Search Results (78)

Background/Objectives: The increase in life expectancy and the share of the elderly population has the effect of increasing the number of osteoporotic hip fractures. At the same time, the number of total hip arthroplasty (THA) interventions is continuously increasing. The objective of this study is to investigate the incidence rates of hip fractures during the period 2008–2019, in Romania, among people who are at least 40 years old, as well as to determine the extent to which the increase in the prevalence of people who have undergone THA has affected the incidence of hip fractures, given that the operated hip no longer presents a risk of fracture. Methods: We extracted the information, between 2008 and 2019, from nationwide retrospective studies about the incidence and time trend of hip fractures in Romania. Information on primary THA interventions during the period 2001–2019 was obtained from the Romanian Arthroplasty Register (RAR). We obtained the population size, by gender and age groups, from the reports of the National Institute of Statistics. For the period 2008–2019, we calculated the standardized annual hip fracture incidence rates by sex and by age. Given that each person has two hips at risk of fracture, we calculated hip fracture rates in a scenario without THA interventions. For this, we subtracted 0.5 people from the at-risk population for each prevalent hip prosthesis. Thus, we revealed the effects of decreasing fracture rates due to having hip prostheses. Results: From 2008 to 2019, age-standardized incidence rates of hip fractures increased by 10.8% in women, and by 2.8% in men. By excluding hips being replaced with prostheses in the at-risk population, we obtained higher hip fracture incidence rates. These recorded values were considerably higher for the elderly population. The variation in hip fracture rates during the observed period was 10.16% (9.76% in women and 11.68% in men) lower due to the increased prevalence of hip prostheses. Conclusions: Although the incidence of hip fractures has continued to rise, the growing number of people who have undergone THA and are living with hip prostheses has helped to blunt this increase. Full article

The process of secularization was long considered irreversible and characteristic of all contemporary culture. Nonetheless, more recent approaches view it as strictly linked to Western religiosity and in relation to a process of de-secularization and post-secular orientations regarding the sacred. For Romanian Orthodox theologians, secularization represents more of a trial than a danger. The current article presents the results of qualitative research regarding the religiosity of future graduates of Orthodox vocational theological high schools in Romania. The students enrolled in the research were asked to graphically represent God and briefly explain their drawings. The data were theoretically coded and compared with the canonical attributes of God as acknowledged by Orthodox theology. The results indicated the canonical correctness of students’ representations of divinity. Orthodox vocational high school education proves to be effective in imposing the Christian dogmatic line to the detriment of popular religiosity characterized by old pre-Christian beliefs and practices. Full article

Educational achievement plays a significant role in the labour market, benefiting individuals and society. Graduating from high school is a key step towards better employment opportunities and a prerequisite for higher education attainment. In 2023, only 22.5% of the Romanian population graduated tertiary education, while 16.6% left education or training early. The Romanian public high school network comprises 1558 units, mostly located in urban areas. The high school enrolment rate is 83.5% in urban areas, and it drops to less than 60% in rural areas, with the country registering the highest out-of-school rate in the EU for the 15-year-old population. Spatial accessibility may influence enrolment in high schools, particularly for students living in rural or remote areas, who often face financial challenges fuelled by long distances and limited transportation options. Hence, travel distance may represent a potential barrier to completing the educational process or may determine inequalities in educational opportunities and outcomes. This paper aims to assess the spatial accessibility of the public high school network in Romania by using distance data provided by the Open Street Map API (Application Programming Interface). We examine variations in spatial accessibility based on the distribution of high school units and road network characteristics considering three variables: travel distance to the nearest high school, the average distance to three different categories of high schools, and the number of high schools located within a 20 km buffer zone. The results highlight a significant urban–rural divide in the availability of public high school facilities, with 84.1% (n = 1311) located in urban areas while 49.1% of the high school-aged population lives in rural areas. Many rural communities lack adequate educational facilities, often having limited options for high school education. The findings also show that 32% of the high school-aged population has to travel more than 10 km to the nearest high school, and 7% has no high school options within a 20 km buffer zone. This study provides insights into the educational landscape in Romania, pointing out areas with limited access to high schools, which contributes to further inequalities in educational attainment. The findings may serve as a basis for developing policies and practices to bridge the urban–rural divide in educational opportunities and foster a more equitable and inclusive education system. Full article

