Literary translation has recently gained attention as a distinct and complex task in machine translation research, yet translation by small open models remains an open problem, particularly for low-resource languages such as Romanian. We introduce the TinyFabulist Translation Framework (TF2), a unified framework for dataset creation, fine-tuning, and evaluation in English → Romanian literary translation. Building on DS-TF1-EN-3M, the largest collection of synthetic English fables to date, our pipeline first generates 15k high-quality Romanian references from the TF1 pool using a high-performing large language model (LLM). We then apply a two-stage fine-tuning process to a 12B-parameter open-weight model: (i) instruction tuning to capture genre-specific narrative style, and (ii) adapter compression for efficient deployment. Evaluation combines a five-dimension LLM-based rubric (accuracy, fluency, coherence, style, cultural adaptation) as the primary comparative framework, alongside corpus-level Bilingual Evaluation Understudy (BLEU) reported as a secondary reference-based consistency metric. Our fine-tuned model (TF2-12B) achieves strong fluency and adequacy, narrowing the gap to top-performing proprietary models under automated and human-anchored evaluation, while being open, accessible, and significantly more cost-effective. We publicly release the fine-tuned model and two large-scale synthetic parallel datasets (DS-TF2-EN-RO-3M and DS-TF2-EN-RO-15K), along with all scripts and evaluation prompts. TF2 provides an end-to-end, reproducible pipeline for research on cost-efficient translation, cross-lingual narrative generation, and the broad adoption of open models for culturally significant literary content in low-resource settings.
This study examines trade-offs between organizational culture, measured by the Competing Values Framework, and high financial compensation among Romanian Generation Z (n = 584). Using a quantitative cross-sectional design and scenario-based choice experiments, binary logistic regression models assessed how culture preferences and demographics predict employer choice. Results show that preferences for Clan culture most consistently increased the likelihood of selecting a culturally defined employer over high-salary alternatives (odds ratios 1.08-1.15), particularly through mentoring and employee development. Notably, Hierarchy culture preferences also significantly influenced decisions, indicating that this generation values both support and structured predictability. Employment status strongly moderated these trade-offs, with employed respondents significantly more likely to prioritize cultural attributes (odds ratios 2.07-2.47). Findings indicate that Generation Z makes nuanced, context-sensitive trade-offs, challenging one-dimensional assumptions about their motivations. These findings provide context-specific insights into Romanian Generation Z employer choice and offer practical implications for employer branding and talent attraction strategies.
Background and Objectives: Artificial intelligence (AI) is increasingly integrated into healthcare management and pharmaceutical marketing workflows, yet determinants of AI adoption intention among non-clinical professionals remain under-studied in Central and Eastern Europe. This cross-sectional study quantified AI adoption intention (AAI) across three professional groups and examined its organizational, cognitive, attitudinal, and regulatory correlates. Methods: We surveyed 127 Romanian professionals (43 hospital administrators, 42 pharmaceutical marketing professionals, 42 community pharmacy managers) using a 46-item structured instrument. The instrument combined items adapted from UTAUT/TAM and organizational-readiness measures with study-specific AI-marketing, AI-literacy, and regulatory-literacy items; Analyses included ANOVA with Tukey HSD, Spearman correlations, age-adjusted OLS regression with HC3 robust standard errors, bootstrap indirect-effect analysis, moderation, exploratory k-means clustering, and exploratory logistic/ROC analysis. Results: AAI differed across groups: pharmaceutical marketing 4.33 ± 0.50, hospital administrators 3.39 ± 0.47, and pharmacy managers 2.88 ± 0.54; all pairwise Tukey contrasts p < 0.001. In the multivariable model (R2 = 0.833)-interpreted cautiously because conceptually related adoption constructs may overlap despite acceptable collinearity diagnostics-perceived usefulness, organizational readiness, and perceived ease of use were the strongest associated factors, while data governance concern was the main negative correlate. Perceived usefulness statistically accounted for 61.7% of the AI literacy-AAI indirect association, and regulatory literacy moderated the AI literacy-AAI association. An exploratory age-adjusted logistic model showed high within-sample discrimination for top-tertile AAI but should be interpreted as convergent validity among survey constructs rather than as a validated screening tool. Conclusions: AI adoption intention in Romanian medical management and pharmaceutical marketing is associated mainly with perceived usefulness and organizational readiness, tempered by data governance concern and regulatory knowledge. Longitudinal, multi-site, real-world implementation studies with external validation are needed.
