A disfunção erétil (DE) tem alta prevalência entre hipertensos e tem sido considerada marcador precoce de risco cardiovascular. A presença e gravidade da DE bem como a resposta clínica aos inibidores da fosfodiesterase tipo 5 (PDE5) parecem depender da biodisponibilidade do óxido nítrico (NO) endotelial e da extensão da doença aterosclerótica. O objetivo deste estudo foi avaliar a resposta clínica da vardenafila usada em dois regimes terapêuticos em hipertensos com DE vasculogênica e sem doença cardiovascular maior, correlacionando a gravidade da DE e a eficácia da vardenafila com dados antropométricos, laboratoriais, escore de risco cardiovascular e parâmetros vasculares funcionais e estruturais. A resposta clínica à vardenafila nos dois regimes foi avaliada conforme o percentual de respostas positivas à questão 3 do Perfil do Encontro Sexual (PES3). Os parâmetros vasculares considerados foram a espessura médio-intimal (EMI) da carótida comum, a dilatação mediada pelo fluxo (DMF) da artéria braquial e a dilatação nitrato-mediada (DNM). Foram incluídos 100 homens hipertensos com idade entre 50 e 70 anos, sendo 74 portadores de DE vasculogênica e 26 com função erétil normal que serviram de grupo controle. Nos pacientes com DE, o índice de massa corporal, relação cintura-quadril, EMI da carótida, níveis séricos de triglicerídeos, colesterol total e LDL foram significativamente maiores que no grupo controle. Após o uso de vardenafila on demand (fase 1), os pacientes com mais de 50% de respostas positivas ao PES3 ou 50% de respostas afirmativas e um incremento de 6 pontos ou mais em relação ao Índice Internacional de Função Erétil (IIEF-FE) basal e/ou resposta positiva a Questão de Avaliação Global (QAG), foram considerados respondedores. O escore do IIEF-FE basal se correlacionou negativamente com a EMI da carótida (r=-0,48, P<0,001) e com o escore de Framingham (r= -0,41, P<0,001) no grupo com DE. Houve forte correlação positiva entre a resposta clínica à vardenafila com a DMF (r= 0,70, P<0,001), que não se observou entre o sub-grupo de diabéticos. Os 35 pacientes considerados não-respondedores na fase 1 foram randomizados e, em desenho duplo-cego, receberam vardenafila ou placebo diariamente durante cinco semanas, podendo usar 10 mg de vardenafila uma hora antes da atividade sexual (fase2). Houve resposta clínica positiva em 38,8% dos que receberam a vardenafila na fase 2 e esta resposta se correlacionou com a frequência sexual (r= 0,68, P<0,01) e com o escore de Framingham (r= -0,65, P<0,01), com a EMI da carótida (r= -0,61, P=0,01) e com o LDL-colesterol (r= -0,64, P<0,01). A vardenafila foi bem tolerada em ambos os regimes terapêuticos. Concluímos que nessa amostra de hipertensos, a gravidade da DE foi relacionada a parâmetros vasculares estruturais (EMI), enquanto a resposta clínica à vardenafila on demand foi mais diretamente dependente da função vascular momentânea (DMF). Houve benefício na utilização de vardenafila diariamente com o objetivo de resgatar a eficácia do inibidor quanto à melhora do desempenho sexual. A falta de eficácia clínica ao inibidor da PDE5 em ambos os regimes terapêuticos pode servir como marcador clínico que identifica homens hipertensos com um risco cardiovascular aumentado. / Erectile dysfunction (ED) is a high prevalent disease in hypertensive subjects and has been considered an early cardiovascular risk marker. EDs presence and severity, as well as clinical response to phosfodiesterase type 5 (PDE5) inhibitors, vary according to nitric oxide (NO) availability and atherosclerosis extension. We investigated whether vasculogenic ED severity and clinical response to vardenafil used on demand or continuously were associated with structural and functional vascular changes in patients with uncomplicated hypertension. Our main efficacy criterion was per patient percentage of positive answers on Sexual Encounter Profile question 3(SEP3). Vascular parameters considered were