La maladie de Huntington est une pathologie héréditaire qui se caractérise par une dégénérescence sélective des neurones striataux de la voie indirecte des ganglions de la base. Chez les patients ainsi que chez les souris modèles de la pathologie, en plus des symptômes moteurs, cognitifs et psychiatriques, des troubles du sommeil peuvent aussi apparaitre dès la phase pré-symptomatique. L’étude électrophysiologique in vivo des souris transgéniques R6/1a, en outre, révélé en début de phase symptomatique l’apparition du rythme pathologique β observé principalement durant le sommeil. Ces travaux de thèses ont donc eut pour but d’étudier le lien entre les modifications d’activités de réseaux cérébraux, les troubles du sommeil et l’émergence du rythme β ainsi que l’implication de ces anomalies dans les perturbations comportementales observées chez les souris R6/1. Notre étude de l’imagerie c-Fos a montré une hyperactivation de la voie frontostriatale chez ces souris, et ceci uniquement au stade pré-symptomatique sans aucune modification d’activation de la voie indirecte. Notre étude pharmacogénétique a démontré que la modification d’activité de ces neurones de projection striataux pouvait modifier l’alternance veille/sommeil mais ne pouvaient générer le rythme β. Enfin, notre étude pharmacologique a établit le lien entre le dysfonctionnement du système orexinergique et l’émergence du rythme β chez les souris R6/1. Ces travaux ont permis de mieux décrire des modifications d’activités de réseaux associées aux différents stades de la pathologie, en particulier au stade présymptomatique, et leurs contributions aux troubles du sommeil et l’émergence du rythme β. / Huntington’s disease (HD) is an inherited pathology that causes selective degeneration ofindirect striatal pathway neurons of the basal ganglia. In addition to the classic motor,cognitive and psychiatric symptoms, patients and mouse models of HD develop sleepdisorders, which can appear at as early as pre-symptomatic stage. Furthermore, in vivoelectrophysiological study of R6/1 transgenic mice revealed a unique and pathological βrhythm that appear at early symptomatic stage and which is mainly observed during sleep.The aim of this thesis work was to examine the link between changes in cerebral networkactivities, sleep disturbances and β rhythm, and to determine the contribution of theseabnormalities to the behavioral disturbances observed in R6/1 mice. Our neuroimaging study of the marker of neuronal activity c-Fos showed a hyperactivation of frontostriatal pathway at pre-symptomatic stage without any activity changes of the vulnerable indirect pathway neurons. Our pharmacogenetic study demonstrated that changes of striatal projection neuronal activity can modify sleep/wake behaviors, without inducing the pathological β rhythm. Finally, our pharmacological study established a link between orexinergic system dysfunction and β rhythm emergence in R6/1 mice. Our data, therefore, described further the natures of altered neural circuit activity associated with different disease stages, in particular pre-motor symptomatic period, and the importance of these alterations for sleep disturbances as well as β rhythm appearance in transgenic HD mice.

No description available.

