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Background/Objectives: Operating rooms represent valuable and pivotal units of any hospital. Therefore, their management affects healthcare service delivery through rescheduling, staff shortage/overtime, cost inefficiency, and patient dissatisfaction, among others. To optimize scheduling, we aim to assess preoperative evaluation criteria that influence the prediction of surgery duration for gastric cancer (GC) patients. In GC, radical surgery with curative intent is the ideal treatment. Nevertheless, the intervention sometimes must be palliative if the patient’s status and tumor staging prove too advanced. Methods: A 6-year retrospective cohort study was performed in a tertiary care hospital, including all cases diagnosed with GC (ICD-10 code C16), confirmed through histopathology, and undergoing surgical treatment (N = 108). Results: The results of our study confirm male predominance (63.89%) among GC surgery candidates while bringing new perspectives on patient evaluation criteria and choice of surgical intervention (curative—Group 1, palliative—Group 2). Surgery duration, including anesthesiology (175.19 [95% CI (157.60–192.77)] min), shows a direct correlation with the number of lymph nodes dissected (Surgical duration [min] = 10.67 × No. of lymph nodes removed − 32.25). Interestingly, the aggressiveness of the tumor based on histological grade (highly differentiated being generally less aggressive than poorly differentiated) shows differential correlation with surgery duration among curative and palliative surgery candidates. Similarly, TNM staging indicates the need for a longer surgical duration (pTNM stage IIA, IIB, and IIIA) for curative interventions in patients with less advanced stages, as opposed to shorter surgery duration for palliative interventions (pTNM stage IIIC and IV). Conclusions: The study quantitatively presents the resources needed for the optimal surgical treatment of different groups of GC patients, as the disease coding systems in use regard the treatment of each pathology as “standard” in terms of patient management. The results obtained are anchored in the global perspectives of surgical outcomes and aim to improve the management of operating room scheduling, staff, and resources.

Background and Aim: Many people seek health information online, but misinformation can lead to incorrect medical decisions. The aim of the study was to assess patients’ medical internet use and their intention to discuss online findings with doctors. Materials and Methods: The observational and cross-sectional study included a sample of patients with chronic non-communicable diseases who voluntarily participated in a health education and screening campaign, conducted in four cities in Romania during March-November 2024. Socio-demographic data and answers to seven specific questions were collected using a face-to-face questionnaire developed by the authors. The study was conducted with the approval of the ethics committee of George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures. Results: The study sample included 495 respondents. The mean age of respondents was 48.7 years; 72.9% were females, and 73.4% resided in urban areas. Approximately half of the respondents (51.2%) had a high school education or less, while 48.7% had post-secondary or university education. Over 65% of respondents searched for health information online frequently or sometimes, while 34.4% did so rarely or never. Most respondents (90.9%) searched for medical information using a mobile device, while fewer used laptops (19.9%), tablets (11.3%), or desktops (10.8%). The vast majority (94.1%) used Google to find medical information, while fewer relied on websites (21.2%), social media (15.0%), forums (9.6%), or artificial intelligence chatbots (3.9%). The vast majority (81.6%) believed that it would be useful to discuss online health information with doctors. More than half (57.4%) had asked a doctor to explain medical information found online, while 35.2% had not. Most respondents (84.8%) received a response from their doctor: 50.8% obtained a detailed answer, while 34.0% received a brief one. However, 10.9% felt that their questions were avoided or unwelcome. Conclusions: Most respondents frequently search for health information online, mainly using mobile devices and Google. Many patients appreciate discussing the health information they find online with doctors, highlighting the need for professional guidance. While most doctors provided answers, some patients perceived reluctance or avoidance, suggesting room for better communication.

