Smart Cutting Tools Used in the Processing of Aluminum Alloys.

The processing of aluminum alloys in optimal conditions is a problem that has not yet been fully resolved. The research carried out so far has proposed various intelligent tools, but which cannot be used in the presence of cooling-lubricating fluids. The objective of the research carried out in the paper was to design intelligent tools that would allow a control of the vibrations of the tool tip and to determine a better roughness of the processed surfaces. The designed intelligent tools can be used successfully in the processing of aluminum alloys, not being sensitive to coolants-lubricants. In the research, the processing by longitudinal turning of a semi-finished product with a diameter Ø = 55 mm of aluminum alloy A2024-T3510 was considered. Two constructive variants of smart tools were designed, realized, and used, and the obtained results were compared with those registered for the tools in the classic constructive variant. The analysis of vibrations that occur during the cutting process was performed using the following methods: Fast Fourier Transform (FFT); Short-Time Fourier-Transformation (STFT); the analysis of signal of vibrations. A vibration analysis was also performed by modeling using the Finite Element Method (FEM). In the last part of the research, an analysis of the roughness of the processed surfaces, was carried out and a series of diagrams were drawn regarding curved profiles; filtered profiles; Abbott-Firestone curve. Research has shown that the use of smart tools in the proposed construction variants is a solution that can be used in very good conditions for processing aluminum alloys, in the presence of cooling-lubrication fluids.

Mainstem Bronchial Diameters and Dimensions in Infants and Children: A Systematic Review of the Literature.

Anatomic measurements of the right (RMB) and left mainstem bronchi (LMB) in infants and children have been accomplished using various modalities. The objective of the present review was to determine whether enough data were available to provide standardized lower airway dimensions in the pediatric population. For the present study, 12 studies with data of the lower pediatric airway dimensions of 1,611 children published from 1923-2020 were reviewed and analyzed. The eligible criteria included studies measuring lower airway dimensions in the pediatric population. Various techniques were used for airway measurement, with computed tomography studies being most abundant. There was a progressive increase in the size of RMB and LMB with age, with a close approximation of the LMB-to-RMB ratio across all studies. In children younger than 1 year old, the RMB and LMB diameters were between 4 and 5 mm and 3 and 5 mm, respectively. Overall, there was significant variation in the methods and modality used to obtain measurements, and therefore it was difficult to establish standardized lower airway dimensions in the pediatric population. Additional homogeneous data with standardized measurement techniques and modalities across different pediatric age groups are needed to define these dimensions further. Such data may be helpful in designing airway equipment, lung isolation devices, and airway stents.

Particularities and Efficacy of Extracorporeal Shock Wave Lithotripsy in Children.

BACKGROUND: Extracorporeal shock wave lithotripsy (ESWL) was first introduced in paediatric population in 1986. Given the more frequent recurrence in children, compared to adults, urinary stones treatments should require minimal invasive treatment methods. In this study, we aimed to evaluate the profile of the young patient with lithiasis who can benefit from ESWL, analysing the experience of 2 clinical departments. MATERIALS AND METHODS: We have retrospectively reviewed the medical records of 54 children who underwent ESWL for urolithiasis. ESWL success rate was defined as stone-free status or the presence of clinically insignificant residual fragments. Data were analysed using the STATA 14.2. RESULTS: In our study, the incidence of renal-ureteral calculi is significantly higher in girls (68.5%), compared to boys (31.5%). In total, 83.3% of patients showed a favourable outcome after treatment and the remaining 16.7% showed minimal complications. The presence of complications and remaining calculi was correlated to children age. The overall stone free rate was 88.9%. For calculus of 8.5 mm, only one ESWL session is recommended. CONCLUSIONS: The high percentage of cases with favourable outcome indicate that ESWL treatment is effective, considering the minimal cost, minimal invasiveness, repeatability and no need for general anaesthesia.

[Coping mechanisms of mentally disabled patients in need of dental treatment]. / Mecanisme de coping ale pacientilor cu disabilitati psihice implicate în nevoia de tratament stomatologic.

