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The scientific paper proposes a pragmatic perspective of presenting some theoretical and practical aspects regarding a new approach within the studied organization, a process-based approach. The point of view submitted is a small part of the possibilities to implement the process-based approach. For an overview, I did a presentation of the organization in which I carry out my activity, the Sibiu County Directorate for the Registration of Persons, I showed the place and the role of the organization. Later, I explained the way, was organized and the activities that take place in the organization. An important aspect was the realization, in the organization, of personal analysis to make a new, process-based approach. Based on these processes we have made a current map of processes. A further direction of research is building a new process map following analysis to improve the processes within the studied public organization. Subsequently, we intend to execute the modeling of processes with a method that we will establish later.

Dental displacement, an obligatory state for a good result of an orthodontic treatment, is obtained by bone resorption and apposition, resulting from an inflammatory process localized at this level. Lymphocytes produce a large number of peptides with regulatory functions upon the organism in autocrine, paracrine or at high distance (endocrine) ways. These peptides were described as cytokines. Among these, interleukin 1β and interleukin 8 are the main proinflammatory cytokines, and they can be use as inflammation markers. In these conditions, the objective of this paper is the assessment of the IL β and IL-8 levels in the gingival crevicular fluid of the orthodontic tractioned teeth compared to the teeth upon which no orthodontic force is applied, before as well as after the device application. The patients taken into this study were 12 girls and 6 boys, between 7 and 12 years, average age of 9.3 years, who exhibited an orthodontic tooth movement of a single tooth (experimental tooth), the homonym tooth from the antagonistic arcade being considered as control. The gingival fluid was sampled before the beginning of the treatment, and after 1 hour, 24 hours and 7 days from the device application. The levels of IL-1β and IL-8 in the gingival crevicular fluid was assessed by ELISA technique. The level of the two pro-inflammatory interleukins in the gingival fluid of the tractioned teeth was significantly higher (p<0,01) at 24 hours from the device application compared with the control teeth; at 7 days from the beginning of the treatment, only the IL 8 level in the experimental teeth being significantly higher compared with the control teeth. These results demonstrate that the levels of IL-1β and IL-8 in the gingival fluid increase with the dental movement taking place, due to a localized inflammatory process, as a response to mechanical stress. [ABSTRACT FROM AUTHOR]

The use of orthodontic appliances in the treatment of the various dento-maxillar anomalies most frequently presume the application of high intensity forces, non-physiological, which always will produce an inflammatory response localised around the tooth or the teeth subjected to displacement. The presence of an inflammatory process at this level will produce an increased synthesis of free radicals, secondary followed by the oxidative stress. In order to asses the level of the oxidative stress, a series of its markers are used, including the reactive species of oxygen and nitrogen, and the oxidation products in particular, such as lipid peroxides and oxidized proteins respectively. Thus, the objective of the present study is to determine and compare the levels of some oxidative stress markers (malondialdehyde, ceruloplasmine, hydrogen donors) in saliva of patients with orthodontic appliances, before and after the initiation of the treatment. The patients included in this study were 7 girls and 4 boys, with the average age of 9.9 years, in which orthodontic biomechanical appliances were applied, in the purpose of treatment of some dento-maxillar anomalies. Saliva has been collected before the initiation of the orthodontic treatment, at 1 hour, at 24 hours, and at 7 days from from the orthodontic appliance application. The variations in the concentrations of the saliva markers of the oxidative stress reached a maximum at 24 hours from the debut of the treatment for ceruloplasmine and malondialdehyde, and at one hour for the hydrogen donors respectively, while at 7 days from the device application the concentrations were close to the initial values. The health condition at the level of the oral cavity in the patients taken into study did not change during the research. These results demonstrate that the utilization of an orthodontic appliance changes the levels of the saliva markers of oxidative stress, but these variations, even statistically significant, do not determine the appearance of certain pathological processes at the level of the oral cavity. [ABSTRACT FROM AUTHOR]