intima-media thickness (IMT), flow-mediated dilation (FMD) on brachial artery and nitrate-mediated dilation. A total of 100 hypertensive men aging between 50 and 70 years were included. Among these patients, 74 had vasculogenic ED and 26 presented normal erectile function according to erectile domain of International Index of Erectile Function (IIEF-EF). Among those with ED, body mass index, waist-rip ratio, carotid IMT, triglycerides, total cholesterol and LDL-cholesterol were significantly higher than controls. After vardenafil on demand usage during phase 1, patients with more than 50% of positive answers on SEP3 or 50% and more than 6 points on IIEF basal score or positive answer to global evaliation question were considered responders. IIEF basal score correlated inversely with carotid IMT (r=-0.48, P<0.001) and with Framingham risk score (r= -0.41, P<0.001) in ED group. Clinical response to vardenafil strongly correlated with FMD (r= 0.70, P<0.001), except among diabetics. Non responders (n=35) on phase 1 were included on phase 2 when, after randomization, they received vardenafil 10 mg nightly or placebo during five weeks. Open vardenafil on demand were allowed one hour before sexual intercourse, and 38.8% of active group improved and became responders to vardenafil. Clinical response on phase 2 correlated with sexual frequency (r= 0.68, P<0.01), Framingham score (r= -0.65, P<0.01), carotid IMT (r= -0.61, P=0.01) and LDL-cholesterol (r= -0.64, P<0.01). We concluded that in hypertensive males with vasculogenic ED and no other clinical evidence of atherosclerosis, ED severity correlated with structural parameters (carotid IMT), while phosphodiesterase-5 effectiveness correlated with functional vascular aspects (brachial FMD). There were positive impact with continuous vardenafil on non responders to on demand regime and that could be an option to salvage strategy. Lack of PDE5 inhibitor efficacy in both therapeutic strategies could point out to higher cardiovascular risk and could be considered a useful clinical marker.

[pt] Em apresentações hipermídia, umas das principais tarefas coordenadas pelo orquestrador da apresentação é a sincronização entre os diversos objetos componentes, que pode ser obtida através do ajuste elástico do tempo de exibição dos objetos. Esta técnica pode ser aplicada em tempo de compilação, de forma a manter os relacionamentos de sincronização especificados pelo autor, ou em tempo de apresentação, para prevenir qualquer descasamento temporal causado pelos ambientes de transmissão e de execução. Este trabalho descreve um conjunto de mecanismos para executar o ajuste elástico em fluxos MPEG-2 de Vídeo e de Sistemas, propondo algoritmos para a realização da compressão e expansão do tempo de exibição, do controle da ocupação do buffer do decodificador, da sincronização intermídia e da reconstrução do relógio de referência. Visando seu emprego em tempo de execução, todo o processo de ajuste é realizado diretamente no fluxo MPEG, sem qualquer transcodificação. / [en] In hypermedia presentations, one of the main tasks provided by the orchestrator is the synchronization of all presentation objects, which may be achieved by elastic time adjustment of period of exhibition of the objects, or simply timescale adaptation. This technique can be applied at compilation time, in order to keep track of synchronism relationships specified by authors, or at presentation time, to prevent any temporal mismatch caused by transmission or execution environments. This work presents a set of mechanisms to carry out timescale adaptation in MPEG-2 Systems and Video streams, proposing algorithms to perform compression and expansion of exhibition period, also called playback dilation, rate control, inter-media synchronization and clock reconstruction. In order to be performed at execution time, timescale operations are realized directly in compressed MPEG-2 streams, requiring no transcodification.