Background: Nonadherence to antihypertensive therapy affects nearly half of treated patients worldwide, and persistence often falls below 60% within the first year, contributing substantially to uncontrolled blood pressure and cardiovascular morbidity. Adherence and persistence to antihypertensive therapy among primary care patients in Mureș County, Romania, were assessed using validated measures, and modifiable risk factors for targeted interventions were identified. Methods: A cross-sectional study of 399 hypertensive adults (≥18 years) receiving treatment for ≥1 year across primary care clinics in Mureș County, Romania, was performed. Adherence was evaluated using the Romanian-validated Hill–Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) and confirmed by mean arterial pressure (MAP) < 100 mmHg. Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal HBCTS cutoff, and multivariate logistic regression was used to identify independent predictors of adherence. Persistence was assessed via healthcare-engagement metrics over a 360-day observation period. Results: Effective blood pressure control (MAP < 100 mmHg) was achieved by 45.9% of participants. The HBCTS demonstrated good reliability (McDonald’s ω = 0.82). ROC analysis established 51 points as an optimal threshold (sensitivity = 88.0%, specificity = 38.9%). Male gender (OR = 0.47, 95% CI: 0.29–0.75, p = 0.002) and younger age (OR = 1.04 per year, 95% CI: 1.01–1.06, p = 0.001) independently predicted poor adherence. Treatment coverage days showed the strongest correlation with blood pressure control (r = −0.50, p < 0.001). Among participants, 67.7% demonstrated persistence, achieving significantly better blood pressure control than non-persistent patients. Conclusions: The validated HBCTS (≥51 points) provides an efficient screening tool for Romanian primary care settings. Treatment coverage days emerged as the strongest modifiable predictor of blood pressure control (r = −0.50), highlighting medication availability as a key intervention target. Targeted approaches for male and younger patients, combined with systematic medication continuity monitoring, represent evidence-based strategies for reducing cardiovascular morbidity in this population.

Background: Age-related vascular stiffening increases cardiovascular risk by altering ventricular–arterial coupling (VAC). Physical activity, a modifiable factor, may improve cardiovascular health. This pilot study evaluated the relationship between physical activity evaluation and VAC, measured by the carotid–femoral pulse wave velocity to global longitudinal strain (cfPWV/GLS) ratio, in a Romanian primary care cohort. Methods: The prospective cohort analysis was performed on 81 adults (49 females, mean age 50.27 ± 12.93 years). Physical activity was quantified through anamnesis using metabolic equivalents (METs) according with Compendium of Physical Activities, and patients were stratified into four groups: G1 (METs < 1.5, n = 39), G2 (METs = 1.5–2.9, n = 2), G3 (METs = 3–5.9, n = 23), and G4 (METs ≥ 6, n = 17). Demographic and echocardiographic data were recorded to explore associations between physical activity and VAC. Results: The cfPWV/GLS ratio differed significantly across groups (p = 0.012), with the lowest values present in the moderate-intensity group (G3). VAC ≥ 0.391 can predict sedentary lifestyles (AUC = 0.730; CI: 0.617–0.833, p > 0.001). Multivariate analysis revealed that age, arterial age, and hypertension independently predict VAC. Conclusions: Higher physical activity is inversely associated with VAC (cfPWV/GLS ratio) and can predict sedentary lifestyles. Encouraging moderate-to-vigorous exercise in primary care may improve cardiovascular function and aid prevention.

Background The goal of the study was to evaluate a potential role for tumor necrosis factor alpha (TNF-α) genetic variability as biomarker in sepsis. In particular, we aimed to determine if single nucleotide polymorphisms (SNPs) of TNF-α gene are associated with sepsis in terms of risk, severity and outcome. Methods We performed a prospective study on 163 adult critically ill septic patients (septic shock 65, sepsis 98, further divided in 40 survivors and 123 deceased) and 232 healthy controls. Genotyping of TNF-α SNPs (-308G/A, -238G/A, -376G/A and +489G/A) was performed for all patients and controls and plasma cytokine levels were measured during the first 24 h after sepsis onset. Results TNF-α  +489G/A A-allele carriage was associated with significantly lower risk of developing sepsis and sepsis shock (AA+AG vs GG: OR = 0.53; p  = 0.004; 95% CI = 0.34–0.82 and OR = 0.39; p  = 0.003; 95% CI = 0.21–0.74, respectively) but not with sepsis-related outcomes. There was no significant association between any of the other TNF-α promoter SNPs, or their haplotype frequencies and sepsis or septic shock risk. Circulating TNF-α levels were higher in septic shock; they were not correlated with SNP genotype distribution; GG homozygosity for each polymorphism was correlated with higher TNF-α levels in septic shock. Conclusions TNF-α  +489G/A SNP A-allele carriage may confer protection against sepsis and septic shock development but apparently does not influence sepsis-related mortality. Promoter TNF-α SNPs did not affect transcription and were not associated with distinct sepsis, septic shock risk or outcomes.

