recycling because conventional routes require a costly, water- and energy-intensive washing–drying pretreatment. Research gap: No published study combines a fully dry, washing-free valorisation route for such waste with certified mechanical characterisation and a quantified CO₂ mass balance that explicitly credits elimination of the washing–drying stage. Methodology: This study presents DMP (Downcycled Mixed Plastic), a patented (OSIM, Romania) dry valorisation process based on continuous single-screw extrusion (D = 150 mm, L/D = 17.3), characterised through differential scanning calorimetry (DSC), certified mechanical/thermal testing at accredited Romanian laboratories, Weber-number dispersion analysis, and a process-parameter sensitivity study. Key findings: The composite exhibits certified mechanical properties (tensile strength 9.22 MPa, elongation at break 112.8%, compressive strength 14.5 MPa); composition–property analysis across four batches shows that increasing the PP weight fraction from 20 to 28 wt% raises tensile strength by 8.3% while reducing elongation by 5.2%; a computed Weber number (We = 166.7 ≫ We_crit) is consistent with fine PP-phase dispersion within the PE matrix; the sensitivity study confirms statistically robust structure–property relationships (R² = 0.93–0.98); and the CO₂ mass balance establishes a net avoidance of 3.150 t CO₂ eq per tonne of waste processed relative to conventional wet recycling. Significance: dry, washing-free processing is a technically promising pathway for valorising plastic waste streams currently considered non-recyclable, potentially reducing production cost by 60–70% relative to wet recycling, pending additional characterisation identified as priorities for future work. Full article

Reducing carbon emissions has become a central objective of sustainable development policies as countries seek to address the environmental challenges associated with climate change and resource depletion. In this context, circular economy practices and energy transition policies have emerged as key mechanisms for achieving environmental sustainability. This study examines the determinants of carbon emissions within the framework of the circular economy and energy transition for selected Central and Eastern European countries (Romania, Poland, Hungary, Bulgaria, Slovakia, and Slovenia) over the period 2010–2024. Using panel data analysis, the study incorporates key variables including circular economy, economic growth, recycling, renewable energy consumption, and urbanization. To enhance the reliability of the empirical estimates, panel unit root tests, the Hausman specification test, fixed-effects estimation, and Driscoll–Kraay robust standard errors are employed to address heteroskedasticity, serial correlation, and cross-sectional dependence. The results indicate that improvements in circular economy practices together with greater renewable energy use are associated with lower carbon emissions, providing empirical support for the proposed hypotheses. Recycling activities are found to increase emissions in the short run, indicating energy-intensive processes. In contrast, the effects of economic growth and urbanization are found to be context-dependent, providing only partial support for the related hypotheses. Overall, the results highlight that carbon emission dynamics are shaped by a complex interaction of economic, structural, and environmental factors, and that policy effectiveness depends on country-specific conditions. By focusing on transition economies in Central and Eastern Europe, this study extends the existing literature through an integrated panel data analysis of circular economy and energy transition policies and offers policy-relevant evidence for the region. Full article

Background: Osteoporosis is increasingly understood as a complex population health condition shaped by interacting behavioral, metabolic, pharmacological, and healthcare system determinants rather than isolated skeletal risk factors. However, comparative studies integrating these dimensions across distinct healthcare and sociocultural settings remain scarce. We aimed to characterize cross-national differences in osteoporosis-related risk clustering between Romanian and Tunisian adults using an integrative multidimensional framework. Methods: We performed a comparative cross-sectional analysis of harmonized data from two pharmacy-based studies conducted in Romania and Tunisia, including adults aged ≥ 40 years (n = 349). Osteoporosis-related knowledge, lifestyle and metabolic risk factors, pharmacological exposures, preventive behaviors, and treatment patterns were assessed. Multivariable regression and mediation analyses were used to identify independent predictors of screening uptake and to evaluate the relationship between knowledge and preventive behavior. An exploratory cumulative preventive deficit score was used to estimate overall preventive burden within the pharmacy-based study sample. Results: Romanian participants demonstrated significantly higher osteoporosis knowledge than Tunisian participants (8.90 ± 2.20 vs. 7.83 ± 2.99; p < 0.001); however, knowledge was not independently associated with Dual-Energy X-ray Absorptiometry (DXA) uptake and did not mediate country-related differences in screening behavior. Compared with the Romanian cohort, the Tunisian cohort exhibited lower DXA screening rates (11.2% vs. 22.8%; p = 0.005), lower vitamin D supplementation (11.9% vs. 38.6%; p < 0.001), greater sedentary behavior, and a significantly higher cumulative preventive deficit burden (3.39 ± 1.08 vs. 2.77 ± 1.26; p < 0.001). Medication-related osteoporosis risk was also greater in Tunisia, particularly due to markedly higher corticosteroid exposure (7.5% vs. 0.5%; p = 0.002). Despite this less favorable preventive profile, the treatment gap among participants with diagnosed osteoporosis was significantly lower in Tunisia than in Romania (4.8% vs. 42.9%; p = 0.003). Conclusions: Distinct but convergent osteoporosis-related risk patterns were identified across the two populations, suggesting that osteoporosis vulnerability emerges through context-specific clustering of behavioral, pharmacological, and healthcare-access determinants rather than through isolated risk factors alone. The dissociation between knowledge and preventive behavior highlights the limited impact of awareness-based strategies when structural barriers remain unaddressed. These findings support a shift toward integrated, population-tailored osteoporosis prevention models that incorporate healthcare-system, medication-related, and behavioral determinants, in addition to conventional educational approaches. Full article