Background and Objectives: The SARS-CoV-2 pandemic disrupted oral and maxillofacial surgery (OMS) services worldwide because of the high aerosol-generating nature of head-and-neck procedures, restricted access to elective dental care, and systemic reallocation of hospital resources. Continuous longitudinal multi-year data covering both the pandemic and the post-pandemic phases from regional Romanian (and more broadly central and southeastern European) emergency centers remain scarce. We aimed to quantify the impact of the pandemic on OMS activity in a large Romanian regional referral center and to evaluate post-pandemic resilience. Materials and Methods: We conducted a retrospective single-center study of all inpatient admissions to the OMS Clinic of a tertiary emergency hospital in western Romania between 1 January 2018 and 31 December 2024. Three periods were pre-specified: pre-pandemic (2018-2019), pandemic (2020-2022) and post-pandemic (2023-2024). A Newey-West segmented interrupted-time-series (ITS) regression and a negative-binomial monthly count model with Fourier seasonality were fitted; length of hospital stay was further analyzed with a multivariable gamma-log generalized linear model adjusted for age, sex, county, primary ICD-10 chapter and total ICD-10 codes. Variables analyzed included case volume, demographics, primary and secondary ICD-10 diagnoses, length of hospital stay (LOS), case complexity (total ICD-10 codes per admission) and in-hospital mortality. Results: A total of 11,628 inpatient admissions corresponding to 8084 unique patients (56.5% male; mean age 52.2 ± 19.2 years) were analyzed. Compared with the pre-pandemic baseline (mean 2037 admissions/year), annual volume dropped by 45.1% in 2020, 44.0% in 2021 and 32.3% in 2022, with a nadir of -76% during the first state of emergency (April 2020; n = 34 admissions). Recovery was rapid; 2024 exceeded the pre-pandemic baseline by +10.1% on raw counts and by +16.2% on admissions per 100,000 catchment population using year-specific INS denominators. The segmented ITS regression confirmed an immediate level drop of -114.2 admissions/month in March 2020 (95% CI -133.1 to -95.3; p < 0.001) and a positive post-intervention slope of +2.06 admissions/month (95% CI 1.23-2.88; p < 0.001), with observed monthly volume returning to the counterfactual projection by October 2023. The case mix shifted significantly (χ2 = 406.9, p < 0.0001); elective benign neoplasm admissions were reduced from 7.2% to 2.0%, while neoplasms of uncertain behavior nearly doubled from 15.7% to 27.5%. Case complexity increased during the pandemic (mean ICD codes 4.08 ± 2.42 vs. 3.44 ± 2.30; p < 0.001); after exclusion of administrative codes (whole Z chapter and U07.x), the difference attenuated to 3.34 vs. 3.17 codes (still p < 0.001 by Kruskal-Wallis), indicating that the largest portion of the unadjusted increase was driven by the new mandatory pre-admission SARS-CoV-2 screening code Z11.5 rather than true clinical complexity. Notably, the clinically interpretable proxy R63.3 (feeding difficulty) independently rose from 41.5% to 53.1%. The crude median LOS did not differ between the pre-pandemic and pandemic periods (3.07 vs. 3.06 d; p = 0.19) and dropped significantly post-pandemic (2.22 d; p < 0.001); however, after multivariable adjustment for case mix, age, sex, county and code count, the LOS was 15.7% shorter during the pandemic (adjusted ratio 0.84, 95% CI 0.82-0.87; p < 0.001) and 22.8% shorter post-pandemic (adjusted ratio 0.77, 95% CI 0.75-0.80; p < 0.001) relative to baseline. Conclusions: The pandemic caused a severe but transient contraction of OMS activity accompanied by increased case complexity and a marked shift away from elective surgery. Inpatient volume returned to and exceeded the pre-pandemic baseline by 2024. These results support the value of standing pandemic-preparedness protocols, sustained access to preventive dental care, and integrated tele-triage pathways for future public-health crises.
