Background and Purpose: Primary nocturnal enuresis (PNE) is a heterogeneous disorder with various underlying pathophysiological mechanisms. Results of our recent studies focused on the relationship of bladder function, sleep and brain function demonstrated a simultaneous occurrence of bladder and brain dysfunction in children with severe refractory PNE. We therefore proposed to use an animal model with altered bladder function to evaluate if abnormalities in bladder function induce functional derangement in brainstem micturition centers and/or sleep-arousal centers. / Materials and methods: In general, the study was divided in to 6 parts. Male Wistar rats (~ 1.5 months) were used for the study. / Study I: Establishment of animal model —— Male Wistar rats (200-220 g) underwent either Sham surgery or surgical reduction of bladder volume (RBV). Animals were used for further Cystometry, EEG, MRS and Cognitive function studies 4-5 weeks postoperatively. / Study II: Conventional Fill Cystometry (CFC) to evaluate bladder functional changes in response to surgical bladder volume reduction —— Twenty-four rats (RBV=12, SHAM 12) were used for the study. CFC was performed under conscious condition for evaluating the functional changes in response to surgical bladder capacity reduction. / Study III: Radiotelemetered EEG study to assess the impact of bladder dysfunction on sleep architecture and cortical arousals in rats —— Twenty-four rats (RBV=12, SHAM 12) were used for the study. Radiotelemeters were implanted in both groups 4 weeks post-operatively. The EEG biopotential and bladder pressure were monitored for 48 hours. Sleep architecture and cortical arousals were then evaluated manually. / Study IV: Evaluation of cognitive function following surgical bladder volume reduction —— Ninety eight rats (RBV=50, SHAM =48) were used for the study. / Morris Water Maze task: A circular plastic translucent pool half-filled with 26 ± 2ºC water, was used in the Morris Animals were given 9 consecutive training (2/day) sessions of Morris Water Maze (MWM) at 4 weeks postoperatively. / 8-arm Radial Maze: Food pellets were randomly placed inside each arm of the maze and the rats were allowed to explore the maze freely for 5 minutes. The rat was allowed to explore the maze for 5 minutes. Total time spent in each arm, total distance traveled in the maze was recorded. / Study V: Magnetic Resonance Spectroscopy to detect functional changes in brain in response to bladder dysfunction elicited by surgical bladder volume reduction —— Proton magnetic resonance spectroscopy was employed to examine brain metabolic changes in 24 rats (RBV=12, SHAM=12). Single voxel 1 H MRS experiments were performed using a 7 T MRI scanner. MR spectra were then processed using the jMRUI software. / Phase VI: Enzyme -linked immunosorbent assay for the assessment of associated changes in neurotransmitters —— Animals were euthanized after MRS study and brain samples were collected. Serotonin and dopamine levels were assessed in 10 mg of tissue extracts from brainstem and cortex, with ELISA kits. / Results: Study I: Bladder reduction surgery did not affect the increase in body weight post -operatively. Average body weight of the RBV and the sham groups were 340.2 ± 47.2 g and 340.5 ± 67.9 g respectively at 4 weeks post operatively. / Study II: Compared to sham group, the maximum cystometric capacity in animals with RBV was remarkably reduced at week 4 (0.78 ± 0.12 ml vs. 1.46 ± 0.22 ml, RBV vs. Sham respectively; p<0.005). Moreover, maximum detrusor pressure during voiding was significantly increased in RBV group at week 4 post operatively (32.4± 2.14 vs.23.27±1.2 5 cm H2O, RBV vs. Sham respectively). / Study III: Light non-repaid eye movement sleep occurred significantly more in RBV rats compared to sham group (61.8% vs 35%). Deep sleep and rapid eye movement sleep occurred significantly less in RBV group compared to that of sham group (30.7% vs 53.4%). / Study IV: Results showed that the RBV group used a significantly longer latency to locate the platform compared to Sham group (24.4s vs 17.19s, RBV vs. Sham respectively, p<0.001).. Moreover, significantly more animals from the RBV group could not complete the visit of the 8 arms of radial maze than that of the sham group. / Study V: Seven metabolites were detected and quantified. The results demonstrated significant changes in the lactate (Lac) metabolism in some specific regions of rat brain. At 4 weeks post - operatively, level of lactate significantly decreased in the hippocampus (43%, P<0.001) cingulate and retrosplenial cortex (29%, p<0.05) of RBV rats compared to that of sham rats. / Study VI: Results demonstrated a significant increase in Serotonin level in the brainstem of RBV rats compared to that of SHAM rats (23.726 + 0.88 ng/ml vs. 1.88 + 0.302 ng/ml). Dopamine levels decreased significantly in brainstem samples of RBV group compared to sham group (2.85 + 0.10 ng/ml vs. 6.85 + 0.84 ng/ml). / Conclusion: Surgical bladder volume reduction of bladder capacity can induce functional changes in the central nervous system. An alteration of the sleep architecture occurred in response to surgical reduction of bladder volume in rats, suggesting that there exists a potential for central consequences of bladder dysfunction. Bladder disorder chronically altered brain energy metabolism. Furthermore, bladder disorder altered the central neurotransmission in the brainstem and cortex. The finding of bladder dysfunction induced significant impairments in cognitive function in RBV rats, suggesting that the alteration in brain energy metabolism may contribute to the behavioral and attention problems, impaired learning and cognitive performance. / 研究背景： 原發性夜間遺尿症（PNE）是一種異質性疾病，涉及多種潛在的病理生理機制。我們最近的研究主要集中在膀胱功能，睡眠和腦功能的關係，結果顯示膀胱和腦功能障礙同時出現在患有嚴重難治性的PNE的兒童。因此，我們建議採用一種已改變膀胱功能的動物模型來評估膀胱功能異常會否引起腦幹排尿中心和/或睡眠 - 覺醒中心的功能紊亂 / 研究工具和方法： 研究被分成6個部分。雄性Wistar大鼠（約1.5個月）被用於研究。 / 研究I： 動物模型的建立 —— 雄性Wistar大鼠（200-220克），會先接受假手術或手術降低膀胱容量（RBV）。手術後4至5週，動物會進行進一步的膀胱測壓，腦電圖，MRS和認知功能研究。 / 研究II： 以常規填充膀胱測壓（CFC）評估減少膀胱容量手術對膀胱功能的變化 —— 二十四隻大鼠（RBV=12，對照=12）被用於研究。 CFC是用以評估在有意識的條件下，膀胱因膀胱容量減少的手術而引起的功能變化。 / 研究III： Radiotelemetered腦電圖研究，以評估在大鼠膀胱功能失調對睡眠結構和皮質覺醒的影響 —— 二十四隻大鼠（RBV=12，對照=12）被用於研究。膀胱容量減少的手術4週後，Radiotelemeters被植入在兩個組別的大鼠，並監測其腦電生物電勢和膀胱內壓48小時，然後手動評估睡眠結構和皮層覺醒。。 / 研究IV： 評估在膀胱容量減少的手術後對認知功能的影響 —— 103個大鼠（RBV=56，對照= =47）被用於研究。 / Morris水迷宮任務： 一個圓形的塑料半透明池盛載半滿的水，溫度介乎26 - ±2℃，手術4週後，該池被用在莫里斯動物進行連續9次Morris水迷宮（MWM）培訓（每天2次）。 / 八臂迷宮： 食物顆粒被隨機放置在迷宮的每個臂內，大鼠可以自由地探索迷宮5分鐘。大鼠被允許探索迷宮5分鐘。在每個手臂所用的總時間，以及在迷宮行走的總距離都會被記錄。 / 研究V： 以磁共振波譜檢測膀胱容量減少的手術所引起的膀胱功能障礙對腦功能的改變 —— 以質子磁共振波譜研究24隻大鼠腦內的代謝變化(RBV=12，對照==12）。以7 T MRI掃描儀進行磁共振波譜實驗，然後使用jMRUI軟件處理MR譜。 / 第六期： 以酶聯免疫吸附測定法評估神經遞質的相關變化 —— 動物在進行MRS研究後實施安樂死，並收集其腦樣品。從腦幹和皮層提取10毫克組織提取物，使用ELISA試劑盒，以評估羥色胺和多巴胺水平。 / 結果： 研究I： 膀胱容量減少手術並沒有影響體重增加。手術4週後，利巴韋林和對照實驗組的平均體重分別為340.2±47.2克和340.5±67.9克。 / 研究II： 相比起對照實驗組的動物，RBV組的最大膀胱容量顯著降低（0. 0.78 ± 0.12毫升對1.46±0.22毫升），排尿頻率顯著增加（2.53±0.30 對.0.53±0.05/hr）。此外，排尿時最大逼尿肌壓力亦顯著升高（32.0.8±2.19 比.20.37±1.2 5厘米水分子） / 研究III： 相比起對照實驗組的動物，光非快速動眼期睡眠顯著地較多發生於RBV大鼠身上（61.8％對35.6％），深層睡眠和快速動眼期睡眠顯著地較少發生在RBV組（32.3％對52.8％） / 研究IV： 結果表明，RBV組使用了顯著較長的時間來定位平台（24.4s vs. vs.17.19s）。而且，在RBV組，顯著地較多動物無法完成行走8臂的放射狀迷宮。 / 研究V： 進行檢測和定量七種代謝物。結果顯示乳酸（LAC）代謝在大鼠大腦的某些特定區域出現顯著變化。在手術4週後，相比起對照實驗組的動物，RBV組大鼠在海馬體（43％，P <0.001），扣帶和夾肌皮質（29％，P <0.05）的乳酸水平均顯著減少。 / 研究VI： 結果顯示RBV大鼠腦幹的血清素水平較對照實驗組的顯著增加（23.726+0.88納克/毫升與1.88±0.302ng/ml）。RBV大鼠腦幹的多巴胺水平則較對照實驗組的顯著下降（2.850.10納克/毫升與6.85+0.84毫微克/毫升）。 / 結論： 外科膀胱容量減少可誘導中樞神經系統的功能變化。以外科手術減少膀胱容量的大鼠亦引起睡眠結構改變，這顯示膀胱功能障礙對中樞有潛在影響。膀胱疾病長期改變大腦的能量代謝。此外，膀胱疾病亦改變了在腦幹和大腦皮層的中樞神經遞質傳遞。研究發現膀胱功能障礙顯著地損害RBV大鼠的認知功能，顯示改變大腦的能量代謝亦可導致行為和專注力的問題，從而損害學習和認知能力。 / Yeung, Chung Kwong. / Thesis Ph.D. Chinese University of Hong Kong 2014. / Includes bibliographical references (leaves 199-230). / Abstracts also in Chinese. / Title from PDF title page (viewed on 14, September, 2016). / Yeung, Chung Kwong. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

The circadian cycle, although seasonally adjusted, consists of two phases: a nocturnal period of darkness and a diurnal period of light. Many parameters of human physiology display either a nocturnal or diurnal peak as seen in athletic performance, immune, endocrine, physiology and cognitive function, respectively. The studies included in this thesis focused on the diurnal (morning or AM versus evening or PM) effect of high-intensity self-paced exercise on physiological and immunological measures and the influence of individual preference for activity or chronotype on these responses. Self-paced time-trials were completed in an environmental chamber (6°C) in the AM and PM and displayed a similar effect on physiological and biological parameters. Performance times were non-statistically quicker (P > 0.05) at PM. Physiological parameters heart rate, rate of perceived exertion, lung function and self-paced treadmill speed were not found to be statistically different at AM or PM trial (p > 0.05). Core body temperature (CBT), was significantly higher (p0.05). CD8+ T-lymphocyte cell-surface markers for naïve/senescence and differentiation (CD27CD45RA and CD27CD28) reported no diurnal difference between AM and PM exercise in experienced and experienced/recreational distance runners respectively (P > 0.05). However, a higher percentage of highly differentiated phenotypes were found in the recreationally active population. Neutrophils displayed a pronounced elevation in response to PM exercise with the mechanism driving this response unclear at this time. Cortisol concentration displayed less inflammatory responses in the morning compared to the evening with higher values pre, post and one-hour post AM trials. Chronotype showed no effect on physiology or biology at rest or in response to exercise. Chapter 4 presents data from a study that investigated diurnal physiology and immune response to high-intensity exercise in highly-trained men. Recreational