Energy communities (ECs) are becoming a key institutional instrument for decentralizing the European energy transition, yet their implementation remains constrained by fragmented legal interpretation, uneven national transposition, and unresolved socio-technical coordination problems. This review synthesizes the peer-reviewed literature, EU primary legal texts, and national legislation to clarify the distinction between Renewable Energy Communities (RECs) and Citizen Energy Communities (CECs), alongside the amendment relationship between the RED II and RED III directives. The analysis demonstrates that the scalability of these initiatives depends less on theoretical legal recognition and more on aligning operational frameworks, including metering, settlement, cybersecurity, and equitable allocation rules. The Romanian case illustrates this challenge clearly: rapid prosumer growth creates valuable distributed generation but also exposes physical grid constraints, asymmetric socio-economic participation capacity, and weak experience with cooperative energy governance. To address these vulnerabilities, this paper contributes a focused analytical framework linking energy justice, peer-to-peer game-theoretic modeling, and the strategic integration of “anchor-prosumers.” The study argues that larger renewable self-consumers can act as stabilizing community anchors when internal energy prices are designed between wholesale export values and retail import prices, thereby improving both producer incentives and consumer affordability. Future research developments, including targeted surveys and longitudinal empirical validations, will sustain this claim and optimize the socio-economic resilience of decentralized energy markets. Full article

Programs aimed at reducing the CO₂e footprint associated with the residential building stock should be informed by several key elements, including the expected evolution of the occupied housing stock, projected population dynamics driven by socio-economic and cultural factors, available implementation budgets, and the specific costs of intervention measures. However, in regions characterized by high seismic hazard, the occurrence of a major earthquake may substantially alter the projected outcomes of emission-reduction programs, as seismically vulnerable buildings may experience severe structural damage. This paper presents the results obtained by applying an integrated methodology for assessing the CO₂e footprint associated with residential buildings. The methodology accounts for emissions related to building operation (space heating), energy-renovation interventions, and seismic retrofitting works. While the proposed approach is applicable to other seismically exposed regions, the results presented herein refer specifically to the residential building stock in Romania and its local seismic conditions. The methodology integrates information on the existing building stock, the projected evolution of population and the built environment, energy consumption associated with building operation, changes in the energy fuel mix, construction practices across different historical periods with respect to energy efficiency and seismic protection, and the CO₂e footprint associated with energy renovation and seismic retrofitting. In addition, the analysis explicitly considers the potentially negative effects of a major earthquake, particularly the disruption of greenhouse-gas emission-reduction programs. The assessment is conducted at the building stock level and is based on combining building stock evolution with average, representative CO₂e intensity values for heating, energy renovation, and seismic retrofitting. The results demonstrate that when the sole objective is to reduce the CO₂e footprint associated with space heating, renovation of the energy fuel mix represents the most effective measure. At the same time, the analysis shows that the CO₂e footprint generated by construction works for energy renovation and/or seismic retrofitting represents only a small fraction of the emissions associated with building operation. The occurrence of a major earthquake is likely to jeopardize overall environmental objectives by increasing emissions related to building operation, energy renovation, reactive seismic retrofitting, and replacement of severely damaged buildings. Conversely, systematic preventive seismic retrofitting of the building stock does not lead to an increase in cumulative CO₂e emissions over the program implementation period. Full article

