Type 2 diabetes mellitus (T2D) is a highly prevalent metabolic disorder linked with the development of specific complications and comorbidities that negatively affect life quality and greatly increase the risk of an early death. The main goal of T2D treatment, which in common clinical practice comprises lifestyle changes and pharmacotherapy, is to delay onset of these complications. Evidence from many recent studies shows the ability of some interventional methods to induce remission of T2D, meaning a major improvement or complete disappearance of T2D symptoms. Besides bariatric surgery procedures, some dietary regimens such as low-energy diet, low-carbohydrate diet and intermittent fasting, can also lead to T2D remission. Attributes of these dietary regimens, especially their effect in T2D treatment, is summarized in the theoretical part of this theses. The aim of the practical part of this thesis was to assess the effect of the dietary regimens mentioned above on morphometric and biochemical parameters associated with T2D by clinical and survey research. In most of the subjects with T2D, the individual dietary regimens, more precisely low-energy diet and low-carbohydrate diet, decreased body weight, where the weight loss induced by low-carbohydrate diet was caused by major decrease in the amount...

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Le syndrome d'apnée obstructive du sommeil (SAOS), est une maladie chronique qui se caractérise par des interruptions répétées de la respiration durant le sommeil en raison de la fermeture temporaire des voies aériennes supérieures. L'hypoxie intermittente chronique (HI) résultante de cette fermeture transitoire des voies aériennes supérieures, constitue l’une des conséquences majeures du SAOS, et elle est la responsable de la plupart des complications liées à cette pathologie, dont nous citons: l’hypertension artérielle, l’infarctus de myocarde et plus généralement le remodelage cardiovasculaire.D’autre part, l’entrainement physique intensif(EI)est bien connu d’avoir des bénéfices sur le système cardiovasculaire, d’où nous avons poser l’hypothèse que l’EI peut inverser les effets délétères de l’HI sur la réactivité et le remodelage vasculaire ainsi que sur la signalisation calcique intracellulaire dans les cellules musculaires.Pour répondre à cette question, nous avons choisi le rat comme modèle animal, pour étudier l’effet potentiel de l'EI dans la prévention et l’inversion des effets délétères de (HI) en termes de réactivité et signalisation calcique dans les tissues musculaires.Des rats ont été exposés durant 21 jours à l’hypoxie intermittente dans des cages spécialement équipées pour maintenir un flux d’air alternant entre 21% et 5% de PO2 dans les cages contenant les rats hypoxique et a 21% de PO2 dans les cages contenant les rats contrôles. Durant les deux dernières semaines d’exposition à l’HI, un groupe des rats hypoxiques et un des rats normoxiques ont subi des sessions d'EI en courant sur un tapis roulant avec une vitesse allant de 16m/min jusqu'à 30 m/min.Les paramètres physiologiques ont été mesurés (Pression artérielle, fréquence cardiaque, hématocrites), l’aorte a été prélevé pour étudier la réactivité vasculaire, les cellules musculaires lisses de l’aorte ont été ensuite prélevés et cultivées pour étudier la signalisation calcique par microscopie à EPIfluorescence. Finalement les gènes codant pour les médiateurs de la signalisation calcique : RyR1, RyR2 RyR3, (ryanodine receptors), TRPV4 (transient receptor potential channel), SERCA1, SERCA2 (Sarco/Endoplasmic Reticulum Ca2+ -ATPase) et IP3R1 (Inositol 1,4,5-Trisphosphate Receptor) dans différentes tissues vasculaires et squelettiques ont été étudiés au niveau moléculaire par Q-PCR et Western Blot.Nos résultats montrent que l'HI induit une augmentation significative de pression artérielle et de l’hématocrite et une diminution dans la relaxation de l'aorte induite par l'acétylcholine pré contractée par la phénylnephrine. Ceci est conforme à notre observation selon laquelle HI augmente le niveau de calcium intracellulaire dans le muscle lisse aortique cultivé. D'autre part, l'EI induit une diminution significative de l’hématocrite et de la vasoconstriction aortique induite par la phénylnephrine et l'endothélie-1, conformément à l'observation que l'EI réduit la différence HI-N dans la réponse calcique. A l’échelle moléculaire, HI induit une