and experienced endurance male runners at differing diurnal time-points were investigated in Chapter 5, while individual chronotype differences and circadian phase responses were explored in Chapter 6.In summary, it is concluded from this work that there was a lack of evidence showing a diurnal effect on running performance and subsequent immune response. Elevated circulating immune counts prior to exercise, irrespective of diurnal phase, appear to govern exercise-induced responses. The effect of high intensity exercise is subject to three distinct variables: the fitness status and experience of the individual completing the exercise, the time of day at which the exercise is undertaken, and the phase response of exercise at that point of the circadian cycle. No diurnal phase mediated a divergent effect on variables examined was observed at 09.00hrs and 17.00hrs. These time-points should be considered not sufficiently dissimilar to elucidate diurnal variation in trained and healthy males.

Introdução: O equilíbrio é a capacidade de um indivíduo em controlar seu corpo no espaço e mantê-lo estável, mesmo quando submetido a algum tipo de perturbação. A postura se refere ao alinhamento dos segmentos corporais com o mínimo de estresse e tensão sobre os músculos e ligamentos, mantendo condições adequadas para realizar os movimentos. A integração do sistema neuromuscular é necessária para manter o equilíbrio, a postura, bem como a função miccional adequada. Várias alterações, incluindo, genética, hormonal, comportamental, distúrbios do sono, déficits sensoriais e neuromotores são associados à enurese noturna; em nossa prática clínica, observamos também uma alteração consistente na postura nessas crianças. Como a postura e o sistema de controle de equilíbrio são fortemente ligados, este estudo teve como objetivo investigar a postura e o equilíbrio em crianças e adolescentes com enurese noturna. Material e métodos: O estudo incluiu crianças e adolescentes com idades entre 7 e 16 anos; 65 com diagnóstico de enurese noturna monossintomática (ENM); 46 com enurese noturna não monossintomática (ENNM) pareadas em idade com 60 crianças assintomáticas (CTRL). Os participantes foram subdivididos em faixas etárias: A (7-11 anos de idade) e B (12-16 anos de idade). Integração sensorial e ajuste postural compensatório foram utilizados para inferir o equilíbrio, que foi avaliado utilizando uma plataforma de força eletrônica (100 Hz) para calcular a área do deslocamento do centro de pressão (COP). O COP é o ponto resultante da ação de forças verticais aplicados sobre a placa de força. A integração sensorial foi avaliada com o participante em pé, em uma tentativa de 60 segundos para cada uma das quatro condições sensoriais: (1) olhos abertos, superfície estável; (2) olhos fechados, superfície estável; (3) olhos abertos, superfície instável; (4) olhos fechados, superfície instável. O ajuste postural foi avaliado usando um cinto de tração posterior com uma carga equivalente a 4% de peso corporal, sendo esta liberada de maneira inesperada, de modo a produzir uma perturbação postural que foi observada durante os 8 segundos subsequente. A postura foi avaliada colocando marcos anatômicos reflexivos sobre a espinha ilíaca ântero-superior (ASIS), a espinha ilíaca póstero-superior (EIPS), o trocânter maior (GT) e o maléolo lateral (LM). Uma fotografia foi adquirida enquanto o participante permaneceu parado. Os ângulos foram obtidos a partir de conexões dos marcadores, utilizando o software para avaliar as seguintes variáveis: ante/retroversão da pelve e ante/retropulsão da pelve. A mobilidade do quadril foi medidas utilizando a goniometria manual. Resultados: Os grupos ENM e ENNM não apresentaram diferenças nas quatro condições sensoriais avaliadas. Deste modo continuamos seguimos a análise apenas com um grupo enurético comparado a um grupo controle. O GE/A apresentou maior área de deslocamento do COP em relação ao GC/A nas quatro condições sensoriais, enquanto o GE/B nas condições sensoriais 1, 2 e 4 quando comparado ao GC/B. Na avaliação do ajuste postural não houve diferença entre os grupos GE e GC para os subgrupos A e B mostrando que reagiram da mesma forma à perturbação. Embora tenha reagido igualmente à perturbação como averiguado em t1, o grupo GE/A comportou-se diferentemente do GC/A praticamente em todos os demais tempos. Em relação à postura e, mobilidade do quadril os grupos GE apresentou anteversão pélvica acentuada e extensão do quadril diminuída quando comparados ao GC em ambas faixas etárias. Conclusão: Crianças enuréticas apresentaram alterações no equilíbrio, na postura e, na mobilidade do quadril em relação à crianças do grupo controle / Introduction: Balance is the ability of an individual to control their body in space keeping it stable, even when submitted to any type of disturbance. Posture refers to the alignment of the body segments with minimal stress and strain