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Background/Objectives: Moral hazard represents a significant challenge in healthcare systems globally, reflecting the tendency of insured individuals to over-utilize medical services when shielded from the full costs of care. Methods: This paper investigates the dynamics and implications of moral hazard within the Romanian public hospital sector, offering practical recommendations for healthcare policymakers to mitigate the financial risks associated with excessive healthcare utilization and ensure long-term sustainability. To achieve the objectives of this study, a quantitative research approach utilizing vignettes was employed. Vignettes allow for the simulation of real-world decision-making under conditions of insurance coverage, capturing nuanced behaviors that traditional surveys may overlook. Results: The study examined patient behaviors in the context of moral hazard in public hospitals in Romania, employing a quantitative approach based on vignettes. A total of 303 valid responses were collected. The findings indicate a significant tendency among insured patients, both publicly and privately insured, to opt for more expensive treatments compared to uninsured patients, who preferred more affordable options such as medication or physiotherapy. In the case of treatments for severe conditions, insured patients frequently chose combinations of higher-cost therapies, while uninsured individuals either delayed treatment or opted for less expensive alternatives. These results highlight the impact of moral hazard, driven by a reduced sensitivity to costs in the presence of insurance, and underscore the need for cost-sharing policies to mitigate the overutilization of medical resources. Conclusions: This paper uniquely contributes to the understanding of moral hazard by integrating insights from both Romanian public hospitals and international case studies, offering practical policy recommendations for mitigating the financial risks associated with excessive healthcare utilization. [ABSTRACT FROM AUTHOR]

Background/Objectives: Our study investigates the primary characteristics of managerial decision-making processes in the public hospital units in Romania, particularly in the Northeast region. This research aims to delineate the decision-making model applied by managers in these units, considering the multitude of legislative, economic, technical, ethical, and organizational changes prompted by the pandemic. Methods: A mixed-method research approach was utilized, combining semi-structured interviews and autoethnography, to capture experiences, attitudes, perceptions, motivations, and ethical considerations of decision-makers within the healthcare system. Results: The findings revealed that managerial decisions in public hospitals were influenced by unique elements such as the vulnerability and support needs of patients, the absence of a clear hierarchy, the personalized nature of healthcare services, the complexity of care processes, and the use of advanced technology. External factors, notably political and economic influences, alongside internal ethical dilemmas, significantly impacted decision making. Conclusions: This study identifies the reliance on evidence-based decision making and a consultative managerial style as key to addressing these challenges. This research contributes theoretically by comparing decision-making models and practically by identifying a decision-making model that includes forms, techniques, and tools that could guide managers in decision making in Romanian public hospitals. [ABSTRACT FROM AUTHOR]

(1) Background: Asthma is a syndrome found in both adults and children, characterized by airflow obstruction caused by the inflammation of the airways. In recent years, an increasing number of studies have found that lipid metabolism influences both the development and symptomatology of asthma. Lipid metabolism plays an important role both in the occurrence of exacerbations and in the reduction of lung inflammation. Our study aimed to identify any type of association between patients diagnosed with asthma and their serum lipids, including HDL-cholesterol, LDL-cholesterol, total cholesterol, and triglycerides in adults. (2) Methods: To find articles for our review, we searched two platforms: PubMed and Google Scholar. A total of 309 articles from two platforms were analyzed. Finally, 12 papers were selected from the initial pool of identified articles. (3) Results: The positive correlation between triglycerides, total cholesterol, low-density lipoprotein-cholesterol (LDL-cholesterol), and asthma has been demonstrated in several studies. Moreover, it appears that there is an association between biomarkers of type 2 inflammation and HDL and serum triglycerides in people with atopic status. Regarding the nutrition of asthmatic patients, the greatest impact on the development of the disease seems to be the consumption of fruit and vegetables. Several studies show that a predominantly vegan diet is associated with better control of the disease and a decrease in the number of pro-inflammatory cytokines. (4) Conclusions: Studies show a positive correlation between total cholesterol, triglyceride, and LDL-cholesterol levels and asthma and a negative correlation between HDL-cholesterol and asthma. Increased cholesterol values would lead to the stimulation of pro-inflammatory processes and the secretion of cytokines involved in these processes. The most successful diets for asthma patients seem to be those in which the consumption of fruit, vegetables, and high-fiber foods is increased because all of these food groups are rich in vitamins, antioxidants, and minerals. [ABSTRACT FROM AUTHOR]