UNLABELLED: The concept of the study appeared as a necessity of a better understanding the patients with mental disabilities, exposed to the need of professional dental treatment. AIM: The study's purpose consists in the investigation of mechanisms by which the patients with mental disabilities react while exposed to the action of a stress agent, represented in the study by the necessity of following a dental treatment. MATERIALS: The lot consisted in 52 patients with mental disabilities from the University Hospital of Psychiatry "Socola"-Iasi, who needed prosthetic restaurative treatment which implies the use of syringe with needle, extraction and endodonthic tools, dental turbine. METHOD: The evaluation was made on the basis of: the coping COPE questionnaire. The procedure consists in registering 14 scales for the measurement of so many forms of coping which can have a preponderantly active state or a passive one. RESULTS: From the statistical point of view, the only significant differences were found depending on the sex of patients in the case of coping C14 study method (using alcohol or medicines). The highest score was obtained for coping C7 (positive reinterpretation). CONCLUSIONS: Due to the analysis of parameters' values of coping in the studied lot, we can conclude that the patients with mental disabilities, in the need of dental treatment, preponderantly react by active mechanisms of coping, focused on the issue, in disfavour of passive ones.

Postoperative pain control for primary cleft lip repair in infants: is there an advantage in performing peripheral nerve blocks?

BACKGROUND: Primary cleft lip repair is performed in infants under 1 year of age. The efficacy of an infraorbital nerve block vs intravenous fentanyl was compared in our prospective, randomized controlled trial. METHODS: Forty-six infants scheduled for primary cleft lip repair were prospectively randomized to one of two groups: group F that received 2 mcg x kg(-1) of fentanyl intravenously and an infraorbital nerve block with 0.5 ml on each side of preservative-free normal saline, and, group B that received bilateral infraorbital nerve blocks with 0.5 ml on each side of 0.25% bupivacaine and 2 ml of preservative-free saline solution intravenously after induction of anesthesia but prior to surgical incision. Patients were observed by a blinded observer for (i) pain scores using neonatal infant pain score; (ii) need for rescue medication in the anesthesia care unit (PACU), in the short stay unit (SSU) and at home and (iii) feeding parameters including difficulty in feeding, time to first feeding and volume of feeds in the PACU, SSU and at home. RESULTS: There were no significant differences in pain scores between the two groups over time (P = 0.98); there were no differences between groups in the number of rescue medications in the PACU, in the SSU as well as at home; however, the time to first rescue medication was greater in the block group compared with the fentanyl group (P = 0.07). There were no significant differences in feeding volumes between groups in the PACU (P = 0.46), SSU (P = 0.57) and at home (P = 0.15). There were no differences in time to initiate feeding between the two groups (P = 0.81). However, there was difficulty with feeding in the block groups compared with the fentanyl group (P = 0.01). CONCLUSIONS: The infraorbital nerve block can be effectively used for pain control in infants undergoing primary cleft lip repair. Although children undergoing a nerve block experienced minor difficulties in feeding, there were no differences in feeding volumes or other feeding parameters. This study has shed light into postoperative outcomes besides pain control on children undergoing cleft lip repairs.

Anatomical location of the bifurcation of the sciatic nerve in the posterior thigh in infants and children: a formula derived from MRI imaging for nerve localization.

BACKGROUND AND OBJECTIVES: Sciatic nerve block is performed at the popliteal fossa for various surgical procedures in infants and children. The aim of this study is to review magnetic resonance imaging scans in children of various ages to assess the location of the division of the nerve in the posterior thigh. METHODS: After Institutional Review Board approval was obtained, measurements of the bifurcation of the sciatic nerve in the posterior thigh were recorded from magnetic resonance images that were previously obtained in children of various ages. Data were recorded in a database and parametric and nonparametric statistical analysis was performed. RESULTS: Measurements were recorded from 59 patient images. Using a linear regression model, we were able to arrive at a formula for determining the point of bifurcation of the sciatic nerve at the posterior thigh. The mathematical formula derived from the linear regression equation was: CONCLUSIONS: We speculate that this knowledge will assist practitioners who use nerve stimulation techniques for sciatic nerve blocks in children of all ages.