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Perceptual multistability is a phenomenon that is mostly studied in all modalities separately. The phenomenon reveals fundamental principles of the perceptual system in the formation of an emerging cognitive representation in the consciousness. The momentary perceptual organizations evoked during the stimulation with ambiguous stimuli switches between several perceptual organizations or percepts: The auditory streaming stimulus in audition and the moving plaids stimulus in vision, elicit different at least two percepts that dominate awareness exclusively for a random phase or dominance duration before an inevitable switch to another percept occurs. The similarity in the perceptual experience has led to propose a global mechanism contributing to the perceptual multistability phenomena crossmodally. Contrary, the difference in the perceptual experience has led to propose a distributed mechanism that is modality-specific. The development of a hybrid model has synergized both approaches. We accumulate empirical evidence for the contribution of a global mechanism, albeit distributed mechanisms play an indispensable role in this cross-modal interplay. The overt report of the perceptual experience in our experiments is accompanied by the recording of objective, cognitive markers of the consciousness: Reflexive movements of the eyes, namely the dilation of the pupil and the optokinetic nystagmus, correlate with the unobservable perceptual switches and perceptual states respectively and have their neuronal rooting in the brainstem. We complement earlier findings on the sensitivity of the pupil to visual multistability: It was shown in two independent experiments that the pupil dilates at the time of reported perceptual switches in auditory multistability. A control condition on confounding effects from the reporting process confines the results. Endogenous, evoked internally by the unchanged stimulus ambiguity, and exogenous, evoked externally by the changes in the physical properties of the stimulus, perceptual switches could be discriminated based on the maximal amplitude of the dilation. The effect of exogenous perceptual has on the pupil were captured in a report and no-report task to detect confounding perceptual effects. In two additional studies, the moment-by-moment coupling and coupling properties of percepts between concurrent multistable processes in audition, evoked by auditory streaming, and in vision, evoked by moving plaids, were found crossmodally. In the last study, the externally induced percept in the visual multistable process was not relayed to the simultaneous auditory multistable process: Still, the observed general coupling is fragile but existent. The requirement for the investigation of a moment-by-moment coupling of the multistable perceptual processes was the application of a no-report paradigm in vision: The visual stimulus evokes an optokinetic nystagmus that has machine learnable different properties when following either of the two percepts. In combination with the manually reported auditory percept, attentional bottlenecks due to a parallel report were circumvented. The two main findings, the dilation of the pupil along reported auditory perceptual switches and the crossmodal coupling of percepts in bimodal audiovisual multistability, speak in favor of a partly global mechanism being involved in control of perceptual multistability; the global mechanism is incarcerated by the, partly independent, distributed competition of percepts on modality level. Potentially, supramodal attention-related modulations consolidate the outcome of locally distributed perceptual competition in all modalities.:COVER 1 BIBLIOGRAPHISCHE BESCHREIBUNG 2 ACKNOWLEDGEMENTS 3 CONTENTS 4 CHAPTER 1: Introduction 6 C1.1: Stability and uncertainty in perception 6 C1.2: Auditory, visual and audio-visual multistability 14 C1.3: Capturing the subjective perceptual experience 25 C1.4: Limitations of preceding studies, objectives, and outline of the Thesis 33 CHAPTER 2: Study 1 “Pupillometry in auditory multistability” 36 C2.1.1 Experiment 1: Introduction 36 C2.1.2 Experiment 1: Material and Methods 38 C2.1.3 Experiment 1: Data analysis 44 C2.1.4 Experiment 1: Results 48 C2.1.5 Experiment 1: Discussion 52 C2.2.1 Experiment 2: Introduction 54 C2.2.2 Experiment 2: Material and Methods 54 C2.2.3 Experiment 2: Data analysis 56 C2.2.4 Experiment 2: Results 57 C2.3 Experiment 1 & 2: Discussion 61 C2.4 Supplement