Alina Cristian

Dr. Alina Cristian

orcid

Research Focus & Metrics

Academic Career Length

13Years (2014-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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26 February 2025 in Healthcare
Verified
Journal Article
Open access
PDF file
LOLilioara-Alexandra Oprinca-Muja
Lilioara-Alexandra Oprinca-Muja
ACAdrian Nicolae Cristian
Adrian Nicolae Cristian
ETElena Topircean
Elena Topircean
ACAlina Cristian
Alina Cristian
MPMarius Florentin Popa
Marius Florentin Popa
SMSilviu Morar
Silviu Morar
Background/Objectives: Burnout is a critical concern among healthcare professionals, particularly during crises such as the COVID-19 pandemic. This study investigated burnout levels among forensic medicine and pathology personnel at three distinct phases: the early pandemic period (Phase 1—September 2020), the peak of the pandemic (Phase 2—October 2021), and the post-pandemic period (Phase 3—October 2024). Methods: A total of 37 participants employed in forensic medicine and pathology departments completed the Maslach Burnout Inventory (MBI). A one-way repeated measures ANOVA was conducted to assess within-subject differences over time. Normality and sphericity were tested using the Shapiro–Wilk test and Mauchly’s test, with the Greenhouse-Geisser correction. Post hoc Bonferroni-adjusted comparisons identified significant differences, and partial eta squared (η2) was reported for effect sizes. Results: Results showed significant fluctuations in burnout levels across the three phases. Emotional exhaustion and low personal accomplishment peaked during Phase 2, with slight reductions observed in Phase 3. Gender differences were evident, with females reporting higher EE levels and males exhibiting higher depersonalization across all phases. Marital and parental status also influenced burnout levels, with unmarried individuals and those without children showing higher burnout scores. Medical doctors experienced the highest burnout levels among professional roles, while auxiliary staff showed significant challenges in the PA subscale. Conclusions: The COVID-19 pandemic was pivotal in exacerbating burnout levels due to increased workload, crisis decision-making, and emotional toll. Although the sample size is limited, these findings underscore the importance of implementing targeted interventions to mitigate burnout among forensic and pathology personnel, especially during healthcare emergencies. Gender-based differences in burnout suggest the necessity of specific workplace well-being strategies, while the protective role of family status demonstrates the importance of work-life balance policies. The persistence of psychological distress after a medical crisis calls for long-term monitoring and support programs. There is a need for improved workload distribution, peer support networks, and mental health training to build resilience among forensic and pathology personnel.

16 May 2025 in Healthcare
Verified
Journal Article
Open access
PDF file
LOLilioara-Alexandra Oprinca-Muja
Lilioara-Alexandra Oprinca-Muja
ACAdrian Nicolae Cristian
Adrian Nicolae Cristian
ETElena Topircean
Elena Topircean
ACAlina Cristian
Alina Cristian
MPMarius Florentin Popa
Marius Florentin Popa
SMSilviu Morar
Silviu Morar
Background and Objectives: Burnout syndrome is increasingly recognized as a significant occupational hazard among forensic medicine professionals, a population exposed to intense psychological stress and complex work demands. This study aimed to assess the prevalence of burnout, job satisfaction, and unconditional self-acceptance among forensic personnel in Romania and to explore potential predictors and mediators of burnout within this context. Materials and Methods: A cross-sectional survey was conducted among 153 forensic medicine professionals from 31 counties across Romania. Participants completed a battery of standardized instruments, including the Maslach Burnout Inventory—General Survey (MBI-GS), the Job Satisfaction Survey (JSS), and the Unconditional Self-Acceptance Questionnaire (USAQ). Cut-off scores for burnout subscales were established using the 75th percentile. Data were analyzed to identify demographic, occupational, and psychological correlates of burnout. Descriptive statistics were used to summarize sample characteristics and burnout prevalence. Group comparisons were made across demographic and professional categories. A mediation model was tested to evaluate whether unconditional self-acceptance mediated the relationship between job satisfaction and burnout. We hypothesized that job satisfaction would be negatively associated with burnout symptoms and that unconditional self-acceptance would mediate this relationship, acting as a protective psychological factor. Results: Approximately a quarter of respondents met the criteria for high total burnout, emotional exhaustion, and professional inefficacy, while cynicism was present in a fifth of participants. Burnout was more prevalent among younger workers, forensic medicine residents, and those working in the capital. Job satisfaction was generally high, but lower in women, younger individuals, and residents. Nearly half of the participants reported low or very low self-acceptance. Mediation analysis revealed that unconditional self-acceptance partially mediated the relationship between job satisfaction and burnout, suggesting a protective psychological mechanism. Conclusions: This study highlights the considerable burden of burnout among forensic medicine professionals in Romania and identifies job dissatisfaction and low self-acceptance as key contributors. Findings underscore the need for targeted interventions aimed at enhancing job satisfaction and emotional resilience, particularly in vulnerable subgroups. Institutional efforts that support mental well-being, foster emotional coping, and improve organizational dynamics are essential to reduce burnout in this high-risk population.

