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Objective The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe. The reasons for these changes remain unknown. The aim of this study was to investigate whether an East–West gradient in the incidence of IBD in Europe exists. Design A prospective, uniformly diagnosed, population based inception cohort of IBD patients in 31 centres from 14 Western and eight Eastern European countries covering a total background population of approximately 10.1 million people was created. One-third of the centres had previous experience with inception cohorts. Patients were entered into a low cost, web based epidemiological database, making participation possible regardless of socioeconomic status and prior experience. Results 1515 patients aged 15 years or older were included, of whom 535 (35%) were diagnosed with Crohn's disease (CD), 813 (54%) with ulcerative colitis (UC) and 167 (11%) with IBD unclassified (IBDU). The overall incidence rate ratios in all Western European centres were 1.9 (95% CI 1.5 to 2.4) for CD and 2.1 (95% CI 1.8 to 2.6) for UC compared with Eastern European centres. The median crude annual incidence rates per 100 000 in 2010 for CD were 6.5 (range 0–10.7) in Western European centres and 3.1 (range 0.4–11.5) in Eastern European centres, for UC 10.8 (range 2.9–31.5) and 4.1 (range 2.4–10.3), respectively, and for IBDU 1.9 (range 0–39.4) and 0 (range 0–1.2), respectively. In Western Europe, 92% of CD, 78% of UC and 74% of IBDU patients had a colonoscopy performed as the diagnostic procedure compared with 90%, 100% and 96%, respectively, in Eastern Europe. 8% of CD and 1% of UC patients in both regions underwent surgery within the first 3 months of the onset of disease. 7% of CD patients and 3% of UC patients from Western Europe received biological treatment as rescue therapy. Of all European CD patients, 20% received only 5-aminosalicylates as induction therapy. Conclusions An East–West gradient in IBD incidence exists in Europe. Among this inception cohort—including indolent and aggressive cases—international guidelines for diagnosis and initial treatment are not being followed uniformly by physicians.

Much research exists on the role of textual enhancement in instructed second language (L2) development, yet little is known about how its effectiveness is influenced by multiple exposures, whether it can facilitate the acquisition of L2 derivational morphology, and how it may affect child language learning. To fill these gaps, this study employed a six-week multiple-exposure design to investigate the extent which to textual enhancement can benefit children’s knowledge of L2 derivational morphemes. The study employed a pretest-posttest design, with six treatment sessions. Participants were 91 L2 learners of English in two primary school EFL contexts (Romania, Sweden). In each context, participants were randomly assigned to two groups: the +highlight group received textually enhanced texts, whereas the –highlight group read unenhanced texts during the treatment. The children read the texts through a digital reader application during their English lessons. The target constructions were the –ion and –ment morphemes. The pretest and posttest included a non-word derivational suffix choice and a nonword derivational suffix decomposition task. Results of linear mixed effects models found a small advantage of textual enhancement for the acquisition of the –ion morpheme by Swedish learners on the suffix choice task, but Romanian learners showed no benefits from highlighting.

With the expansion and omnipresence of digital technologies in most aspects of human life, organizations have felt the need to implement changes. Thus, digital transformation has become imperative, with organizations having to adapt to the new standards imposed by a digitalized world. This paper analyses the digital transformation in Romanian SMEs using a methodology based on quantitative analysis of data collected through a questionnaire. The aim is to understand how these companies’ approach and implement digital transformation, as well as the impact of this process on management strategies and business models. The analysis of the quantitative research results will focus on the demographic profile of the companies, the stage of the digital transformation process, the impact on business performance, investments in digital transformation and predictive models. This work makes a significant contribution to understanding and promoting digital transformation among SMEs, providing a specific and relevant insight into the Romanian SME context.

