En médecine, le diagnostic est la démarche par laquelle le médecin, généraliste ou spécialiste vadéterminer l’affection dont souffre le patient, et qui va permettre de proposer un traitement. Il reposesur la recherche des causes (pathologie) et des effets (symptômes) de l’affection. Un diagnosticmédical efficace doit aujourd’hui int égrer des analyses multidisciplinaires tant au niveau des donnéesque des experts: et compte tenu de la r épartition géographique (par exemple de la désertificationm´ edicale), il peut être compliqué de réunir au même endroit les experts.L’ évolution des technologies de communication, en particulier Internet, a ouvert de nouvelles possibilités dans le domaine des applications collaboratives à distance et tout particulièrement celuidu t élé-diagnostic médical : par exemple un panel d’experts distants se réunit virtuellement parl’intermédiaire d’une salle d’examen virtuelle qui favorisera la collaboration afin de coproduire undiagnostic. Mais dans le domaine de la médecine, l’aspect médico-l égal est crucial, et il a freinéledéveloppement de ces pratiques à distances.Dans ce contexte, nous avons développé une plateforme appelée COOVADIS (COllabOrative VAscularDIagnoSis) qui permet la traçabilité dans de telles applications en s’appuyant sur trois ontologiesoriginales (ontologie de la pathologie, ontologie du diagnostic et ontologie de traçabilité). Cette plateformed’aide `a la collaboration entre professionnels de santé à été implémentée en mode SaaS(Software as a Service) sous la forme d’un serveur Web, et validé d’un point de vue théorique et clinique. / In medicine, physicians (general practitioner or specialist) realize a diagnosis to determine patients’disease and propose an adapted treatment. This diagnosis is based on research of causes (pathologies)and effects (symptoms) of affection. Today, to realize an effective medical diagnosis, it isimportant to realize a multidisciplinary analysis at a data level. But it is also important to make worktogether experts from different domains. A problem can happen if these experts do not work in thesame place. Thus, how is it possible to ease the way to collaborate together?With evolutions of communication technologies and more particularly Internet, it is easier to developremote collaborative applications. One of the fields covered by theses applications is telemedicineand telediagnosis. Thus, a remote panel of experts can meet together virtually through a virtual roomto ease diagnosis collaboration and co-production. Despite everything, forensic aspects slowed downdevelopment of remote practices due to privacy and personal information sharing.In this context, we developed a platform called COOVADIS (COllabOrative VAscular DIagnoSis) thatenables traceability in such applications based on three original ontologies (pathologies ontology,diagnosis ontology and traceability ontology). This framework was implemented in SaaS (Softwareas a Service) as a web server, to support the collaborative work between health professionals. It wasalso validated from a theoretical and clinical point of view.

We present the theory of selfdistributive quasigroups and the construction of non-affine selfdistributive quasigroup of size 216 that was presented by Onoi in 1970 and which was the least known example of such structure of size 2k . Based on this construction, we introduce the notion of Onoi structures and Onoi mappings between them which generalizes Onoi's construction and which allows us to construct non-affine selfdistributive quasigroups of size 22k for k ≥ 3. We present and implement algorithm for finding central extensions of self- distributive quasigroups which enables us to classify non-affine selfdistributive quasigroups of size 2k and prove that those quasigroup exists exactly for k ≥ 6, k ̸= 7. We use this algorithm also in order to better understand the structure of non-affine selfdistributive quasigroups of size 26 . 1

