21 resultados para State Medicine


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Cerebral vascular disease is the primary cause of permanent disability in Portugal. Impaired stability is considered an important feature after stroke as it is related with higher risk of falls and functional dependence. Physiotherapy intervention usually starts early after stroke in order to direct motor recovery and help patients to improve their ability to perform activities of daily living (ADL). Purpose: to investigate the relationship of balance to functionality in acute stroke patients. Methods: 16 subjects (8 women and 8 men), mean age 63,62 ± 2,16y, with unilateral ischemic stroke in the middle cerebral artery territory, who were admitted to physiotherapy department of Fernando Fonseca Hospital in Portugal, within the first month after stroke were recruited to participate in this study. All subjects have no cognitive impairment according to Mini Mental State, no history of lower extremity orthopedic problems and no other disease that could interfere with treatments. All patients gave their inform consent to participate in this study. Subjects were assessed with the Modified Barthel Index (MBI) and the Berg Balance Scale (BBS).

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A new circuit topology is proposed to replace the actual pulse transformer and thyratron based resonant modulator that supplies the 60 kV target potential for the ion acceleration of the On-Line Isotope Mass Separator accelerator, the stability of which is critical for the mass resolution downstream separator, at the European Organization for Nuclear Research. The improved modulator uses two solid-state switches working together, each one based on the Marx generator concept, operating as series and parallel switches, reducing the stress on the series stacked semiconductors, and also as auxiliary pulse generator in order to fulfill the target requirements. Preliminary results of a 10 kV prototype, using 1200 V insulated gate bipolar transistors and capacitors in the solid-state Marx circuits, ten stages each, with an electrical equivalent circuit of the target, are presented, demonstrating both the improved voltage stability and pulse flexibility potential wanted for this new modulator.

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A newly developed solid-state repetitive high-voltage (HV) pulse modulator topology created from the mature concept of the d.c. voltage multiplier (VM) is described. The proposed circuit is based in a voltage multiplier type circuit, where a number of d.c. capacitors share a common connection with different voltage rating in each one. Hence, besides the standard VM rectifier and coupling diodes, two solid-state on/off switches are used, in each stage, to switch from the typical charging VM mode to a pulse mode with the d.c. capacitors connected in series with the load. Due to the on/off semiconductor configuration, in half-bridge structures, the maximum voltage blocked by each one is the d.c. capacitor voltage in each stage. A 2 kV prototype is described and the results are compared with PSPICE simulations.

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Mestrado em Radiações Aplicadas às Tecnologias da Saúde. Área de especialização: Protecção contra Radiações

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This paper addresses the voltage droop compensation associated with long pulses generated by solid-stated based high-voltage Marx topologies. In particular a novel design scheme for voltage droop compensation in solid-state based bipolar Marx generators, using low-cost circuitry design and control, is described. The compensation consists of adding one auxiliary PWM stage to the existing Marx stages, without changing the modularity and topology of the circuit, which controls the output voltage and a LC filter that smoothes the voltage droop in both the positive and negative output pulses. Simulation results are presented for 5 stages Marx circuit using 1 kV per stage, with 1 kHz repetition rate and 10% duty cycle.

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The purpose of this paper is to present and discuss a general HV topology of the solid-state Marx modulator, for unipolar or bipolar generation connected with a step-up transformer to increase the output voltage applied to a resistive load. Due to the use of an output transformer, discussion about the reset of the transformer is made to guarantee zero average voltage applied to the primary. It is also discussed the transformer magnetizing energy recovering back to the energy storage capacitors. Simulation results for a circuit that generates 100 kV pulses using 1000 V semiconductors are presented and discussed regarding the voltage and current stress on the semiconductors and result obtained.

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This paper presents an algorithm to efficiently generate the state-space of systems specified using the IOPT Petri-net modeling formalism. IOPT nets are a non-autonomous Petri-net class, based on Place-Transition nets with an extended set of features designed to allow the rapid prototyping and synthesis of system controllers through an existing hardware-software co-design framework. To obtain coherent and deterministic operation, IOPT nets use a maximal-step execution semantics where, in a single execution step, all enabled transitions will fire simultaneously. This fact increases the resulting state-space complexity and can cause an arc "explosion" effect. Real-world applications, with several million states, will reach a higher order of magnitude number of arcs, leading to the need for high performance state-space generator algorithms. The proposed algorithm applies a compilation approach to read a PNML file containing one IOPT model and automatically generate an optimized C program to calculate the corresponding state-space.

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The stability of the color flavor locked phase in the presence of a strong magnetic field is investigated within the phenomenological MIT bag model, taking into account the variation of the strange quark mass, the baryon density, the magnetic field, as well as the bag and gap parameters. It is found that the minimum value of the energy per baryon in a color flavor locked state at vanishing pressure is lower than the corresponding one for unpaired magnetized strange quark matter and, as the magnetic field increases, the energy per baryon decreases. This implies that magnetized colorflavor locked matter is more stable and could become the ground state inside neutron stars. The mass-radius relation for such stars is also studied.