A fundamental question in a sequential decision making setting under uncertainty is “how to allocate resources amongst competing entities so as to maximize the rewards accumulated in the long run?”. The resources allocated may be either abstract quantities such as time or concrete quantities such as manpower. The sequential decision making setting involves one or more agents interacting with an environment to procure rewards at every time instant and the goal is to find an optimal policy for choosing actions. Most of these problems involve multiple (infinite) stages and the objective function is usually a long-run performance objective. The problem is further complicated by the uncertainties in the sys-tem, for instance, the stochastic noise and partial observability in a single-agent setting or private information of the agents in a multi-agent setting. The dimensionality of the problem also plays an important role in the solution methodology adopted. Most of the real-world problems involve high-dimensional state and action spaces and an important design aspect of the solution is the choice of knowledge representation. The aim of this thesis is to answer important resource allocation related questions in different real-world application contexts and in the process contribute novel algorithms to the theory as well. The resource allocation algorithms considered include those from stochastic optimization, stochastic control and reinforcement learning. A number of new algorithms are developed as well. The application contexts selected encompass both single and multi-agent systems, abstract and concrete resources and contain high-dimensional state and control spaces. The empirical results from the various studies performed indicate that the algorithms presented here perform significantly better than those previously proposed in the literature. Further, the algorithms presented here are also shown to theoretically converge, hence guaranteeing optimal performance. We now briefly describe the various studies conducted here to investigate problems of resource allocation under uncertainties of different kinds: Vehicular Traffic Control The aim here is to optimize the ‘green time’ resource of the individual lanes in road networks that maximizes a certain long-term performance objective. We develop several reinforcement learning based algorithms for solving this problem. In the infinite horizon discounted Markov decision process setting, a Q-learning based traffic light control (TLC) algorithm that incorporates feature based representations and function approximation to handle large road networks is proposed, see Prashanth and Bhatnagar [2011b]. This TLC algorithm works with coarse information, obtained via graded thresholds, about the congestion level on the lanes of the road network. However, the graded threshold values used in the above Q-learning based TLC algorithm as well as several other graded threshold-based TLC algorithms that we propose, may not be optimal for all traffic conditions. We therefore also develop a new algorithm based on SPSA to tune the associated thresholds to the ‘optimal’ values (Prashanth and Bhatnagar [2012]). Our thresh-old tuning algorithm is online, incremental with proven convergence to the optimal values of thresholds. Further, we also study average cost traffic signal control and develop two novel reinforcement learning based TLC algorithms with function approximation (Prashanth and Bhatnagar [2011c]). Lastly, we also develop a feature adaptation method for ‘optimal’ feature selection (Bhatnagar et al. [2012a]). This algorithm adapts the features in a way as to converge to an optimal set of features, which can then be used in the algorithm. Service Systems The aim here is to optimize the ‘workforce’, the critical resource of any service system. However, adapting the staffing levels to the workloads in such systems is nontrivial as the queue stability and aggregate service level agreement (SLA) constraints have to be complied with. We formulate this problem as a constrained hidden Markov process with a (discrete) worker parameter and propose simultaneous perturbation based simulation optimization algorithms for this purpose. The algorithms include both first order as well as second order methods and incorporate SPSA based gradient estimates in the primal, with dual ascent for the Lagrange multipliers. All the algorithms that we propose are online, incremental and are easy to implement. Further, they involve a certain generalized smooth projection operator, which is essential to project the continuous-valued worker parameter updates obtained from the SASOC algorithms onto the discrete set. We validate our algorithms on five real-life service systems and compare their performance with a state-of-the-art optimization tool-kit OptQuest. Being ��times faster than OptQuest, our scheme is particularly suitable for adaptive labor staffing. Also, we observe that it guarantees convergence and finds better