This study analyzes the long-run relationships between digitalization, investment, innovation, and economic growth in connection with the energy transition in the SPRING-F group (Spain, Poland, Romania, Italy, the Netherlands, Germany, and France) using annual data for the period of 2000–2024. The analysis starts from the premise that digitalization affects economic performance not only directly, but also through structural transmission mechanisms linked to investment and the energy transition. To capture these dynamics, this study employs three complementary panel ARDL models. The first model explains economic growth (GDP per capita) as a function of digitalization, capital accumulation, R&D expenditure, renewable energy consumption, trade openness, and foreign direct investment. The second model estimates gross capital formation (GCF) in order to assess the investment transmission channel. The third model explains renewable energy consumption (RNEC) in order to capture the sustainability dimension. The results show that trade openness and capital accumulation are the strongest long-run drivers of economic growth in the SPRING-F group. Internet use, R&D expenditure, and FDI also display positive long-run associations with GDP per capita, whereas fixed broadband subscriptions and renewable energy consumption enter the growth equation with negative coefficients, suggesting that digital infrastructure and the green transition do not automatically generate immediate growth gains. The GCF model confirms that investment acts as an important transmission mechanism, especially through the robust GDP–GCF linkage. The RNEC model indicates that the energy transition is positively associated with investment, innovation, and trade openness, while GDP and digital infrastructure remain negatively associated with the renewable energy share. Overall, the findings point to a conditional and nonlinear relationship between growth, digitalization, investment, and sustainability, with the sustainability channel remaining more specification-sensitive than the growth and investment equations. The long-run results for the GDP equation should also be interpreted with additional caution, given the comparatively weaker cointegration evidence for Model 1. Full article

In developing countries, sustainable development strategies are increasingly shifting toward a green economy that integrates economic, social, and environmental dimensions. Despite the growing importance of green economic growth, comparative empirical studies examining its determinants in Turkey and Romania remain limited. This study investigates the dynamic relationships between environmentally sustainable growth, carbon emissions, life expectancy, renewable energy consumption, education, and technological innovation in Turkey and Romania over the period 1980–2023. Using annual time series data, the analysis applies the Augmented Dickey–Fuller and Zivot–Andrews unit root tests to examine stationarity and potential structural breaks. The empirical framework is based on the Autoregressive Distributed Lag (ARDL) bounds testing approach, which allows the estimation of both long-run equilibrium relationships and short-run dynamics. The results provide partial evidence of long-run relationships among the variables. Although the ARDL bounds test results fall within the inconclusive region, the negative and statistically significant error correction terms indicate that deviations from long-run equilibrium are corrected over time. The findings also reveal heterogeneous short-run causal interactions across the two countries, suggesting that the drivers of environmentally sustainable growth differ between Turkey and Romania. Overall, the results highlight the importance of country-specific policy frameworks, institutional structures, and energy transition pathways in promoting green economic growth. Full article

This paper examines differences in agri-environmental climate and energy performance across the 27 European Union (EU) Member States. An integrated methodological framework was applied, combining the Shannon Entropy Index for objective weighting of indicators with the PROMETHEE–GAIA multi-criteria decision-making approach to rank EU countries according to their relative performance. The analysis focuses on four key indicators: (1) Climate: greenhouse gas emissions from agriculture (GHG) and (2) Energy: (1) gross available energy (GAE), (2) renewable energy primary production (REPP), and (3) gross inland consumption (GIC)—expressed as intensity measures (ktoe per million euro of agricultural gross value added), and covers the period 2017–2023. The results reveal a reduction in cross-country dispersion for greenhouse gas emission intensity, reflected in a decline in entropy values, suggesting partial convergence in climate-related performance. In contrast, energy-related intensity indicators (GAE, GIC, and REPP) remain highly heterogeneous, indicating persistent structural differences in energy efficiency, energy mix and agricultural systems across Member States, despite modest signs of convergence for selected indicators. The PROMETHEE ranking identified Romania, Italy, Greece, Spain and Poland as leading performers, reflecting favourable combinations of lower emission intensity and more efficient energy use per unit of agricultural value added. Conversely, structurally constrained economies such as Malta, Cyprus, and Luxembourg consistently ranked among the lowest-performing countries, primarily due to high energy and emission intensities relative to agricultural output. The findings point to selective and indicator-specific convergence rather than uniform long-term convergence across the EU, underscoring the need for differentiated policy approaches to support a more balanced and sustainable energy transition in agriculture. Full article

The accelerating global demand for renewable heating, cooling and electricity, driven by climate change and rising living standards, presents both a challenge and an opportunity for sustainable energy transitions. This paper introduces the Initial-Aid Cashback (IAC) model, an innovative business model designed to finance renewable energy solutions, with a focus on space cooling, by leveraging citizen participation and collaborative financing mechanisms. The model incentivizes private investors through discounted energy prices, while system operators benefit from reduced upfront capital requirements and minimised financial risk. Through two case studies, an office building in Romania (small-scale case) and the application of the REGEN-BY-2 technology in a mixed housing–office area (large-scale case), the paper demonstrates the model’s potential to accelerate the adoption of renewable cooling technologies, enhance profitability for operators, and provide attractive returns for investors. The findings highlight the model’s adaptability to diverse stakeholder needs, its scalability, and its role in fostering the clean energy transition (CET). However, challenges such as the need for a minimum number of investors, legal complexities, and trust-building among stakeholders are identified as critical barriers to implementation. The paper concludes that the IAC model offers a promising pathway to integrate citizens and small investors into the CET, while emphasising the importance of supportive policies, clear governance structures, and practical testing to ensure its success. Full article