The blueberry (Vaccinium corymbosum L.) is known for its high content of bioactive compounds, which are widely recognized for their health-promoting properties. This study aimed to characterize the fruit quality, total phenolic content (TPC), total monomeric anthocyanin content (TMA), anthocyanin profile and antioxidant activity of the nine Romanian V. corymbosum genotypes ('Augusta', 'Azur', 'Delicia', 'Lax', 'Pastel', 'Prod', 'Safir', 'Simultan', and 'Vital') over three consecutive harvest seasons (2023-2025). Significant genotype- and year-dependent variation was observed for all parameters. 'Lax' consistently accumulated the highest total anthocyanin content across all three seasons, while 'Simultan' exhibited the highest antioxidant activity and total monomeric anthocyanin content. 'Prod' consistently recorded the lowest phytochemical values despite achieving the highest firmness in 2025. UPLC analysis identified 10 anthocyanins, covering all five major anthocyanidin classes. Strong positive correlations were found between TPC, TMA, and antioxidant activity. These results confirm that genotype is the primary determinant of blueberry phytochemical composition, as indicated by the largest effect sizes in the two-way ANOVA, with harvest year and genotype × year interaction as statistically significant but secondary modulating factors, and identify 'Lax', 'Simultan', and 'Safir' as promising cultivars for nutraceutical and breeding applications.
Background and Objectives: Multidrug-resistant (MDR) uropathogens are reshaping the empirical management of acute pyelonephritis, particularly in Eastern European centers. We aimed to describe MDR patterns, identify admission-level predictors, including renal impairment/renal-failure status at presentation and major healthcare exposure variables, and derive a bedside risk score (PYELO-MDR-Risk) for adult pyelonephritis at a Romanian tertiary hospital. Methods: We retrospectively analyzed 129 consecutive culture-confirmed acute pyelonephritis admissions at "Victor Babeș" University Hospital, Timișoara (March 2022-March 2025). MDR was defined as non-susceptibility to ≥1 agent in ≥3 antimicrobial categories. We compared MDR and non-MDR cases on demographics, microbiology, time-to-effective therapy (TTE), and outcomes; multivariable logistic regression identified independent predictors and was the basis for a points-based score with bootstrap-based internal validation (1000 resamples). Results: Fifty-four patients (41.9%) had MDR pyelonephritis. Escherichia coli remained the dominant uropathogen (55.8%) but was less prevalent in the MDR group (40.7% vs. 66.7%; p = 0.003), whereas Klebsiella pneumoniae and Pseudomonas aeruginosa were enriched. Independent predictors of MDR were antibiotic exposure ≤90 days (aOR 5.7, 95% CI 2.4-13.6), recurrent UTI (aOR 3.4, 1.4-8.2), recent hospitalization (aOR 3.1, 1.2-8.0), and renal impairment/renal-failure status at admission (aOR 2.4, 1.0-6.2). Immunosuppression, prior urinary tract instrumentation, and nephrolithiasis/urolithiasis were evaluated as candidate predictors but did not independently improve the final point score after adjustment. MDR was associated with delayed effective therapy (28.4 vs. 9.7 h; p < 0.001), longer hospitalization (13.7 vs. 8.9 days; p < 0.001), and higher 30-day readmission (20.4% vs. 8.0%; p = 0.038). The PYELO-MDR-Risk score (range 0-12) achieved an optimism-corrected AUC of 0.84 with adequate calibration (Hosmer-Lemeshow p = 0.624). Conclusions: MDR drives a substantial fraction of pyelonephritis admissions in Western Romania and tracks closely with prior antibiotic and healthcare exposure. The PYELO-MDR-Risk score offers a transparent bedside tool for empirical-therapy decisions in the local setting, pending national and international external validation.