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Sub-nanosecond bipolar high voltage pulses are a very important tool for food processing, medical treatment, waste water and exhaust gas processing. A Hybrid Modulator for sub-microsecond bipolar pulse generation, comprising an unipolar solid-state Marx generator connected to a load through a stack Blumlein system that produces bipolar pulses and further multiplies the pulse voltage amplitude, is presented. Experimental results from an assembled prototype show the generation of 1000 V amplitude bipolar pulses with 100 ns of pulse width and 1 kHz repetition rate.

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Nos últimos dez a quinze anos temos assistido a um aumento do número de iniciativas com a participação da sociedade civil, no sentido de exercer pressão para a reformulação dos direitos sociais. Estes já não são tão vistos como direitos para aceder aos serviços estruturados e administrados pelo Estado (de acordo com o conceito de cidadania de Marshall), mas como uma reivindicação dos cidadãos para terem um papel ativo na definição das políticas públicas e dos serviços. Este debate tem sido muito intenso entre os cientistas sociais desde a década de 1980 e está bastante presente no sistema de cuidados de saúde. Vários estudos têm salientado a forte tensão entre o tecnicismo da medicina e a organização burocrática do sistema de saúde, por um lado, e o modelo de comunicação quotidiana, por outro lado. De facto, um dos temas centrais das reformas dos cuidados de saúde nos últimos 20 anos centrou-se na valorização da experiência e da perspetiva dos cidadãos. O artigo começa com um breve esboço das novas abordagens sociológicas em torno da relação entre os sistemas sociais e o mundo real – nas dimensões micro e macro; estrutura e ação. Assim, apresenta-se o estado da arte atual sobre a participação nos sistemas de saúde ocidentais, resultante da revisão da literatura, destacando as novas estratégias de envolvimento dos doentes bem como as questões relativas às críticas e às limitações. Para terminar, procede-se a uma reflexão acerca da complexidade da relação entre o sistema de cuidados de saúde e as associações de doentes e utentes.

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Introduction - European nuclear medicine technologist’s education is delivered by Higher Education Institutions and students obtain a grade of Bachelor of Sciences (BSc), during which they are initiated to research during their studies. Once BSc nuclear medicine technologists are in professional practice, they have very few opportunities to develop a real research experience and they rather become passive users than active contributors the growth of scientific knowledge in nuclear medicine. Aim - To describe and discuss an innovative educational and professional experience aimed in strengthen research knowledge, skills and competencies of former nuclear medicine technologists student in the context of an international mobility stay.

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Purpose - The education and training of a nuclear medicine technologist (NMT) is not homogeneous among European countries, which leads to different scope of practices and, therefore, different technical skills are assigned. The goal of this research was to characterize the education and training of NMT in Europe. Materials and methods - This study was based on a literature research to characterize the education and training of NMT and support the historical evolution of this profession. It was divided into two different phases: the first phase included analysis of scientific articles and the second phase included research of curricula that allow health professionals to work as NMT in Europe. Results - The majority of the countries [N=31 (89%)] offer the NMT curriculum integrated into the high education system and only in four (11%) countries the education is provided by professional schools. The duration in each education system is not equal, varying in professional schools (2-3 years) and high education level system (2-4 years), which means that different European Credit Transfer and Accumulation System, such as 240, 230, 222, 210 or 180 European Credit Transfer and Accumulation System, are attributed to the graduates. The professional title and scope of the practice of NMT are different in different countries in Europe. In most countries of Europe, nuclear medicine training is not specific and curriculum does not demonstrate the Nuclear Medicine competencies performed in clinical practice. Conclusion - The heterogeneity in education and training for NMT is an issue prevalent among European countries. For NMT professional development, there is a huge need to formalize and unify educational and training programmes in Europe.

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This paper proposes a multifunctional architecture to implement field-programmable gate array (FPGA) controllers for power converters and presents a prototype for a pulsed power generator based on a solid-state Marx topology. The massively parallel nature of reconfigurable hardware platforms provides very high processing power and fast response times allowing the implementation of many subsystems in the same device. The prototype includes the controller, a failure detection system, an interface with a safety/emergency subsystem, a graphical user interface, and a virtual oscilloscope to visualize the generated pulse waveforms, using a single FPGA. The proposed architecture employs a modular design that can be easily adapted to other power converter topologies.

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This paper describes a modular solid-state switching cell derived from the Marx generator concept to be used in topologies for generating multilevel unipolar and bipolar high-voltage (HV) pulses into resistive loads. The switching modular cell comprises two ON/OFF semiconductors, a diode, and a capacitor. This cell can be stacked, being the capacitors charged in series and their voltages balanced in parallel. To balance each capacitor voltage without needing any parameter measurement, a vector decision diode algorithm is used in each cell to drive the two switches. Simulation and experimental results, for generating multilevel unipolar and bipolar HV pulses into resistive loads are presented.

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A mathematical model that simulates the operation of a solid-state bipolar Marx modulator topology, including the influence of parasitic capacitances is presented and discussed as a tool to analyze the circuit behavior and to assist the design engineer to select the semiconductor components and to enhance the operating performance. Simulations show good agreement with experimental results, considering a four stage circuit assembled with 1200 V isolated gate bipolar transistors and diodes, operating at 1000 V dc input voltage and 1-kHz frequency, giving 4 kV and 10-mu s output pulses into several resistive loads. Results show that parasitic capacitances between Marx cells to ground can significantly load the solid-state switches, adding new operating circuit conditions.