on the muscles and ligaments, maintaining proper conditions to perform movements. The integration of the neuro-muscular system is required for maintaining balance, posture and for adequate voiding function. Various alterations, including the genetic, hormonal, behavioral, sleep disturbances, neuro-motor and sensory deficits are associated with nocturnal enuresis in children; in our clinical practice, we have observed a consistent alteration in their posture. Because posture and the balance control system are strongly connected, this study aimed to investigate posture and balance in children and adolescents with nocturnal enuresis. Material and methods: The study included children and adolescents aged between 7-16 years, 65 with monosymptomatic nocturnal enuresis (ENM); 46 with non-monosymptomatic nocturnal enuresis (ENNM) and 60 asymptomatic children (CTRL). The participants were divided into two age subgroups: A (7-11 years old) and B (12-16 years old). Sensory integration and compensatory postural adjustment were used to infer the balance that was assessed using an electronic force plate (100 Hz) to calculate the area of the center of pressure (COP) displacement. The COP is the point that results from the action of vertical forces projected onto the force plate. Sensory integration was analyzed using a 60-second trial with the participantes standing under four conditions: (1) eyes open, stable surface; (2) eyes closed, stable surface; (3) eyes open, unstable surface; (4) eyes closed, unstable surface. Postural adjustment was assessed using a posterior belt traction with 4% of body weight and unexpected release of it to produce a controlled postural perturbation followed by adjustments observed during 8 seconds. Posture was assessed by placing reflective anatomical landmarks on the anterior superior iliac spine (ASIS), the posterior superior iliac spine (PSIS), the greater trochanter (GT) and the lateral malleolus (LM). A photograph was acquired while the subject stood quietly. The angles were obtained from landmark connections using software to assess the following posture variables: pelvis ante/retroversion and pelvis ante/retropulsion. The hip mobility was measured using goniometry. Results: ENM and ENNM groups not showed difference in the four sensorial conditions. Thus we still follow the analysis with a only enuretic group compared to a control group (CG). The EG/A showed a greater area of COP displacement compared to the GC/A in all sensorial conditions, while EG/B in sensorial conditions 1, 2 and 4 when compared with CG/B. In the evaluation of postural adjustment no difference between EG and CG for subgroups A and B showing that reacted the same way to the disturbance. Although it has also responded to the disturbance as ascertained at t1, the EG/A behaved differently from GC/A virtually all other times. Regarding posture an hip mobility the EG and CG showed higher angles of pelvic anteversion and lower hip extension than CG. Conclusions: Enuretic children showed alterations in balance, posture with forward inclination of the pelvis, diminished mobility of hip and lower flexibility of spine

Introdução: A enurese noturna (EN) é considerada como a eliminação de urina no período noturno, de forma involuntária, em indivíduos com cinco ou mais anos de idade em pelo menos duas noites no mês até todas as noites. EN pode ser do tipo monossintomática, quando ocorre na ausência de outros sintomas, ou não monossintomática, na presença de sintomas de vesicais diurnos. Apesar de historicamente conhecida com uma desordem psiquiátrica, a EN monossintomática está incluída na Classificação Internacional dos Transtornos de 2012 como uma parassonia podendo ocorrer em qualquer fase do sono, porém predominantemente no sono não REM. Está comumente associada a hiperatividade vesical, produção excessiva de urina e falha em acordar após o enchimento vesical. Apesar de ocorrer no sono, a avaliação do sono pelos padrões usuais falhou em encontrar justificativa para este processo patológico. A análise da microestrutura do sono é uma ferramenta mais refinada e precisa que pode auxiliar na busca do mecanismo neurofisiológico que justifica este processo. Objetivo: Analisar os padrões de microarquitetura de sono atrvés do Padrão alternante Cíclico (CAP) nas crianças com EN monossintomática para melhor compreensão das bases neurofisiológicas da EN. Metodologia: Trinta e seis crianças sendo, 22 enuréticos e 14 controles com idade variando entre sete e 17 anos de idade, que satisfizeram os critérios de inclusão, foram submetidas a triagem clínica e laboratorial, avaliados quanto aos aspectos do sono, com uso de diários de sono, das escalas de Berlin, Sleep Scale for Children (SDSC) e Escala de Sonolência de Epworth e posteriormente submetidos ao de estudo polissonográfico completo de noite inteira, com a avaliação do CAP. Resultados: As escalas de sonolência e de Berlin não evidenciaram