Nasal colonization plays a pivotal role in Methicillin-resistant Staphylococcus aureus (MRSA) carriage and transmission, especially in healthcare settings. Asymptomatic carriers amongst healthcare workers (HCWs) may serve as an important source for inner-hospital transmission, besides personal increased risks of endogenous infections. Medical students are an often-overlooked part of medical staff which, while not typically included in statistics concerning HCWs, are associated with increased patient contact and exposure to healthcare-associated pathogens. This study aimed to assess MRSA carriage rate amongst clinical-year medical students in the largest Romanian medical university, in addition to identifying potential risk factors. Nonetheless, a methodological aim was incorporated, in order to evaluate the effect of nasal swab pre-moistening with sterile saline on MRSA retrieval rate. A cross-sectional study was conducted among clinical-year students from the 'Carol Davila' University of Medicine and Pharmacy in Bucharest, Romania. Participants completed a survey regarding potential risk factors and underwent nasal swab sampling, being randomly assigned to the two swab collection methods-dry swab or pre-moistened swab with sterile saline, randomization ensuring comparable baseline characteristics. Samples were inoculated on chromogenic MRSA agar media and incubated for 24-48 h at 35-37 °C. Isolates exhibiting characteristic growth further underwent coagulase testing, bacterial identification and methicillin resistance confirmation. The study comprised 156 medical students, with an overall prevalence of asymptomatic MRSA nasal carriage of 5.76% (n = 9, 95% CI: 3.05-10.58%). No statistically significant associations were identified between MRSA carriage and hospital exposure. The prevalence of MRSA positive cultures was 5.00% (n = 4/80) among the conventional dry swab sampling subgroup, while the subgroup undergoing pre-moistened swab collection presented a 6.57% prevalence (n = 5/76), revealing no statistical significance (p = 0.74). Asymptomatic MRSA carriage among medical students in this cohort suggests the potential role of this population in intra-hospital transmission. In addition, pre-moistening the nasal swab for collection of the sample showed no statistically significant impact on MRSA recovery rates, correlating with existing literature on the topic. These findings further emphasize the need for strict adherence to infection prevention and control measures in hospitals.
Inflammatory bowel diseases (IBD), including Crohn's disease (CD), ulcerative colitis (UC), and IBD-unclassified (IBD-U), are increasingly recognized across Eastern Europe, including Romania, where historical data indicated low incidence. Contemporary real-time epidemiological data for our country are scarce. This study evaluated the short-term frequency and epidemiological characteristics of IBD patients presenting to major Romanian gastroenterology centers. We conducted a prospective, cross-sectional observational study over a 14-day period in November 2024 across 18 university-affiliated tertiary gastroenterology clinical sites in Romania. All consecutive adult patients with confirmed IBD were enrolled using a centralized online platform. Demographics, disease type and phenotype, severity, and treatment were recorded and analyzed descriptively. A total of 1,045 patients were registered: 52.4% CD, 46.9% UC, and 0.7% IBD-U. Geographical distribution revealed a statistically significant variation, with Crohn's disease being more frequent in Southern Romania, while UC predominated in the Eastern and Central-western regions (p=0.0009). Most patients resided in urban areas, and the majority were in clinical remission at presentation. Phenotypic analysis revealed ileocolonic CD (L3) and left-sided/pancolitis UC (E2/E3) as most frequent. Severe disease history was more common in CD, and prior surgery was significantly higher in CD than UC. Smoking and appendectomy were more frequently associated with CD as previously reported. Therapeutic patterns reflected disease type: anti-TNF use predominated in CD, while other biologics and small molecules were more common in UC. Regional differences in therapy were observed, with southern centers showing higher use of novel therapies, likely reflecting a more mature IBD population, with a higher CD prevalence. Notably, the number of IBD diagnoses increased over time, correlating with Romania's GDP growth (R² = 0.89, p < 0.001), suggesting that socioeconomic factors may influence disease recognition and diagnosis. This study offers the most recent snapshot of IBD epidemiology in Romania, highlighting a transition toward medium-incidence patterns and growing clinical complexity. These findings provide evidence for the need to establish nationwide population-based surveillance systems and healthcare planning initiatives aimed at mitigating the rising burden of IBD.
Cerebral venous sinus thrombosis (CVST) is a rare form of stroke with heterogeneous clinical presentation and etiological profile. This study aimed to evaluate the demographic, clinical, imaging, etiological, treatment, and outcome characteristics of CVST in a Romanian population. We conducted a retrospective monocentric cohort study including 55 patients diagnosed over a six-year period in a tertiary neurological center. CVST accounted for 1.2% of all stroke cases, with an incidence of 13.75 per million per year. Gender distribution was relatively balanced, differing from international cohorts, and traditional female-specific risk factors were less prominent. Thrombophilia (68.6%) and infections (38.2%) were the most frequent etiologies. Younger patients were more frequently associated with thrombophilia, while a higher inflammatory response was observed in older individuals; additionally, female patients showed a higher prevalence of the MTHFR C677T mutation. Transverse and sigmoid sinuses were the most affected, while cavernous sinus involvement was more frequent than typically reported and associated with infections. At discharge, long-term anticoagulation was recommended in 67.3% of patients, tailored to underlying etiology and risk profile. Outcomes were favorable, with 70-80% achieving a modified Rankin Scale score ≤2 at discharge and over 90% at 90-day follow-up, despite inconsistent correlation with imaging findings. These results highlight the heterogeneous nature of CVST and the need for comprehensive, individualized evaluation and management.
