Hospital visitors as controls in case-control studies

OBJECTIVE: Selecting controls is one of the most difficult tasks in the design of case-control studies. Hospital controls may be inadequate and random controls drawn from the base population may be unavailable. The aim was to assess the use of hospital visitors as controls in a case-control study on the association of organochlorinated compounds and other risk factors for breast cancer conducted in the main hospital of the "Instituto Nacional de Câncer" -- INCA (National Cancer Institute) in Rio de Janeiro (Brazil). METHODS: The study included 177 incident cases and 377 controls recruited among female visitors. Three different models of control group composition were compared: Model 1, with all selected visitors; Model 2, excluding women visiting relatives with breast cancer; and Model 3, excluding all women visiting relatives with any type of cancer. Odds ratios (OR) and 95% confidence intervals were calculated to test the associations. RESULTS: Age-adjusted OR for breast cancer associated with risk factors other than family history of cancer, except smoking and breast size, were similar in the three models. Regarding family history of all cancers, except for breast cancer, there was a decreased risk in Models 1 and 2, while in Model 3 there was an increased risk, but not statistically significant. Family history of breast cancer was a risk factor in Models 2 and 3, but no association was found in Model 1. In multivariate analysis a significant risk of breast cancer was found when there was a family history of breast cancer in Models 2 and 3 but not in Model 1. CONCLUSIONS: These results indicate that while investigating risk factors unrelated to family history of cancer, the use of hospital visitors as controls may be a valid and feasible alternative.

Reorganização do controlo postural em indivíduos com AVE. Intervenção em fisioterapia

Objectivos: Identificar as alterações no controlo postural do tronco e repercussões na independência funcional de indivíduos com acidente vascular encefálico (AVE), bem como averiguar se ocorreram mudanças a esse nível após a intervenção, baseada na abordagem segundo o Conceito de Bobath. Metodologia: Foram seleccionados para este estudo dois indivíduos com alterações no controlo postural, resultantes de um AVE, em fase aguda. A avaliação foi realizada em dois momentos (M0 e M1), antes e após quatro semanas da realização da intervenção através da análise do movimento, da aplicação da Escala de Avaliação Postural para Pacientes com Sequelas de AVE (PASS), da Escala de Equilíbrio de Berg (EEB), da Escala Modificada de Barthel (BEM), do Teste Timed Up & Go (TUG) e da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Resultados: Os scores obtidos em M1 nos vários instrumentos aplicados, bem como a análise de movimento traduzem a evolução favorável no controlo postural do tronco e na independência nas actividades da vida diária (AVD), observada em ambos os casos clínicos. Verificou-se uma evolução mais evidente na EMB e EEB onde o indivíduo A evoluiu na EMB de 51 em M0 para 94 pontos em M1e o indivíduo B de 51 para 89 pontos. Na EEB o indivíduo A progrediu de 22 para 41 pontos e o indivíduo B de 10 para 36 pontos. Conclusão: Os participantes em estudo evidenciaram modificações no controlo postural com repercussões positivas na independência funcional, após a intervenção com base numa abordagem segundo o conceito de Bobath.

Casos clínicos e evidência em cuidados intensivos pediátricos

O relatório final do Mestrado em Fisioterapia Cárdio-Respiratória aqui apresentado tem como principal objectivo a revisão e discussão da mais recente evidência em Fisioterapia Cárdio-Respiratória aplicada aos cuidados intensivos pediátricos, relacionada com alguns casos clínicos observados no decorrer do estágio. Os casos clínicos foram seleccionados de acordo com o seu enquadramento no tema do projecto de estágio. Será apresentada uma breve revisão bibliográfica relacionada com a ventilação mecânica em geral, sendo depois diferenciada em modalidade invasiva e não invasiva, com as implicações inerentes a cada uma. Foram descritos os protocolos de desmame mais comuns na realidade destas unidades e, finalmente, o papel da ventilação não invasiva neste processo, de três formas distintas: na extubação precoce, na extubação electiva, e no resgate após falha na extubação. Será ainda apresentado um caso que reflecte uma estratégia específica de intervenção em fisioterapia como alternativa eficaz na alta hospitalar precoce. Finalmente será discutido o papel e a importância do Fisioterapeuta nas unidades de cuidados intensivos como parte integrante da equipa, tendo em conta a realidade vivida durante o estágio e recomendações científicas actuais.

A new control strategy with saturation effect compensation for an autonomous induction generator drivenby wide speed range turbines

This paper presents a variable speed autonomous squirrel cage generator excited by a current-controlled voltage source inverter to be used in stand-alone micro-hydro power plants. The paper proposes a system control strategy aiming to properly excite the machine as well as to achieve the load voltage control. A feed-forward control sets the appropriate generator flux by taking into account the actual speed and the desired load voltage. A load voltage control loop is used to adjust the generated active power in order to sustain the load voltage at a reference value. The control system is based on a rotor flux oriented vector control technique which takes into account the machine saturation effect. The proposed control strategy and the adopted system models were validated both by numerical simulation and by experimental results obtained from a laboratory prototype. Results covering the prototype start-up, as well as its steady-state and dynamical behavior are presented. (C) 2011 Elsevier Ltd. All rights reserved.