anormalidades, o SDSC evidenciou apneia em 11/22 (50%), hiperidrose em 2/22 (9%) e transtorno da transição vigília-sono, do despertar e do início e manutenção de sono em 1/22 (4,5%) cada. A análise da estrutura do sono mostrou maiores números de despertares (p < 0,001) e de sono N2 (p=0,0025) além de maior quantidade de sono N3 (p < 0,0001) do que nos controles. A microestrutura do sono evidenciou aumento da fase A1 (p=0,05), porém de forma mais contundente, redução das fases A2 e A3 (p < 0,0001), mesmo com a taxa de CAP igual à dos controles normais.Conclusão: Crianças com EN possuem sono com comorbidades (avaliado pelo SDSC) e menos fases CAP A2 e A3, significando uma redução no seu mecanismo de despertar e que ainda não havia sido demonstrado num estudo de PSG com análise das variáveis comuns. Este é o primeiro estudo que demonstra tal fenômeno / Introduction: Nocturnal enuresis (NE) is defined as the lack of nocturnal urine control, in individuals with five or more years old for at least two nights in a month, but up to every night. EN can be monosymptomatic (ENM), when it occurs in the absence of other symptoms or non monosymptomatic in the presence of diurnal renal symptoms. Although historically known as a psychiatric disorder, ENM is included in the International Classification of Sleep Disorders 2012 as a parasomnia. It can occur at any sleep stage but predominantly in non-REM sleep. EN is commonly associated to bladder hyperactivity, excessive urine production and/or failure to wake up after bladder filling. Despite the occurrence in sleep, standard sleep evaluation has failed to find abnormalities. The analysis of sleep microstructure is a refined and more accurate tool that can help find the neurophysiological mechanism underlying this process. Purpose: To evaluate sleep microarchitecture through Clyclic Altenating Pattern (CAP) analysis in children with monosymptomatic NE and provide a better understanding of the neurophysiological basis of EN. Methods: After IRB approval, 36 children, 22 with NE and 14 controls aged between seven and 17 years old who met the inclusion criteria were submitted to clinical and laboratory screening, evaluated for aspects of sleep, using sleep logs, Berlin Questionnaire (BQ), Sleep Scale for Children (SDSC) and Epworth Sleepiness Scale (ESS) and submitted to a full polysomnographic study, with evaluation of CAP. Results: ESS and BQ evidenced no abnormalities, the SDSC showed mild sleep apnea in 11/22 (50%), hyperhidrosis in 2/22 (9%) and disorder of the sleep-wake transition, awakening and initiation and maintenance sleep in 1/22 (4.5%) each. Analysis of sleep macrostructure showed higher numbers of awakenings (p < 0.001) and N2 sleep (p = 0.0025) as well as greater amount of sleep N3 (p < 0.0001) when compared to controls. Sleep microstructure showed an increase in A1 phase (p = 0.05), and reduction of A2 and A3 (p < 0.0001). CAP rate was the same for both enuretic and controls. Conclusion: Children with EN may present sleep comorbidities (measured by SDSC) and less A2 and A3 CAP phases, meaning a reduction in its wake regulation. This is the first study to acknowledge this phenomenon

Study Objectives: Nocturnal awakenings may constitute a unique risk for falls among older adults. We describe differences in gait and balance between presleep and midsleep testing, and whether changes in the lighting environment during the midsleep testing further affect gait and balance. Methods: Twenty-one healthy, late middle-aged and older (64.7 ± 8.0 y) adults participated in this repeated-measures design consisting of four overnight laboratory stays. Each night, participants completed baseline visual acuity, gait, and balance testing. After a 2-h sleep opportunity, they were awakened for 13 min into one of four lighting conditions: very dim white light (< 0.5 lux); dim white light (∼28.0 lux); dim orange light (∼28.0 lux); and white room-level light (∼200 lux). During this awakening, participants completed the same sequence of testing as at baseline. Results: Low-contrast visual acuity significantly decreased with decreasing illuminance conditions (F(3,45) = 98.26, p < 0.001). Our a priori hypothesis was confirmed in that variation in stride velocity and center of pressure path length were significantly worse during the mid-sleep awakening compared to presleep baseline. Lighting conditions during the awakening, however, did not influence these parameters. In exploratory analyses, we found that over one-third of the tested gait and balance parameters were significantly worse at the midsleep awakening as compared to baseline (p < 0.05), and nearly one-quarter had medium to large effect sizes (Cohen d ≥ 0.5; r ≥ 0.3). Conclusions: Balance and gait are impaired during midsleep awakenings among healthy, late middle-aged and older adults. This impairment is not ameliorated by exposure to room lighting, when compared to dim lights.