Os efeitos dos canabinoides em algumas áreas encefálicas que expressam receptores endocanabinoides, como é o caso dos núcleos hipotalâmicos, não são ainda muito bem definidos. Vários estudos têm demonstrado o papel de alguns núcleos hipotalâmicos na organização das reações induzidas pelo medo inato e pelo pânico. As respostas de defesa induzidas pelo medo instintivo caracterizam-se por serem mais elaboradas e dirigidas para algum abrigo ou rota de fuga. O estado de pânico pode ser provocado experimentalmente em animais de laboratório através da diminuição da atividade do sistema GABAérgico. O objetivo deste trabalho foi estudar os padrões comportamentais de fuga elaborada induzidos pelo bloqueio de receptores GABAérgicos do tipo A, com microinjeções intra-hipotalâmicas de bicuculina (BIC), especificamente na divisão dorso-medial do hipotálamo ventro-medial (VMHDM), assim como estabelecer o envolvimento endocanabinoides e o papel do receptor canabinoide do tipo 1 (CB1) na modulação das respostas defensivas organizadas pelo hipotálamo medial. Os resultados mostraram que a administração prévia de doses intermediárias (5pmol) de anandamida (AEA) atenuaram as respostas defensivas induzidas pela microinjeção intra-VMHDM de bicuculina (40ng), efeito este prevenido pelo pré-tratamento intra-hipotalâmica com antagonista de receptores CB1. Os resultados indicam que a AEA pode modular os efeitos pró-aversivos da bicuculina no VMHDM por meio do recrutamento de receptores CB1. / The effects of cannabinoids in some brain areas that express endocannabinoid receptors, such as some hypothalamic nuclei, are not yet well known. Several studies have demonstrated a role of hypothalamic nuclei in the organisation of behavioural responses induced by innate fear and panic attacks. The defensive responses induced by instinctive fear are more elaborated and oriented toward a burrow or alternative route of escape. Panic-prone states are able to be experimentally induced in laboratory animals decreasing the GABAergic system activity. The aim of this work was to study panic-like elaborated defensive behaviour evoked by GABAA receptor blockade with bicuculline (BIC) in the dorsomedial division of the ventromedial hypothalamus (VMHDM), we also aimed to establish the involvement of endocannabinoids and the role of CB1 cannabinoid receptor in the modulation of elaborated defense behavioural responses organised by medial hypothalamus. The results showed that intra-hypothalamic administration of anandamide (AEA) at the intermediate dose (5pmol) attenuated defensive responses induced by intra-VMHDM microinjection of bicuculline (40ng). This effect, however, was prevented by the pre-treatment of VMHDM with the CB1 receptor antagonist AM251. These results indicate that AEA can modulate the pro-aversive effects of bicuculline into the VMHDM, recruiting CB1 receptors.

A administração sistêmica de canabidiol (CBD), o principal constituinte não psicomimético da Cannabis sativa, induz efeito antidepressivo em modelos préclínicos. O mecanismo de ação do canabidiol, no entanto, permanece pouco conhecido, podendo envolver a ativação de receptores serotoninérgicos do tipo 1A (5-HT1A). Ademais, as estruturas encefálicas envolvidas nesses efeitos permanecem desconhecidas. O córtex pré-frontal medial ventral (CPFmv), dividido em infra-límbico (IL) e pré-límbico (PL), recebe densa inervação serotoninérgica e desempenha importante papel na modulação da resposta emocional ao estresse e na neurobiologia da depressão. Dessa