solutions than OptQuest in many cases. Wireless Sensor Networks The aim here is to allocate the ‘sleep time’ (resource) of the individual sensors in an intrusion detection application such that the energy consumption from the sensors is reduced, while keeping the tracking error to a minimum. We model this sleep–wake scheduling problem as a partially-observed Markov decision process (POMDP) and propose novel RL-based algorithms -with both long-run discounted and average cost objectives -for solving this problem. All our algorithms incorporate function approximation and feature-based representations to handle the curse of dimensionality. Further, the feature selection scheme used in each of the proposed algorithms intelligently manages the energy cost and tracking cost factors, which in turn, assists the search for the optimal sleeping policy. The results from the simulation experiments suggest that our proposed algorithms perform better than a recently proposed algorithm from Fuemmeler and Veeravalli [2008], Fuemmeler et al. [2011]. Mechanism Design The setting here is of multiple self-interested agents with limited capacities, attempting to maximize their individual utilities, which often comes at the expense of the group’s utility. The aim of the resource allocator here then is to efficiently allocate the resource (which is being contended for, by the agents) and also maximize the social welfare via the ‘right’ transfer of payments. In other words, the problem is to find an incentive compatible transfer scheme following a socially efficient allocation. We present two novel mechanisms with progressively realistic assumptions about agent types aimed at economic scenarios where agents have limited capacities. For the simplest case where agent types consist of a unit cost of production and a capacity that does not change with time, we provide an enhancement to the static mechanism of Dash et al. [2007] that effectively deters misreport of the capacity type element by an agent to receive an allocation beyond its capacity, which thereby damages other agents. Our model incorporates an agent’s preference to harm other agents through a additive factor in the utility function of an agent and the mechanism we propose achieves strategy proofness by means of a novel penalty scheme. Next, we consider a dynamic setting where agent types evolve and the individual agents here again have a preference to harm others via capacity misreports. We show via a counterexample that the dynamic pivot mechanism of Bergemann and Valimaki [2010] cannot be directly applied in our setting with capacity-limited alim¨agents. We propose an enhancement to the mechanism of Bergemann and V¨alim¨aki [2010] that ensures truth telling w.r.t. capacity type element through a variable penalty scheme (in the spirit of the static mechanism). We show that each of our mechanisms is ex-post incentive compatible, ex-post individually rational, and socially efficient

本研究主要目的在探討高中生的睡眠型態與學業表現的關係，試圖分析睡眠時間量及睡眠的規律性與其課業表現以及睡眠相關現象(白天嗜睡程度及睡眠品質)的關係，並探討白天嗜睡及睡眠品質之中介效果及以日夜節律型態之調節效果。本研究以自填「青少年睡眠習慣問卷」，對台灣北區普通高中及綜合高中中學術學程的高中生進行調查，採群集抽樣的方式進行，共進行42個班級施測，發出1,650份問卷，取得有效問卷1,308份樣本分別以日夜節律型態類型及高低成就動機兩種分類方式進行分析，主要研究結果如下： 1.夜貓型高中生之週間週末規律性變項對於學業表現具有影響力。 2.白日型高中生之週間規律性變項對於學業表現具影響力。 3.以高低成就動機分組，兩組之睡眠型態變項對於學業影響力皆未達顯著性。 4.白天嗜睡及睡眠品質在兩種分類分析下，皆無中介效果。 本研究初步結果支持夜貓型高中生在維持週間週末某種程度睡眠規律性對於學業表現具有相當的影響性，而早晨型在週間內維持其規律性也是對於其學業表現是具有顯著影響性，也就是依其日夜節律型態在其睡眠型態維持自己生活作息的規律性，而不在時間點或睡眠量的多寡來作要求，也許對於正值課業壓力或生心理高度變化的青少年時期會是更合適的睡眠作息。 / The purposes of this study are to explore the relationship of the sleep pattern with academic performance, day time sleepiness and sleep quality in senior high school students. Data were collected by sleep pattern questionnaire of the adolescent. The participants included 1650 students form the 10th grade to 12th grade, recruited form senior high schools in Taipei. Using stratified cluster sampling method. There were 1308 of valid questionnaires obtained. The major results are as follow: (1) The variablity of the sleep-wake pattern between weekdays and weekends has significant influences on academic performace in the evening type students. (2) The variablity of the sleep-wake pattern during weekdays showed significant influences on academic performace in the morening type students. (3) In both the high and low achievement motivation groups, sleep pattern showed no significant associations with academic performance. (4) The mediation effect of daytime sleepiness and sleep quality were not proven in all the data analyses. In coclusion, the results indicate that in evening type students, maintaining regularity of sleep pattern between weekdays and weekends would be beneficial to their academic performance; and in the morning type students, keeping regular weekday sleep-wake schedules seem to be more important for better academic performance. Therefore, when considering the influences on academic performance, regularity of sleep seem to be more important than quantity of sleep in high schoolers.