The paper illustrates the way in which the dimensional control can be optimized via PC. It's about the dimensional measuring command as process, due to the PC, and also about the obtaining processing results, aided by PC. This aspect was solved by the graphical programming for the interfacing with the user of the aided by PC process. The graphical programming ensures not only the entire necessary information about each dimensional control cycle, but also the statistical monitorising of the measuring precision. [ABSTRACT FROM AUTHOR]

In this paper it is presented one model of distance measuring to some using an ultrasonic sensor. The objects are made from materials with different texture and are displayed on some presets distances over the sensor. For the measurements it was use a DT020-1 ultrasonic sensor. The operational principle of an ultrasonic sensor is based on the generation of acoustic waves and their detection when reflected by an object. The measurements results are used to improve the mobile robots navigation.

This paper present a study regarding the emissions produced at the engine cold start. The main goal of this work is to describe the relative cold start extra emissions as a function of exhaust gas temperature. Experimental research has been done for two light vehicle, Dacia Sandero 1.4 liter SIE and Dacia Logan 1.5 liter CIE. There were been made several tests, in different temperature conditions, using a portable analyzer, GA-21 plus (produced by Madur Austria). The parameters measured with the analyzer and used in the analysis are: CO, NO, NO2 and SO2. It was concluded that the highest pollutants values are recorded until the point when the catalyst sistems comes into operation and exhaust gas temperature is 40-50ºC for SIE and 35-40ºC for CIE.

The ESKAPE group ( Enterococcus faecium , Staphylococcus aureus , Klebsiella Pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , Enterobacter spp.) is a group of bacteria very difficult to treat due to their high ability to acquire resistance to antibiotics and are the main cause of nosocomial infections worldwide, posing a threat to global public health. Nosocomial infections with MDR bacteria are found mainly in Intensive Care Units, due to the multitude of maneuvers and invasive medical devices used, the prolonged antibiotic treatments, the serious general condition of these critical patients, and the prolonged duration of hospitalization., Materials and Methods: During a period of one year, from January 2023 to December 2023, this cross-sectional study was conducted on patients diagnosed with sepsis admitted to the Intensive Care Unit of the Sibiu County Emergency Clinical Hospital. Samples taken were tracheal aspirate, catheter tip, pharyngeal exudate, wound secretion, urine culture, blood culture, and peritoneal fluid., Results: The most common bacteria isolated from patients admitted to our Intensive Care Unit was Klebsiella pneumoniae , followed by Acinetobacter baumanii and Pseudomonas aeruginosa . Gram-positive cocci ( Enterococcus faecium and Staphilococcus aureus ) were rarely isolated. Most of the bacteria isolated were MDR bacteria., Conclusions: The rise of antibiotic and antimicrobial resistance among strains in the nosocomial environment and especially in Intensive Care Units raises serious concerns about limited treatment options.

The worldwide increase of multidrug-resistant Gram-negative bacteria is a global threat. The emergence and global spread of Klebsiella pneumoniae carbapenemase- (KPC-) producing Klebsiella pneumoniae represent a particular concern. This pathogen has increased resistance and abilities to persist in human reservoirs, in hospital environments, on medical devices, and to generate biofilms. Mortality related to this microorganism is high among immunosuppressed oncological patients and those with multiple hospitalizations and an extended stay in intensive care. There is a severe threat posed by the ability of biofilms to grow and resist antibiotics. Various nanotechnology-based strategies have been studied and developed to prevent and combat serious health problems caused by biofilm infections. The aim of this review was to evaluate the implications of nanotechnology in eradicating biofilms with KPC-producing Klebsiella pneumoniae , one of the bacteria most frequently associated with nosocomial infections in intensive care units, including in our department, and to highlight studies presenting the potential applicability of TiO 2 nanocomposite materials in hospital practice. We also described the frequency of the presence of bacterial biofilms on medical surfaces, devices, and equipment. TiO 2 nanocomposite coatings are one of the best long-term options for antimicrobial efficacy due to their biocompatibility, stability, corrosion resistance, and low cost; they find their applicability in hospital practice due to their critical antimicrobial role for surfaces and orthopedic and dental implants. The International Agency for Research on Cancer has recently classified titanium dioxide nanoparticles (TiO 2 NPs) as possibly carcinogenic. Currently, there is an interest in the ecological, non-toxic synthesis of TiO 2 nanoparticles via biological methods. Biogenic, non-toxic nanoparticles have remarkable properties due to their biocompatibility, stability, and size. Few studies have mentioned the use of nanoparticle-coated surfaces as antibiofilm agents. A literature review was performed to identify publications related to KPC-producing Klebsiella pneumoniae biofilms and antimicrobial TiO 2 photocatalytic nanocomposite coatings. There are few reviews on the antibacterial and antibiofilm applications of TiO 2 photocatalytic nanocomposite coatings. TiO 2 nanoparticles demonstrated marked antibiofilm activity, but being nano in size, these nanoparticles can penetrate cell membranes and may initiate cellular toxicity and genotoxicity. Biogenic TiO 2 nanoparticles obtained via green, ecological technology have less applicability but are actively investigated.