forma, o objetivo do presente trabalho foi avaliar a hipótese de que a administração de canabidiol no CPFmv, diferenciado em PL e IL, produz efeito tipo-antidepressivo por meio da ativação de receptores 5- HT1A. Para tanto, ratos Wistar canulados bilateralmente no CPFmv, receberam CBD (10, 30, 60 nmol/0,2?l) ou veículo intra-PL e CBD (30, 45 e 60nmol/0,2?l) ou veículo intra-IL e foram submetidos ao teste do nado forçado ou ao teste do campo aberto. Outro grupo de animais recebeu microinjeção (intra PL ou IL) do agonista de receptores 5-HT1A, 8-OH-DPAT (5, 10nmol/0,2?l) e foram submetidos aos mesmos testes. Um grupo adicional recebeu um antagonista 5-HT1A, WAY1006365 (10, 30nmol/0,2?l), seguido pela administração de 8-OH-DPAT (10nmol0,2?l) ou CBD (10 nmol0,2?l) intra-PL, ou 8-OH-DPAT (10nmol0,2?l) ou CBD (45 nmol0,2?l) intra-IL, e avaliados no teste do nado forçado. Os resultados demonstraram que a administração de CBD e de 8-OH-DPAT, intra-PL e intra-IL, reduziu significativamente o tempo de imobilidade no teste do nado forçado, um efeito tipoantidepressivo, sem alterar a atividade locomotora dos animais no teste do campo aberto. Além disso, a administração de WAY100635 intra-PL e intra-IL não alterou o tempo de imobilidade per se, mas foi capaz de bloquear os efeitos da administração do CBD e do 8-OH-DPAT. Esses resultados sugerem que a administração local do CBD no CPFmv induz efeito tipo-antidepressivo por meio da ativação de receptores 5-HT1A. Portanto, é possível que o CPFmv esteja envolvido no efeito tipoantidepressivo induzido pelo CBD. / Systemic administration of cannabidiol (CBD), the main non-psychotomimetic constituent of Cannabis sativa, induces antidepressant-like effects in pre-clinical models. The mechanism of action of Cannabidiol, which remains poorly understood, may involve serotonergic type 1A receptors activation (5-HT1A). Furthermore, the brain structures involved in these effects are still unknown. The ventral medial prefrontal cortex (vmPFC), divided in infra-limbic (IL) and pre-limbic (PL) subregions, receives dense serotonergic innervation and plays an important role in the modulation of emotional responses to stress and in the neurobiology of depression. Thus, the aim of this study was evaluate the hypothesis that the administration of cannabidiol into the vmPFC, differentiated into IL and PL, would induce antidepressant-like effect by activating 5-HT1A receptors. Therefore, male Wistar rats with cannulae bilaterally implanted into the Il and PL were given CBD (10, 30, 45, 60 nmol/0,2?l) or vehicle and were submitted to the forced swimming test or to the open field test. Another group of animals received microinjections (intra PL or IL) of the 5- HT1A agonist 8-OH-DPAT (5, 10nmol/0,2?l) and was submitted to the same tests. An additional group received an 5-HT1A antagonist, WAY100635 (10, 30 nmol/0,2?l.), followed by the administration of 8-OH-DPAT (10 nmol/0,2?l) or CBD (10 nmol0,2?l) intra-PL, or 8-OH-DPAT (10nmol0,2?l) or CBD (45 nmol0,2?l) intra- IL, and avaluated in the forced swimming test. The results showed that CBD and 8- OH-DPAT administration, intra-PL and intra-IL, significantly reduced the immobility time in the forced swimming test, an antidepressant-like effect, without changing the locomotor activity of the animals in the open field test. Moreover, the administration of WAY100635, intra-PL and intra-IL, did not change the immobility time per se, but blocked the CBD- and 8-OH-DPAT-induced effects. These results suggest that the local administration of CBD into the vmPFC induces antidepressant-like effects through the activation of 5-HT1A receptors. Therefore, it is possible that the vmPFC is involved in CBD-induced antidepressant-like effect.