Dažniausiai inversijos sąlygos pavojingos miestams/ didmiesčiams, kurių didžiausias teršalų kiekis išmetamas dienos metu, o naktį teršalams išsisklaidyti trukdo inversijos reiškinys, kuris išsilaiko iki paryčių. Todėl yra svarbu kuo aiškiau apibrėžti inversijos sąlygų susidarymo priežastis ir išanalizuoti šio reiškinio įtaką miesto taršai. Taigi šіo dаrbo tіkѕlаѕ – nuѕtаtytі temperаtūroѕ іnverѕіјoѕ dėѕnіngumų įtаkа oro teršаlų ѕklаіdаі Kаuno mіeѕte. Pagrindiniai uždaviniai: nuѕtаtytі temperаtūroѕ іnverѕіјoѕ dėѕnіngumą pаroјe ѕkіrtіngаіѕ metų lаіkаіѕ, tuomet іšаnаlіzuotі temperаtūroѕ іnverѕіјoѕ įtаką teršаlų koncentrаcіјаі іr ѕtаtіѕtіškаі įvertіntі ryšіnę prіklаuѕomybę tаrp šіų rodiklių, taip pat įvertіntі kіtų meteorologіnіų rodiklių įtаką temperаtūroѕ іnverѕіјoѕ formаvіmuіѕі beі teršаlų pаѕіѕkіrѕtymuі kartu įvertinant oro teršalų koncentracijų ribinių verčių dinamiką 2006-2008 metais. Pagrindinis darbo metodas - duomenų analizė ir jų statistinių sąryšių kiekybinis įvertinimas. Atlikus tyrimą paaiškėjo kad, naktinės temperаtūroѕ іnverѕіјoѕ reіškіnyѕ Kаuno mіeѕte pаѕіreіškіа bet kurіuo metų lаіku іr ѕkіrіаѕі tіk vertіkаlаuѕ temperаtūroѕ grаdіento аmplіtudė. Taip pat nustatytos teigiamos vidutinio stiprumo teršalų koncentracijos priklausomybės nuo temperatūros inversijos išskyrus SO2. Be to nustatyta, kad KD10 koncentracija 2006 -2008 metų kovo pabaigoje ir balandžio pradžioje pasiekia didžiausią lygį ir viršija leistiną paros koncentracijos vertę, kai NO2 koncentracija ore... [toliau žr. visą tekstą] / Most inversion conditions dangerous cities / cities with the highest emissions of pollutants during the day and night to disperse pollutants prevents inversion phenomenon, which exists to morning. It is important to clarify the reasons for the formation of inversion conditions and analyze the impact of the phenomenon of urban pollution. The main thesis goal is to identify temperature inversions conditions and its impaction to the spread of pollutant Main tasks: identify temperature inversion phenomenon in different cycles of year, then calculate temperature inversion and pollutants correlation plus to analyze the concentration amount of pollutants in 2006- 2008 years. The method used for this investigation is the analysis of the data correlations calculation. The investigation revealed that temperature inversion exist on all cycles of year and detectable on night. Also the positive dependence of pollutant concentration to temperature inversion is detected, with the exception of SO2. In addition, it was found that the concentration of KD10 exceeded maximum values on 2006 -2008 in the end of March and beginning of April. What is more, NO2 concentration in air exceeds its level a several times a year and this is the signal for our health.