Aim: Clostridium difficile infection is a cause of increased morbidity and mortality in hospitals, particularly in patients with cancer pathology. There are several factors favouring the development of Clostridium difficile infection among cancer patients, including age, exposure to antibiotic and proton pump inhibitors therapy, and chemotherapy. This study was conducted to observe the prevalence of Clostridium difficile infection after the reversal of ileostomy loop for rectal cancer surgery, which were initially operated either open or laparoscopic., Method: A retrospective study was performed on patients who were operated in a single surgical team for rectal cancer who benefited of a diverted loop ileostomy over a 4-year period. Results: 23 patients were documented with Clostridium difficile infection out of a total of 63. All 23 patients underwent ileostomy closure later than 3 months after primary surgery, and postoperatively received antibiotic therapy associated with proton pump inhibitors in the first 24 hours. Conclusions: Closure of ileostomy later than 3 months after primary surgery, combined with chemotherapy, antibiotic therapy and proton pump inhibitors, increases the risk of developing Clostridium difficile infection., (Celsius.)

Background: Teledermatology utilizes photoimaging and background information to allow dermatologists to remotely provide a diagnosis to practitioners. ConsultDerm is an asynchronous, web-based teledermatology software that allows practitioners to submit their electronic referrals for assessment by board-certified dermatologists., Objective: Our study aimed to retrospectively analyze teledermatology's utilization in Canada by using the teledermatology platform ConsultDerm., Methods: After implementing inclusion criteria, 1000 patients were selected, and relevant demographic and clinical information were extracted for data analysis. In addition, an online survey with pre-formulated questions was distributed to 7 dermatologists currently using the ConsultDerm platform to determine their experience in utilizing teledermatology., Results: Of the 1000 patients, 66.5% had not received treatment prior to their teledermatology referral, and on average, patients experienced symptoms for 489.5 days prior to their referral. Diagnoses made were categorized by conditions, most common being dermatitis (37.1%), followed by acneiform conditions (10.6%), benign lesions/neoplasms (12.1%), infections (9.4%), and dyspigmentation (3.1%). Most consults originated from small population centers, and the referring practitioners were predominantly family physicians. Dermatologists utilizing the platform expressed ease of use, however, areas of improvement were identified such as increasing the quality of imaging and more detailed patient history., Conclusion: Through our analysis of 1000 cases, we identified how a teledermatology consultation could be used to assess a wide variety of cutaneous conditions, improving access for patients who may face barriers to seeing a dermatologist.