Os efeitos dos canabinoides em algumas áreas encefálicas que expressam receptores endocanabinoides, como é o caso dos núcleos hipotalâmicos, não são ainda muito bem definidos. Vários estudos têm demonstrado o papel de alguns núcleos hipotalâmicos na organização das reações induzidas pelo medo inato e pelo pânico. As respostas de defesa induzidas pelo medo instintivo caracterizam-se por serem mais elaboradas e dirigidas para algum abrigo ou rota de fuga. O estado de pânico pode ser provocado experimentalmente em animais de laboratório através da diminuição da atividade do sistema GABAérgico. O objetivo deste trabalho foi estudar os padrões comportamentais de fuga elaborada induzidos pelo bloqueio de receptores GABAérgicos do tipo A, com microinjeções intra-hipotalâmicas de bicuculina (BIC), especificamente na divisão dorso-medial do hipotálamo ventro-medial (VMHDM), assim como estabelecer o envolvimento endocanabinoides e o papel do receptor canabinoide do tipo 1 (CB1) na modulação das respostas defensivas organizadas pelo hipotálamo medial. Os resultados mostraram que a administração prévia de doses intermediárias (5pmol) de anandamida (AEA) atenuaram as respostas defensivas induzidas pela microinjeção intra-VMHDM de bicuculina (40ng), efeito este prevenido pelo pré-tratamento intra-hipotalâmica com antagonista de receptores CB1. Os resultados indicam que a AEA pode modular os efeitos pró-aversivos da bicuculina no VMHDM por meio do recrutamento de receptores CB1. / The effects of cannabinoids in some brain areas that express endocannabinoid receptors, such as some hypothalamic nuclei, are not yet well known. Several studies have demonstrated a role of hypothalamic nuclei in the organisation of behavioural responses induced by innate fear and panic attacks. The defensive responses induced by instinctive fear are more elaborated and oriented toward a burrow or alternative route of escape. Panic-prone states are able to be experimentally induced in laboratory animals decreasing the GABAergic system activity. The aim of this work was to study panic-like elaborated defensive behaviour evoked by GABAA receptor blockade with bicuculline (BIC) in the dorsomedial division of the ventromedial hypothalamus (VMHDM), we also aimed to establish the involvement of endocannabinoids and the role of CB1 cannabinoid receptor in the modulation of elaborated defense behavioural responses organised by medial hypothalamus. The results showed that intra-hypothalamic administration of anandamide (AEA) at the intermediate dose (5pmol) attenuated defensive responses induced by intra-VMHDM microinjection of bicuculline (40ng). This effect, however, was prevented by the pre-treatment of VMHDM with the CB1 receptor antagonist AM251. These results indicate that AEA can modulate the pro-aversive effects of bicuculline into the VMHDM, recruiting CB1 receptors.

Age-related hearing loss (ARHL) or presbycusis has grown to be a prevalent problem among the increasing aging population over the past century. Efficacy of hearing aids, cochlear implants or auditory brainstem implants have been shown, but with variable performance among patients, a fuller understanding of the complex circuitry of the auditory system would be beneficial for improving upon current technology as well as developing alternative treatments. In the current study, chemogenetics or DREADDs was utilized to inhibit the neuronal activity of the pathway between the medial geniculate body and the inferior colliculus. Subsequent effects of chemogenetic inhibition was assessed with electrophysiological measures– including auditory evoked potential recordings and single-unit recordings–as well as behavioral measures using the acoustic startle response and prepulse inhibition paradigm.

Bakgrund: Skada på det mediala kollateralligamentet (MCL) är en av de vanligast förekommande knäskadorna och drabbar främst yngre idrottande personer. En av fysioterapeutens roller i rehabiliteringen är att se till människans helhet där biomedicinska, psykiska och sociala aspekter ingår, detta för att patienten ska få ett bra omhändertagande. Syfte: Att undersöka hur fysioterapeuter beskriver sitt arbete med rehabilitering av patienter med MCL-skador. Metod: En kvalitativ intervjustudie med deskriptiv design utfördes. Data insamlad från sex intervjuer av fysioterapeuter bearbetades med hjälp av en induktiv ansats i en kvalitativ innehållsanalys. Ett ändamålsenligt bekvämlighetsurval användes vid valet av intervjupersoner. Resultat/slutsats: Studiens resultat mynnade ut i fyra kategorier med två underkategorier inom varje. Kategoriernas namn var ”Identifierar behov av och arbetar med att ge patienterna stöd”, ”Anpassar rehabilitering efter patientens träningsmöjligheter och olika aktiviteter”, ”Arbetar med att minska rädsla, oro och öka tillit till knät hos patienterna” och ”Arbetar med patienternas motivation”. Det visade sig i studiens resultat att hänsyn togs av intervjupersonerna till såväl biomedicinska som psykosociala faktorer i sitt arbete med denna patientgrupp. / Background: Injury to the Medial Collateral Ligament (MCL) are one of the most common knee injuries and mainly affect younger athletes. One of the physiotherapists' roles in rehabilitation is to look at the whole of the human being, which includes biomedical, psychological and social aspects, in order to ensure a good medical care. Purpose: To investigate how physiotherapists describe their work with rehabilitation of patients with MCL injuries. Method: The design of the study was a qualitative interview study, with an inductive approach. Data collected from six interviews of physiotherapists was analysed using a qualitative content analysis. An appropriate convenience sample was used in the selection of interviewees. Result / conclusion: The study's results consisted of four categories with two subcategories within each. The names of the categories were "Identifying need of and work with supporting biopsychosocial factors", "Adapting rehabilitation to the patient's possibilities regarding training and various activities", "Working with reducing fear, worry and increasing the patient’s confidence regarding their knees" and "Working with the patients' motivation". It was shown in the results that consideration was taken by the interviewees regarding the patient’s biomedical and psychosocial factors.

