Search Results (1,456)

Periodontal disease is a widespread chronic condition linked to systemic illnesses such as cardiovascular disease, diabetes, and adverse pregnancy outcomes. Despite its global burden, population-specific studies on its risk factors remain limited, particularly in Central and Eastern Europe. The SANA-biome Project is a cross-sectional, community-based study designed to investigate the biological and social determinants of periodontal disease in Romania, a country with disproportionately high oral disease rates and minimal microbiome data. This protocol will integrate metagenomic, proteomic, and metabolomic data of the oral microbiome from saliva and dental calculus samples with detailed sociodemographic and lifestyle data collected through a structured 44-question survey. This study is grounded in two complementary frameworks: the IMPEDE model, which conceptualizes inflammation as both a driver and a consequence of microbial dysbiosis, and Ecosocial Theory, which situates disease within social and structural contexts. Our aims are as follows: (1) to identify lifestyle and behavioral predictors of periodontal disease; (2) to characterize the oral microbiome in individuals with and without periodontal disease; and (3) to evaluate the predictive value of combined microbial and sociodemographic features using statistical and machine learning approaches. Power calculations based on pilot data indicate a target enrollment of 120 participants. This integrative approach will help disentangle the complex interplay between microbiological and structural determinants of periodontal disease and inform culturally relevant prevention strategies. By focusing on an underrepresented population, this work contributes to a more equitable and interdisciplinary model of oral health research and supports the development of future precision public health interventions. Full article

The COVID-19 pandemic unprecedentedly challenged families worldwide, yet little is known about how parents from diverse cultural contexts retrospectively interpret their parenting roles and coping strategies. This study explores parenting adjustments two years after the pandemic’s onset among five cultural groups: Bulgarian and Spanish (Eastern and Western Europe), Israeli Arabs and Jews (Middle East), and U.S. families. Fifty parents, primarily mothers of children aged 2–8, were recruited through snowball sampling. Semi-structured interviews were conducted using the Parenting Pentagon Model (PPM), which includes five constructs: Partnership, Parental Leadership, Love, Encouraging Independence, and Adherence to Rules. Data were analyzed using grounded theory and directed content analysis. Across cultures, Love and Parental Leadership were central to maintaining emotional stability and family cohesion. Partnership showed cultural variation: Bulgarian and Spanish parents often shared responsibilities, while U.S. mothers reported handling childcare alone, heightening work–life tension. Israeli-Arab fathers became more involved in caregiving, while Israeli-Jewish mothers described both strengthened and strained partnerships. Coping strategies were shaped by cultural values and family demographics (e.g., family size). The findings emphasize parents’ vital role in fostering family resilience during crises and stress the importance of culturally sensitive support to enhance families’ adaptive capacity for future challenges. Full article

Background/Objectives: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease with limited epidemiological data from Central–Eastern Europe. This study characterized a Hungarian PSC cohort, comparing patients with and without inflammatory bowel disease (IBD), and longitudinally evaluated the predictive efficacy of established prognostic scores (Mayo Risk Score, Amsterdam-Oxford Model [AOM], UK-PSC short/long). Methods: Data from 135 PSC patients (median diagnosis age 31 years, 57.7% male) were collected yearly at two Hungarian centers, with a median follow-up of 8.8 years. Outcomes included liver transplantation (LT) and liver-related death. Prognostic value of baseline clinical scores was assessed for 2-, 5-, 8-, and 10-year composite outcome. Results: PSC-IBD patients (54.1%) were younger with higher baseline Mayo and AOM scores, and had increased rates of colorectal carcinoma (8.22% vs. 0.00%) and liver transplantation (26.03% vs. 9.68%) within 10 years than PSC-only patients. There were no differences in liver-related mortality or composite outcomes between the groups. All prognostic scores showed good short-term predictive ability for poor outcomes (AUROC at 2 years: 0.858–0.958), which diminished over time (AUROC at 10 years: 0.708–0.756). The AOM demonstrated the most consistent performance. Persistent alkaline phosphatase (ALP) elevation (≥2.2×ULN) 2 years post-diagnosis, despite ursodeoxycholic acid therapy, strongly predicted 10-year adverse outcomes (HR: 3.927, p < 0.001), outperforming formal scoring systems (HR: 2.688–1.522). Conclusions: While PSC-IBD patients had more CRC and liver transplantation, overall transplantation-free survival was similar to PSC-only patients. Prognostic utility of current scores declines with longer follow-up; AOM was most stable. Sustained ALP elevation is a robust long-term prognostic indicator. Full article

