Background: Repeated surveys are essential for tracking trends in smoking prevalence among physicians, especially pulmonologists, who play a pivotal role in cessation counseling. Methods: In 2024, we conducted a descriptive cross-sectional surveillance study during the Romanian National Congress of Pneumology. A total of 332 registered pulmonologists were invited, and 226 (68.1%) provided a complete 30-item online questionnaire. The survey assessed smoking behavior and smoking-cessation counseling practices among Romanian pulmonologists for smokers and users of alternative nicotine products. Results: In a 2024 survey, current smoking rates were 4.9% (11/226) for conventional cigarettes, 2.2% (5/226) for heated tobacco products (HTPs), and 0.9% (2/226) for electronic cigarettes (e-cigarettes). Counseling practices were strongest for the initial steps of the 5A model: 93.4% (211/226) consistently asked about smoking status, and 88.1% (199/226) advised cessation. However, fewer assessed readiness to quit (65%, 147/226), monitored long-term abstinence (66.4%, 150/226), or assisted through referral and treatment. Only 36.3% (82/226) referred patients to the national STOP SMOKING program, and just 15.9% (36/226) declared to recommend Quitline programs. Conclusions: Smoking prevalence among Romanian pulmonologists has declined substantially over the past two decades. Despite high adherence to asking and advising patients, significant gaps remain in assistance and follow-up. Strengthened training and system-level support are needed to optimize cessation counseling.
The therapeutic landscape for multiple sclerosis has evolved markedly in recent years, with an expanding arsenal of disease- modifying therapies offering clinicians more tools to manage the disease. This progress presents both opportunities and complexities, as treatment decisions increasingly require individualized strategies balancing efficacy, safety, and long-term outcomes. While current therapies effectively reduce inflammation and delay disease progression, they fall short in halting neurodegeneration, highlighting a critical unmet need. Treatment paradigms range from escalation strategies prioritizing safety to early high-efficacy approaches aimed at aggressive disease control. Data increasingly support early initiation of high-efficacy DMTs in patients with poor prognostic indicators, but concerns over long-term safety and tolerability remain. Shared decision-making, informed by patient preferences and evolving evidence, is central to modern MS care. The future is promising, with new therapies in advanced stages of research, which seek to exceed the limits of current therapy, to act in a targeted manner, limiting both inflammation and neurodegeneration, for better control of disease activity, with an improved safety profile.
Crimean-Congo hemorrhagic fever virus (CCHFV) is a highly pathogenic agent that causes severe hemorrhagic disease with high mortality. Outbreak control requires rapid and accurate diagnosis together with effective vaccination strategies. The nucleoprotein (NP) is a central component of viral replication and of innate and adaptive immune responses, making it a promising target for diagnostic and vaccine development. NP is highly conserved across CCHFV isolates, which supports broad molecular and serological detection. Several studies have demonstrated that NP-based assays provide sensitive and specific results, a critical requirement for outbreak management. In vaccine research, NP has been shown to induce strong cellular immune responses that contribute to long-term protection. Multiple platforms, including recombinant proteins, DNA constructs, and viral vectors, have successfully incorporated NP with promising preclinical immunogenicity. Despite this progress, challenges remain in ensuring safety and achieving consistent immune responses across populations. Advances in nanotechnology, structural vaccinology, and bioinformatics may further improve the effectiveness of NP-based products. In conclusion, NP represents a key element for both reliable diagnostics and the induction of protective immunity. Future research should focus on optimizing NP-based platforms for translation into clinical applications and improving global preparedness against CCHFV.
