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Given two $2n$--dimensional symplectic ellipsoids whose symplectic sizes satisfy certain inequalities, we show that a certain map from the $n$--torus to the space of symplectic embeddings from one ellipsoid to the other induces an injective map on singular homology with mod $2$ coefficients. The proof uses parametrized moduli spaces of $J$--holomorphic cylinders in completed symplectic cobordisms., 32 pages. Comments welcome!

Tuberous sclerosis complex (TSC) is a rare autosomal dominant neurocutaneous syndrome. It is manifested mainly in cutaneous lesions, epilepsy and the emergence of hamartomas in several tissues and organs. The disease sets in due to mutations in two tumor suppressor genes: TSC1 and TSC2. The authors present the case of a 33-year-old female patient registered with the Bihor County Regional Center of Medical Genetics (RCMG) since 2021 with a TSC diagnosis. She was diagnosed with epilepsy at eight months old. At 18 years old she was diagnosed with tuberous sclerosis and was referred to the neurology department. Since 2013 she has been registered with the department for diabetes and nutritional diseases with a type 2 diabetes mellitus (T2DM) diagnosis. The clinical examination revealed: growth delay, obesity, facial angiofibromas, sebaceous adenomas, depigmented macules, papillomatous tumorlets in the thorax (bilateral) and neck, periungual fibroma in both lower limbs, frequent convulsive seizures; on a biological level, high glycemia and glycated hemoglobin levels. Brain MRI displayed a distinctive TS aspect with five bilateral hamartomatous subependymal nodules associating cortical/subcortical tubers with the frontal, temporal and occipital distribution. Molecular diagnosis showed a pathogenic variant in the TSC1 gene, exon 13, c.1270A>T (p. Arg424*). Current treatment targets diabetes (Metformin, Gliclazide and the GLP-1 analog semaglutide) and epilepsy (Carbamazepine and Clonazepam). This case report presents a rare association between type 2 diabetes mellitus and Tuberous Sclerosis Complex. We suggest that the diabetes medication Metformin may have positive effects on both the progression of the tumor associated with TSC and the seizures specific to TSC and we assume that the association of TSC and T2DM in the presented cases is accidental, as there are no similar cases reported in the literature.

This paper attempts to demonstrate the need of implementing measurement solutions to surgical mechanical staplers. The object of the writing is to present a working electronic system that can be implemented in a circular surgical stapler and to bring solid conclusions after testing on animal tissue. The setup contains an Arduino-based system together with a required sensor, placed on an already existing surgical circular stapler. Measurements and results are described with the goal of defining the range of appropriate compression that can be exercised on the living tissue, without leading to side (negative) effects.

This project was designed to create a low-cost iontophoresis device that treats palm-plantar hyperhidrosis. The project includes the components of the device with the necessary description, the way it works, observations and indications, contraindications and side effects.

The paper proposes a design solution for a low cost device with feedback for upper extremity rehabilitation after a stroke event. Cerebral vascular accident (CVA) or stroke is one of the leading causes of morbidity and mortality worldwide. CVA is the most important cause of long-term disability in Europe, and demographic changes have led to an increase in both incidence and prevalence of this. Most secondary stroke disability is recovered in a few months, but others may persist for life. The rehabilitation should be started as soon as there is a greater chance of recovery in this early stage. Disabilities get worse and remain permanent over time, which is why is recommended the establishment of a rehabilitation program as soon as possible. Today, the use of virtual reality environments allow patients to perform tasks that mimic real life in rehabilitation clinics, but it tends increasingly more in the future these tasks can be done at home, sending data and receiving feedback from doctors. The devices presented in this paper are not only mechanical devices that allow the movement on a certain direction with predetermined effort degree for the patient, possibly controlled by the force of the muscle activity (EMG), but are innovative devices with the possibility to record a full set of biomedical signals. The patient device can record one or more biomedical parameters such as electrocardiography (ECG), heart rate (HR), electromyography (EMG), non-invasive blood pressure (NIBP), oxygen concentration in the blood (SpO2), movement speed and acceleration, angle of motion of a body extremity, torsion, s.a. according to the physician’s prescription and the patient needs. This means that the patient device will be very flexible and can communicate with other medical devices for home use

