Search Results (81)

Background and Objectives: Coronavirus Disease 2019 (COVID-19) may cause extensive multi-organ pathology, particularly in the lungs, heart, kidneys, and liver. While hypercoagulability—often signaled by elevated D-dimer—has been thoroughly investigated, the concurrent pathological findings across organs and their interrelation with distinct D-dimer levels remain incompletely characterized. This study aimed to evaluate the pathological changes observed in autopsied or deceased COVID-19 patients, focusing on the prevalence of organ-specific lesions, and to perform subgroup analyses based on three D-dimer categories. Methods: We conducted a retrospective review of 69 COVID-19 patients from a Romanian-language dataset, translating all clinical and pathological descriptions into English. Pathological findings (pulmonary microthrombi, bronchopneumonia, myocardial fibrosis, hepatic steatosis, and renal tubular necrosis) were cataloged. Patients were grouped into three categories by admission D-dimer: <500 ng/mL, 500–2000 ng/mL, and ≥2000 ng/mL. Laboratory parameters (C-reactive protein, fibrinogen, and erythrocyte sedimentation rate) and clinical outcomes (intensive care unit [ICU] admission, mechanical ventilation, and mortality) were also recorded. Intergroup comparisons were performed with chi-square tests for categorical data and one-way ANOVA or the Kruskal–Wallis test for continuous data. Results: Marked organ pathology was significantly more frequent in the highest D-dimer group (≥2000 ng/mL). Pulmonary microthrombi and bronchopneumonia increased stepwise across ascending D-dimer strata (p < 0.05). Myocardial and renal lesions similarly showed higher prevalence in patients with elevated D-dimer. Correlation analysis revealed that severe lung and heart pathologies were strongly associated with high inflammatory markers and a greater risk of ICU admission and mortality. Conclusions: Our findings underscore that COVID-19-related organ damage is magnified in patients with significantly elevated D-dimer. By integrating pathology reports with clinical and laboratory data, we highlight the prognostic role of hypercoagulability and systemic inflammation in the pathogenesis of multi-organ complications. Stratifying patients by D-dimer may inform more tailored management strategies, particularly in those at highest risk of severe pathology and adverse clinical outcomes. Full article

Telemedicine in emergency contexts presents unique challenges, particularly in multilingual and low-resource settings where accurate, clinical understanding and triage decision support are critical. This paper introduces TriagE-NLU, a novel multilingual natural language understanding system designed to perform both semantic parsing and clinical intervention classification from emergency dialogues. The system is built on a federated learning architecture to ensure data privacy and adaptability across regions and is trained using TriageX, a synthetic, clinically grounded dataset covering five languages (English, Spanish, Romanian, Arabic, and Mandarin). TriagE-NLU integrates fine-tuned multilingual transformers with a hybrid rules-and-policy decision engine, enabling it to parse structured medical information (symptoms, risk factors, temporal markers) and recommend appropriate interventions based on recognized patterns. Evaluation against strong multilingual baselines, including mT5, mBART, and XLM-RoBERTa, demonstrates superior performance by TriagE-NLU, achieving F1 scores of 0.91 for semantic parsing and 0.89 for intervention classification, along with 0.92 accuracy and a BLEU score of 0.87. These results validate the system’s robustness in multilingual emergency telehealth and its ability to generalize across diverse input scenarios. This paper establishes a new direction for privacy-preserving, AI-assisted triage systems. Full article