Digital transformation has become a critical topic for organizations that want to stay competitive in today’s digital age. The widespread use of digital technologies has brought significant changes to the way organizations exist, operate and interact with customers. They are going through a process of reshaping and reorganizing processes and operations, as well as rethinking and redefining the human role in the value creation process. However, digital technologies and their diffusion are not the only driver of digital transformation, as the success of such change initiatives depends on many other factors, the definition of which is crucial to the success of digital transformation. The objective of this paper is to explore the drivers of digital transformation and their impact on management. The work presents a comprehensive review of the literature on digital transformation, identifying the main drivers that influence the success of digital transformation initiatives. It also defines the impact of these drivers on the management of organizations, identifying how the role of the executive is being redefined in today’s digital age.

The main objective of the present material is to identify some nuances of fiscal and monetary policy in Romania over the last 10 years and their descriptive-resultative impact on the most important macroeconomic aggregates, with a focus on economic growth and inflation. Although it represents the Keynesian solution to relaunch this type of economy, the fiscal expansion and the promoted expansionary monetary policy no longer generated the same anticipated positive effects (increased consumption, increased income and private investments, etc.), because they are conditioned by the reaction of private economic agents to fiscal incentives. Regarding monetary policy, the adoption of the direct inflation targeting strategy adopted in August 2005 and, implicitly, ensuring price stability as the main mission of the NBR and a way to support long-term economic growth, combined with the ability to be independent in the use of debt instruments and with the introduction of a flexible exchange rate, strengthened the credibility of the central bank by giving it the explicit establishment of a numerical inflation target, the accepted range of fluctuation (the width of the target band) and the horizon for reaching the target. As a result, the last decade has seen extremely low inflation targets (-0.6% in 2015, 4.6% in 2018 - the highest -, 2.6% in 2020). In the last year, the annual CPI inflation rate, after reaching a maximum in November 2022 (16.76%), followed an anticipated downward trajectory throughout the projection interval, maintaining still higher values (14.53% in March 2023·), but with a clearly downward forecast (7.1% forecast at the end of2023). The disinflationary path was marked by the group of energy goods, both against the background of the evolution of fuel prices, whose annual variation felt strong favorable effects, and as a result of the extension of the scope of the support scheme for the payment of electricity bills starting from January 01, 2023. The inflation rate would decrease to 4.2% in December 2024 and to 3.9% in March 2025. This, given the risks induced by the Covid pandemic and the persistence, even the amplification, of the military conflict in Ukraine and related sanctions imposed on Russia.

The aim of the study was to determine menopause-related changes in serum levels of main proinflammatory and anti-inflammatory cytokines. The study included 175 women, who were divided into 5 study groups (group 1 - fertile women; group 2 - pre- and perimenopausal women; group 3 - postmenopausal women; group 4 - surgically induced menopausal women; group 5 - women with chronic inflammatory pathology). We evaluated the serum levels of interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, IL-20 and of the tumour necrosis factor (TNF)α with the use of two multiplex cytokine kits. We also determined the serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), 17β-estradiol (17β-E2), progesterone (P), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) using sandwich ELISA. The serum level of IL-1β, IL-8 and TNF-α in women with natural menopause and in women with surgically induced menopause is significantly higher than in fertile women in the control group. In patients with surgically induced menopause and in women with natural menopause, IL-8 serum levels are similar to those seen in patients with chronic inflammatory diseases. There is a statistically significant decrease in serum levels of IL-20 in women with natural or surgical menopause than in fertile and premenopausal women. Women in menopause have elevated levels of the key proinflammatory cytokines, i.e. IL-1β, IL-8 and TNF-α and low serum levels of IL-20 in comparison with fertile women.

Carbapenem-resistant Klebsiella pneumoniae (CR-Kp) is eroding therapeutic options for urinary tract infections. We isolated a multidrug-resistant strain from the urine of a chronically bacteriuric patient and confirmed its identity by Vitek-2 and MALDI-TOF MS. Initial disk-diffusion profiling against 48 antibiotics revealed susceptibility to only 5 agents. One month later, repeat testing showed that tetracycline alone remained active, highlighting the strain’s rapidly evolving resistome. Given the scarcity of drug options, we performed an “aromatogram” with seven pure essential oils, propolis, and two commercial phytotherapeutic blends. Biomicin Forte® produced a 30 mm bactericidal halo, while thyme, tea tree, laurel, and palmarosa oils yielded clear inhibition zones of 11–22 mm. These in vitro data demonstrate that carefully selected plant-derived products can target CR-Kp where conventional antibiotics fail. Integrating aromatogram results into One Health’s stewardship plans may therefore help preserve last-line antibiotics and provide adjunctive options for persistent urinary infections.