Study 1 65 CHAPTER 3: Study 2 “Multimodal moment-by-moment coupling in perceptual bistability” 71 C3.1.1 Experiment 1: Introduction 71 C3.1.2 Experiment 1: Results 74 C3.1.3 Experiment 1: Discussion 80 C3.1.4 Experiment 1: Material and Methods 84 C3.1.5 Experiment 1: Data analysis 87 C3.2 Supplement Study 2 92 CHAPTER 4: Study 3 “Boundaries of bimodal coupling in perceptual bistability” 93 C4.1.1 Experiment 1: Introduction 93 C4.1.2 Experiment 1: Material and Methods 98 C4.1.3 Experiment 1: Data analysis 102 C4.1.4 Experiment 1: Results 108 C4.1.5 Experiment 1: Discussion 114 C4.2.1 Experiment 2: Introduction 116 C4.2.2 Experiment 2: Material and Methods 119 C4.2.3 Experiment 2: Data analysis 125 C4.2.4 Experiment 2: Results 133 C4.3 Experiment 1 & 2: Discussion 144 C4.4 Supplement Study 3 151 CHAPTER 5: General Discussion 154 C5.1 Significance for models of multistability and implications for the perceptual architecture 162 C5.2 Recommendations for future research 166 C5.3 Conclusion 168 REFERENCES 170 APPENDIX 186 A1: List of Figures 186 A2: List of Tables 188 A3: List of Abbreviations and Symbols 189

Les uninormes són uns operadors d'agregació que, per la seva definició, es poden considerar com a conjuncions o disjuncions, i que han estat aplicades a camps molt diversos. En aquest treball s'estudien algunes equacions funcionals que tenen com a incògnites les uninormes, o operadors definits a partir d'elles. Una d'elles és la distributivitat, que és resolta per les classes d'uninormes conegudes, solucionant, en particular, un problema obert en la teoria de l'anàlisi no-estàndard. També s'estudien les implicacions residuals i fortes definides a partir d'uninormes, trobant solució a la distributivitat d'aquestes implicacions sobre uninormes. Com a aplicació d'aquests estudis, es revisa i s'amplia la morfologia matemàtica borrosa basada en uninormes, que proporciona un marc inicial favorable per a un nou enfocament en l'anàlisi d'imatges, que haurà de ser estudiat en més profunditat. / Las uninormas son unos operadores de agregación que, por su definición se pueden considerar como conjunciones o disjunciones y que han sido aplicados a campos muy diversos. En este trabajo se estudian algunas ecuaciones funcionales que tienen como incógnitas las uninormas, o operadores definidos a partir de ellas.Una de ellas es la distributividad, que se resuelve para las classes de uninormas conocidas, solucionando, en particular, un problema abierto en la teoría del análisis no estándar. También se estudian las implicaciones residuales y fuertes definidas a partir de uninormas, encontrando solución a la distributividad de estas implicaciones sobre uninormas. Como aplicación de estos estudios, se revisa y amplía la morfología matemática borrosa basada en uninormas, que proporciona un marco inicial favorable para un nuevo enfoque en el análisis de imágenes, que tendrá que ser estudiado en más profundidad. / Uninorms are aggregation operators that, due to its definition, can be considered as conjunctions or disjunctions, and they have been applied to very different fields. In this work, some functional equations are studied, involving uninorms, or operators defined from them as unknowns. One of them is the distributivity equation, that is solved for all the known classes of uninorms, finding solution, in particular, to one open problem in the non-standard analysis theory. Residual implications, as well as strong ones defined from uninorms are studied, obtaining solution to the distributivity equation of this implications over uninorms. As an application of all these studies, the fuzzy mathematical morphology based on uninorms is revised and deeply studied, getting a new framework in image processing, that it will have to be studied in more detail.

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Made available in DSpace on 2016-06-02T20:18:10Z (GMT). No. of bitstreams: 1 2010.pdf: 2854762 bytes, checksum: b0421ce836a4726be750d7bf5a373fb9 (MD5) Previous issue date: 2008-08-18 / Universidade Federal de Sao Carlos / The ageing process is known to affect different tissues and systems. It is well-established that age-associated changes in cardiovascular structure and function are related to the risk of cardiovascular diseases. Because of the vast amount of cardiovascular modifications observed with ageing, the present study focused on three important topics: heart rate variability (HRV), blood pressure variability (BPV) and endothelial dysfunction. Furthermore, we also