Objectives: Scarce data are available regarding preventive medicine in forcibly displaced populations especially regarding non-communicable diseases like neoplasia, while even more limited data are available on Ukrainian refugees in Romania. To address this research gap, the present analysis was performed to investigate Ukrainian refugee women’s beliefs, attitudes, and opinions towards the Romanian and Ukrainian healthcare system in a comparison model while focusing on the HPV immunization rates and factors influencing the uptake for themselves and their children. Methods: Participants were recruited using the snowball sampling method through their General Practitioner (GP) and a health mediator. Results: In total, 105 women completed the online or physical survey. The mean age was 50 years. In total, 40% of women had not been to a gynecological check-up in 3 or more years, and more than 56% had never been screened. Only four were vaccinated against HPV, and none remembered which type of vaccine was dispensed or how many doses were utilized. The primary hindrances to accessing health services or immunization programs were language barriers, financial burdens, and a lack of information. Respondents’ general distrust of health systems and healthcare workforces were recurrent themes. Relationship status, living arrangements, and previous engagement in screening practices influenced immunization rates. Perceiving the healthcare officials as proactive concerning optional vaccination programs such as HPV immunization and actively receiving recommendations drove respondents to pursue vaccination. Conclusions: This analysis offers a foundational insight into the specific needs of refugee women. It can guide the development of effective public health interventions to improve health outcomes and vaccination rates among Ukrainian refugees in Romania. Tailored preventive campaigns with adequate native language information and prompts from medical experts in designated centers should be deployed to ensure inclusive tactics for vulnerable populations. Full article

Background/Objectives: This study evaluates the performance of a large language model (lLm) in providing geographically tailored colorectal cancer screening and surveillance recommendations to gastrointestinal surgeons. Methods: Fifty-four patient cases, varying by age and family history, were developed based on colorectal cancer guidelines. Standardized prompts with predefined query terms were used to query ChatGPT-4.5 on 18 April 2025, from four locations: Canada, Italy, Romania, and the United Kingdom. Responses were classified as “Correct,” “Partially Correct,” or “Incorrect” based on clinical guidelines and expert recommendations for each country. Outcomes were analyzed using descriptive statistics. Results: ChatGPT provided recommendations on screening eligibility, test interpretation, the management of positive results, and surveillance intervals. Correct recommendations were given for 50.0% (27/54) of cases in Canada, 63.0% (34/54) of cases in Italy, 40.7% (22/54) of cases in Romania, and 55.6% (30/54) of cases in the United Kingdom. Queries in Italian yielded correct guidance for 64.8% (35/54) of cases, while Romanian queries were accurate for 40.7% (22/54) of cases. Notably, Romania and Italy lacked detailed guidelines for polyp management and post-test surveillance. A key finding was the inconsistency between ChatGPT-generated titles and corresponding recommendations, which may impact its reliability in clinical decision-making. Conclusions: ChatGPT-4.5’s performance varies by country and language, highlighting inconsistencies in geographically tailored recommendations. This study highlights limitations associated with the training data cutoff and the potential biases introduced by model-generated responses. Healthcare professionals should recognize these limitations and the possible gaps in guideline availability, particularly for high-risk screening, polyp management, and surveillance in certain European countries. Full article

(1) Background: Globally, lung cancer is the leading cause of cancer death, but immunotherapy has impressively improved the outcomes, generating longer progression-free survival and overall survival. Endocrine immune-related adverse events (irAEs) are mostly irreversible and need life-long hormonal substitution therapy. The evaluation of the quality of life of lung cancer patients experiencing endocrine toxicities during immune checkpoint inhibitor (ICI) treatment is relevant for both patients and healthcare providers. (2) Methods: This was a prospective cohort study of lung cancer patients treated with immune checkpoint inhibitors in a tertiary-level hospital in Romania from 1 December 2021 to 30 September 2024. Quality of life was assessed using versions of the EORTC QLQ-C30 and EORTC QLQ-LC-13 validated and translated into the Romanian language. We investigated several clinical variables to evaluate their impact on QoL. (3) Results: Fifty-nine lung cancer patients were evaluated for their QoL before ICI initiation and at the end of the study. Endocrine-irAEs occurred in 17 lung cancer patients (28.8%). Quality of life as assessed using the EORTC questionnaires was statistically significantly improved, even in patients experiencing endocrine-irAEs. (4) Conclusions: Our prospective cohort study succeeded in delivering the proof of concept of an increased QoL in lung cancer patients who had developed endocrine-irAEs under immunotherapy. Despite toxicities, especially rather frequent endocrine-irAEs, ICIs enabled durable disease control and symptom relief, improving the QoL of the overall trial population. As more lung cancer patients undergo immunotherapy in metastatic or early stages, we draw attention to this particular patient population with autoimmune endocrinopathies, as they will live longer and require life-long hormonal therapy. Full article