Endometriosis is a common gynecological condition with a complex physio-pathological background. This study aimed to assess the role of Rubus idaeus leaf extract (RiDE) as a potential therapeutic agent in reducing the size of the endometriotic lesions and modulate the plasma expression of MMP-2, MMP-9, and TGF-β1. The endometriotic lesions were induced in a rat model by the autologous transplant of endometrium. Thirty-six female rats, Wistar breed, with induced endometriosis, were divided into four groups and underwent treatment for 28 days. The CTRL group received 0.5 mL/day of the vehicle; the DG group received 1 mg/kg b.w./day dienogest; the RiDG group received 0.25 mL/kg b.w./day RiDE and the D+RiDG group received 1 mg/kg b.w./day dienogest and 0.25 mL/kg b.w./day RiDE, respectively. Rats’ weight, endometriotic lesion diameter and grade, and plasma levels of MMP-2, MMP-9, and TGF-β1 were assessed before and after treatment. The administration of RiDE in association with dienogest vs. dienogest determined a lower weight gain and a reduction in diameter of the endometriotic lesions. RiDE administration restored MMP2 and MMP9 plasma levels to initial conditions. Rubus idaeus extract may help in reducing dienogest-associated weight gain, lower the size of endometriotic lesions, and have anti-inflammatory effects through MMP2 and MMP9 reduction.

We present a case of acute respiratory distress syndrome (ARDS) secondary to COVID-19 who required venovenous extracorporeal membrane oxygenation (V-V ECMO). Initially, a right ventricular assist device (RVAD), the ProtekDuo with an oxygenator, was placed in an outside heart center and the patient was transferred to us for ECMO management. Due to severe hypoxia, the configuration was later modified, and a 25 Fr femoral drainage cannula was inserted for venous drainage only. The arterial return tubing was spliced and using a Y-connector, arterialized blood was returned through both limbs of the ProtekDuo resulting in a significantly increased oxygenation and flow.

Soil quality, characterized by its physical, chemical, and biological properties, is closely linked to soil management. Reducing soil disturbance can limit soil degradation; however, tillage is still considered essential, particularly on poorly drained soils. This study aimed to identify the optimal tillage practices for winter wheat crops following long-term no tillage practice and crop rotation (2020–2023). Additionally, it highlights the considerable advantages of particular tillage practices in emphasizing their role in enhancing soil health and sustainable agriculture. The experiment followed a randomized complete block design with three replications and two tillage practices: no tillage (NT) and conventional tillage (CT). The research was carried out on a cambic chernozem soil type. The results revealed that physical properties such as bulk density (BD) can increase or decrease under NT, while soil water content (SWC) increased under the same system. The status of water-stable aggregates (WSAs) also improved in NT (88.41%) due to the incorporation of cover crop or plant residues in the 0–10 cm depth. Notably, the highest SWC value at harvest was obtained in the 0–10 cm soil depth, under NT, reaching 24.47%. Grain yields over four years of research were also influenced by tillage systems, resulting in mean yields of 6070 kg/ha for CT and 4285.25 kg/ha for the NT system. The Pearson correlation coefficient was calculated for the soil physical properties considered in pairs. Between BD and water-stable aggregates (WSAs), there was a moderate positive correlation (r = 0.458**) and statistical significance, but no linear correlation between BD and SWC (r = 0.089), and between WSAs and SWC (r = 0.026). Generally, using NT, which reduces soil disturbance and maintains residues on the surface, could contribute to land sustainability and climate mitigation in north-east Romania.