Background: Odontometrics is useful for sex estimation when other skeletal elements are missing or when DNA analysis is not feasible due to the greater durability of teeth under various taphonomic factors. The aim of this study was to evaluate canine odontometrics in a Romanian sample using manual versus AI-based measurements and to compare these two methods. Methods: Out of 200 orthopantomograms, 134 (64 females, 70 males) met the inclusion and exclusion criteria and were analyzed. Manual and AI-based measurements were used to assess total canine length and canine distance. Subsequently, statistical analyses were performed to estimate the accuracy of sex discrimination between the two groups. Results: Inter-observer agreement was excellent (ICC = 0.923-0.992). Mandibular canines, particularly tooth 33, provided the strongest sex-discriminatory performance in both manual and AI-derived measurements, with cross-validated accuracy values of 69.4% (manual) and 64.9% (AI); intercanine distances showed lower discriminatory value. The multivariate manual and AI models achieved comparable performance (AUC = 0.765 vs. 0.732), with no statistically significant difference between the two approaches (p = 0.375). Conclusions: AI-based and manual measurements showed comparable sex-estimation performance in this sample. Given its accuracy, this approach should be applied as part of an integrated forensic assessment rather than as a stand-alone method.
Adverse childhood experiences (ACEs) have been associated with increased vulnerability to depressive symptoms during pregnancy and may also be related to emerging prenatal relational processes. This cross-sectional study examined whether prenatal depressive symptoms statistically accounted for the association between ACEs and maternal-fetal attachment (MFA), and whether this indirect association varied as a function of perceived social support from partners, family, and friends. The sample included 149 Romanian women in the first trimester of their first pregnancy. Participants completed self-report measures assessing ACEs, prenatal depressive symptoms, MFA, and perceived social support. Conditional process analyses were conducted using PROCESS Model 7, controlling for maternal age and perceived socioeconomic status. Higher ACEs were significantly associated with increased prenatal depressive symptoms (b = 0.43, p = 0.001), which in turn were associated with lower MFA (b = -0.03, p = 0.023). The indirect association between ACEs and MFA via prenatal depressive symptoms was statistically significant (b = -0.01, 95% CI [-0.028, -0.0009]). However, perceived social support from partners, family, and friends did not significantly moderate this indirect association. These findings provide preliminary evidence that prenatal depressive symptoms represent an important psychological correlate linking early-life adversity with lower MFA in early pregnancy. Given the cross-sectional design, findings should be interpreted as indirect associations rather than causal mediation.
Dietary habits adopted during young adulthood play a critical role in physical, emotional, and cognitive health. University students represent a particularly vulnerable group due to academic stress, lifestyle transitions, and increased autonomy, factors that may influence eating behaviors, body weight perception, and psychological well-being. This study aims to examine dietary habits among students and their associations with self-perceived body weight, lifestyle characteristics, and psychological factors within a biopsychosocial framework. A cross-sectional observational study was conducted using a structured, self-administered online questionnaire distributed to university students aged 18-30 years in Romania. The questionnaire assessed dietary habits, nutritional knowledge, lifestyle behaviors, and psychological variables, including perceived stress and body weight perception. Body mass index was calculated based on self-reported anthropometric data. The findings indicated substantial variability in dietary behaviors, with a high prevalence of irregular meal patterns, frequent snacking, and engagement in weight-control practices. Irregular meal patterns were reported by approximately 62% of participants, while 47% had engaged in at least one weight-loss diet. Discrepancies between self-reported BMI and perceived body weight were observed in roughly 38% of cases, and 83% of respondents reported at least one psychological symptom (stress, anxiety, or low mood) related to eating behaviors. A positive correlation was observed between sleep duration and perceived rest quality (r = 0.364, p < 0.001). High frequencies of caffeinated beverage consumption were also observed. Additionally, 204 participants reported no alcohol consumption, while the variety of alcoholic beverages consumed was strongly correlated with alcohol intake frequency (r = 0.734, p < 0.001). Dietary habits among university students are closely interconnected with body weight perception, lifestyle behaviors, and psychological well-being. These findings emphasize the need for integrative health promotion strategies that address nutrition, emotional regulation, and lifestyle balance to support mental and cognitive health during young adulthood.