investigated the effects of physical activity (endurance and strength) on the autonomic control of heart rate (HR), which might be used as non-pharmacological therapy. Thirty five young subject between 18 and 30 years old (14 sedentary men, 5 sedentary women and 16 active men) and thirty eight middleaged/older subjects between 55 and 70 years old (16 sedentary men, 14 sedentary women and 8 active men) were studied. In addition, the subjects are distributed among 3 different studies. In the first one, the effects of the ageing process and active life-style on the autonomic control of HR were investigated in young and middleaged/older subjects. Electrocardiogram was recorded during 15 minutes of rest and 4 minutes of controlled breathing (5 to 6 cycles/min) in the supine position. HR and RR intervals were analyzed by time and frequency domain methods. The active groups presented lower HR and higher HRV (time domain) than the sedentary groups, whereas both middle-aged/older groups showed lower HRV (frequency domain). Additionally, interaction between ageing and life-style effects was observed for respiratory sinus arrhythmia (ASR) indexes (calculated during the controlled breathing test). The sedentary middle-aged/older group presented lower ASR magnitude than the other groups studied. The results suggest that ageing reduces HRV, however, regular physical activity improves vagal modulation on the heart and, consequently, attenuates the effects of ageing on the autonomic control of HR. In the second study, we aimed to investigate if strength training is able to improve cardiac autonomic control in healthy middle-aged/older men. HRV was evaluated before and after 12 weeks of isokinetic eccentric strength training (2days/week, 2-4 sets of 8-12 repetitions at 75-80% peak torque), involving knee flexion and extension. Strength training decreased the systolic blood pressure and increased the torque. However, an autonomic imbalance towards sympathetic modulation predominance was induced by an unknown mechanism. In the third study, we evaluated the effect of ageing on the BPV and endothelial function. We also sought for correlations between increased BPV and impaired endothelium dependent-dilation (EDD) in the middle-aged/older group. Intra-brachial artery BPV and conduit vessel EDD (brachial artery flow-mediated dilation, FMD) were determined in healthy young and middle-aged/older subjects. Moreover, endothelial function of resistance vessels was evaluated by venous occlusion plethysmoghaphy in the middle-aged/older group. The young group presented lower systemic oxidative stress, lower systolic BPV and higher FMD compared with the middle-aged/older group. After split this group according to the BPV, lower FMD was observed in the middleaged/older group with higher BPV. In addition, FMD was inversely correlated to BPV. The lower BPV group showed a great reduction (55%) in the forearm blood flow responses when NG-monometyl-L-arginine (nitric oxide inhibitor) was co-infused with acetylcholine (vs 14% in the higher BPV group). The results suggest that ageing process increases BPV and reduces endothelial function. Additionally, middle-aged/older subjects with higher BPV also have impaired EDD compared with their peers with lower BPV. General Conclusions: the results from the studies described above suggest that ageing process causes decrease of HRV, increase of BPV and decrease of endothelial function. Moreover, aerobic exercise has a cardioprotector effect, since it was able to attenuate the ageing effects on the cardiac vagal modulation. This same benefit, however, was not observed after 12 weeks of eccentric strength training. On the other hand, the strength training program performed by healthy older subjects modified the sympato-vagal balance toward the sympathetic modulation. Finally, systolic BPV oscillations seem to have a narrow relationship with vasodilation mediated by nitric oxide. Then, more studies are needed to clarify the cause-effect relation between those important variables. / O envelhecimento é um processo complexo que causa alterações em vários sistemas do organismo. Em relação ao sistema cardiovascular, modificações na sua estrutura e função estão diretamente relacionadas com o risco aumentado de desenvolvimento de doenças cardiovasculares em idosos. Dentre as diversas alterações cardiovasculares observadas com o envelhecimento, apenas as relacionadas à variabilidade da freqüência cardíaca (VFC), variabilidade da pressão arterial (VPA) e