This study aimed to assess the validity and reliability of the Therapeutic Communication Questionnaire for nurses. This cross-sectional analytical research was conducted in Kashan in 2023. After the translation process, the questionnaire was distributed among the target community. The questionnaire was designed in electronic form (Porsline) and consisted of three sections: demographic information, the Therapeutic Communication Questionnaire for nurses with patients, and a questionnaire on barriers to effective (“nurse–patient”) communication. After completing the questionnaire, the data were entered into SPSS (version 16). Out of 347 participants, 123 (35.47%) were male, with a mean age of 27.07 ± 3.97 years, respectively. The Cronbach's alpha coefficient for the questionnaire was 0.89, and the test–retest reliability (intraclass correlation coefficient, ICC (3,1) was 0.80. The Bartlett's test value was 10368.72, which was statistically significant (P<0.001). The Kaiser-Meyer-Olkin Measure (KMO) index in the results analysis was 0.86. Exploratory factor analysis using principal axis factoring with Promax rotation, combined with scree plot and parallel analysis, supported a three-factor solution explaining 42.46% of the variance. (Only factors 1 and 2 had acceptable reliability.) The questionnaire shows good validity and reliability for Persian speakers. However, cultural differences must be considered, as attitudes influence the nature of communication.
Heart failure with preserved ejection fraction (HFpEF) is a complex pathology that has undergone a paradigm shift in the last few years. As technology develops and diagnosis algorithms become more refined, early diagnosis leads to prompt medical management. This management has also changed in recent years. Moreover, HFpEF phenotyping attempts further nuance the management of patients with this disease. Whereas guidelines are not so firm on the medical classes of drugs that should be employed in HFpEF compared to HFrEF, new trials are on the way to change this. This literature review focuses on the evolution of diagnosis criteria for HFpEF, the clinical scores proposed by current guidelines, and also on the medical management of this pathology, focusing on medical management and how it has changed recently, by highlighting landmark trials that have been published on the topic or that are going to be published on the topic.
This study explores behavioral and demographic predictors of sustainability engagement in sustainable food choices among Romanian adults, addressing a regional gap in Eastern European sustainability research, based on an online non-probability sample of 406 respondents collected through an online cross-sectional survey, with voluntary response and snowball sampling techniques, conducted between 15 October 2024 and 30 January 2025. From 527 initial responses, 121 questionnaires were excluded due to incomplete or inconsistent answers, resulting in a final analytic sample of 406 respondents. A modified version of the Food Choice Questionnaire (FCQ), termed the Consumers’ Engagement in Food Choices Questionnaire (CEFCQ), was employed to capture sustainability-related behaviors and attitudes. Four hypotheses were tested using multiple linear regression. While snowball sampling is appropriate for exploratory research, we acknowledge its limitations in terms of representativeness at the national level. The respondents haven’t received any incentives, and data privacy and confidentiality were guaranteed. A modified version of the Food Choice Questionnaire (FCQ) was employed to assess sustainability-related attitudes and behaviors, including food label awareness, shopping frequency, and food waste reduction practices. Drawing on existing literature, four hypotheses were formulated and tested using multiple linear regression analysis. Results indicate that label reading behavior and perceived importance of digitalization are positively associated with sustainability engagement, while shopping frequency is negatively associated. Educational attainment and digital marketplace engagement show no significant association after controlling for other variables. The model explains approximately 25% of the variance in sustainability engagement. Given the non-probabilistic sampling design and demographic skew toward female and highly educated respondents, findings are interpreted as exploratory. This study contributes region-specific evidence on sustainable food behavior in Romania and highlights the role of information-oriented behaviors over formal education in predicting sustainability engagement. Implications for consumer education, labeling policy, and targeted interventions aligned with the European Green Deal are discussed.
Burns that affect functional areas present unique challenges in terms of diagnosis and therapy due to their particular mobility and aesthetic importance. In this article, we summarize the current principles in the diagnosis, treatment, and rehabilitation of burns that affect these regions. In this regard, the recent medical literature (clinical evidence) was analyzed to outline management strategies specific to each region. Early and correct evaluation of lesions, along with individualized treatment are essential for maintaining mobility and preventing sequelae. The results obtained are applicable in both civilian and military environments. Superficial burns respond well to conservative care with dressings, splints, and physiotherapy on the one hand, and on the other hand, deep burns benefit from excision and early grafting, the standard modern procedure that shortens hospitalization and greatly improves results. Long-term recovery depends on scar modulation, reconstructive surgery, and multidisciplinary rehabilitation addressing both functional and psychological aspects. Treatment of the burns of functional areas requires prompt, tailored, and multidisciplinary management to restore function and minimize disability. Standardized treatment algorithms and expanded research on long-term rehabilitation remain essential for improving burn care outcomes.