Spatial distribution analyses of fossil bones are often used in cave taphonomy for i) assessing directly the size of a given fossil population and ii) indirectly, for palaeo-environmental reconstructions. Urşilor Cave from northwestern Romania hosts one of the richest MIS 3 cave bear bone assemblages of Europe, and as the nature of the bone deposition was not settled yet, the study of the size of cave bear population and the distribution of the skeletal element was needed. More than 11,500 cave bear skeletal elements (NISPtotal = 11, 511), derived from 105 individuals (MNIcanines = 105) were extracted from the palaeontological excavation (ca. 9 m2) from the lower level of the cave and documented (photographed, mapped, and topographically measured). Almost 58% of all analyzed bones and teeth are concentrated in three quadrants of the excavation (C1, D1 and E2); the bones’ density decreases in the D4 and A1 quadrants. Based on the obtained results on the spatial distribution of the cave bear bones, we assume that the studied bone assemblage should be now regarded as a consequence of a cave trap (deposition in situ) while the hypothesis of fluvial transport (previously assumed) becomes questionable.

Constipaţia este un fenomen comun în practica pediatrică. Prevalenţa sa este în creştere, fiind prezentă, conform diferitelor statistici, la 0,7-29,6% dintre copii. Constipaţia este întâlnită la toate grupele de vârstă, cu severitate şi durată variabile, de la forme uşoare şi de scurtă durată la forme severe şi de lungă durată, cu impactare fecală şi in continenţă fecală. Acest articol revede aspectele epidemiologice, clinice şi terapeutice ale constipaţiei la copil, funcţionale în majoritatea cazurilor.

The paper proposes a solution for monitoring of cardiovascular parameters during home-based hand rehabilitation. The most important cause of long-term disability in Europe is cerebral vascular accident (CVA) or stroke. The effects of stroke can vanish after a short period or can remain for the rest of the life depending on therapeutic program. The system developed for this study is not only therapeutically devices that allow the movement of hand for physical exercises controlled by electromyography (EMG) but also record one or more biomedical parameters such as: electromyogram (EMG), electrocardiogram (ECG), pulse wave, heart rate (HR), temperature, respiration rate, non-invasive blood pressure (NIBP) or oxygen concentration in the blood (SpO2). These physiological parameters are selected according to the physician’s prescription and the patient needs. In this paper it is presented an application that refers to the hand rehabilitation of post-stroke. It was observed the cardiovascular system status, analyzing the heart rate variability. During therapeutic procedure it was recorded ECG (1 lead) and pulse wave (using an ear lobe sensor). After that HRV was calculated for each signal. The results were used to determine the stress level induced by the rehabilitation program.

Given two 4-dimensional ellipsoids whose symplectic sizes satisfy a specified inequality, we prove that a certain loop of symplectic embeddings between the two ellipsoids is noncontractible. The statement about symplectic ellipsoids is a particular case of a more general result. Given two convex toric domains whose first and second ECH capacities satisfy a specified inequality, we prove that a certain loop of symplectic embeddings between the two convex toric domains is noncontractible. We show how the constructed loops become contractible if the target domain becomes large enough. The proof involves studying certain moduli spaces of holomorphic cylinders in families of symplectic cobordisms arising from families of symplectic embeddings., Comment: 16 pages, 5 figures. Comments are welcome!

The authors provide a list of 213 caves and of the species of Oniscidea known to inhabit them, presenting their altitudinal distribution across major physical-geographic units of Romania.