The coexistence of psychiatric disorders and cardiovascular diseases represents a complex clinical challenge, often necessitating the concurrent use of medications from both therapeutic categories. While these medications are essential for managing their respective pathologies, their combined use can lead to interactions that may affect treatment outcomes and patient safety. Understanding the interactions between psychotropic drugs and those used in cardiovascular diseases is crucial for healthcare professionals to optimize therapeutic regimens and minimize potential adverse effects. This article aims to explore the various types of interactions between psychotropic and cardiovascular medications, analyze their underlying mechanisms, evaluate the clinical implications, and propose strategies to reduce risks and optimize treatment outcomes. By understanding these interactions, healthcare professionals can enhance clinical decision-making and provide safer and more effective pharmacotherapy for patients with complex medical needs. [ABSTRACT FROM AUTHOR]

Background and Objectives: Assessment of the prothrombotic, proinflammatory, and functional status of a cohort of COVID-19 patients at least two years after the acute infection to identify parameters with potential therapeutic and prognostic value. Materials and Methods: We conducted a retrospective, descriptive study that included 117 consecutive patients admitted to Iasi Pulmonary Rehabilitation Clinic for reassessment and a rehabilitation program at least two years after a COVID-19 infection. The cohort was divided into two groups based on the presence (n = 49) or absence (n = 68) of pulmonary fibrosis, documented through high-resolution computer tomography. Results: The cohort comprises 117 patients, 69.23% females, with a mean age of 65.74 ± 10.19 years and abnormal body mass index (31.42 ± 5.71 kg/m2). Patients with pulmonary fibrosis have significantly higher levels of C-reactive protein (CRP) (p < 0.05), WBC (7.45 ± 7.86/mm3 vs. 9.18 ± 17.24/mm3, p = 0.053), neutrophils (4.68 ± 7.88/mm3 vs. 9.07 ± 17.44/mm3, p < 0.05), mean platelet volume (MPV) (7.22 ± 0.93 vs. 10.25 ± 0.86 fL, p < 0.05), lactate dehydrogenase (p < 0.05), and D-dimers (p < 0.05), but not ferritin (p = 0.470), reflecting the chronic proinflammatory and prothrombotic status. Additionally, patients with associated pulmonary fibrosis had a higher mean heart rate (p < 0.05) and corrected QT interval (p < 0.05). D-dimers were strongly and negatively correlated with diffusion capacity corrected for hemoglobin (DLCO corr), and ROC analysis showed that the persistence of high D-dimers values is a predictor for low DLCO values (ROC analysis: area under the curve of 0.772, p < 0.001). The results of pulmonary function tests (spirometry, body plethysmography) and the 6-minute walk test demonstrated no significant difference between groups, without notable impairment within either group. Conclusions: Patients with COVID-19-related pulmonary fibrosis have a persistent long-term proinflammatory, prothrombotic status, despite the functional recovery. The persistence of elevated D-dimer levels could emerge as a predictive factor associated with impaired DLCO. [ABSTRACT FROM AUTHOR]