Motivation Hypertension and type 2 diabetes mellitus are common in the black population of South Africa. The literature also shows that elevated blood glucose concentrations can lead to an increase in blood pressure and a blunted decline in nocturnal blood pressure. Therefore, the motivation for this study was to determine if blood glucose may play a role regarding the blunted nocturnal decline in blood pressure in African and Caucasian men. Aim The aim of this study was to investigate the relationship between a blunted nocturnal decline in blood pressure and blood glucose in African and Caucasian men. Methodology A comparative population study was preformed that consisted of 202 school teachers (101 African and 101 Caucasian) between the ages of 25–60 years from the North West Province, South Africa. Subjects were excluded if their body temperature was elevated, had a dependence or abuse of psychotropic substances, were regular blood donors and/or vaccinated in the previous three months. Ambulatory systolic (SBP) and diastolic blood pressure (DBP) were measured. Blood samples from the antebrachial vein were collected in sodium fluoride tubes to determine the serum glucose level and glycosylated hemoglobin A1c (HbA1c) percentage. Estimated average glucose (eAG) was determined from the percentage HbA1c by means of a regression formula. Means and proportions were compared by standard t–test and the chi–square test, respectively. Pearson correlations were used to determine unadjusted associations and multiple regression analysis to determine adjusted associations between variables. Results and Conclusion African men had an elevated HbA1c (p<0.001), eAG (p<0.001), nighttime SBP (p<0.001) and DBP (p<0.001). These results remained similar when non–dipping African and Caucasian men were compared. The Africans also smoked more (p=0.012), consumed more alcohol (p=0.049), had a higher percentage of non–dippers (p=0.054), HIV infected subjects (p<0.001) and a larger number of subjects that used anti–hypertensive medication (p=0.049). The unadjusted analysis showed positive correlations between all the blood pressure measurements and serum glucose, HbA1c and eAG in the African non–dipper men. While in the non–dipper Caucasian men, only daytime SBP and nighttime SBP (22:00–06:00) correlated positively with serum glucose, HbA1c and eAG. Furthermore, when viewing the relationship between carotid intima–media thickness (CIMT) and the blood pressure measurements in the African population, only nighttime (00:00– 04:00) SBP (r=0.581, p<0.001) and DBP (r=0.566, p<0.001) showed positive associations. After adjustments were made for age and body mass index the associations between the various blood pressure measurements and blood glucose disappeared in the non–dipper Caucasian men. However, in the non–dipper African men both nighttime (22:00–06:00) SBP and (00:00– 04:00) SBP showed positive correlations with serum glucose, HbA1c and eAG. After full adjustments (age, BMI, smoking, alcohol intake, physical activity, C–reactive protein and baroreceptor sensitivity) were made, nighttime (00:00–04:00) SBP was the only measure of blood pressure that correlated positively with HbA1c (p=0.069) and eAG (p<0.001) in the nondipper African men. No significant relationships were found for Caucasian men. Furthermore, to determine if the association between nighttime (00:00–04:00) SBP and eAG were independent of CIMT, we adjusted for CIMT. By doing so the positive association between SBP and eAG remained significant in the non–dipper African men (R2=0.617; =0.438; p=0.008) and nonsignificant in the non–dipper Caucasian men (R2=0.423; =0.169; p=0.33). However, the relationship between CIMT and eAG disappeared when we adjusted for SBP, suggesting that the SBP and eAG relationship drives CIMT. In conclusion, the association between the early morning SBP (00:00–04:00) and the blood glucose in non–dipping African men suggests that the blunted decline in nocturnal blood pressure during the early morning hours is associated with chronically elevated blood glucose. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2011.

Motivation Hypertension and type 2 diabetes mellitus are common in the black population of South Africa. The literature also shows that elevated blood glucose concentrations can lead to an increase in blood pressure and a blunted decline in nocturnal blood pressure. Therefore, the motivation for this study was to determine if blood glucose may play a role regarding the blunted nocturnal decline in blood pressure in African and Caucasian men. Aim The aim of this study was to investigate the relationship between a blunted nocturnal decline in blood pressure and blood glucose in African and Caucasian men. Methodology A comparative population study was preformed that consisted of 202 school teachers (101 African and 101 Caucasian) between the ages of 25–60 years from the North West Province, South Africa. Subjects were excluded if their body temperature was elevated, had a dependence or abuse of psychotropic substances, were regular blood donors and/or vaccinated in the previous three months. Ambulatory systolic (SBP) and diastolic blood pressure (DBP) were measured. Blood samples from the antebrachial vein were collected in sodium fluoride tubes to determine the serum glucose level and glycosylated hemoglobin A1c (HbA1c) percentage. Estimated average glucose (eAG) was determined from the percentage HbA1c by means of a regression formula. Means and proportions were compared by standard t–test and the chi–square test, respectively. Pearson correlations were used to determine unadjusted associations and multiple regression analysis to determine adjusted associations between variables. Results and Conclusion African men had an elevated HbA1c (p<0.001), eAG (p<0.001), nighttime SBP (p<0.001) and DBP (p<0.001). These results remained similar when non–dipping African and Caucasian men were compared. The Africans also smoked more (p=0.012), consumed more alcohol (p=0.049), had a higher percentage of non–dippers (p=0.054), HIV infected subjects (p<0.001) and a larger number of subjects that used anti–hypertensive medication (p=0.049). The unadjusted analysis showed positive correlations between all the blood pressure measurements and serum glucose, HbA1c and eAG in the African non–dipper men. While in the non–dipper Caucasian men, only daytime SBP and nighttime SBP (22:00–06:00) correlated positively with serum glucose, HbA1c and eAG. Furthermore, when viewing the relationship between carotid intima–media thickness (CIMT) and the blood pressure measurements in the African population, only nighttime (00:00– 04:00) SBP (r=0.581, p<0.001) and DBP (r=0.566, p<0.001) showed positive associations. After adjustments were made for age and body mass index the associations between the various blood pressure measurements and blood glucose disappeared in the non–dipper Caucasian men. However, in the non–dipper African men both nighttime (22:00–06:00) SBP and (00:00– 04:00) SBP showed positive correlations with serum glucose, HbA1c and eAG. After full adjustments (age, BMI, smoking, alcohol intake, physical activity, C–reactive protein and baroreceptor sensitivity) were made, nighttime (00:00–04:00) SBP was the only measure of blood pressure that correlated positively with HbA1c (p=0.069) and eAG (p<0.001) in the nondipper African men. No significant relationships were found for Caucasian men. Furthermore, to determine if the association between nighttime (00:00–04:00) SBP and eAG were independent of CIMT, we adjusted for CIMT. By doing so the positive association between SBP and eAG remained significant in the non–dipper African men (R2=0.617; =0.438; p=0.008) and nonsignificant in the non–dipper Caucasian men (R2=0.423; =0.169; p=0.33). However, the relationship between CIMT and eAG disappeared when we adjusted for SBP, suggesting that the SBP and eAG relationship drives CIMT. In conclusion, the association between the early morning SBP (00:00–04:00) and the blood glucose in non–dipping African men suggests that the blunted decline in nocturnal blood pressure during the early morning hours is associated with chronically elevated blood glucose. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2011.