Background and aims Multichannel intraluminal impedance (MII) is a pH-independent method of assessing gastroesophageal reflux. We aimed to evaluate the diagnostic accuracy of MII-pH as compared with conventional pH monitoring in detecting reflux events and symptom association. Materials and methods A retrospective study was performed. For patients suspected of GER, without anti-reflux treatment, examined through MII-pH and with normal pH-metry (differently defined according to age), the following were analysed: the number of weekly acid reflux (WAR) episodes, the number of weekly alkaline reflux (AlkR) episodes, the symptomatic correlation between reflux and symptom by analysing the probability of symptomatic association (SAP), the extension of reflux episodes within the level of proximal oesophagus recorded in percentage. Results 35 children (20 male, 15 female), age between 1 month and 11 years (22 infants), were recorded. The reasons for recommending pH-metry associated with electrical impedance were recurrent vomiting and growth failure in 22 cases, recurrent wheezing associated with chronic vomiting in 7 cases and recurrent wheezing or chronic cough in 6 cases. All patients showed in most cases an extension of the reflux episodes at a proximal oesophagus level. WAR was increased in the case of 23 children, 9 positive symptomatic correlation (4 with acid reflux) and 4 increased WAR as well as positive symptomatic correlation. AlkR episodes were absent in all children. The therapeutic recommendations were: hypoallergenic diet in 17 cases, prokinetic agents and/or alginates for 19 patients and histamine 2 receptor antagonists (H2RAs) or proton pump inhibitors (IPPs) in 8 cases. Conclusion The association of electrical impedance to pH-metry provides new criteria in establishing pathological GER diagnosis, and allows an accurate therapeutic approach in the case of these children.

The concept of a rare disease refers on its prevalence in general population, which is below the threshold of 1/2000. We will introduce the term of “rare hepatitis in children” for those having the same low prevalence in paediatric population. When the prevalence is under 1/10 000, we speak of an “ultrarare” hepatitis. Our aim is to realise a synthesis of rare hepatitis, with genetic and non-genetic origins, illustrating our clinical experience. Liver is suffering – primarily – in almost all inborn errors of metabolism: carbohydrates or fatty acid beta-oxidation disorders, hyper/dyslipoproteinemia, urea cycle disorders, hereditaries aminoacidopathies, disorders of biliary tract and bile acid synthesis, hemocromatosis, Wilson disease. Lysosomal strorage diseases is a chapter opening widely, with the progress of diagnosis tools: sphingolipidosis (e.g. Gaucher disease), glycogenosis (e.g. I, II), glycoproteinosis, mucolipidosis. Ultrarare hepatitis like peroxisomal or mitochondrial disorders are mentioned. Secondary liver involvement appears in genetic or non-genetic disorders: cystic fibrosis, alpha-1-antitrypsine deficiency, polycystic kidney disease (AR) and autoimmune diseases, respectively. We present clinical picture highlights for each entity, general or specific laboratory work-up, including the enzymatic assay and molecular diagnosis. Prognosis is mentioned in actual context, when DNA recombinant technology is developing, making possible the enzyme replacement or the biologic therapies. From our cohort of 380 cases, admitted in 9½ years (July 2006–January 2016), we have selected 85 non-infectious hepatitis: 33 were congenital hepatic fibrosis, 5 autoimmune hepatitis, 2 glycogenosis and 3 secondary liver involvement in cystic fibrosis. We present other 43 patients with cirrhosis, 9 secondary to biliary atresia, 7 primary biliary cirrhosis, 2 autoimmune and 2 in cystic fibrosis and 3 gangliosidosis. One child had propionic academia. We will refer especially to the rare causes, detailing 6 patients. Conclusion The etiopathogenic spectrum of child’s hepatitis is changing. Rare diseases, especially inborn errors of metabolism and autoimmune causes are more frequently found. Diagnosis is complex, comprising a specific genetic workup. Prognostic depends on the moment of diagnosis, the neurological involvement and the availability of specific treatment.

Background and aims The mechanism underlying symptoms in gastroesophageal reflux disease remain to be fully elucidated. Weakly acid reflux and the presence of gas in the refluxing could be relevant in the pathogenesis of symptoms. We aimed to evaluate the role of gas reflux in children evaluated with pH-metry associated with multichannel intraluminal impedance (MII-pH) and analyse there clinical and therapeutical implications. Methods We performed a retrospective study. We examined all our recording of patients referred for suspected gastroesophageal reflux disease evaluated with MII-pH and selected the registrations with pathological gas reflux. The limit value for pathological gas reflux was 72. Results Thirty two children (18 male) were selected for the study, according to protocol, aged between 4 months and 16 years (average age was 3 years and 5 months). Predisposing conditions for gaseous reflux were identified in 24 children: 20 children were diagnosed with alimentary allergies (17 non IgE mediated) and four children with small intestinal bacterial overgrowth detected by determining the level of expired hydrogen, after glucose ingestion. 11 patients were treated with proton pump inhibitors for acid RGE. Conclusions Combining impedance and pH monitoring improves the detection and characterisation of GER. The majority of children with gaseous reflux were allergic (62.5%), 6.25% of them suffered from constipation. For 31,25% we have not found predisposing conditions causes.