District heating systems are central to Europe’s decarbonisation strategy and its 2050 climate-neutrality objective. However, district heating is deeply embedded in the socio-economic system and the built environment. This makes compliance with policy targets at the local level particularly challenging. The issues are attributable to two factors. Firstly, the process is characterised by a high degree of complexity and multidimensionality. Secondly, there is a scarcity of local resources (e.g., land, surface waters, waste heat, etc.). In Bucharest, Romania, the largest district heating system in the European Union, the process of decarbonisation represents a particularly complex challenge. The system is characterised by large physical dimensions, high technical wear, heavy dependence on natural gas, significant heat losses and complex governance structures. This paper presents a strategic planning exercise for aligning the Bucharest system with the Energy Efficiency Directive 2023/1791. Drawing on system data, investment modelling, and local resource mapping from the LIFE22-CET-SET_HEAT project, the study evaluates scenarios for 2028 and 2035 that shift heat generation from natural gas to renewable, waste heat, and high-efficiency sources. The central objective is the identification of opportunities and issues. Options include large-scale heat pumps, waste-to-energy, geothermal and solar heat. Heat demand profiles and electricity price dynamics are used to evaluate economic feasibility and operational flexibility. The findings show that the decarbonisation heat supply in Bucharest is technically possible, but financial viability hinges on phased investments, interinstitutional coordination, regulatory reforms and access to EU funding. The study concludes with recommendations for staged implementation, coordinated governance and socio-economic measures to safeguard heat affordability and system reliability. Full article

This study analyses the dynamics of the energy transition within the SPRING-F group (Spain, Poland, Romania, Italy, the Netherlands, Germany, France) through a hybrid approach that combines econometric panel ARDL models with machine learning algorithms. The analysis is based on energy, economic, and technological indicators, including renewable energy consumption, energy intensity, CO₂ emissions, GDP per capita, urbanization, trade openness, and R&D expenditure. The results of the exploratory analysis highlight the existence of clear structural differences between Western European and emerging Central and Eastern European economies. Based on the estimates made with the ARDL panel model, the long-term equilibrium relationships were confirmed. They indicated positive and significant effects of urbanization and economic growth on renewable energy consumption, as well as a negative impact of CO₂ emissions. Regarding the short-term effects, the error correction coefficient suggests a moderate convergence towards equilibrium. Machine learning models highlight the superiority of nonlinear approaches, and SHAP analysis confirms the dominant role of CO₂ emissions and the heterogeneity of national energy transition trajectories. Full article

The transition to a low-carbon economy is profoundly reshaping European labour markets, creating both opportunities for sustainable employment and challenges for regions reliant on carbon-intensive sectors. Assessing how prepared EU Member States are for this shift remains difficult due to the lack of unified evaluation tools. This study introduces the Green Labour Market Readiness Index (GLMRI)—a composite measure assessing the adaptability of national labour markets to the energy-driven green transformation in nine EU countries: Germany, France, Sweden, Spain, Italy, Greece, Poland, Romania, and the Czech Republic. The index integrates five dimensions—education and skills, investment and infrastructure, policy and institutional quality, labour market structure, and innovation—based on harmonized data from 2010 to 2024. Panel econometric models (Fixed and Random Effects), combined with Hausman tests, are used to examine how structurally independent external energy-system characteristics, institutional capacity, and macro-structural labour-market conditions are associated with observed variation in labour-market readiness, as captured by the GLMRI composite outcome. Machine learning algorithms (Random Forest, XGBoost, LSTM) are employed to forecast readiness trajectories until 2040 under alternative policy scenarios. Results reveal persistent asymmetries between Northwestern and Southeastern Europe, showing that successful energy transition is closely associated not only with investment and innovation but also with human capital and governance quality. These associations are interpreted as diagnostic rather than causal, highlighting how external structural conditions shape the translation of energy-transition pressures into differentiated labour-market outcomes. The GLMRI provides a methodological and policy-relevant framework, helping decision-makers prioritize resources and design measures that make Europe’s energy transition sustainable, inclusive, and equitable. Full article