This paper presents an integrated workflow for smart manufacturing, combining CAD modeling, Digital Twin synchronization, and automated visual inspection to detect defective fuses in industrial electrical panels. The proposed system connects Onshape CAD models with a collaborative robot via the ThingWorx IoT platform and leverages computer vision with HSV color segmentation for real-time fuse validation. A custom ROI-based calibration method is implemented to address visual variation across fuse types, and a 5-s time-window validation improves detection robustness under fluctuating conditions. The system achieves a 95% accuracy rate across two fuse box types, with confidence intervals reported for statistical significance. Experimental findings indicate an approximate 85% decrease in manual intervention duration. Because of its adaptability and extensibility, the design can be implemented in a variety of assembly processes and provides a foundation for smart factory systems that are more scalable and independent. Full article

Introduction: Adequate maternal vitamin D status during pregnancy is essential for fetal skeletal development and neonatal vitamin D reserves. Evidence from Central and Eastern Europe on maternal deficiency, its determinants, and supplementation effectiveness in late pregnancy is limited. This study assessed the impact of 2000 IU/day and 4000 IU/day maternal vitamin D supplementation during the third trimester, compared to no supplementation, on maternal and neonatal 25-hydroxyvitamin D [25(OH)₂D] levels at birth, and explored sociodemographic, obstetric, dietary, and lifestyle factors affecting vitamin D status. Methods: In a cross-sectional study at Târgu Mureș County Clinical Hospital, Romania, 322 term mother–newborn pairs (37–41 weeks) from January 2021 to July 2023 were evaluated. The maternal and umbilical cord 25(OH)₂D was measured via electrochemiluminescence immunoassay. Data on socioeconomic status, parity, sun exposure, diet, and supplementation were collected through questionnaires and records. Statistical analysis included chi-square, linear regression, and multivariate modeling. Results: Vitamin D insufficiency and deficiency affected 32.3% and 18.9% of mothers, respectively. Supplementation was the strongest predictor of sufficiency (p < 0.01), showing a dose–response effect (r = 0.84, p < 0.01). Maternal and neonatal 25(OH)₂D levels were strongly correlated (r = 0.99, p < 0.01). Although several factors correlated with deficiency in univariate analyses, only supplementation remained significant in multivariate models. No link was found between 25(OH)₂D status and neonatal anthropometrics or early complications. Conclusions: A high prevalence of vitamin D deficiency has been documented among pregnant women in Romania. High-dose supplementation during late pregnancy is critical to ensure sufficient maternal and neonatal vitamin D, highlighting the need for standardized antenatal supplementation protocols, especially in disadvantaged groups. Full article

This study examines the evolution of agricultural raw material exports in seven emerging economies of Central and Eastern Europe (Romania, Poland, Slovakia, Croatia, Bulgaria, the Czech Republic, and Hungary) from 1995 to 2023 and provides forecasts for 2024–2026 using ARIMA models. The results indicate a general downward trend in the share of agricultural raw material exports within total exports, reflecting ongoing economic modernization and a structural shift toward higher value-added products and industrial sectors. Romania, Poland, and Hungary remain as significant players in the cereals market, while Slovakia and the Czech Republic show the most pronounced transitions toward non-agricultural industries. Croatia, however, follows an atypical trajectory, maintaining a relatively high share of agricultural exports. Statistical tests (Dickey–Fuller) confirm the non-stationarity of the initial series, necessitating differencing for ARIMA modeling. Correlation analyses reveal a synchronized regional dynamic, with strong links among Poland, Slovakia, the Czech Republic, and Bulgaria. Forecasts suggest continued decline or stabilization at low levels for most countries: Romania (0.45% in 2026), Poland (0.93%), Slovakia (0.62%), Bulgaria (0.51%), the Czech Republic (0.95%), and Hungary (0.53%), while Croatia is an exception, with a projected moderate increase to 4.19% in 2026. Although the share of raw agricultural exports is decreasing, the findings confirm that agriculture remains a strategic sector for food security and regional trade. The study recommends investments in processing, technological modernization, and export market diversification to strengthen the competitiveness and resilience of the agricultural sector in the context of global economic transformations. Full article