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Background and Objectives: Psoriasis is a chronic immune-mediated inflammatory disease characterized by heterogeneous clinical presentation and variable response to biologic therapy. Genetic variation within the IL-23/Th17 inflammatory pathway may influence treatment outcomes. This study evaluated the association between IL12B rs3213094 and IL23R rs11209026 single-nucleotide polymorphisms (SNPs) and response to biologic therapy in patients with moderate-to-severe psoriasis. Materials and Methods: We conducted a multicenter observational study including 92 Romanian patients with moderate-to-severe psoriasis vulgaris receiving their first biologic therapy (anti-TNF, anti-IL-17, or anti-IL-23 monoclonal antibodies). Clinical response was assessed using the Psoriasis Area and Severity Index (PASI) at baseline and weeks 12, 24, 36, and 48. Early response was defined as achieving PASI75 at week 12. Patient-reported disease impact was assessed using the Dermatology Life Quality Index (DLQI) at the same time points. Genotyping of IL12B rs3213094 and IL23R rs11209026 was performed using TaqMan assays. Longitudinal PASI dynamics were analyzed using repeated-measures ANOVA, while multivariable logistic regression was used to identify independent predictors of PASI75 at week 12. Results: A significant reduction in PASI scores over time was observed (p < 0.001). The IL12B rs3213094 genotype was associated with differences in early response kinetics, with T-allele carriers showing significantly greater PASI improvement at week 12 compared with CC homozygotes (90.0% vs. 65.7%, p = 0.003). This effect was limited to early treatment and attenuated at later time points. In multivariable analysis, the IL12B rs3213094 CT + TT genotype was independently associated with PASI75 achievement at week 12 (OR = 4.285, 95% CI 1.500-12.239, p = 0.007). Treatment with anti-IL-17 agents was also an independent predictor of early response (OR = 3.946, 95% CI 1.416-10.998, p = 0.009). No significant association was observed between IL23R rs11209026 and treatment response. DLQI scores improved significantly over time (p < 0.001), without genotype-dependent differences. Conclusions: IL12B rs3213094 SNP is significantly associated with early biologic treatment response in psoriasis, supporting its potential role as a pharmacogenetic biomarker of treatment responsiveness. These findings may inform the integration of genetic markers into personalized therapeutic strategies, particularly in underrepresented populations such as those from Eastern Europe. Further studies in larger cohorts are warranted to validate these results.
Malnutrition, encompassing both undernutrition and overnutrition, is a common complication in children with cancer and is associated with impaired treatment tolerance, increased infection risk, altered pharmacokinetics, reduced quality of life, and poorer survival outcomes. Despite its importance, nutritional management in pediatric oncology lacks a unified, systematically organized clinical framework applicable to the full trajectory of the disease. This study aimed to develop expert consensus recommendations for nutritional intervention in pediatric oncology patients aged 4 to 18 years. A modified electronic Delphi (e-Delphi) process was conducted with a multidisciplinary expert panel of 22 specialists, including pediatric oncologists, pediatric gastroenterologists, clinical nutrition specialists, radiotherapy specialists, and pediatric surgeons. Statements were rated on a 9-point Likert scale across two anonymous rounds, with consensus predefined as ≥80% agreement. Forty-one consensus recommendations were formulated across nine domains: nutritional screening and assessment, energy and protein requirements, micronutrient supplementation, physical activity, nutritional support escalation, refeeding syndrome prevention, treatment-specific management, survivorship, and palliative care. All recommendations achieved the predefined consensus threshold. This Delphi consensus provides a structured, multidisciplinary, and clinically actionable framework for nutritional management across the full trajectory of childhood cancer and is intended to reduce institutional variability and improve patient outcomes.