(1) Background: There has been a growing interest in understanding the causes of obesity and developing effective prevention strategies. Lifestyle change programs are often considered the gold standard for weight reduction, and they can help individuals with obesity achieve an annual weight loss of around 8–10%. The aim of this review was to evaluate the effect of food during the winter holidays. This knowledge will serve as a valuable foundation for the development of targeted interventions and prevention programs. (2) Methods: We conducted a systematic search of the literature via one database (PubMed). The search was limited to studies published in English in the last 10 years, with adult participants, but without specifying limits regarding the study design. We excluded articles that addressed intermittent fasting diets or weight loss intervention methods during the holidays through various diets. (3) In separate sections, we analyzed the psychological causes of gaining weight during the winter holidays, behavioral patterns, prevention strategies and the nutritional composition of the different types of food served during the festive period. Results: Using the combination of the terms "holiday and obesity", "holiday and weight gain", "festive season and obesity", and "festive season and weight gain" we obtained 216 results involving the addressed topic. Thus, only ten articles remained after screening, with a total of 4627 participants. Most participants experienced weight fluctuations during the study period, particularly during holidays. One concerning observation was that most of the weight gained during these periods was maintained even after the end of the studies, especially in those with obesity. A supervised exercise program and a controlled diet at work over the Christmas period are effective strategies for avoiding weight gain and its deleterious effects in people with metabolic syndrome or weight problems. (4) In addition, attention must be focused on the psycho-social factors during the holidays because for some people it is a stressful period and can cause a much higher caloric consumption. The simplest method to approach during the holidays is to implement small tips and tricks during this period that will prevent individuals from gaining extra pounds. Conclusions: It is essential to acknowledge that obesity is a multifaceted condition that requires a comprehensive and multidisciplinary approach to address its underlying factors and provide ongoing assistance to individuals in their weight-management endeavors. Even the most effective short-term interventions are likely to produce continued positive outcomes with persistent intervention and support. [ABSTRACT FROM AUTHOR]

The development of proper computer-aided methods for analyzing bio-signal data, such as ECG, can greatly support decision making and information sharing among health care professionals and organizations. Semantic Web provides a common framework for data structuring, sharing and reusing across applications and platforms. In this paper, we present the use of Ontology Web Language (OWL) and Semantic Web Rule Language (SWRL) for data representation and discovery of ECG data. The use of ontology can support data interoperability across heterogeneous applications, while the use of SWRL can support the discovery of data that may not be explicitly expressed. The paper also presents the use of the knowledge existing in the domain for ontology enrichment, evaluation and investigative information gathering [ABSTRACT FROM AUTHOR]

Background and Objectives : Assessment of the prothrombotic, proinflammatory, and functional status of a cohort of COVID-19 patients at least two years after the acute infection to identify parameters with potential therapeutic and prognostic value. Materials and Methods : We conducted a retrospective, descriptive study that included 117 consecutive patients admitted to Iasi Pulmonary Rehabilitation Clinic for reassessment and a rehabilitation program at least two years after a COVID-19 infection. The cohort was divided into two groups based on the presence ( n = 49) or absence ( n = 68) of pulmonary fibrosis, documented through high-resolution computer tomography. Results : The cohort comprises 117 patients, 69.23% females, with a mean age of 65.74 ± 10.19 years and abnormal body mass index (31.42 ± 5.71 kg/m 2 ). Patients with pulmonary fibrosis have significantly higher levels of C-reactive protein (CRP) ( p < 0.05), WBC (7.45 ± 7.86/mm 3 vs. 9.18 ± 17.24/mm 3 , p = 0.053), neutrophils (4.68 ± 7.88/mm 3 vs. 9.07 ± 17.44/mm 3 , p < 0.05), mean platelet volume (MPV) (7.22 ± 0.93 vs. 10.25 ± 0.86 fL, p < 0.05), lactate dehydrogenase ( p < 0.05), and D-dimers ( p < 0.05), but not ferritin ( p = 0.470), reflecting the chronic proinflammatory and prothrombotic status. Additionally, patients with associated pulmonary fibrosis had a higher mean heart rate ( p < 0.05) and corrected QT interval ( p < 0.05). D-dimers were strongly and negatively correlated with diffusion capacity corrected for hemoglobin (DLCO corr), and ROC analysis showed that the persistence of high D-dimers values is a predictor for low DLCO values (ROC analysis: area under the curve of 0.772, p < 0.001). The results of pulmonary function tests (spirometry, body plethysmography) and the 6-minute walk test demonstrated no significant difference between groups, without notable impairment within either group. Conclusions: Patients with COVID-19-related pulmonary fibrosis have a persistent long-term proinflammatory, prothrombotic status, despite the functional recovery. The persistence of elevated D-dimer levels could emerge as a predictive factor associated with impaired DLCO.