Comparative study of power converter topologies and control strategies for the harmonic performance of variable-speed wind turbine generator systems

Power converters play a vital role in the integration of wind power into the electrical grid. Variable-speed wind turbine generator systems have a considerable interest of application for grid connection at constant frequency. In this paper, comprehensive simulation studies are carried out with three power converter topologies: matrix, two-level and multilevel. A fractional-order control strategy is studied for the variable-speed operation of wind turbine generator systems. The studies are in order to compare power converter topologies and control strategies. The studies reveal that the multilevel converter and the proposed fractional-order control strategy enable an improvement in the power quality, in comparison with the other power converters using a classical integer-order control strategy. (C) 2010 Elsevier Ltd. All rights reserved.

Fast optimum-predictive control and capacitor voltage balancing strategy for bipolar back-to-back NPC converters in high-voltage direct current transmission systems

Multilevel power converters have been introduced as the solution for high-power high-voltage switching applications where they have well-known advantages. Recently, full back-to-back connected multilevel neutral point diode clamped converters (NPC converter) have been used inhigh-voltage direct current (HVDC) transmission systems. Bipolar-connected back-to-back NPC converters have advantages in long-distance HVDCtransmission systems over the full back-to-back connection, but greater difficulty to balance the dc capacitor voltage divider on both sending and receiving end NPC converters. This study shows that power flow control and dc capacitor voltage balancing are feasible using fast optimum-predictive-based controllers in HVDC systems using bipolar back-to-back-connected five-level NPC multilevel converters. For both converter sides, the control strategytakes in account active and reactive power, which establishes ac grid currents in both ends, and guarantees the balancing of dc bus capacitor voltages inboth NPC converters. Additionally, the semiconductor switching frequency is minimised to reduce switching losses. The performance and robustness of the new fast predictive control strategy, and its capability to solve the DC capacitor voltage balancing problem of bipolar-connected back-to-back NPCconverters are evaluated.

HVDC transmission systems: Bipolar back-to-back diode clamped multilevel converter with fastoptimum-predictive control and capacitor balancing strategy

Voltage source multilevel power converter structures are being considered for high power high voltage applications where they have well known advantages. Recently, full back-to-back connected multilevel neutral diode clamped converters (NPC) have been used in high voltage direct current (HVDC) transmission systems. Bipolar back-to-back connection of NPCs have advantages in long distance HVDC transmission systems, but highly increased difficulties to balance the dc capacitor voltage dividers on both sending and receiving end NPCs. This paper proposes a fast optimum-predictive controller to balance the dc capacitor voltages and to control the power flow in a long distance HVDCsystem using bipolar back-to-back connected NPCs. For both converter sides, the control strategy considers active and reactive power to establish ac grid currents on sending and receiving ends, while guaranteeing the balancing of both NPC dc bus capacitor voltages. Furthermore, the fast predictivecontroller minimizes the semiconductor switching frequency to reduce global switching losses. The performance and robustness of the new fast predictive control strategy and the associated dc capacitors voltage balancing are evaluated. (C) 2011 Elsevier B.V. All rights reserved.

Crioterapia como tratamento de entorses de tornozelos de atletas: revisão sistemática

A crioterapia é prática comum na medicina esportiva, pela praticidade, facilidade de acesso e baixo custo, possuindo vantajoso uso na Saúde Pública. No entanto, os efeitos analgésicos do gelo tem pouca base objetiva e sistematizada em termos de técnicas, duração e frequência. O objetivo deste estudo foi sintetizar através da revisão sistemática (RS) as evidências relativas à efetividade da crioterapia para o tratamento das entorses de tornozelo de atletas. A RS é um método de pesquisa observacional e retrospectivo, pelo qual se tratam artigos, preferencialmente Ensaios Clínicos Aleatórios – ECA, como sujeitos da investigação, com rigorosos critérios de inclusão e exclusão e, quando possível, realiza-se uma macro estatística dos resultados – metaanálise. No presente RS, foram consultados cinco bancos de dados - Medline, Embase, Cochrane, Lilacs e PEDro para buscar ECA sobre crioterapia com os desfechos dor, edema, rigidez e função. Resultados: 289 estudos foram identificados inicialmente, dos quais nove com tratamentos isolados ou associados à crioterapia, porém apenas um preencheu aos critérios de inclusão, cujo N era 121 atletas, dos quais 64 receberam a crioterapia (funcional) e 57 no grupo controle (imobilização). Maior probabilidade para o evento dor foi observada no grupo controle, após 3 e 12 meses. A RS revelou uma lacuna em ECA dentro do tema, mas não encontrou efeito adverso na prática da crioterapia, sendo um princípio analgésico importante, sobretudo em lesões de tecidos moles.