Urinary tract infections (UTIs) represent a growing concern in both clinical practice and public health, affecting hospitalized and outpatient populations across all ages and genders. This study aims to evaluate the prevalence of uropathogens and their antimicrobial resistance profiles in male and female patients comparatively at a tertiary urological center. A retrospective descriptive analysis was conducted, covering three identical 6-month periods-September 1 to February 28-in three consecutive years from 2023 to 2025. The study included 2270 male patients (2270. 57.06%) and 1708 female patients (1708. 42.94%), all with at least one positive urine culture (>105 CFU/mL). Data on age, gender, bacterial species, and antimicrobial agents were collected and analyzed. A higher prevalence of Gram-negative bacteria was observed compared to Gram-positive bacteria in both male (1752; 77.18% vs. 518; 22.82%) and female (1369; 80.15% vs. 339; 19.85%) groups. The most common microorganisms were Escherichia coli, followed by Klebsiella and Enterococcus. Klebsiella showed high rates of antimicrobial resistance, especially in males, across various antibiotic classes such as amoxicillin-clavulanic acid (60.6% vs. 43.25%), levofloxacin (40.18% vs. 27.91%), aztreonam (37.4% vs. 27.27%), and ceftazidime (36.23% vs. 24.03%). High resistance levels, although not statistically significant, were also noted for trimethoprim/sulfamethoxazole (43.64%) and nitrofurantoin (65.69%). In males, E. coli exhibited higher resistance rates to trimethoprim/sulfamethoxazole (44.65% vs. 32.89%), levofloxacin (43.27% vs. 30.78%), and amoxicillin-clavulanic acid (40.18% vs. 27.19%). Carbapenems remained highly susceptible in both groups. Enterococcus showed similar resistance patterns in both cohorts, primarily resistant to penicillin and levofloxacin. This study highlights higher resistance rates among Gram-negative bacteria in males to commonly used antibiotics such as fluoroquinolones, trimethoprim/sulfamethoxazole, and β-lactams. Resistance patterns in Gram-positive bacteria remained stable across both populations, with high susceptibility to fosfomycin, nitrofurantoin, linezolid, and carbapenems. Differences between sexes emphasize the need for more detailed analysis of local and sex-specific resistance patterns.
Background and Objectives: Adolescent pregnancy is traditionally associated with increased obstetric risk, particularly among very young adolescents. Romania continues to report one of the highest adolescent birth rates in the European Union, yet age-stratified clinical data on obstetric outcomes among minors remain limited. This study aimed to evaluate maternal and intrapartum outcomes among underage mothers (<18 years), stratified by age (<15, 15-16, and 17 years), and to identify predictors of adverse obstetric outcomes. Materials and Methods: We conducted a retrospective cohort study of all live births and stillbirths among mothers aged 12-17 years recorded between 2020 and 2024 at a secondary maternity hospital in Romania. Data were extracted from standardized obstetric and neonatal records. Primary outcomes included preterm birth (<37 weeks), cesarean delivery, and intrapartum complications. Group comparisons were performed using non-parametric tests and the χ2 test. Multivariable logistic regression models were used to assess independent associations between maternal age and obstetric outcomes. Results: The cohort comprised 763 adolescent mothers aged 12-17 years. No significant differences were observed across age groups in gestational age at birth, preterm birth rate, fetal presentation, or mode of delivery. In multivariable analyses, younger maternal age was not independently associated with preterm birth (adjusted odds ratios [aORs] 0.87-1.21) or cesarean delivery (aORs 0.74-1.08). Obstetric factors, such as non-cephalic presentation and characteristics of membrane rupture, were the main predictors of adverse outcomes. Temporal analyses demonstrated stable outcome patterns across the study period, with no significant interaction between maternal age and year of delivery. Conclusions: In this tertiary-care cohort, very young maternal age (<15 years) was not associated with poorer obstetric outcomes compared with older adolescents. These findings suggest that standardized antenatal surveillance and intrapartum management may mitigate age-related obstetric risk among underage mothers. Further population-based studies are warranted to contextualize these results within broader healthcare access and social determinants of adolescent pregnancy. Cesarean section rates were high across all groups (~50%), with no significant differences by maternal age.