Abstract Quantum computing (QC) has emerged as a transformative technology with the potential to surpass classical computational limits, especially in complex domains like medical imaging. This study investigates the integration of QC and quantum machine learning (QML) into medical imaging, with a focus on MRI, EEG, and CT. A structured literature review was conducted to identify recent developments, focusing on studies using accessible open-source data and English-language peer-reviewed publications. By leveraging quantum principles such as superposition and entanglement, hybrid quantum-classical models have demonstrated enhanced accuracy, speed, and efficiency in diagnostic tasks. In MRI, QML has improved early detection and classification of neurological diseases like Alzheimer’s and brain tumours. In EEG analysis, quantum algorithms such as Quantum EEGNet and Quantum Support Vector Machines have shown superior performance in detecting disorders, including schizophrenia and autism spectrum disorder. Additionally, quantum algorithms for CT image reconstruction and classification have achieved faster processing with fewer artifacts and greater fidelity. Despite current hardware constraints, results highlight the promise of QC in addressing existing limitations in medical diagnostics. The findings support continued development of QML models and quantum- enhanced workflows, with potential to revolutionise clinical practice by offering more accurate, efficient, and personalised care in neurological imaging and analysis.
Objective. In this retrospective study, we aimed to analyse bone profile in menopausal women who suffered a low-trauma fall and were found to have an osteoporotic fracture. Methods. This real-life setting included individuals with a fall within the last year before DXA scan [providing bone mineral density (BMD)/T-score], and excluded traumatic falls, prior anti-osteoporosis therapy, diagnosis of osteoporosis, cancers, and bone metabolic diseases. Results. 5-year age-group analysis was statistically significantly different (N=48, p=0.017): in the 70-74 year interval, 75% were in group F (fracture +ve), in the 50-54 year interval, 83.33% were in group nonF (fracture-free). Mineral metabolism assays and bone turnover markers pinpointed a similar profile, except for DXA: femoral neck T-score was lower in group F versus nonF (-1.75±0.72 versus -1.17±0.91, p=0.029). Receiver operating characteristic curve of femoral neck T-score for predicting a fracture showed an area under the curve of 0.691 (p=0.031). Conclusion. Menopausal women with a 1-year fall history with fractures were older, had a longer menopause duration, and had lower femoral neck BMD than fracture-free women. Type 2 diabetes and hypertension had similar prevalence, as did the vitamin D profile and bone turnover markers. Individuals with vertebral fractures (most common types) showed a lower lumbar BMD versus those with non-vertebral fractures.
Objective. In this pilot study, we aimed to analyze the blood irisin levels in relation to glucose and mineral metabolism assays in menopausal women with non-diabetic altered glucose regulation: impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Methods. This was a prospective, transversal, non-interventional, bi-centric (bi-country) study, between December 2024 and October 2025. Results. The patients (N=47) with IGT (N=21) or IFG (N=26) had a similar age (63±9.24 versus 63.46±8.16years, p=0.856), menopause duration (14.05±9.37 versus 16.76±8.07years, p=0.297), and body mass index with mean values within the obesity range (34.84±5.07 versus 31.34±6.46kg/sqm, p=0.765). Average 25-hydroxyvitamin D showed an insufficiency (28.62±8.09 versus 28.06± 6.99ng/mL). The IGT versus IFG group were found with statistically significantly higher 1-hour glycaemia in the oral glucose tolerance test (207.04±34.72 versus 179.40±33.91mg/dL, p=0.009), 2-hour insulin (101.44±67.26 versus 48.97±34.35 µUI/mL, p=001), fasting insulin (13.00±7.38 versus 8.36±3.96µUI/mL, p=0.008); HOMA-IR (3.53±2.32 versus 2.27±1.17; p=0.21) with mean levels sustaining insulin resistance. Conclusion. Circulating irisin was marginally elevated in the IGT versus the IFG group and positively correlated with body mass index in both. We found no correlation with the glucose profile, but with selective mineral metabolism assays. This pilot study requires an expansion of the sample size to pinpoint the potential practical utility of irisin as a biomarker.