Background: Soybean (Glycine max (L.) Merr.), a nutrient-rich leguminous crop high in protein, lipids, and minerals, is extensively cultivated worldwide. The chemical composition of soybean seeds depends not only on the genetic characteristics of the cultivar but also on environmental conditions and agricultural practices. In recent years, biostimulants have gained increasing importance in crop production due to their ability to enhance physiological processes in plants and potentially influence nutrient accumulation. This study aimed to investigate how cultivar and biostimulant type influence the chemical composition of soybean seeds under varying weather conditions in Central Europe. Methods: A three-year field experiment (2017–2019) was conducted in eastern Poland (Central Europe) using a split-plot design. The experimental factors included three non-GMO soybean cultivars (Abelina, Merlin, and SG Anser) and two foliar biostimulants (Asahi SL and Improver). In addition to classical ANOVA, the multivariate analysis of the impact of the investigated factors included principal component analysis (PCA). Results: The applied factors significantly affected seed contents of fat, protein, dry matter, ash, fibre, and macronutrients (N, P, K). Cv. Merlin had the highest fat (22.65%) and fibre content (9.33%), while Abelina showed the highest protein (37.06%) and dry matter content (94.42%). Biostimulant application increased the accumulation of several seed components. Asahi SL significantly enhanced fat content (by 0.69%), protein content (by over 1.5%), and dry matter content (by nearly 0.2%) compared to the control. Improver was more effective in increasing nitrogen (by 0.24%), phosphorus (by 0.5%), and potassium (by 0.15%) contents. Weather conditions throughout the growing seasons significantly altered the impact of the biostimulants. The PCA analysis revealed distinct relationships among the chemical properties of seeds, meteorological factors, and the applied biostimulants. Full article

This retrospective longitudinal study evaluated the significance of cholestasis syndrome and the diagnosis of primary sclerosing cholangitis (PSC) in inflammatory bowel disease (IBD) patients from a tertiary center in Romania. Methods: From 2011 to 2022, 3767 patients suspected for IBD were evaluated, with 2499 confirmed cases. Of these, 34 patients (1.36%) had an IBD-PSC phenotype. Of the IBD-PSC cases, 56% were associated with UC and 44% with CD. Results: Enzymatic cholestasis was observed in 13.3% of IBD patients, with gamma-glutamyl transpeptidase (GGT) elevated in 70.2% and alkaline phosphatase (ALP) in 51.3%. However, only 10.2% of the patients with enzymatic cholestasis were diagnosed with PSC. Other liver diseases identified included metabolic-associated steatotic liver disease (MASLD), chronic viral hepatitis, Primary Biliary Cholangitis, autoimmune hepatitis, and liver neoplasms. A higher incidence of cholangiocarcinoma (11.76% vs. 0.24%, p < 0.001) and liver-related death (8.82% vs. 0.65%, p < 0.001) was found between IBD-PSC patients and those without PSC. PSC-CD patients were diagnosed at a younger age (30.2 vs. 43 years, p < 0.001), had higher rates of severe disease (73.3% vs. 10.5%, p < 0.001), required more biological treatment (60% vs. 15.7%, p < 0.001), and experienced higher mortality (20% vs. 0%, p < 0.001). Discussions: This study represents the most extensive cohort analysis of PSC-IBD patients in Romania and Eastern Europe, highlighting clinical differences between PSC-UC and PSC-CD phenotypes. Conclusions: The regular monitoring of ALP and GGT in IBD patients helps detect liver diseases, including PSC. However, only one in ten patients with IBD and enzymatic cholestasis was diagnosed with PSC. Full article

Background/Objectives: Burn injuries are a major public health concern. This study estimated global, regional, and national burn burdens by total body surface area from 1990 to 2021 and projected trends to 2050. Methods: Utilizing data from the Global Burden of Disease Study 2021, we examined the prevalence, mortality, and years lived with disability (YLDs) according to age, sex, and region. Future trends were predicted using Bayesian meta-regression models and Das Gupta decomposition analysis. Results: In 2021, global prevalence was 12.99 million for severe burns and 235.34 million for mild burns, with age-standardized rates of 158.75 and 2815.26 per 100,000. Severe burns were highest in Southern Latin America (7836.51 per 100,000) and mild burns in the Caribbean (626.94 per 100,000). The largest declines from 1990 to 2021 were in high-income North America for severe burns (−38.22%) and East Asia for mild burns (−73.03%). Females had higher severe burn prevalence at younger and older ages, while males had higher mild burn prevalence from early adulthood. Leading risk factors were fire, heat, and hot substances (38.22% of severe burn YLDs; 53.87% for mild burns). By 2050, severe burns are projected to rise by 233.4% and mild burns by 142.5%, with Eastern Europe showing the largest growth. Conclusions: Although age-standardized burn rates are declining, absolute cases are projected to rise due to population growth and aging, particularly in low- and middle-income countries, underscoring the need for stronger prevention and improved burn care infrastructure. Full article