Background/Objectives: Temporomandibular disorders (TMDs) constitute an umbrella term encompassing a spectrum of conditions, including pain in the temporomandibular joint (TMJ), masticatory muscle pain, and restricted mandibular movement. The objective of the present study was to translate the Fonseca and TMD-7 questionnaires into Romanian, to assess their face validity, and to determine the reliability of the Romanian-language versions for use in the diagnosis of temporomandibular disorders (TMDs) and in subsequent epidemiological and clinical studies. A secondary objective was to establish a scoring scale for the TMD-7 questionnaire. Methods: Both questionnaires were translated from English into Romanian and back-translated by two independent teams of translators, after which the final versions were established for face validity assessment and reliability testing. Results: The study demonstrated reliability according to the Cronbach's α coefficient, with values of 0.862 for the TMD-7 questionnaire and 0.840 for the Fonseca questionnaire. The scoring scale corresponding to the Fonseca questionnaire could not be implemented for the TMD-7 questionnaire. Conclusions: Both Romanian-language questionnaires demonstrated high corresponding Cronbach's α coefficients; however, for clinical use, the Fonseca questionnaire will be utilized, as the TMD-7 questionnaire does not have a scoring scale.
Selective dry cow therapy (SDCT) has emerged as a key strategy to reduce antimicrobial use in dairy production while maintaining udder health. This study aimed to evaluate the feasibility and impact of implementing SDCT in Romanian dairy farms by comparing low-risk cows treated with internal teat sealant only (ITS) at dry-off with low-risk cows treated with intramammary antibiotics at dry-off. A prospective field study was conducted on two commercial dairy herds, including 87 cows classified based on somatic cell count (SCC) and differential SCC (DSCC), and compared with a historical cohort of 37 cows. Udder health parameters, milk yield during the first 100 days in milk (DIM), antimicrobial use, and economic outcomes were evaluated. No significant differences were observed between groups in terms of postpartum intramammary infections, somatic cell score, DSCC, or clinical mastitis incidence. Milk yield during early lactation was also not affected by treatment. The ITS-only strategy resulted in a substantial reduction in antimicrobial use (-88.8% per cow) without significant differences in total economic costs. Farm-related differences highlighted the influence of management conditions on outcomes. These findings indicate that, in low-risk cows, SDCT using ITS alone is a safe and effective alternative to antibiotic treatment and support the feasibility of implementing SDCT under Romanian dairy production conditions as a sustainable strategy to promote the targeted and prudent use of antimicrobials while reducing unnecessary antibiotic exposure in dairy herds. However, given the limited number of herds and animals included, further studies are needed to confirm these promising findings under a broader range of production conditions.
Second-generation long-acting injectable antipsychotics (SG-LAIs) improve adherence, reduce relapse, and enhance outcomes in schizophrenia, yet remain underused. In Romania, data on psychiatrists' views is limited. To assess Romanian psychiatrists' attitudes and prescribing behaviors regarding SG-LAIs, and identify key drivers and barriers to their use. We conducted a cross-sectional questionnaire survey among psychiatrists in urban hospital, outpatient, and private settings, treating more than 1,000 patients with schizophrenia. The survey rated the four SG-LAIs available in Romania (aripiprazole, olanzapine, paliperidone, and risperidone) on efficacy, tolerability, dosing flexibility, monitoring needs, prescribing frequency, and perceived obstacles/facilitators. 80 psychiatrists participated. Aripiprazole LAI received the most favorable ratings, ranking highest for efficacy, safety, patient functioning, ease of administration, guideline alignment, side-effect profile, monitoring requirements, and overall preference. Paliperidone and risperidone were also positively evaluated for dosing versatility, whereas olanzapine generally scored lowest. Main factors encouraging LAI prescription were improved adherence (96.3%) and reduced relapse risk (96.3%), followed by a favorable clinical profile (66.3%). Key barriers included lack of patient trust (57.5%), lack of hospital supply (43.8%), absence of LAI formulations for certain antipsychotics (43.8%), and limited experience (36.3%). Romanian psychiatrists show a strong preference for aripiprazole LAI, with decisions driven mainly by clinical benefits. Reducing patient concerns and system-level limitations-especially availability, indications, and communication- may support increased use of SG-LAIs in everyday clinical care.