The present study proposes an artificial upper limb prosthesis simulation that combines elements of electric engineering (sensors, data acquisition / transfer, servo-motors) and virtual instruments programming technique (LabVIEW). Since we are in the process of working on a prototype of the prosthesis, the paper presents a model that enables the movement of a single phalanx, operated by a LabVIEW program. This program controls the servo-motor rotation, by using the data acquired by the Arduino board.

The EOG signal is based on the potential difference between the cornea and retina (also known as the corneo-retinal potential) and can be measured by using electrodes placed around the eyes. The amplitude of the EOG signal varies between 50 ... 3500 uV. The eye can be seen as a dipole with a positive pole in the retina and the negative one in the cornea. Thus, an electric potential field is created that is changing proportionally with the rotation of the eye. The movements can be assessed from a single eye, but because for a healthy human being the eye movements are coupled, in this paper the signal obtained from both eyes is used. Furthermore, this method allows assessing both vertical and horizontal signal simultaneously. One of the most complex algorithms used to detect steep slopes and peaks within medical signals is the Pan-Tompkins algorithm, but is especially used for ECG signals. This is the reason why the previous studies focused on the detection of the abrupt discontinuities in the EOG signal, from the wavelet transform perspective. In this manner, the points of discontinuity determined by the eye movement will generate high wavelet coefficients, regardless of scale. Starting from previous results regarding different technics used for eye movement investigation and electrooculogram signal (EOG), the paper presents a robust algorithm that is capable of performing real time eye movement detection. This algorithm was implemented in LabVIEW, based on virtual instruments and it was successfully tested in the laboratory of Biomedical Engineering from Technical University of Cluj-Napoca.

In the medical field, ample and diverse data related to clinical and logistical processes is produced. In order to facilitate access to this data and ensure secure storage of information, digitization is mandatory. Existing literature shows that integration with medical equipment increases productivity of beneficiaries, facilitates workflow and reduces the prevalence of medical errors arising from incomplete information.

The Ursilor Cave (NW Romania) is a famous cave bear paleontological site hosting an important Late Pleistocene faunal assemblage and subject to systematic excavation works. To better understand the origin of fossil assemblages, the sedimentary history of the cave must be reconstructed. We conducted a series of investigations on various cave deposits which included sedimentology and grain-size analyses, U-series dating of speleothems, OSL dating of sediments, and AMS radiocarbon dating of fossil remains. The results allowed for the identification of several major chronological controls for the evolution of the cave during the last 300,000 years. Five evolutionary stages or key-moments were dated, and a tentative speleogenetic scenario is presented. The combined numerical dates and sedimentological study show that the evolution of the cave was more complex than previously thought. In particular, the fossil accumulation was related to a succession of rapid flooding events at ∼47–40 ka. Alternating depositional and erosional phases have occurred since at least 210 ka complicating the sediment structures. The results suggest that the upper and lower levels of the cave may have been functioned occasionally as hydrologically separated karst systems and that the animal populations from what is now a single cave system may not necessarily be synchronous. This case study shows that reconstructing sedimentary history of a given cave is crucial for the correct understanding of its thanatocenosis.

The bacterial and fungal assemblages of clastic sediments collected from two caves located in north-western Romania were investigated by assessing ITS and 16S rRNA gene diversity. Bacterial members belonging to Chloroflexi, Nitrospirae, Proteobacteria, Firmicutes, Acidobacteria, Gemmatimonadetes, and fungal members of Ascomycota were identified. Except for Bacillus sp., all bacteria were related to uncultured or unknown species and the majority (86%) of the bacterial sequences from one of the caves had no close GenBank relatives. The bacterial sequences obtained clustered with species found in extreme environments. Half of the bacterial operational taxonomic units were clustered with clones isolated from deep subsurface sediments of a radioactively contaminated site in the USA. The present study represents the first attempt to identify microorganisms in Quaternary cave sediments. Supplemental materials are available for this article. Go to the publisher's online edition of Geomicrobiology Journal to view ...

