Alexandru Ciolofan

Dr. Alexandru Ciolofan

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Research Focus & Metrics

Academic Career Length

2Years (2025-Present)

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

Representative Publications

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6 November 2025 in Healthcare
Verified
Journal Article
Open access
PDF file
SESorina Enasoni
Sorina Enasoni
DNDorin Novacescu
Dorin Novacescu
ABAlina Cristina Barb
Alina Cristina Barb
ACAlexandru Ciolofan
Alexandru Ciolofan
Cristina-Stefania DumitruCristina-Stefania Dumitru
Cristina-Stefania Dumitru
AEAlexandra Enache
Alexandra Enache
The COVID-19 pandemic has profoundly amplified burnout and moral injury among nurses, exposing structural vulnerabilities in healthcare systems and accelerating workforce attrition. Beyond the acute crisis, nurses continue to face chronic staff shortages, overwhelming workloads, and unresolved ethical tensions that compromise both well-being and quality of care. Synthesis of recent meta-analyses in this review indicates that nurse burnout during the pandemic ranged between 30% and 50%, illustrating the magnitude of the problem. Particular attention is given to innovative organizational strategies that foster resilience, including workload redistribution, enhanced professional autonomy, supportive leadership, and the integration of digital technologies such as telecare. Comparative perspectives across healthcare systems illustrate how policy reforms, staffing models, and ethical frameworks can mitigate psychological distress and strengthen organizational resilience. By reframing burnout and moral injury not only as individual challenges but as systemic phenomena requiring structural solutions, this review emphasizes the imperative of multilevel interventions. Building resilient nursing workforces through innovation, leadership, and evidence-based policies is essential for sustaining high-quality patient care in the post-pandemic era.

Verified
Journal Article
Open access
PDF file
RBRoxana Brata
Roxana Brata
LMLavinia Marcut
Lavinia Marcut
ABAlina Cristina Barb
Alina Cristina Barb
AMAlexia Manole
Alexia Manole
ACAlexandru Ciolofan
Alexandru Ciolofan
RPRaul Patrascu
Raul Patrascu
Head and neck squamous cell carcinoma (HNSCC) remains one of the most aggressive solid tumors, characterized by marked molecular heterogeneity and a complex tumor microenvironment (TME). Recent evidence highlights the pivotal role of microRNAs (miRNAs) in regulating tumor progression, immune evasion, angiogenesis, and stromal remodeling. This review synthesizes current insights into miRNA-mediated molecular pathways that modulate the TME in HNSCC and discusses emerging therapeutic strategies, including nanocarrier- and exosome-based miRNA delivery systems, targeting these molecules. Key miRNAs, including miR-21, miR-146a, and miR-221, orchestrate bidirectional signaling between cancer cells, fibroblasts, and immune infiltrates, thereby shaping tumor aggressiveness and therapy resistance. Advances in nanotechnology have facilitated the development of miRNA-based therapeutics—such as mimics, antagomiRs, and exosome-mediated systems—capable of restoring physiological expression patterns and reprogramming the TME toward an anti-tumor state. However, clinical translation remains hindered by challenges in targeted delivery, molecular stability, and tumor heterogeneity. By integrating molecular and translational perspectives, this review underscores how miRNA-targeting strategies may evolve into a new generation of precision therapies, bridging the gap between molecular oncology and personalized treatment of head and neck cancer.

29 November 2025 in Nutrients
Verified
Journal Article
Open access
PDF file
CMCristina Merlan
Cristina Merlan
SBSimona Buda
Simona Buda
AOAlexandru Oancea
Alexandru Oancea
NJNarcisa Jianu
Narcisa Jianu
TOTeodor Nicolae Onea
Teodor Nicolae Onea
Valentina Oana budaValentina Oana buda
Valentina Oana buda
Background/Objectives: Osteoporosis represents a major yet underdiagnosed public health concern in developing countries, including Tunisia. Limited awareness, delayed diagnosis, and suboptimal adoption of preventive strategies contribute to increased risk of fragility fractures in aging populations. This study aimed to assess post-pandemic knowledge, attitudes, and preventive practices regarding osteoporosis in the Tunisian general population. Methods: A cross-sectional survey was conducted between February and April 2024 in six randomly selected community pharmacies in Tunis. Adults ≥ 40 years old completed a validated 31-item questionnaire assessing socio-demographic factors, osteoporosis knowledge, risk factors, screening practices, and preventive behaviors. A total of 160 fully completed questionnaires were analyzed using SPSS v22. Results: Only 60.6% of respondents reported awareness of osteoporosis. Knowledge levels were significantly higher in men (8.37 vs. 7.40; p = 0.043), urban residents (8.22 vs. 7.21; p = 0.036), participants with higher education (8.73 vs. 7.00; p < 0.001), those with a family history (8.58 vs. 7.49; p = 0.033), and individuals already diagnosed (9.19 vs. 7.63; p = 0.025). Screening rates were low: only 11.3% had ever undergone DXA testing, despite 18.8% reporting prior fractures. Preventive behaviors were inadequate: 80% did not supplement calcium, 88.1% did not use vitamin D, and 58.8% did not engage in <30 min of daily activity. Osteoporosis was reported by 13.1% of participants and 95.2% of diagnosed cases received treatment, predominantly bisphosphonates (75%). Comorbidities were significantly associated with osteoporosis (24.5% vs. 7.5%; p = 0.003). Conclusions: This study reveals suboptimal awareness, limited access to screening, and insufficient preventive behaviors regarding osteoporosis in Tunisia. Targeted educational initiatives, expansion of DXA availability, adoption of national osteoporosis guidelines, and multidisciplinary stakeholder involvement are critical to improve early detection, prevention, and management in the aging Tunisian population. Furthermore, promoting balanced nutrition that includes calcium- and vitamin D-rich foods, along with appropriate dietary supplementation when needed, is an essential preventive strategy to support optimal bone health and reduce osteoporosis risk in the general population.