Matrix Converter-Based Unified Power-Flow Controllers: Advanced Direct Power Control Method

This paper presents a direct power control (DPC) for three-phase matrix converters operating as unified power flow controllers (UPFCs). Matrix converters (MCs) allow the direct ac/ac power conversion without dc energy storage links; therefore, the MC-based UPFC (MC-UPFC) has reduced volume and cost, reduced capacitor power losses, together with higher reliability. Theoretical principles of direct power control (DPC) based on sliding mode control techniques are established for an MC-UPFC dynamic model including the input filter. As a result, line active and reactive power, together with ac supply reactive power, can be directly controlled by selecting an appropriate matrix converter switching state guaranteeing good steady-state and dynamic responses. Experimental results of DPC controllers for MC-UPFC show decoupled active and reactive power control, zero steady-state tracking error, and fast response times. Compared to an MC-UPFC using active and reactive power linear controllers based on a modified Venturini high-frequency PWM modulator, the experimental results of the advanced DPC-MC guarantee faster responses without overshoot and no steady-state error, presenting no cross-coupling in dynamic and steady-state responses.

Intelligent supervisory control system for home devices using a cyber physical approach

Although we have many electric devices at home, there are just few systems to evaluate, monitor and control them. Sometimes users go out and leave their electric devices turned on what can cause energy wasting and dangerous situations. Therefore most of the users may want to know the using states of their electrical appliances through their mobile devices in a pervasive way. In this paper, we propose an Intelligent Supervisory Control System to evaluate, monitor and control the use of electric devices in home, from outside. Because of the transferring data to evaluate, monitor and control user's location and state of home (ex. nobody at home) may be opened to attacks leading to dangerous situations. In our model we include a location privacy module and encryption module to provide security to user location and data. Intelligent Supervising Control System gives to the user the ability to manage electricity loads by means of a multi-agent system involving evaluation, monitoring, control and energy resource agents.

Transient analysis of variable-speed wind turbines at wind speed disturbances and a pitch control malfunction

As wind power generation undergoes rapid growth, new technical challenges emerge: dynamic stability and power quality. The influence of wind speed disturbances and a pitch control malfunction on the quality of the energy injected into the electric grid is studied for variable-speed wind turbines with different power-electronic converter topologies. Additionally, a new control strategy is proposed for the variable-speed operation of wind turbines with permanent magnet synchronous generators. The performance of disturbance attenuation and system robustness is ascertained. Simulation results are presented and conclusions are duly drawn. (C) 2010 Elsevier Ltd. All rights reserved.

Wind turbines equipped with fractional-order controllers: Stress on the mechanical drive train due to a converter control malfunction

This paper is on variable-speed wind turbines with permanent magnet synchronous generator (PMSG). Three different drive train mass models and three different topologies for the power-electronic converters are considered. The three different topologies considered are respectively a matrix, a two-level and a multilevel converter. A novel control strategy, based on fractional-order controllers, is proposed for the wind turbines. Simulation results are presented to illustrate the behaviour of the wind turbines during a converter control malfunction, considering the fractional-order controllers. Finally, conclusions are duly drawn. Copyright (C) 2010 John Wiley & Sons, Ltd.

Adaptable control for electrical generation at irregural wind speeds

The main aims of this work are the development and the validation of one generic algorithm to provide the optimal control of small power wind generators. That means up to 40 kW and blades with fixed pitch angle. This algorithm allows the development of controllers to fetch the wind generators at the desired operational point in variable operating conditions. The problems posed by the variable wind intensity are solved using the proposed algorithm. This is done with no explicit measure of the wind velocity, and so no special equipment or anemometer is required to compute or measure the wind velocity.

Genetic algorithm methodology applied to intelligent house control

In recent years the use of several new resources in power systems, such as distributed generation, demand response and more recently electric vehicles, has significantly increased. Power systems aim at lowering operational costs, requiring an adequate energy resources management. In this context, load consumption management plays an important role, being necessary to use optimization strategies to adjust the consumption to the supply profile. These optimization strategies can be integrated in demand response programs. The control of the energy consumption of an intelligent house has the objective of optimizing the load consumption. This paper presents a genetic algorithm approach to manage the consumption of a residential house making use of a SCADA system developed by the authors. Consumption management is done reducing or curtailing loads to keep the power consumption in, or below, a specified energy consumption limit. This limit is determined according to the consumer strategy and taking into account the renewable based micro generation, energy price, supplier solicitations, and consumers’ preferences. The proposed approach is compared with a mixed integer non-linear approach.