In rural areas without centralized water supply systems, inhabitants often use groundwater of unknown quality as drinking water, without understanding the possible negative consequences on their health. Karstic spring waters from Dobrogea region in Romania were assessed for their potential to be used as drinking water source, according to their quality and seasonal variation. The physico-chemical parameters of waters were compared with the guideline values for drinking water established by the World Health Organization and the Directive 98/83/EC. The nitrate and Cr concentrations exceeded the guideline value in the springs from Southern Dobrogea, but met the quality criteria in those from Northern Dobrogea, thus, to be used as drinking water, the karstic springs located in Southern Dobrogea require treatment for nitrates removal. Heavy metals pollution indices showed low to medium cumulative heavy metal pollution in all springs, while the human health risk assessment by oral exposure indicated possible noncarcinogenic risks of nitrates, both for adults and children in springs from South Dobrogea. A rigorous monitoring of the water quality before human consumption is recommended for all four studied water sources.

In Eastern Europe, wind energy production is currently promoted as an important source of renewable energy, yet in most cases without appropriate consideration of the negative impacts wind turbines (WT) may have on protected species such as bats. Here, we present first data on fatality rates, fatality factors and the likely origin of bats killed by WT in the Dobrogea region (Romania), located in a major migratory corridor for wildlife in Eastern Europe. Over a 4-year period, we found a total of 166 bat carcasses from 10 species, mostly representing migratory species such as Pipistrellus nathusii and Nyctalus noctula. Most fatalities at WT occurred in July and August. We documented 15 cases of barotrauma and 34 cases of blunt-force trauma in carcasses found below WT. After adjusting for carcass removals and variations in searcher efficiency, we estimated for the 4-year study period a total of 2394 bat casualties at the studied WT facility consisting of 20 units, resulting in a mean fatality rate of 30 bats/WT/year, or 14.2 bats/MW/year. By implementing a curtailment measure at wind speeds below 6.5 m/s, we reduced fatality rates by 78%. Isoscape origin models based on hydrogen stable isotope ratios in fur keratin revealed that the majority of N. noctula that were killed by WT or captured nearby in mist nets originated from distant areas in the North (Ukraine, Belarus, Russia). The estimated high fatalitjegangy rates of bats at WT in this area have far-reaching consequences, particularly for populations of migratory bats, if no appropriate mitigation schemes are practised.

This paper explores the application of Transfer Entropy (TE) in deep neural networks as a tool to improve training efficiency and analyze causal information flow. TE is a measure of directed information transfer that captures nonlinear dependencies and temporal dynamics between system components. The study investigates the use of TE in optimizing learning in Convolutional Neural Networks and Graph Convolutional Neural Networks. We present case studies that demonstrate reduced training times and improved accuracy. In addition, we apply TE within the framework of the Information Bottleneck theory, providing an insight into the trade-off between compression and information preservation during the training of deep learning architectures. The results highlight TE’s potential for identifying causal features, improving explainability, and addressing challenges such as oversmoothing in Graph Convolutional Neural Networks. Although computational overhead and complexity pose challenges, the findings emphasize the role of TE in creating more efficient and interpretable neural models.

This paper presents a sentiment analysis solution on tweets using Recurrent Neural Networks (RNNs). The method is can classifying tweets with an 80.74% accuracy rate, considering a binary task, after experimenting with 20 different design approaches. The solution integrates an attention mechanism aiming to enhance the network, with a two-way localization system: at memory cell level and at network level. We present an in-depth literature review for Twitter sentiment analysis and the building blocks that grounded the design decisions of our solution, employed as a core classification component within a sentiment indicator of the SynergyCrowds platform.

Current neural networks architectures are many times harder to train because of the increasing size and complexity of the used datasets. Our objective is to design more efficient training algorithms utilizing causal relationships inferred from neural networks. The transfer entropy (TE) was initially introduced as an information transfer measure used to quantify the statistical coherence between events (time series). Later, it was related to causality, even if they are not the same. There are only few papers reporting applications of causality or TE in neural networks. Our contribution is an information-theoretical method for analyzing information transfer between the nodes of feedforward neural networks. The information transfer is measured by the TE of feedback neural connections. Intuitively, TE measures the relevance of a connection in the network and the feedback amplifies this connection. We introduce a backpropagation type training algorithm that uses TE feedback connections to improve its performance.