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are adverse drug reactions., Objectives: To learn about the clinical characteristics of patients with SJS/TEN including treatments provided, outcomes, and mortality., Methods: We conducted a retrospective chart review of patients who were hospitalized with the diagnosis of SJS/TEN at the Ross Tilley Burn Center between the years 1999 and 2015., Results: A total of 43 patients were identified with a mean age of 54 ± 19 (58, 18-85). The most common offending medications were allopurinol and carbamazepine. The overall mortality rate in our study is 21% with the most common causes of death being multiorgan failure and sepsis. The majority of our patients had oral (84%), ocular (79%), and genital (60%) involvement during hospitalization. Our data revealed that combination treatment involving oral corticosteroids with intravenous immunoglobulin (IVIG) had the highest mortality rate in our study since 55% (6/11) of patients who were treated in this manner passed away compared to 11% (2/18) of patients passing away who were treated with solely IVIG and 33% (1/3) who were treated with only supportive care. Our study also demonstrates the addition of etanercept and cyclosporine treatment in the second time period we studied: 2008-2015 versus the earlier time period of 1999-2007. None of the patients in our study who were treated with therapies including cyclosporine and/or etanercept passed away., Conclusions: Our study sheds light on a possible beneficial role of cyclosporine and etanercept for the treatment of SJS and TEN and reinforces the necessity of a multidisciplinary care team for patients.

Gamma and theta oscillations have been functionally associated with cognitive processes, such as learning and memory. Synaptic conductances play an important role in the generation of intrinsic network rhythmicity, but few studies have examined the effects of voltage-gated ion channels (VGICs) on these rhythms. In this report, we have used a pyramidal-interneuron-gamma (PING) network consisting of excitatory pyramidal cells and two types of inhibitory interneurons. We have constructed a conductance-based neural network incorporating a persistent sodium current ( I NaP ), a delayed rectifier potassium current ( I KDR ), a inactivating potassium current ( I A ) and a hyperpolarization-activated current ( I H ). We have investigated the effects of several conductances on network theta and gamma frequency oscillations. Variation of all conductances of interest changed network rhythmicity. Theta power was altered by all conductances tested. Gamma rhythmogenesis was dependent on I A and I H . The I KDR currents in excitatory pyramidal cells as well as both types of inhibitory interneurons were essential for theta rhythmogenesis and altered gamma rhythm properties. Increasing I NaP suppressed both gamma and theta rhythms. Addition of noise did not alter these patterns. Our findings suggest that VGICs strongly affect brain network rhythms. Further investigations in vivo will be of great interest, including potential effects on neural function and cognition., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Olteanu, Habibollahi and French.)

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are potentially life-threatening, immune-mediated adverse reactions characterized by widespread erythema, epidermal necrosis, and detachment of skin and mucosa. Efforts to grow and develop functional international collaborations and a multidisciplinary interactive network focusing on SJS/TEN as an uncommon but high burden disease will be necessary to improve efforts in prevention, early diagnosis and improved acute and long-term management. SJS/TEN 2019: From Science to Translation was a 1.5-day scientific program held April 26-27, 2019, in Vancouver, Canada. The meeting successfully engaged clinicians, researchers, and patients and conducted many productive discussions on research and patient care needs., (Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.)

Background and Aims: The purpose of the study is to evaluate through a FEM (Finite Element Method) the effects of the rotation movement upon a complex structure (enamel- pulp -alveolar bone, PDL), for external load., Method: The progressive action of a fixed orthodontic device on three teeth: first molar, first and second premolar is modeled and simulated with the components placed on the buccal and palatal surfaces of the tooth. For the reproduction of a situation similar to the real one, the loading of the model was performed through a nodal force applied at a height of the crown, of various amplitudes, F = 1 N; 2, 3 and 4 N. The values of stress are: maximum stress of the whole structure and the shearing effect for the pulp., Results: The characteristics of the material are Young's E modulus and Poisson's ratio of the components of the modeled structure. The most stressed elements of the structure are the pulp and the ligament, revealed by von Mises stress. The elements of the structure are mainly stressed in fiber compression in the direction of the moment's action given by the orthodontic forces and in fiber stretching in the opposite direction. Out of the orthodontic movements: translation, tipping, intrusion-extrusion, rotation is the most dangerous., Conclusions: The accumulated stress effect in the pulp becomes dangerous. The orthodontic movements given by dental force values higher than 1.5-2N are to be avoided.