In the era of Artificial Intelligence, the magic of achieving results at the “speed of light” for tasks that until recently required a lot of work and effort shocks, arouses enthusiasm and generates fears at the same time. Therefore, starting from this reality of our days, we proposed within the current research to study the relationship between the factors of technostress (techno-overload, techno-invasion, techno-complexity, techno-insecurity, techno-uncertainty) perceived as a result of the implementation of AI at the societal level and the quality of life, filtering the relationship through the “lens” of the positive and negative affect mediators. The mediation analyses, conducted on a sample of 217 adult Romanian citizens (18–62 years old), suggested that although AI-related technostress does not directly influence quality of life, it has a significant indirect impact through affective traits—general tendencies to frequently experience positive or negative emotions. This indicates that technostress contributes to variations in quality of life by influencing emotional experiences, which mediate the relationship. These findings emphasize not only the absence of a direct effect, but also the importance of the indirect pathway in understanding how individuals are affected by AI-related stress. We believe that the results of the current study can be equally useful in raising awareness of the psychological mechanisms responsible for the quality of life and in understanding the importance of implementing official programs, both technically, regarding the development of skills to understand and work with AI, and psychological support programs, considering the management of emotions, with reference to this technology. Full article

Background: The transition from pediatric to adult care in Duchenne Muscular Dystrophy (DMD) is challenging due to the disease’s complexity and the need for lifelong, comprehensive management. In Romania, ongoing efforts aim to enhance multidisciplinary collaboration, though systemic barriers, such as fragmented healthcare services, persist. Nonsense mutations, including those in exon 30 described here, are often associated with more severe disease progression. Methods: We present the case of a 17-year-old Romanian DMD patient with a nonsense mutation in exon 30 of the dystrophin gene. The patient received multidisciplinary pediatric care addressing his medical needs, including neuromuscular, respiratory, cardiac, and orthopedic management. Transition readiness was assessed using the Transition Readiness Assessment Questionnaire (TRAQ), and the patient’s perspective on the process was documented. Results: Care followed international standards, but the disease progressed predictably, with gradual loss of ambulation, respiratory decline, and cardiac complications. The TRAQ revealed strengths in communication with healthcare providers but moderate confidence in self-management tasks. From the patient’s perspective, fragmented adult services and difficulty accessing specialized neuromuscular support remain major obstacles, underscoring the importance of early, structured transition planning and patient-centered approaches. Conclusions: Transitioning to adult services requires strong communication between pediatric and adult teams and integration of specialized care. Tailored follow-up plans ensure continuity of care and effective disease management. This case reflects broader needs in similar healthcare contexts, highlighting the necessity of robust transition frameworks to respond to patient-specific challenges and ultimately support long-term quality of life. Full article

Pathogenic variants in the NEXMIF gene are associated with a broad neurodevelopmental phenotype, including autism spectrum disorder (ASD), intellectual disability (ID), and epilepsy. However, the role of NEXMIF in specific epileptic syndromes remains insufficiently explored. We present the case of an 11.9-year-old Romanian girl diagnosed with ASD, attention-deficit/hyperactivity disorder (ADHD), mild ID, and Jeavons syndrome (generalized epilepsy characterized by eyelid myoclonia, absence seizures, and photosensitivity). Genetic testing identified a pathogenic NEXMIF variant: c.1882C>T (p.Arg628*), a pathogenic variant rarely reported in the literature, with only two documented cases to date. To better understand the genotype–phenotype correlation, we conducted a systematic review of NEXMIF-associated disorders and compared our findings with previously reported cases. Our analysis suggests that NEXMIF variants may contribute to a broader spectrum of epileptic syndromes, including photosensitive epilepsy such as Jeavons syndrome. This highlights the need for a greater awareness of atypical seizure presentations in individuals with NEXMIF-related disorders. This study underscores the importance of genetic testing in individuals with overlapping ASD and epilepsy phenotypes as early diagnosis may facilitate targeted therapeutic interventions and genetic counseling. Further research is needed to clarify the molecular mechanisms linking NEXMIF dysfunction to epileptic syndromes and neurodevelopmental disorders. Full article