Spatial memory and navigation relies on estimation of location. This can be achieved through several strategies, including the use of landmarks and by path integration. The latter involves inferring location from direction and distance moved relative to a known start point. The neural mechanisms of path integration are not well understood and implementation of experiments that dissociate path integration from alternative strategies is challenging. The roles of specific cell types are also unknown. Although grid cells in layer 2 of the medial entorhinal cortex (MEC) are theorised to be involved given their periodic and repeating firing fields that form a grid-like map that tiles the environment. Two excitatory cell populations have been identified in layer 2 of the MEC. Clusters of pyramidal cells that project to the CA1 are surrounded by dentate gyrus (DG) projecting stellate cells. Both populations have been shown to exhibit grid-like activity. The extent to which these cell types contribute to path integration or other strategies for solving spatial tasks is unknown. To investigate these issues, I developed a spatial memory task for mice, which uses virtual reality to generate sensitive measures of an animal’s ability to path integrate. In this task mice are trained to locate a reward zone marked with a visual cue within a virtual linear track. Use of path integration strategies can be tested in trials in which the reward zone is unmarked. In this task mice can locate the reward zone using either a local beaconing cue or path integration strategies. To assess whether self-motion derived motor information or visual feedback is used for path integration, I manipulated the translation between physical and virtual movement, putting optic and motor feedback in conflict. These manipulations suggest that mice use motor information to locate the reward zone on path integration trials. To test roles of stellate cells in the task I injected adeno-associated virus expressing the light chain of tetanus toxin, conditionally on the presence of Cre, into the MEC of mice expressing Cre specifically in stellate cells. This abolishes synaptic output from stellate cells therefore preventing them from influencing downstream neurons. I find mice with dorsal expression of the tetanus toxin virus in layer 2 stellate cells are unable to locate the reward zone using a local beaconing cue or path integration strategies. In contrast, mice with expression of green fluorescent protein (GFP) were able to locate the reward zone using both strategies. Locating the reward zone using path integration strategies first requires animal’s to learn the reward zone location, as denoted in trials with a beacon cue. To distinguish the role of stellate cells in learning versus execution of the tasks, I temporally modified the activity of stellate cells after mice had learnt to locate the reward zone using both strategies. Temporal control was achieved by use of cre-dependent adeno-associated viruses expressing mutant human muscarinic 4 receptor (hM4). When activated by clozapine - N - oxide (CNO), this receptor opens G-protein inwardly rectifying potassium (GIRK) channels and attenuates neuronal firing. Using this method, the activity of stellate cells can be temporally controlled during task execution and potentially distinguish their involvement in learning and execution of spatial memory tasks. No effect on behavioural performance was seen under these conditions. This may indicate stellate cells are required for learning but not execution of spatial memory tasks that require the use of local beaconing cues or path integration.