15 February 2026 in Forensic Sciences
Verified
Journal Article
Open access
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LOLilioara-Alexandra Oprinca-Muja
Lilioara-Alexandra Oprinca-Muja
ACAdrian Nicolae Cristian
Adrian Nicolae Cristian
GOGeorge Călin Oprinca
George Călin Oprinca
ETElena Topircean
Elena Topircean
ACAlina Cristian
Alina Cristian
SMSilviu Morar
Silviu Morar
Burnout syndrome is increasingly recognized as a significant occupational health issue, characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. It predominantly arises from chronic work-related stress, but recent research has highlighted the role of genetic and epigenetic factors in determining individual vulnerability to burnout. This review aims to synthesize findings regarding the genetic footprints of burnout, focusing on genes related to stress regulation, including the 5-HTT (serotonin transporter) gene, BDNF (brain-derived neurotrophic factor) gene, and NR3C1 (glucocorticoid receptor) gene. Twin studies reveal that burnout is moderately heritable, with genetic factors accounting for 33–36% of the variability in burnout-related traits, such as emotional exhaustion and performance-based self-esteem. However, burnout risk seems highly driven by non-shared environmental factors, such as work stress, lack of social support, and personal coping mechanisms. Specific genetic polymorphisms in the serotonergic system (5-HTT) and HPA axis genes (NR3C1, FKBP5) have been linked to increased burnout susceptibility, particularly in individuals exposed to chronic job strain or early-life stressful situations. Variations in 5-HTT rs6354 and HTR2A rs6313 are associated with altered stress reactivity, while polymorphisms in NR3C1 and FKBP5 contribute to dysregulation of the HPA axis, which influences cortisol secretion patterns in response to stress. Increased methylation in genes like BDNF and SLC6A4 has been observed in individuals with burnout, suggesting that environmental stressors may lead to lasting changes in gene expression, contributing to the syndrome’s development. Studies on telomere length have shown that burnout is associated with accelerated cellular aging, with individuals exhibiting shorter telomeres, particularly during high-stress periods. These findings hold particular relevance for professionals within the forensic and justice systems, including law enforcement, the judiciary, and forensic experts, who operate under chronic, high-stakes stress. We examine how understanding the biological basis of burnout can inform more objective ‘fitness-for-duty’ evaluations and provide a scientific framework for distinguishing physiological exhaustion from professional negligence in legal contexts.

22 August 2025 in Applied Sciences
Verified
Journal Article
Open access
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Elisabeta AntonescuElisabeta Antonescu
Elisabeta Antonescu
LSLaura Stef
Laura Stef
GBGabriela Boța
Gabriela Boța
ADAndreea Dinu
Andreea Dinu
OAOana Raluca Antonescu
Oana Raluca Antonescu
ACAlina Cristian
Alina Cristian
Introduction: Diabetes mellitus negatively influences oral health, significantly contributing to the worsening of odonto-periodontal pathology. Accurate diagnosis and monitoring of lesions are essential to prevent complications. CBCT (cone beam computed tomography) provides a detailed image of bone structures, being a valuable tool in this context. Materials and methods: Thisprospective observational comparative study included 120 patients with chronic periodontitis, divided into two equal groups: 60 with type 2 diabetes mellitus and 60 without systemic diseases. All were examined clinically and radiologically using high-resolution CBCT. Results: Diabetic patients presented a significantly higher mean bone loss (4.7 mm) compared to the non-diabetic patients (3.0 mm). Periodontal pockets >5 mm were more frequent in the diabetic group (75% vs. 50%). CBCT revealed vertical defects and extensive periapical lesions especially in patients with diabetes. Three-dimensional imaging allowed for detailed assessment and clear differentiation between the severity of cases. Conclusions: CBCT is essential in the early identification and evaluation of periodontal disease in diabetic patients. The use of this method significantly contributes to the correlation of clinical and imaging data, optimizing the diagnosis and treatment plan.

Verified
Journal Article
Open access
PDF file
MPMarius Florentin Popa
Marius Florentin Popa
Paul ȘiancuPaul Șiancu
Paul Șiancu
CMCalin Ilie Mohor
Calin Ilie Mohor
LOLilioara-Alexandra Oprinca-Muja
Lilioara-Alexandra Oprinca-Muja
GOGeorge Călin Oprinca
George Călin Oprinca
BABereanu Simona Alina
Bereanu Simona Alina
From a molecular perspective, colorectal cancer is a heterogeneous disease in which microsatellite instability (MSI) phenotypes, mismatch repair (MMR) status, chromosomal instability, or mutations in BRAF, KRAS, NRAS, and TP53 can influence prognosis, hereditary cancer risk assessment, and therapeutic approaches. Conventional biomarker testing via immunohistochemistry, polymerase chain reaction, and next-generation sequencing remains the diagnostic standard, but it can be limited by cost, turnaround time, tissue consumption, and uneven access. This narrative review synthesizes 30 peer-reviewed studies, identified across major scientific databases, that evaluate artificial intelligence (AI) platforms designed to detect molecular alterations from routine hematoxylin and eosin-stained colorectal cancer tissue slides. The strongest and most reproducible evidence exists for MSI phenotypes and MMR status, for which weakly supervised, attention-based, transformer-based, foundation-model, and clinically oriented multiple-instance learning systems achieve high discriminatory performance and particularly high negative predictive values at screening thresholds. BRAF mutation status is moderately predictable, although often through morphology associated with microsatellite instability or the CpG island methylator phenotype (CIMP). In contrast, despite promising single-center results, the predictability of KRAS, NRAS, PIK3CA, and other point mutations remains less consistently generalizable. Interpretability analyses indicate that these algorithms rely on features such as tumor-infiltrating lymphocytes, plasma cells, mucinous and medullary differentiation, necrosis, stromal architecture, tumor heterogeneity, nuclear morphometry, and tumor purity. Current evidence supports the use of AI as a triage and enrichment tool rather than a replacement for validated molecular diagnostics. Ultimately, prospective validation, pre-analytical standardization, calibrated thresholds, regulatory oversight, and pathologist-centered workflow integration are essential for successful clinical translation.