Introduction: Few studies have reported the physical complications among Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) survivors., Objective: The aim of this study was to comprehensively characterize the physical complications among SJS/TEN survivors and to learn about patients' perspectives of surviving SJS/TEN., Methods: SJS/TEN survivors older than 18 years of age were assessed by different methods: a medical interview; a questionnaire assessing patients' perspectives; thorough skin, oral mucous membrane, and ophthalmic examinations; and a retrospective assessment of medical records., Results: Our cohort consisted of 17 patients with a mean time of 51.6 ± 74.7 months (median 9, range 1-228) following SJS/TEN. The most common physical complications identified in the medical examination were post-inflammatory skin changes (77%), cutaneous scars (46%), dry eyes (44%), symblepharon, and chronic ocular surface inflammation (33% each). Novel physical sequelae included chronic fatigue (76%) and pruritus (53%). We also found a novel association between the number of mucous membranes affected in the acute phase of SJS/TEN and hair loss during the 6 months following hospital discharge; hair loss was reported in 88% of the group of patients who had three or more mucous membranes affected versus 29% of patients who had less than three mucous membranes involved (p = 0.0406). Following hospital discharge due to SJS/TEN, 59% of patients were followed by a dermatologist, although 88% had dermatological complications; 6% were followed by an ophthalmologist, even though 67% had ophthalmological complications; and 6% of female survivors were followed by a gynecologist, even though 27% had gynecological complications., Conclusion: Survivors of SJS/TEN suffer from severe physical complications impacting their health and lives that are mostly under recognized and not sufficiently treated by medical professionals.

Background: Enucleation (eye removal) is often the only curative treatment for the childhood eye cancer retinoblastoma, yet parental refusal of enucleation commonly contributes to treatment delay and poor survival globally., Methods: Physicians who treat retinoblastoma were surveyed to glean underlying reasons for treatment refusal., Results: Refusal rates were higher when less time was spent with parents explaining retinoblastoma/enucleation, and where fewer support services were available. Reasons for refusal included parental belief in alternative treatments, culture, and social stigma., Conclusions: We suggest strategies to increase parental compliance with enucleation and save the lives of children with retinoblastoma.

Objective: The purpose of this study is to highlight the high incidence of gallstones and the etiology in young people, as well as the fact that the onset is associated with complications: i.e. acute pancreatitis, jaundice., Material and Methods: This retrospective study was conducted between January 2007 and February 2012 on patients admitted to the two surgical wards of Pitesti District Hospital and was based on the analysis of observation charts and theatre records. A total of 1905 cholecystectomies were performed, 1023 laparoscopic and 882 classic, respectively., Results: A total of 36 patients aged between 16 and 25 years were included in the study. Laparoscopic cholecystectomy was performed in 34 patients, only two patients being operated by the classical open approach. 6 patients developed postoperative jaundice, which resolved under medical treatment in 3 patients within 3-5 days. The remaining 3 patients underwent endoscopic retrograde cholangiopancreatography (ERCP) 4-5 days postoperatively., Conclusions: The most important risk factors for gallstones are: age, female gender, pregnancy and obesity. Common complications of gallstones in young people are: duct stones and acute pancreatitis., (RevistaChirurgia.)

Objective: The purpose of the analysis accomplished is to identify how much pregnancy influences the occurrence of gravel at young women., Material and Method: This retrospective analysis was realized between January 2007 and April 2009 in the two surgery departments of Pitesti county Hospital and it was based on the analysis of the medical history and operational standards. During this period, there were operated 762 cholecystectomys, out of which, 348 through laparoscopics and 414 usual., Results: Out of 605 female patients, 10 patients were operated during the first 6 months after giving birth. The cholecystectomys at 10 patients were realized through laparoscopics. Two patients had postoperatoric icterus. Under medical treatment icterus was relegated in the 3 postoperator day. The second patient who had icterus, a retrograde endoscopy of common biliary duct was aplied in the 5 a postoperator day, Conclusions: During pregnancy period, profound functional gastro intestinal, gall bladder and pancreas changes occur. Following this changes, there can be formed gravel which can lead the characteristic symptomatology: gall bladder colic, icterus, fever, vomit.