augmentation significative de l'expression de RyR1, RyR2, RyR3, SERCA1, SERCA2, TRPV4 et IP3R1 au niveau de l'ARNm dans les tissus de tous les groupes, avec une plus grande quantité de RyR1,RyR2,et RyR3 dans les tissus HI des muscles lisses (principalement dans l'aorte thoracique et abdominale) et le SERCA1 (9 fois plus haut dans les tissus IH) et le SERCA2 (10 fois plus élevé dans les tissus HI) dans les muscles squelette (Gastrocnemius, plantaris et soléus). De plus, HI induit une augmentation significative de RYR1, RYR2 et TRPV4 au niveau protéique dans l'aorte thoracique et abdominale; et l'EI réduit la différence d'expression entre les animaux N et IH.Nos résultats suggèrent que l'EI représente un traitement prometteur non pharmacologique ou complémentaire pour limiter les complications cardio-vasculaires induites par l’HI et le remodelage musculaire chez les patients atteints de SAOS. / Obstructive sleep apnea syndrome (OSAS) is a chronic disease characterized by repeated interruptions of breathing during sleep due to the temporary closure of the upper airway. Its prevalence increases with the increasing in prevalence of obesity, especially in developed countries.Chronic intermittent hypoxia (IH) resulting from this transient closure of the upper airway is one of the major consequences of OSAS and is responsible of most of the complications related to this pathology, including hypertension, myocardial infarction, atherosclerosis and more generally cardiovascular remodeling.On the other hand, intensive physical training(IT) is well known to have benefits on cardiovascular system, thus we hypothesize that physical training can reverse the deleterious effects of IH on reactivity and vascular remodeling as well as intracellular calcium signaling in muscle cells.To answer this question, we chose the rat as an animal model to study the potential effect of IT in the prevention and reversal of deleterious (IH) effects in terms of reactivity and calcium signaling in muscle tissue.Rats were exposed for 21 days to intermittent hypoxia and housed in cages specially equipped to maintain an airflow alternating between 21% and 5% PO2 in cages containing hypoxic rats and 21% PO2 in cages containing the control rats. During the last two weeks of exposure to IH, a group of hypoxic rats and one of the normoxic rats underwent IT sessions on a treadmill at a speed of 16m / min to 30m / min.Physiological parameters were measured (blood pressure, heart rate, hematocrit), the aorta was removed to study the vascular reactivity, then vascular smooth muscle cells were removed and cultured to study calcium signaling by EPIfluorescence microscopy. Finally, the genes coding for the key mediators of the calcium signaling: RyR1, RyR2 RyR3, (ryanodine receptors), TRPV4 (transient receptor potential channel), SERCA1, SERCA2 (Sarco / Endoplasmic Reticulum Ca2 + -ATPase) and IP3R1 , 5-Trisphosphate Receptor) in various vascular and skeletal tissues were studied at the molecular level as mRNA by Q-PCR or as protein by Western Blot.Our results show that IH induces a significant increase in blood pressure and hematocrit and a decrease in acetylcholine-induced aortic relaxation pre-contracted with phenylnephrine. This was consistent with our observation that HI increases the level of intracellular calcium in cultured aortic smooth muscle. On the other hand, IT induced a significant decrease in hematocrit and aortic vasoconstriction induced by phenylnephrine and endothelial-1, consistant with the observation that IT reduces the IH-N difference in the calcium response. On the molecular scale, IH induces a significant increase in the expression of RyR1, RyR2, RyR3, SERCA1, SERCA2, TRPV4 and IP3R1 at the mRNA level in the tissues of all groups with a greater amount of RyR1,RyR2,& RyR3 higher in IH tissue of smooth muscles (mainly in the thoracic and abdominal aorta) and SERCA1 (9-fold higher in IH tissues) and SERCA2 (10-fold higher in IH tissues) in the skeletal muscles (Gastrocnemius, plantaris and soléus). In addition, IH induces a significant increase in RYR1, RYR2 and TRPV4 at the protein level in the thoracic and abdominal aorta; And IT reduces the difference in expression between animals N and IH.Our results suggest that IT is a promising, non-pharmacological or complementary treatment for limiting cardiovascular complications induced by IH and muscle remodeling in patients with OSAS.