Aim To evaluate whether coeliac disease (CD) can be diagnosed by measuring autoantibodies without small-intestinal mucosal biopsies in children with type 1 diabetes. Methods Case finding of CD was undertaken in 181 consecutive IgA-competent children with type 1 diabetes using transglutaminase 2 (TG2) and endomysial IgA antibody (EMA) tests in serum and the rapid point of care test in fingertip whole-blood sample. Endoscopy with intestinal biopsies was recommended for patients with high TG2-IgA titres (>96 U) and in children with lower positive tests if either the EMA test or the rapid point of care test was additionally positive. The duodenal mucosal biopsies were graded according to the Marsh classification. Results The TG2-IgA test had a 15.5% and the EMA test a 6.0% seropositivity. All seven biopsied high-titre TG2-IgA-positive children were symptom free and found to have CD (Marsh 3 type lesion). These patients were also positive for EMA and in the rapid point of care test. Lower titre TG2-IgA-positive children had histological Marsh 1 to 3a lesions. Conclusions None of the type 1 diabetes children with high TG2-IgA titres would have needed endoscopy with duodenal biopsies to reach a CD diagnosis. Lower TG2-IgA-positive patients need to be biopsied.

The paper presents ZPM dynamic control of walking robots, developing an open architecture real time control multiprocessor system, in view of obtaining new capabilities for walking robots. The complexity of the movement mechanism of a walking robot was taken into account, being a repetitive tilting process with numerous instable movements and which can lead to its turnover on an uneven terrain. The control system architecture for the dynamic robot walking is presented in correlation with the control strategy which contains three main real time control loops: balance robot control using sensorial feedback, walking diagram control with periodic changes depending on the sensorial information during each walk cycle, predictable movement control based on a quick decision from the previous experimental data. The results obtained through simulation and experiments show an increase in mobility, stability in real conditions and obtaining of high performances related to the possibility of moving walking robots on terrains with a configuration as close as possible to real situations, respectively developing new technological capabilities of the walking robot control systems for slope movement and walking by overtaking or going around obstacles.

The Mehedinţi Plateau represents an area highly marked by the intensity of the karst processes and by the diversity of the exokarst and endokarst features. The analyzed area includes two parallel limestone bars, developed on the Carpathian structures direction (NNE-SSW). The geological and geomorphological research, guided by a working protocol similar to that of the EPIK method, highlighted the role played by the lithology, structure, tectonics, epikarst and protective cover, related to the infiltration conditions, flow parameters and impact area of a potential contamination event; also, we carried on microtectonic studies on the Bulba Valley, Peşterii Hill, Podul Natural Cave and Bulba Cave. In addition to the results obtained following the EPIK method protocol, we bring forward data concerning the water quality, performing hydrogeochemical analyses on water samples collected from the main sources in the region. Our research has been focused on TDS, on cations (Ca2+, Mg2+, Na+, K+, NH4+) and on anions (HCO3-, Cl-). We conclude by modelling the cumulative abundance and the species richness of the harvestmen (Opiliones) in the studied area, under different degrees of human impact on habitats

The karst geosystems functioning frequently implies very quick mass and energy transfers, which make them highly sensitive to any natural or anthropogenic disturbance. Therefore, the groundwater resources, threatened by agricultural and industrial pollution, should be carefully exploited, taking into account the intrinsic vulnerability of the region. This paper aims to present the results of the geological, geomorphological and hydrogeochemical studies carried out in the Banat Mountains (Romania), in order to widely assess and map the vulnerability of the most exposed karst aquifers. Following the principles of the EPIK method and using GIS, we were able to delineate upon degree 4 vulnerability classes (low, moderate, high, very high). Moreover, each unit has been assigned to a specific protection framework, comprising suitable management solutions, designed for environmental managers.

A photovoltaic (PV) system, based on a Maximum Power Point Tracking (MPPT) controller that extracts the maximum possible output power from the solar panel is described. Output efficiency of a PV energy system can be achieved only if the system working point is brought near the maximum power point (MPP). The proposed system, making use of several MPPT control algorithms (Perturb and Observe, Incremental conductance, Fuzzy Logic), demonstrates in simulations as well as in real experiments good tracking of the optimal working point.