Single-family residential buildings represent the highest share of building sector in Romania. Their operation emits the most CO₂ into Earth’s atmosphere, as most of them are not energy efficient. A life cycle assessment is performed for a case study building, built in 2019 in Romania, establishing its carbon footprint. For this building CO₂ emissions are 177.55 tCO₂ for the construction stage, 76.19 tCO₂ for the operation stage, 3.55 tCO₂ for the demolition stage, and a total of 129.76 tCO₂ after reducing with the carbon sequestration from vegetation 127.53 tCO₂. The main purpose of this study is to analyse the carbon footprint for a typical single-family Romanian household, with an emphasis on the operational stage. The study compares the results and extrapolates them to all single-family residential buildings in Romania regarding CO₂ emissions, with an emphasis on the operational stage. The results illustrate a considerable reduction in CO₂ emissions from old, high energy consumption buildings to new, low energy consumption buildings. The highest operational stage emissions for old buildings in Romania are 962.94 tCO₂ for firewood heating and 573.69 tCO₂ for gas boiler heating, as those buildings are not insulated and don’t use a heat pump. Additionally, considering the use of photovoltaic panels for the entire lifespan, the CO₂ emissions for the operational stage decrease for the case study building from 76.18 tCO₂ to 19.90 tCO₂. Moreover, using a heat pump detriments firewood or gas boilers, decreasing CO₂ emissions for the operational stage by up to 34% and 26%, respectively. Due to the higher cost of electrical energy compared to natural gas in Romania, gas boilers are more cost-effective than heat pumps. Because of this, and the higher implementation costs, the tendency is towards natural gas. This will in turn result in an increase of CO₂ emission for the entire life cycle of the building by approximate 32% for new buildings and 86% for old, high-energy-consumption buildings. Full article

(1) Background and Objective: The debate on the stability and variability of subjective wellbeing (SWB) is decades old. However, despite the wealth of literature on this topic, there are relatively few studies that aim to explain the “why” and “how” of the dynamics of SWB. In this context, the objective of this exploratory study is to test the plausibility of a model of the cognitive component of SWB (CWB) inspired by the control theory. In this model, a measure of future life expectations (FLEs) serves as a target in the control loop regulating cognitive wellbeing (CWB), while general self-efficacy (GSE) and affective wellbeing (AWB) are mediators in the direct and feedback loops. (2) Method: To test this model, we collected data from a convenience sample of N-98 Romanian students in Computer Science using well-established questionnaires measuring CWB, GSE, AWB, and FLE. Mediation analyses and path modeling were conducted to evaluate the feedback-based model of the interplay between these variables. (3) Results: The findings confirm a significant relationship between FLE and CWB (β = 0.62, p < 0.001). GSE partially mediates the link between FLE and CWB (β = 0.139, p = 0.02), while AWB mediates the feedback from CWB to FLE (β = 0.297, p < 0.001). The model explains 42% of the variance of CWB. (4) Conclusions: Our study remains exploratory in nature, but preliminary data suggest that a model of SWB based on feedback control is worth attention as it might provide a better understanding of the dynamics of SWB. Full article