Place cells in the hippocampus fire in specific locations within an environment. The aim of this thesis is to investigate the different inputs to the hippocampus and what they contribute to place cell activity and performance of hippocampus-dependent tasks. Place cell activity can also be modulated by relevant features of a task such as a future destination or trajectory. Initial experiments investigated the origin and function of this trajectory-dependent activity and later experiments targeted the medial entorhinal cortex inputs to the hippocampal formation and investigated what they contributed to place cell activity and behaviour. The purpose of the first study was to determine whether trajectory dependent activity occurs in CA3 in a hippocampus-dependent serial-reversal task on the double-Y-maze and to compare it with that seen in CA1. Place cells in both CA3 and CA1 were recorded in rats trained on a serial-reversal task on a double-Y-maze. Rats were trained to run from a start box through two Y-junctions to one of four goal locations. After 10 trials the reward was moved to a new location, until all the boxes had been rewarded. Previous research has found that 44% of CA1 place cells with fields in the start areas of the maze show trajectory-dependent activity in rats trained on the task. This study found that a similar proportion of CA3 place cells also show trajectory-dependent activity in rats trained on this task and that this activity develops at the same time point as the task is learned. This result suggests that trajectory-dependent activity may be generated earlier in the circuit than CA1. Secondly, the contribution of the nucleus reuniens (N.Re) to spatial tasks was investigated. Previously, trajectory-dependent activity has been found to reach the hippocampus via N.Re, however this was shown in a hippocampus-independent task. To investigate the possible role that this input may play in behaviour, N.Re was lesioned and animals were tested on acquisition and performance of the double-Y-maze serial-reversal task described previously. Surprisingly, lesions had no effects on either learning or performance. Taken together with previous data from other studies, this suggests that trajectory dependent activity is not one unique phenomenon but is rather multiple similar phenomena which may originate in different brain regions and fulfil different roles in navigation depending on the demands of the task. In addition, animals were tested on tasks involving allocentric or egocentric navigation. Results suggest that N.Re may have a role in the selection or performance of allocentric navigation but not egocentric navigation. Thirdly, the role of inputs from the medial entorhinal cortex (MEC) to place cells was investigated. Consistent with previous research, MEC lesions resulted in larger, less precise place fields in CA1 place cells. By performing cue-rotation experiments using either distal or proximal cues it was observed that place fields in the MEC lesion animals were not anchored to distal cues but were either stable or anchored to other aspects of the environment. However, place cells in the MEC lesion group still followed proximal cues suggesting that the deficit is restricted to distal landmarks. This suggests that the MEC may process distal landmark information allowing the use of distal landmarks for orientation and self-location within an environment. This thesis contributes a better understanding of the role and origins of trajectory dependent activity as well as a novel finding that the MEC contributes information about distal landmarks to the hippocampus.

A Avaliação Tecnológica em Saúde (ATS) é uma sistemática que avalia os impactos clínicos, sociais e econômicos das tecnologias em saúde e tem como finalidade auxiliar os gestores na tomada de decisão quanto ao desenvolvimento, incorporação e descontinuação destas tecnologias. Agências de ATS têm destacado a importância da existência de métodos que visem padronizar e implantar esta sistemática em diferentes contextos. Assim, o objetivo geral desta tese é propor procedimentos para apoiar a avaliação tecnológica de equipamentos médico-hospitalares, por meio de uma pesquisa construtiva (Constructive Research) aplicada à terapia de hemodiálise. Os procedimentos propostos compõem um modelo adaptado do EuroScan, modelo desenvolvido por agências Europeias e indicado como boa prática pelo Ministério da Saúde do Brasil. Também são procedimentos ajustados às necessidades de pesquisadores de centros regionais de avaliação de equipamentos médico-hospitalares. Inicialmente, foi desenvolvida uma coleta de dados sobre os problemas de desenvolvimento e incorporação das tecnologias da saúde por meio de duas fontes: uma revisão sistemática de literatura sobre oportunidades de