In this article, we tested some specific claims made in the literature on relative distances among European languages and among Chinese dialects, suggesting that some language varieties within the Sinitic family traditionally called dialects are, in fact, more linguistically distant from one another than some European varieties that are traditionally called languages. More generally, we examined whether distances among varieties within and across European language families were larger than those within and across Sinitic language varieties. To this end, we computed lexico-phonetic as well as syntactic distance measures for comparable language materials in six Germanic, five Romance and six Slavic languages, as well as for six Mandarin and nine non-Mandarin (‘southern’) Chinese varieties. Lexico-phonetic distances were expressed as the length-normalized MPI-weighted Levenshtein distances computed on the 100 most frequently used nouns in the 32 language varieties. Syntactic distance was implemented as the (complement of) the Pearson correlation coefficient found for the PoS trigram frequencies established for a parallel corpus of the same four texts translated into each of the 32 languages. The lexico-phonetic distances proved to be relatively large and of approximately equal magnitude in the Germanic, Slavic and non-Mandarin Chinese language varieties. However, the lexico-phonetic distances among the Romance and Mandarin languages were considerably smaller, but of similar magnitude. Cantonese (Guangzhou dialect) was lexico-phonetically as distant from Standard Mandarin (Beijing dialect) as European language pairs such as Portuguese–Italian, Portuguese–Romanian and Dutch–German. Syntactically, however, the differences among the Sinitic varieties were about ten times smaller than the differences among the European languages, both within and across the families—which provides some justification for the Chinese tradition of calling the Sinitic varieties dialects of the same language. Full article

This study examines the integration of disadvantaged Roma ethnic minority students in Hungarian-language vocational schools in Central European countries with highly segregated education systems. It focuses on Romania, Slovakia, and Hungary, where Roma students face significant segregation. This research investigates two Romanian, two Slovak, and four Hungarian vocational schools, selected based on their proportion of Roma students aligning with national averages. Surveys and interviews were conducted with teachers to assess their attitudes, commitment, and preparedness in educating Roma students. The main findings of this research are that schools with Roma student proportions matching national averages do not face significant challenges in co-education, teachers generally believe Roma students should complete lower secondary education, and teachers are committed to supporting Roma students but often feel unprepared to teach them. This study’s results suggest that governments should implement policies to eliminate educational segregation in vocational schools and promote inclusive education. Teacher training programs should focus on equipping educators with better tools to support Roma students. Possible directions for further research include a comparative analysis of vocational and grammar secondary schools in the integration of Roma students, longitudinal studies on the long-term educational and career outcomes of Roma students in vocational schools, and an examination of best practices in inclusive vocational education across different European countries. Full article

Nowadays, grammatical error correction (GEC) has a significant role in writing since even native speakers often face challenges with proficient writing. This research is focused on developing a methodology to correct grammatical errors in the Romanian language, a less-resourced language for which there are currently no up-to-date GEC solutions. Our main contributions include an open-source synthetic dataset of 345,403 Romanian sentences, a manually curated dataset of 3054 social media comments, a two-phased GEC approach, and a comparison with several Romanian models, including RoMistral and RoLama3, but also LanguageTool, GPT-4o mini, and GPT-4o. We consider a synthetic dataset to finetune our models, while we rely on two real-life datasets with genuine human mistakes (i.e., CNA and RoComments) to evaluate performance. Building an artificial dataset was necessary because of the scarcity of real-life mistake datasets, whereas introducing RoComments, a new genuine dataset, is argued by the necessity to cover errors amongst native speakers encountered in social media comments. We also introduce a two-phased approach, where we first identify the location of erroneous tokens in the sentence; next, the erroneous tokens are replaced by an encoder–decoder model. Our approach achieved an $F_{0.5}$ of 0.57 on CNA and 0.64 on RoComments, surpassing by a considerable margin LanguageTool as well as an end-to-end version based on Flan-T5 and mT0 in most setups. While our two-phased method did not outperform GPT-4o, arguably by its smaller size and language exposure, it obtained on-par results with GPT-4o mini and achieved higher performance than all Romanian LLMs. Full article