disfunção endotelial foram abordadas no presente estudo. Além disso, foram também investigados os efeitos de dois tipos distintos de exercício físico, ou seja, de resistência aeróbia e de força muscular, sobre o controle autonômico da freqüência cardíaca (FC) de sujeitos saudáveis, como uma forma alternativa de terapia não-farmacológica. Participaram do presente estudo: 35 sujeitos jovens na faixa etária de 18 a 30 anos (14 homens sedentários, 5 mulheres sedentárias e 16 homens ativos) e 38 sujeitos meia-idade/idosos na faixa etária de 55 a 70 anos (16 homens sedentários, 14 mulheres sedentárias e 8 idosos ativos), os quais estão distribuídos em 3 estudos distintos. No primeiro estudo, os efeitos do envelhecimento e do estilo de vida sobre o controle autonômico da FC foram investigados em jovens e meiaidade/idosos com padrão de vida sedentário ou ativo. O sinal eletrocardiográfico foi obtido durante 15 minutos de repouso e 4 minutos de respiração controlada (5-6 ciclos/min), ambos na posição supina. A FC e os intervalos RR foram analisados no domínio do tempo e da freqüência. Adicionalmente, os índices da arritmia sinusal respiratória (ASR) também foram calculados. Os grupos ativos apresentaram menor FC e maior VFC (domínio do tempo) em relação aos grupos sedentários, enquanto que ambos os grupos idosos apresentaram menor VFC (domínio da freqüência). Além disso, foi observado interação entre idade e estilo de vida, já que a magnitude da ASR foi menor no grupo meia-idade/idoso sedentário comparativamente aos demais grupos. Os resultados indicam que a VFC reduz com o aumento da idade. Entretanto, a atividade física regular produz efeitos positivos sobre a modulação vagal cardíaca e, conseqüentemente, atenua os efeitos do envelhecimento sobre o controle autonômico da FC. No segundo estudo, foi avaliado se o treinamento de força excêntrica é capaz de modificar o controle autonômico da FC de idosos saudáveis. A VFC foi avaliada, durante o repouso supino e sentado, após 12 semanas de treinamento de força isocinética excêntrica (extensão e flexão do joelho, 2 dias/semana, 2-4 séries de 8-12 repetições, 75-80% do pico de torque). O treinamento de força foi capaz de aumentar o torque muscular e reduzir a pressão arterial (PA) sistólica de idosos saudáveis. Entretanto, o mesmo causou um desbalanço simpato-vagal, em direção a predominância simpática, o qual foi produzido por mecanismos desconhecidos. No terceiro estudo, foi avaliado se a VPA está aumentada com o avançar da idade e, ainda, se a mesma tem alguma relação com reduções na vasodilatação endotélio-dependente (VED) em sujeitos meiaidade/idosos saudáveis. A VPA intra-arterial e a VED (dilatação mediada por fluxo, DMF) da artéria braquial (i.e., vaso de condutância) foram avaliadas em sujeitos jovens e meia-idade/idosos de ambos os sexos. Adicionalmente, o grupo meia-idade/idoso também foi submetido à pletismografia de oclusão venosa para avaliar a função endotelial dos vasos de resistência. Os jovens apresentaram menor estresse oxidativo sistêmico, menor VPA sistólica e maior DMF, comparativamente ao grupo meia-idade/idoso. Quando esse grupo foi dividido de acordo com a VPA, observou-se DMF reduzida no grupo com alta VPA. Adicionalmente, a DMF mostrou correlação inversa com a VPA. Em relação aos vasos de resistência, o grupo com baixa VPA mostrou redução de 55% na resposta do fluxo sangüíneo quando NG-monometil-L-arginina (inibidor da produção de óxido nítrico) foi co-infudido com acetilcolina (vs 14% no grupo com alta VPA). Os resultados indicam que o envelhecimento causa redução da função endotelial e aumento da VPA. Além disso, sujeitos meia-idade/idosos com alta VPA apresentam DMF reduzida quando comparados aos seus pares com baixa VPA. Conclusão geral: os resultados obtidos nos três estudos sugerem que o envelhecimento causa redução na VFC, aumento da VPA e redução da função endotelial. Além disso, a atividade física aeróbia possui um efeito cardioprotetor, já que essa foi capaz de atenuar os efeitos do envelhecimento sobre a modulação vagal cardíaca. Entretanto, esses efeitos benéficos não foram observados com o treinamento de força excêntrica, pois 12 semanas de treinamento alteraram o balanço simpato-vagal em direção a modulação simpática. Por fim, o aumento nas oscilações da PA sistólica mostrou uma estreita relação com a vasodilatação mediada pelo óxido nítrico, a qual necessita de maiores investigações no sentido de determinar a relação de causa e efeito entre essas duas importantes variáveis.