The global energy transition is accelerating, yet new and underestimated challenges have emerged since 2024. Rising electricity demand—driven by artificial intelligence data centres, extreme heatwaves, and the electrification of transport—has exceeded earlier projections and shifted the system’s pressure point from generation to flexibility. At the same time, an oversupply of solar PV panels and lithium-ion batteries is lowering costs but increasing the risk of trade conflicts and supply chain concentration. This article presents a meta-analysis of 12 energy scenarios from 2024 to 2025, based on institutional outlooks (IEA, BNEF, and WEF) and peer-reviewed publications selected using transparent quality criteria (TRL thresholds, JRC guidance, and data transparency). A difference-in-differences method is applied to identify changes between editions. Results show a demand increase of over 2200 TWh by 2035, a decline in the “Net-Zero premium” from 19% to 15%, and a pressing need to redirect investment from gas infrastructure to grids, storage, and hydrogen. A case study for Central and Eastern Europe reveals that Poland will require USD 5–6 billion annually, primarily for transmission networks. These findings support a capital shift toward resilient and socially acceptable decarbonisation pathways. Full article

Hydrological drought in Central Europe is becoming an increasingly serious threat to agriculture, industry, and people due to climate change and the rising frequency and intensity of extreme weather events. The main aim of the paper was to assess the spatial variability of streamflow drought in Poland. The spatial analysis was conducted using daily streamflow series from 340 gauging stations for the period 1973–2022. Hydrological drought was defined as a period with a streamflow lower than Q_90%. The results show that, on average, hydrological droughts occur 52 times per year at a given gauging station. Drought duration and volume depend on the gauge elevation. At higher-altitude stations, shorter and smaller-volume droughts are most commonly observed. The longest droughts are recorded in Northern Poland, particularly in the Lakeland regions, which is a serious problem mainly for the agriculture sector. Hydrological droughts in Poland most frequently begin in summer and end in late summer or early autumn. Analyses showed that hydrological drought has a strong spatial distribution, and it is possible to identify five main regions with homogeneous drought duration and volume. Trend analysis of the annual number of low-flow days indicates no statistically significant trend at 46% of stations, while 54% exhibit statistically significant increases, with marked regional variability. The highest number of stations with statistically significant decreasing trends occurs in the Southern and Eastern Baltic Lake District and in the Central Poland Lowlands and Highlands with Polesie. The study highlights the necessity of enhancing water retention, particularly in the central, lowland regions of Poland. Full article

Background: Depression is a significant global mental health concern, especially among medical students. This study combines two components: (1) a cross-sectional assessment of depression and related psychological and demographic factors among students at “Dunărea de Jos” University of Galați, and (2) a systematic review and meta-analysis of published Romanian studies on depression in medical students. Methods: For the cross-sectional component, 495 students (Years I–III) completed online questionnaires assessing depressive symptoms (PHQ-9), personality traits, procrastination, and sociodemographic factors. In the systematic review, studies from PubMed and Web of Science were synthesized following PRISMA guidelines, with prevalence data being pooled via random-effects meta-analysis. Results: In the Galați sample, 34.0% of students had clinically significant depressive symptoms (PHQ-9 ≥ 10). Depression was associated with female gender, being in the third year of study, low social support, high neuroticism, and procrastination. The meta-analysis (six studies, N = 1546) yielded a pooled national prevalence of 19.99% (95% CI: 18.24–21.73%). Conclusions: Depression is highly prevalent among Romanian medical students, particularly in Galați. The findings support the need for targeted mental health interventions in Romanian universities. Registration: This systematic review has been registered in the Prospero database (registration number CRD420251056873). Full article