Objectives: The objectives of the current study were to validate the LittlEARS^® Early Speech Production Questionnaire (LEESPQ) in Romanian and to evaluate the psychometric properties of the Romanian version of the questionnaire for Romanian children with normal hearing. The LEESPQ was created and tested for the assessment of preverbal and early verbal skills (0–18 months) in children with normal hearing. Methods: The English version of the LittlEARS^® Early Speech Production Questionnaire (LEESPQ) was adapted into Romanian language using a translation/back-translation procedure and validation of the content before applying the questionnaire. The Romanian version was applied to the parents of 232 children with normal hearing, aged between 0 and 18 months. The questionnaire was statistically analyzed to assess its reliability, internal consistency, predictive accuracy, and the influence of gender on children’s scores. Results: Statistical analyses confirmed the LEESPQ’s reliability (α = 0.876) and high predictive accuracy (λ = 0.951). Age correlated strongly with total scores (ρ = 0.67; p < 0.001), supporting the age-dependent progression of speech production milestones. Gender did not significantly affect the scores. Normative curves and minimum expected scores were established for each age group. Conclusions: This study confirmed that the Romanian version of the LEESPQ is a reliable, valid, language-independent instrument, useful in the assessment of language development in children with normal hearing, aged up to 18 months. Full article

Transformer models produce advanced text representations that have been used to break through the hard challenge of natural language understanding. Using the Transformer’s attention mechanism, which acts as a language learning memory, trained on tens of billions of words, a word sense disambiguation (WSD) algorithm can now construct a more faithful vectorial representation of the context of a word to be disambiguated. Working with a set of 34 lemmas of nouns, verbs, adjectives and adverbs selected from the National Reference Corpus of Romanian (CoRoLa), we show that using BERT’s attention heads at all hidden layers, we can devise contextual vectors of the target lemma that produce better clusters of lemma’s senses than the ones obtained with standard BERT embeddings. If we automatically translate the Romanian example sentences of the target lemma into English, we show that we can reliably infer the number of senses with which the target lemma appears in the CoRoLa. We also describe an unsupervised WSD algorithm that, using a Romanian BERT model and a few example sentences of the target lemma’s senses, can label the Romanian induced sense clusters with the appropriate sense labels, with an average accuracy of 64%. Full article

The present study is concerned with some aspects of the production of [ɨ] and [ə] in Romanian, i.e., their position within the vowel space, degree of acoustic variability and acoustic duration. To this end, acoustic data were collected for the Romanian stressed vowels [i e a o u ɨ ə] produced by six speakers in controlled consonantal context conditions and real and nonsense words. The formant frequency data reveal that [ɨ] and [ə] do not overlap along the F1 dimension, which may be ascribed to the need to set in contrast the two central vowels phonologically. Moreover, [ɨ] is clearly more variable in F2, and thus in vowel fronting, than schwa. Regarding segmental duration, [ɨ] is as short as high vowels and shorter than schwa, whose duration is comparable to that of mid vowels. The phonetic characteristics for stressed schwa in Romanian are in contrast with those for the same vowel in other world’s languages, in which it is highly variable and shorter than all or most peripheral vowels. This behaviour may be attributed to the existence of two central vowels, while suggesting that [ə] has a well-defined articulatory target in the Romanian language. Full article