Chez les insectes où les males chantent en chorus, l’interférence locale de signaux impose des contraintes majeures à des femelles qui doivent évaluer les mâles individuellement. Les mâles subis des difficultés pour évaluer la compétitivité de leurs voisins et pour montrer clairement aux femelles les caractéristiques de leurs propres chants. J’ai analysé différents aspects de cette problématique chez deux espèces acoustiques : chez la sauterelle ephippiger et une pyrale nocturne qui émettent leurs signaux au sein de regroupements. Nos expériences ont mis en évidence certains mécanismes comportementaux permettant aux femelles de localiser les meuliers males et d’autres permettant aux mâles de se communiquer efficacement et percevoir leur environnement acoustique. / In acoustic insects where males sing in choruses, local signal interference may present major difficulties for females evaluating and individual males. Males too may be prevented from assessing the competitivity of their neighbors as well as from advertising the characteristics of their own signals to females in a clear manner. Moreover, the background noise from local signals may prevent both sexes from perceiving other sounds in the environment, e.g. predator cues. I studied these problems at several levels in two acoustic insect species: in which males broadcast their advertisement songs while remaining in dense clusters. The experiments revealed behavioral mechanisms with which females can identify favored males and others with which males can communicate effectively.

Fundação de Amparo à Pesquisa do Estado do Amazonas / The LBA (Large Scale Biosphere-Atmosphere in Amazônia) project has been using the eddy covariance technique since 1998 to continuously monitor the surface fluxes of energy, water vapor and carbon over Amazônia. The results obtained up to now indicate high level of uncertainties, especially regarding the role of the Amazonian ecosystem to the global carbon budget. Besides the problems related with the Eddy measure system (systematic error and nighttime stable conditions), there is an important factor associated with the averaging time scale or time window used by the scientific community to determine the surface fluxes. This work focuses on the determination of the nocturnal turbulence time scale for long term surface fluxes (carbon, energy and water) over the Amazon rainforest. We used the multi-resolution decomposition technique to project the signal into several time scales and determine when the spectral and co-spectral gap occurred. This technique permitted evaluating and separating the real contribution from turbulent and mesoscale fluxes to the total nocturnal surface fluxes. Our results indicate that the nighttime turbulence time scale is near 100 seconds. It suggests that the time averaging commonly used to calculate nocturnal surface fluxes (30 minutes), needs to be revised. Besides, our results show that, when the mesoscale flux contributions were included, the total nocturnal surface flux was generally underestimated. / Desde 1998 o projeto LBA (Large Scale Biosphere-Atmosphere in Amazônia) vem monitorando continuamente os fluxos de energia, água e carbono na Amazônia utilizando o sistema de Covariância dos Vórtices (CV). Os resultados obtidos até agora apresentam um alto grau de incerteza, especialmente no que diz respeito ao papel do ecossistema amazônico no ciclo global do carbono. Além desses problemas relacionados com as medidas do sistema CV (erros sistemáticos e durante condições estáveis), um outro fator extremamente importante está relacionado com a escala de tempo janela de tempo usada pela comunidade científica para determinar os fluxos de superfície. Este trabalho consiste no esforço inicial em determinar essas escalas para as transferências noturnas (carbono, energia e água) para séries de longo prazo sobre a floresta Amazônica. Nós utilizamos a técnica de multiresolução para projetar o sinal em várias escalas de tempo e determinar quando ocorre a falha coespectral. Esta técnica permite avaliar a real contribuição da turbulência, bem como da mesoescala para o fluxo noturno total. Nossos resultados indicam que a escala de turbulência noturna (comprimento da falha) foi em media 100 s. isto sugere que a escala comumente empregada, que é de 30 min, deve ser revisitada, sobretudo para o sítio estudado. Além disso, os resultados mostram que quando adicionamos a contribuição de mesoescala ao fluxo total, em geral, isto provoca subestimativa das transferências noturnas.