Apples (Malus domestica Borkh.) represent one of the most widely cultivated and consumed fruits globally, with significant genetic diversity among cultivars. This study aimed to evaluate the morphological, biochemical, and organoleptic characteristics of 34 apple cultivars, including ancient Romanian varieties, internationally old and modern cultivars, and new selections. The assessment was conducted to identify valuable traits for breeding programs and commercial applications. Morphological analysis revealed significant variation in fruit size, shape, and weight, with international ‘classic’ cultivars exhibiting larger dimensions on average. Biochemical profiling indicated notable differences in moisture content, total soluble solids, titratable acidity, and carotenoid levels, with some traditional cultivars demonstrating high nutritional potential. Texture analysis showed variations in peel hardness, flesh firmness, and toughness, influencing storage capacity and consumer preference. Organoleptic evaluations highlighted the superior sensory attributes of cultivars such as ‘Golden Orange’, ‘Jonathan’, ‘Kaltherer Böhmer’, and ‘Golden Delicious’, which ranked highest in terms of taste, aroma, and juiciness. Statistical analyses, including principal component and hierarchical clustering analyses, further distinguished cultivars based on their physicochemical and sensory profiles. The findings emphasize the importance of genetic diversity in apples in maintaining a resilient and sustainable assortment. This study provides valuable insights for breeding programs and for orchard, market, and apple industry development. We also highlight future directions, promoting the conservation and strategic use of both traditional and modern cultivars. Full article

Background/Objectives: Prurigo pigmentosa (PP) is a rare inflammatory dermatosis characterized by recurrent pruritic eruptions resolving with reticulated hyperpigmentation. Initially described in young Asian women, PP is increasingly reported worldwide, often linked to ketosis-inducing factors such as low-carbohydrate diets. This report documents the first case of PP in a Romanian patient and highlights the importance of recognizing the condition in diverse populations. Methods: We describe a 16-year-old girl with a six-month history of pruritic eruptions on the neck, trunk, shoulders, and thighs. A detailed clinical assessment was conducted, including dietary history, physical examination, laboratory evaluation of urinary ketones, and skin biopsy for histopathological analysis. Results: Clinical examination revealed erythematous papules and plaques with peripheral pustules and post-inflammatory hyperpigmentation. Substantial weight loss and elevated urinary ketone levels suggested dietary-induced ketosis from a strict low-carbohydrate diet. Histopathological findings confirmed the diagnosis of PP. The patient’s skin lesions resolved following carbohydrate reintroduction and doxycycline therapy. Conclusions: This case highlights the association between ketosis and PP, emphasizing the importance of thorough dietary history-taking and histopathological confirmation for accurate diagnosis. As ketogenic diets become more popular globally, heightened awareness of PP is essential to ensure timely diagnosis and effective management. Full article

Background/Objectives: This study aimed to investigate the lifestyle and the behavioral factors that influence the nutritional status of adolescents from Transylvania, Romania. Methods: The Global School-Based Student Health Survey (GSHS) was used to collect data from 900 adolescents between 11 and 18 years old from the Transylvania region, Romania. This study assessed nutritional status by calculating BMI indicators adjusted to Z-Score, cut-off points according to the World Health Organization (WHO), using self-reported weight and height; perceived health status; food vulnerability; physical activity; addictive behaviors (cigarette, alcohol and drug consumption); number of hours spent in front of the computer/phone; hand and oral hygiene; sitting time/day; and sleep. Multivariate logistic regression was used to establish the lifestyle factors that influenced nutritional status. Results: The results showed that 8.7% (n = 78) of girls and 15.2% (n = 137) boys were overweight and obese. In total, 75% of the respondents were engaged in sedentary behaviors, and 65.8% (n = 592) had more than 2 h/day of screen exposure, considering that 98.7% of the study population had a mobile phone. The Romanian adolescents had poor dietary behaviors: over 80% of them did not meet the recommended amount of vegetable and fruit intake per day. Increased BMI was associated with higher-strength physical exercise and with being a boy. Conclusions: While some positive trends are evident, such as good oral and hand hygiene and low prevalence of smoking and drug use, significant challenges remain in areas like nutrition, physical activity, alcohol consumption and screen time. Full article