The poetry of distant country with different culture and language is always distinctive and fascinating. Chinese and Romanian belong to Sinitic languages of the Sino-Tibetan language family and Romance languages of the Indo-European language family, which have relatively different syntax and general imagery of literature. Therefore, in this study, we make an attempt that was rarely involved in previous poetry generation research, using modern Chinese as the carrier, and generating modern poetry with Romanian style based on pre-trained model and direct preference optimization. Using a 5-point grading system, human evaluators awarded scores ranging from 3.21 to 3.83 across seven evaluation perspectives for the generated poems, achieving 76.2% to 91.6% of the comparable scores for the Chinese translations of authentic Romanian poems. The coincidence of the 30th to the 50th most frequently occurring poetic images in both generated poems and Romanian poems can reach 58.0–63.3%. Human evaluation and comparative statistical results on poetic imagery show that direct preference optimization is of great help in improving the degree of stylization, and the model can successfully create Chinese modern poems with Romanian style. Full article

This article provides a short introduction to Balkan Romance, examining and exemplifying a number of its principal features. In particular, the discussion begins in §2 with a review of the main morphosyntactic features of the four principal sub-branches of Old Romanian spoken today within the Balkan Sprachbund (Daco-Romanian, Aromanian, Istro-Romanian, and Megleno-Aromanian), tracing the treatment of such Balkanisms both in the traditional philological literature (§3) and their more recent formalization and expansion in the theoretical literature dedicated to the Balkan Sprachbund (§4). This is followed in §5 by a discussion of some of the dialects spoken in southern Italy and their key morphosyntactic features. These varieties, although not situated in the Balkan Sprachbund proper, have nonetheless either developed under contact with Balkan languages, as in the case of the Romance dialects of the extreme south of Italy which have been in centuries-long contact with Greek (§5.1), or, in the case of Italo-Albanian, have evolved under contact with local Italo-Romance varieties (§5.2). The discussion concludes in §6 with an overview of the principal issues discussed in each of the contributions. Full article

This article explores the order of possessives with respect to nouns in Megleno-Romanian, a branch of Daco-Romance, and Eolian, a variety of southern Italo-Romance. Both are in intense language contact situations, the former with the south Slavonic varieties of Bulgarian and Macedonian, the latter with the southern Italo-Romance variety of Sicilian along with southern regional Italian. In particular, we show that while superficially, both Megleno-Romanian and Eolian copied the patterns found in their respective contact languages, the situation is much more complex. Megleno-Romanian shows high noun movement with kinship terms and low noun movement with common nouns, a situation also found in south Slavonic. In the case of Eolian, younger speakers categorically lack N-to-D movement with kinship terms, reflecting the typical Sicilian pattern. In both cases, this gives rise to prenominal possessives, thus diverging from the most common position of possessives in Eastern Romance, which are generally postnominal in unmarked contexts. Ultimately, these case studies show that the position of possessives is epiphenomenal to the level of noun movement in the varieties under investigation. On this note, deeper structural borrowing concerning the nature of possessives (i.e., whether they have an adjectival or determiner value) did not emerge in our findings and is worthy of further investigation. Full article

In the European context shaped by migration, it is necessary to adapt dietitians to cultural diversity for effective professional practice. The objectives of the research are to analyze the cultural and ethnic diversity in Romania, highlighting the possible influence of acculturation on the dietary behaviors of different ethnic groups, and to formulate ways to apply the stages of cultural competence. The research methodology included the collection and use of data from the population census and other statistical sources to analyze the ethnic, linguistic, and religious composition in different regions of Romania, and the use of a cultural competence model that could be applied in the Romanian medical context for the formulation of health recommendations tailored to eating habits and influenced by acculturation and sociocultural factors. The study reveals the cultural diversity of the Romanian population, with more than 1.7 million inhabitants having a native language other than Romanian and with a wide ethnic and religious variety. We adapted a cultural competence model including methods to assess dietary acculturation, understand food preferences, and respect ethnic, religious, and generational diversity, ensuring its applicability in various multicultural contexts. This study emphasizes the importance of cultural competence in dietetic practice in a diverse health care setting and tailoring nutrition services according to cultural diversity to improve health and patient satisfaction. Full article