melhorias do EuroScan no mundo e discussões com pesquisadores no país. A partir destas investigações foi proposto um modelo preliminar de ATS, aplicado para o domínio Operacional e de Inovação na hemodiálise. Finalmente a aplicação foi validada e examinada por especialistas para a geração de um modelo final. Os principais procedimentos resultantes foram: (i) validação da relevância das avaliações para novos desenvolvimentos e incorporações tecnológicas do ponto de vista de diferentes especialistas, integrando diferentes áreas do conhecimento na ATS; (ii) operação de Observatórios Tecnológicos, auxiliando na definição das tecnologias e domínios a serem avaliadas; (iii) definição de técnicas para análise dos domínios de ATS, como o uso de séries temporais e o Technology Roadmap (TRM) para previsões sobre o futuro das inovações e o uso das dimensões da usabilidade e de incidentes críticos de riscos para os aspectos operacionais; e (iv) integração das diretrizes de ATS no Brasil em um único modelo, amparando pesquisadores não relacionados a saúde na compreensão sobre ATS e no desenvolvimento ágil de novos estudos tanto para equipamentos emergentes como em uso. Já a avaliação dos domínios selecionados para a hemodiálise resultou: (i) na identificação de um crescimento médio anual de 7% dos indicadores da terapia; (ii) no diagnóstico de usabilidade de máquinas eficazes, porém com possibilidades de gerarem maior satisfação aos usuários quanto: ao espaço entre elas, a redução dos desperdícios de água e materiais, aos planos de manutenção para evitar temperaturas elevadas, a capacitação visando mais atenção e treinamento para tarefas de apoio e aos aspectos de display (realimentação de dados e visualização); e (iii) na consolidação entre profissionais sobre um futuro promissor, para os próximos 10 anos no Brasil, da assistência homecare com máquinas de hemodiálise portáteis, mais seguras e sustentáveis. / The Health Technology Assessment (HTA) is a systematic evaluation of clinical, social and economic impacts of health technologies aiming to assist managers in the decision making process related to the development, consolidation and discontinuation of these technologies. HTA agencies have been highlighting the importance of methods to standardize and apply this systematic evaluation in different contexts. Thus, the general objective of this thesis is to propose procedures to support the technology assessment of medical-hospital equipment through a constructive research applied to hemodialysis therapy. The proposed procedures compose a EuroScan adapted model, which was developed by European agencies and is recommended as a good practice by the Brazilian Ministry of Health, and also are procedures adjusted to the needs of researchers in regional centers of medical equipment assessment. Initially, a data collection on the problems of developing and incorporating health technologies was carried out using two sources: a systematic review of the literature on opportunities to improve the EuroScan around the world and discussions with Brazilian researchers. Based on these investigations, it was proposed a preliminary HTA model applied to the hemodialysis’ Operational and Innovation domain. The application of the model was reviewed and evaluated by experts to produce a final version. The main resulting procedures were: (i) to validate the importance of assessments for new technological developments and incorporations considering the point of view of different experts from diverse knowledge areas; (ii) to operate Technological Observatories, assisting to define the technologies and domains to be evaluated; (iii) to set techniques for the analysis of HTA domains such as the use of time series and the Technology Roadmap (TRM) to make predictions about the future of innovations and the use of usability dimensions and critical incidents of risks to the operational aspects; and (iv) to integrate HTA Brazilian guidelines in a single model, supporting researchers not related to health in the understanding of HTA and fast development of new studies for both emerging and in use equipment. The assessment of the domains selected for hemodialysis led to: (i) the identification of an annual growth in therapy indicators (7% in average); (ii) the usability diagnosis of efficient machines, however with the potential to generate greater user satisfaction considering: distance between machines, reduction in the waste of water and materials, maintenance plans to avoid high temperatures, training aiming more attention to supporting tasks as well as focus on display aspects (data feedback and visualization); and (iii) the consolidation among professionals of a future, for the next 10 years in Brazil, based on homecare with portable machines, safer and more sustainable.