Les maladies cardiométaboliques sont les principales causes de décès dans le monde, et au Canada elles sont responsables d'environ 700 000 décès par année. Le diabète de type 2 et la maladie coronarienne sont les maladies cardiométaboliques les plus répandues. Malgré des avancées pharmacologiques, la prévalence de ces maladies demeure élevée, ce qui souligne l'importance des thérapies complémentaires qui améliorent le contrôle glycémique ainsi que la fonction vasculaire afin de prévenir les complications liées à ces maladies. Depuis quelques années, l’exposition à la chaleur reçoit une attention accrue pour son potentiel thérapeutique. En outre, des études scientifiques suggèrent que l’exposition à la chaleur pourrait diminuer la glycémie et améliorer la fonction vasculaire. Cependant, le potentiel thérapeutique de l'exposition à la chaleur demeure sous-étudié chez les personnes atteintes du diabète de type 2 ou de la maladie coronarienne. L’objectif général de cette thèse était d’évaluer les effets aigus de l’exposition à la chaleur sur des marqueurs de la fonction cardiométabolique auprès de gens ayant un diabète de type 2 ou une maladie coronarienne. L’article 1 a déterminé l’effet aigu d’une immersion en eau chaude sur la sensibilité à l’insuline, la fonction vasculaire, les concentrations des protéines de choc thermique plasmatique (eHSP70/90) et intracellulaire (iHSP70/90), les marqueurs inflammatoires (IL-6, IL1-RA, NFKB) ainsi que sur les médiateurs de l'action de l'insuline (IRS-1, GLP-1) comparativement à une immersion thermoneutre au sein d’une population ayant le diabète de type 2. Les résultats démontrent qu’une immersion en eau chaude n’améliore pas la sensibilité à l’insuline, ni la fonction vasculaire et elle n’affecte pas les concentrations de HSP70 / 90 et les marqueurs inflammatoires. L’article 2 a déterminé l’effet aigu d’une exposition dans un sauna Finlandais sur la fonction vasculaire, des marqueurs de dysfonction endothéliale (VCAM-1, ICAM-1) et des marqueurs inflammatoires (IL-6, IL-10, TNF-α, IL-1β, CRP) auprès de personnes ayant une maladie coronarienne. Les résultats démontrent qu’une séance de sauna Finlandais améliore la fonction endothéliale et augmente la concentration circulante d’IL-6 sans affecter d’autres marqueurs inflammatoires (IL-10, TNF-α, IL-1β, CRP) ainsi que des marqueurs de dysfonction endothéliale. Combinées, les deux études de cette thèse démontrent que l’exposition passive à la chaleur n’améliore pas de façon aiguë les marqueurs cardiométaboliques chez les personnes diabétiques de type 2. Par contre, la chaleur exerce un effet bénéfique sur la fonction endothéliale chez les personnes ayant une maladie coronarienne. / Cardiometabolic diseases are the leading cause of death globally, and in Canada they are responsible for approximately 700 000 deaths each year. Type 2 diabetes and coronary artery disease are the most prevalent cardiometabolic diseases. Despite advancements in pharmacological treatments, the prevalence of these diseases remains high which underlines the importance of complementary therapies to prevent complications related to these diseases. In recent years, heat exposure has received attention for its therapeutic potential. Studies have demonstrated that heat exposure could be an effective method to decrease glycemia and improve vascular function. However, the therapeutic potential of heat exposure remains understudied in people with type 2 diabetes or coronary artery disease. The general objective of this thesis was to evaluate the acute effects of heat exposure on cardiometabolic markers in people with type 2 diabetes and coronary artery disease. The first article of this thesis determined the acute effect of hot water immersion on insulin sensitivity, vascular function, plasma (eHSP70 / 90) and intracellular (iHSP70 / 90) heat shock protein concentrations, inflammatory markers (IL- 6, IL1-RA, NFKB) as well as mediators of insulin action (IRS-1, GLP-1) compared to thermoneutral water immersion in a population with type 2 diabetes. Findings from this study demonstrate that acute hot water immersion does not improve insulin sensitivity, vascular function or affect HSP70 / 90 concentrations and inflammatory markers. The second article of this thesis determined the acute effects of Finnish sauna bathing on vascular function, markers of endothelial dysfunction (VCAM-1, ICAM-1) and inflammatory markers (IL-6, IL-10, TNF- α, IL-1β, CRP) in older adults with coronary artery disease. Results from this study demonstrate that one bout of Finnish sauna bathing improves endothelial function and increases the circulating concentration of IL-6 without affecting other markers of inflammation (IL-10, TNF-α IL-1β, CRP) or endothelial dysfunction. Combined, these results show that acute heat exposure does not acutely improve cardiometabolic markers in people with type 2 diabetes. On the other hand, heat exposure has a beneficial effect on endothelial function in people with coronary artery disease.

Mathematical morphology stems from set theory and it makes use of properties of point sets. The first point set is an origin image and the second one (usually smaller) is a structuring element. Morphological image transformations are image to image transformations based on a few elementary set operators. Fundamental morphologic operations are dilation, erosion and hit or miss. Next operations described in this work are opening and closing. Originally morphological operators were used for binary images only, later they were generalized for grey tone and color ones. This work describes the basic morphological image processing methods including their practical usage in image filtering and segmentation.