A major socio-economic and scientific issue is represented by karst hydrostructures vulnerability mapping, which qualitatively and quantitatively highlights their exposure degree. Two research trends have been developed, one taking into account the environment features exclusively – the aquifer and protective cover type, permeability, aquifer depth, recharge rate, etc. (intrinsic vulnerability), the other focused on the types and quantities of pollutants (specific vulnerability). MAGIERA (2000) described and compared 69 methods, grouped in 5 types: hydrogeological complex and setting methods, index models and analogical relations (AF, AVI, Ekv, ΔhT’), parametric system models (DRASTIC, DWSAP, SINTACS, EPPNA, GOD, EPIK, REKS, PI, GSI, GLA), mathematical models (VULK, FAVA) and statistical methods (CALVUL). However, it is also possible to classify the methods on the basis of other criteria, such as scale (local, regional, national), aim (land use planning, protection zoning, site assessment) and target (source or resource vulnerability).

Our paper presents a survay of Oniscidea and the Diplopoda from the Retezat Massif in Romania. The first records in Romania of the species Porcellium productum and Porcellium recurvatum have been presented. .

Within the SALEIE project LLP Programme 527877-LLP-1-2012-“Strategic Alignment of Electrical and Information Engineering in European Higher Education Institutions”, work package 4 is concerned with Widening Participation & Student Support. As an integral part of this work package, consideration is to be given to how students with disabilities can be supported throughout their studies within the electrical and information engineering (EIE) disciplines. An important result of this project will be the on-line Student Support Centre, which is planned to include a technical resource area on undergraduate student projects in the field of designing and using assistive technologies. The purpose of this paper is to present several examples of projects at undergraduate level, undertaken in the area of assistive technologies by students from the Technical University of Cluj-Napoca, Romania.

Unexpected faults occurring in certain conditions on renewable energy sources connected to the power grid may result in severe damages, if capacitive load exists and consequently inductive power factor correction is applied with shunt coils. The paper presents some investigations on a case study.

Telemedicine is used on a large scale for monitoring the state of a patient and permits the real-time contact between the doctor and the patient. The software applications and the TCP/IP protocols, combined with the data acquisition techniques, allow the doctors and engineers to cooperate towards reliable medical equipment and solutions.

The paper aims to emphasize the possibilities offered by Virtual Instrumentation (LabVIEW) in the field of biomedical engineering. Thus, it proposes a low cost and flexible wireless transmission (between two equipments) and ECG signals processing architecture. Since during acquisition the signal may be corrupted by noise, in the first stage of the application the signal is filtered by implementing a designed mean averaged filter, followed by a Butterworth filter. The second stage of the application is represented by the infrared transmission of the signal between two infrared “in range” compatible devices. Finally, for an accurate R-peak detection, the Pan-Tomkins algorithm was implemented.

This paper introduces a structured light based imaging architecture able to serve for the development of an affordable guided fracture reduction system. The 3D models of the bones in the healthy limb are used for the preoperative alignment of the proximal and distal segments of the fractured bone using algorithm for automated registration. A structured light setup performs the reconstruction of 3D information needed for the intraoperative guidance in order to support the fracture reduction in accord with the preoperative alignment.

Non-contact methods for the assessment of vital signs are of great interest for specialists due to the benefits obtained in both medical and special applications, such as those for surveillance, monitoring, and search and rescue. This paper investigates the possibility of implementing a digital processing algorithm based on the MUSIC (Multiple Signal Classification) parametric spectral estimation in order to reduce the observation time needed to accurately measure the heart rate. It demonstrates that, by proper dimensioning the signal subspace, the MUSIC algorithm can be optimized in order to accurately assess the heart rate during an 8–28 s time interval. The validation of the processing algorithm performance was achieved by minimizing the mean error of the heart rate after performing simultaneous comparative measurements on several subjects. In order to calculate the error the reference value of heart rate was measured using a classic measurement system through direct contact.

In this paper we present new results regarding the periodicity of outer billiards in the hyperbolic plane around polygonal tables which are tiles in regular two-piece tilings of the hyperbolic plane., Comment: 15 pages, 7 figures. The paper is presenting results obtained during the REU program Summer@ICERM Brown University 2013