Cystic echinococcosis (CE) is a neglected tropical parasitic disease linked with significant social and economic burdens worldwide. The scientific community has minimal information on echinococcosis in Romanian people, and hospital medical records are the only sources that may be used to investigate its status. A 7-year retrospective clinical study on pediatric patients with CE from Southeast Romania was performed, and 39 children and adolescents were included, aged 2–15 years old. They were hospitalized with cystic echinococcosis in the Pediatric Department and Pediatric Surgery Department of Constanta County Clinical Emergency Hospital “St. Apostle Andrew” between 1 January 2017 and 1 October 2024. Twenty-nine (74.36%) pediatric patients came from rural zones, and 10 (25.64%) had urban residences. In total, 28 children (71.79%) had contact with four different animals (dogs, goats, pigs, and sheep); only four were from urban zones, and they had contact only with dogs. Data regarding the length of hospital stay, cyst location, and complications were collected and analyzed. According to the medical files, the diagnosis was established using imaging techniques and serological tests for CE. IgE and IgG reported appreciable variations in correlation with all parameters, and significant differences (p < 0.05) were recorded. IgE levels considerably increased in cases of no animal contact, pulmonary involvement, complications, surgical treatment, and multiple hospitalizations. Moderate IgE values were recorded in cases of urban residences, pig and sheep contact, and hepatic involvement. The IgG concentration considerably increased with sheep contact and moderately increased in cases of rural zones, hepatic involvement, complications, and surgical treatment. The results show that incidental discovery, symptoms, complications, multiple dissemination, pulmonary involvement, and dog and pig contact increase the hospitalization time. Extensive data analysis supports our results. Our findings highlight the complexity of managing E. granulosus infections in children and evidence the importance of a multidisciplinary approach, combining early diagnostic tools, tailored medical therapy, and careful surgical intervention when necessary. 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

Flood protection infrastructures are crucial for enhancing the resilience of societies exposed to natural hazards. Newly designed infrastructures are evaluated for sustainability using a coherent and internationally recognized method defined by the International Hydropower Association (IHA). However, in operation, old structures require a different assessment approach. Different work proposes a modified IHA protocol, mHSAP, which identifies opportunities for improvement and develops a sustainability evaluation framework for existing infrastructures. This paper applies the modified protocol to evaluate the sustainability of two types of flood protection structures: a unique canal system for flood–drought protection of an urban area and a flood protection dike. The time of operation of these structures is over 250 years and over 50 years, respectively. The application of the modified framework demonstrates its advantages in identifying areas for improving flood protection structure operation while maintaining the structure’s sustainability. It also illustrates how Romanian water boards can use such tools to facilitate collaboration between structure owners and stakeholders, allowing them to assess the risks and effects of flooding on society. Through these two examples from Romania, we also show that the mHSAP framework has the potential to actively support the fulfillment of the United Nations Agenda 2030 Sustainable Development Goals (SDGs). The results presented here show that this method can be further utilized by water board authorities to account for climate change effects, address related challenges in a coordinated and efficient manner, develop resilient flood management strategies, inform infrastructure investment decisions, and enhance collaboration among water management authorities. Full article

The interior of Orthodox churches is entirely decorated with paintings, icons, and frescoes, to help create a special environment for the prayers and visitors. The paintings have religious, esthetic, and historical value, being created in the Byzantine tradition and following recommendations on style and materials according to old church canons. Particular importance is attributed to the Iconostasis decorated with icons on several registers, as well as to polychrome wooden ornaments and imperial doors. This work presents the scientific investigation results of three royal icons, theoretically dating to the 19th century, from the Iconostasis of the Runcu church, an important 19th-century Romanian historical monument, aiming to answer questions regarding their age and constituent materials, especially what were the mineral pigments used in the color palettes for their painting and if there were any old repainting interventions, in order to assist their restoration and conservation. Methods of characterization employed were optical microscopy, SEM-EDX spectrometry, ATR/FTIR spectroscopy, and X-ray fluorescence spectrometry. Results obtained allowed us to date, attribute, and evaluate the conservation state of the Royal icons; to our knowledge, this study is among the very few research studies carried out so far on the religious heritage conservation field in Romania. Full article