Background/Objectives: Burning Mouth Syndrome (BMS) is a chronic orofacial pain disorder characterized by persistent intraoral burning sensations without visible mucosal lesions. Although its biopsychosocial complexity is increasingly recognized, cross-cultural comparison data remain limited. Methods: This cross-sectional study assessed 60 patients with BMS (30 Italian, 30 Romanian) who underwent standardized clinical, psychological, and sleep evaluations. Data collected included sociodemographics, clinical characteristics, diagnostic history, comorbidities, and symptomatology. The assessment tools used included the Numeric Rating Scale (NRS), Short Form of the McGill Pain Questionnaire (SF-MPQ), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Statistical comparisons were conducted using Mann–Whitney U and Fisher’s exact tests with Bonferroni correction. Results: No significant differences were observed in age, sex, or body mass index. Italian patients had fewer years of education (p = 0.001), higher pain intensity (NRS, p < 0.001), poorer sleep quality (PSQI, ESS, p = 0.001), and more frequent pre-existing sleep disorders (p < 0.001). Romanian patients showed higher levels of anxiety (HAM-A, p < 0.001), longer diagnostic delays (p = 0.002), and more dysesthetic or perceptual symptoms, including tingling and oral dysmorphism (p < 0.05). Stressful events before onset were more common among Romanians (p < 0.001), while Italians more often received a correct diagnosis at first consultation (p = 0.005). Conclusions: This first cross-national comparison of BMS in Western and Eastern Europe shows that cultural, healthcare, and clinician education differences can shape symptom profiles, comorbidities, and diagnostic delays, underscoring the need for personalized, country-specific management strategies. Full article

Background: The Mediterranean diet is widely recognised for its health benefits and remains a key reference point in shaping dietary guidelines across populations. Despite its growing international relevance, there is a lack of validated tools assessing Mediterranean diet adherence among children and adolescents in Central and Eastern Europe. Methods: The present study aimed to adapt and validate the KIDMED 2.0 questionnaire for use in Polish children and adolescents aged 10 to 18 years (KIDMED 2.0 PL). The adaptation process involved forward–backward translation, expert consultations, and pilot testing to ensure linguistic and cultural relevance. A total of 102 participants completed the questionnaire twice over a two-week interval, and anthropometric data were collected. Results: The KIDMED 2.0 PL demonstrated high test–retest reliability (Spearman’s ρ = 0.876; p < 0.001) and strong criterion validity, with a significant negative correlation between KIDMED scores and BMI centile (ρ = −0.854; p < 0.001). Children with normal weight showed the highest adherence to the Mediterranean diet, while scores were significantly lower in overweight and obese participants. Item-level analysis indicated that fruit and vegetable consumption was relatively frequent, whereas intake of legumes, whole grains, and extra virgin olive oil remained low. Conclusions: The KIDMED 2.0 PL is a valid and reliable tool for evaluating diet quality and Mediterranean dietary adherence in the Polish pediatric population. Full article

This paper presents a novel integration of bioclimatic-passive architectural elements—Trombe walls, pergolas, and deciduous climbers—in the context of residential buildings in Eastern and Central Europe, a combination that remains largely underexplored in the current literature. The innovativeness of the proposed concept is reflected in the combined use of the following building elements: three types of passive Trombe wall (single-glazed, double-glazed, and triple-glazed), pergolas, and four types of deciduous climbers (V. coignetiae, H. lupulus, W. sinensis, and A. macrophylla). By using meteorological data for the towns Kragujevac and Kielce, the influence of location parameters for two dominant European climate zones (moderate continental and continental) is also included in this investigation. The initial single-family building models were created following the Serbian and Polish rulebooks on energy efficiency for new buildings and equipped with the same thermo-technical systems and people occupancy conditions. Based on the conducted simulations (using Google SketchUp 8 and EnergyPlus 7.1) and obtained results on the annual level, the following main conclusions can be drawn: (1) a moderate continental climate is more suitable for implementing the proposed concept; (2) a single-glazed passive Trombe wall is not energy or environmentally justified; (3) the energy, environmental, and economic benefits for both selected locations are greatest in the case of the combined use of pergolas, V. coignetiae, and triple-glazed passive Trombe wall; and (4) before the wider commercial application of the proposed concept in the future, efforts should be made to explore economic opportunities, which, among other things, involve a focus on market stability and accessibility. Full article