Objectives : 1) Présenter un portrait des douleurs intermittentes et constantes décrites chez les personnes souffrant de l’arthrose du genou à travers la compréhension des caractéristiques des patients et de la douleur, ainsi que la fonction physique associés, 2) identifier les facteurs personnels, physiques, psychologiques, de la douleur et du système nerveux liés aux douleurs intermittente, constante et mixte chez les adultes atteints de l’arthrose du genou. Méthodes : Afin de répondre à notre premier objectif, nous avons effectué un examen de l’ étude de la portée respectant les recommandations de Arksey et O'Malley et élaborées par Levac, Colquhoun et O'Brien avec une stratégie de recherche utilisant multiples bases de données depuis sa création jusqu'en octobre 2018. Notre analyse a été établie à travers des articles qui respectaient nos critères d'inclusion. Pour atteindre notre deuxième objectif, nous avons effectué une étude transversale où 35 variables (questionnaires et tests physiques et psychophysiques) ont été évaluées sur un échantillon de 297 participants atteints d'arthrose du genou. Résultats : Quatre articles ont abordé la douleur intermittente et constante, et ont été inclus dans la lecture finale. Nous avons souligné qu’une performance limitée au niveau des activités de la vie quotidienne, un grade de Kellgren-Lawrence et une prévalence de comorbidité plus élevés peuvent expliqués la douleur constante. La présence d’arthrose du genou symptomatique et de symptômes dépressifs étaient aussi associés à la douleur constante. Des limitations des activités de haut niveau et un temps plus élevé durant la pratique des activités modérés étaient reliés à douleur intermittente. Notre étude transversale inclue 279 participants, 58,6% de femmes, un âge moyen de 63,8 ans (ET = 9,6) ; et un Indice de Masse Corporelle moyen de 31,5 kg /m2 (ET = 8,7). Nous avons observé qu’un âge plus élevé (Odds Ratio (OR) 0,95 ; 95% Intervalle de confiance (IC) 0,90, 1,00), et un niveau de fonctionnement auto-rapportée plus élevé OR 0,94 ; IC 0,91, 0,98 étaient associés à une probabilité plus faible d'avoir des douleurs mixtes qu’intermittentes. Cependant, une intensité de douleur plus élevée OR 1,25 ; IC (1,07, 1,47) était reliée à une probabilité plus élevée d’avoir une douleur mixte qu’intermittente. Les femmes étaient 71% moins susceptibles que les hommes d'avoir une douleur constante qu’intermittente OR 0,29 ; IC (0,11, 0,75). Conclusion : Il est important que les physiothérapeutes et les professionnels de la santé prennent en compte des multiples facteurs associés aux différents profile de douleur lors du traitement des personnes atteints d'arthrose du genou. En effet, la compréhension de ces facteurs pourra aider à la gestion de la douleur et le ralentissement de la progression de la pathologie. / Objectives: 1) To present a portrait of intermittent and constant pain in people with knee OA through the comprehension of their associated pain and patient characteristics and their physical function, 2) to identify personal, physical, psychological, pain and nervous system factors related to intermittent, constant and mixed pain patterns (periods of both intermittent and constant pain) in adults with knee OA. Methods: To answer our first objective, we conducted a scoping review with the framework recommended by Arksey and O’Malley and elaborated on by Levac, Colquhoun and O’Brien, based on a search strategy using multiple databases from inception until October 2018. Our analysis was established with articles that respected our inclusion criteria. To achieve our second objective, we conducted a cross-sectional study where 35 variables (questionnaires and physical and psychophysical tests) where evaluated on a sample of 297 participants with knee OA. Results: Four articles reporting content regarding intermittent and constant pain in people with knee OA were included for the final review. The review revealed that there was a limitation in daily activities, a higher Kellgren-Lawrence grade, a higher prevalence of comorbidities, symptomatic knee OA and depressive symptoms in people with constant pain. Reports of limitations on high impact activities and a greater time spent in moderate activities was related to intermittent pain. Our cross-sectional study included 279 participants, 58.6% female, average age of 63.8 years (SD=9.6), and average BMI of 31.5 kg/m2 (SD=8.7). Increased age, Odds Ratio (OR) 0.95 (95% Confidence Interval (CI) 0.90, 1.00) and higher self-reported function OR CI 0.94 (0.91, 0.98) were associated with a lower likelihood of having mixed pain compared to intermittent pain. An increase in pain intensity OR 1.25 CI (1.07, 1.47) was related to a 25% higher likelihood of mixed pain compared to intermittent pain. Women were 71% less likely than men to have constant pain compared to intermittent pain OR 0.29 CI (0.11, 0.75). Conclusion: Multiple factors associated with the different pain patterns in people with knee OA are important for physiotherapists and health practitioners to consider when treating this population. The understanding of these factors may help in pain management and the control of disease progression.

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Heavy reliance on GPS is preventing unmanned air systems (UAS) from being fully inte- grated for many of their numerous applications. In the absence of GPS, GPS-reliant UAS have difficulty estimating vehicle states resulting in vehicle failures. Additionally, naively using erro- neous measurements when GPS is available can result in significant state inaccuracies. We present a simultaneous localization and mapping (SLAM) solution to GPS-degraded navigation that al- lows vehicle state estimation and control independent of global information. Optionally, a global map can be constructed from odometry measurements and can be updated with GPS measurements while maintaining robustness against outliers.We detail a relative navigation SLAM framework that distinguishes a relative front end and global back end. It decouples the front-end flight critical processes, such as state estimation and control, from back-end global map construction and optimization. Components of the front end function relative to a locally-established coordinate frame, completely independent from global state information. The approach maintains state estimation continuity in the absence of GPS mea- surements or when there are jumps in the global state, such as after map optimization. A global graph-based SLAM back end complements the relative front end by constructing and refining a global map using odometry measurements provided by the front end.Unlike typical approaches that use GPS in the front end to estimate global states, our unique back end uses a virtual zero and virtual constraint to allow intermittent GPS measurements to be applied directly to the map. Methods are presented to reduce the scale of GPS induced costs and refine the map’s initial orientation prior to optimization, both of which facilitate convergence to a globally consistent map. The approach uses a state-of-the-art robust least-squares optimization algorithm called dynamic covariance scaling (DCS) to identify and reject outlying GPS measure- ments and loop closures. We demonstrate our system’s ability to generate globally consistent and aligned maps in GPS-degraded environments through simulation, hand-carried, and flight test re- sults.

[pt] O aumento da penetração de fontes de energia intermitentes é uma realidade dentro da matriz energética brasileira. A utilização em larga escala de energia renovável diminui a flexibilidade operativa com a redução da inércia equivalente sincronizada no sistema, podendo colocar em risco a segurança e a qualidade do suprimento de energia dos sistemas elétricos de potência com a diminuição da capacidade de regulação de frequência. Com expectativas de crescimento acentuado, surgem os dispositivos de armazenamento de energia (Energy Storage Devices – ESD) como uma alternativa viável para contornar essas dificuldades, principalmente quando se trata de um sistema de potência isolado. Nesta dissertação, avalia-se o comportamento dinâmico do sistema elétrico do estado de Roraima, através de uma metodologia desenvolvida para quantificar a penetração de energia renovável intermitente em sistemas isolados. Avalia-se também como a utilização de dispositivos de armazenamento de energia podem contribuir para o controle de frequência, observando as vantagens que tais dispositivos podem acarretar nesse sistema. A construção do Mapa de Decisão pode auxiliar as análises tanto na etapa de planejamento como na fase de programação e operação dos sistemas. Nas simulações realizadas foi possível constatar que a utilização de ESD pode promover um aumento significativo na penetração de usinas renováveis intermitentes, como eólica e solar fotovoltaica, em sistemas de potência isolados / [en] The increase in the penetration of intermittent energy sources is a reality within the Brazilian energy matrix. The large-scale use of renewable energy decreases the operational flexibility with the reduction of the equivalent inertia synchronized in the system, which can endanger the safety and quality of the energy supply of electric power systems with the reduction of the frequency regulation capacity. With expectations of sharp growth, energy storage devices (ESD) appear as a feasible alternative to overcome these difficulties, particularly when it comes to an isolated power network. In this dissertation, the dynamic assessment of the electrical system of the state of Roraima is evaluated, using a methodology developed to quantify the penetration of intermittent renewable energy in isolated systems. It is also evaluated how the use of energy storage devices can contribute to frequency control, observing the advantages that such devices can bring to this system. The construction of the Decision Map can assist the analyses during the planning, programming and operation phases. In the simulations carried out, it was possible to verify that the use of ESD can promote a significant increase in the penetration of intermittent renewable plants, such as wind and solar photovoltaic, in isolated power systems.

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