<p>Uvod - Etiologija sindroma gornjeg otvora grudnog ko&scaron;a (thoracic outlet syndrome- TOS) je udruženost vi&scaron;e faktora koji su posledica naru&scaron;avanja anatomsko-topografskih odnosa u nivou gornjeg otvora grudnog ko&scaron;a: kostoklavikularnog prostora, prednjeg skalenskog otvora, kao i same mehanike rebarnih zglobova i hrskavica, koji dovode do suženja prostora kroz koje prolaze neurovaskularne strukture, njihove kompresije, a samim tim i iritacije neurovaskularnih struktura. Sindrom gornjeg otvora grudnog ko&scaron;a je kompleks simptoma uzrokovanih kompresijom brahijalnog spleta, vene subklavije, arterije subklavije i simpatičkih vlakana, koji karakteri&scaron;u bol, parestezije, mi&scaron;ićna slabost i osećaj nelagodnosti u ruci/rukama koji se pojačava podizanjem ruke/ruku ili prekomernim pokretima glave i vrata, te dovode do smanjenja funkcionalne sposobnosti ruke/ruku i pote&scaron;koća u obavljanju svakodnevnih aktivnosti. Pored toga imaju često izraženu tahikardiju, osećaj stezanja u grudima, glavobolju, vrtoglavicu, zujanje u u&scaron;ima. Navedene tegobe su izraženije ponekad noću i dovode do poremećaja spavanja (problemi usnivanja, hrkanje, ka&scaron;ljanje, osećaj toplo/hladno, apnea, poremećaj dnevno/noćnog ritma- hronotipizacija, itd). Kao posledica lo&scaron;eg spavanja moguća je pojava depresivnih simptoma. U raspoloživoj literaturi, spavanje i kvalitet spavanja se uglavnom posmatraju kroz prizmu drugih bolesti i stanja. Materijal i metode - Istraživanjem je obuhvaćeno ukupno 181 (sto osam deset jedna) osoba. Od tog broja 53 mu&scaron;karca i 128 žena. Test grupu sačinjavalo je 82 ispitanika sa dijagnostikovanim TOS, a 99 zdravih osoba/osoba oba pola koji nemaju simptomatologiju TOS, je predstavljalo kontrolnu grupu. Grupe su bile ujednačene po polu i starosti (od 18 do 65). Tokom studije ispitanici su podvrgnuti kliničkom pregledu &ndash; fizikalnom i neurolo&scaron;kom pregledu. Pregled je podrazumevao pregled posture obolelog (posmatranje mi&scaron;ića regije vrata, ramena i ruku- trofika, tonus, konzistencija, mobilnost i kontraktilnost), posmatranje promena na koži (sa posebnim osvrtom na promene boje kože, trofičkih promena kože i noktiju i temperature kože ruku - &scaron;aka), testiranje refleksa, ispitivanje senzibiliteta u regijama inervacije odgovarajućih spinalnih korenova brahijalnog spleta. Takođe vr&scaron;ena je analiza stanja uhranjenosti (telesna visina, telesna masa, indeks telesne mase) i izvođenje provokativnih testova (Adson manevar, Rus test, Halsted test, Elvi test i Kostoklavikularni test). Kao deo ispitivanja obavljeno je i radiolo&scaron;ko snimanje vratne kičme kao i pregled oscilografom. Ispitanici su imali za zadatak da ispune sledeće upitnike: Upitnik o nesposobnosti ruke, ramena i &scaron;ake (DASH), Pitsbur&scaron;ki indeks kvaliteta spavanja (PSQI), Upitnik o hronotipizaciji (MEQ), Bekov upitnik o depresiji (BDI II). Na kraju ispitanici su davali odgovore na pitanja iz vodiča za istraživača sastavljenog sa ciljem evaluacije različitih aspekata spavanja. Rezultati - Rezultati su pokazali da su upotrebljene skale dale zadovoljavajuću pouzdanost. Pokazalo se da osobe sa dijagnozom TOS pored bogate simptomatologije imaju jo&scaron; i probleme sa spavanjem. Analizom rezultata do&scaron;lo se do zaključka da osobe sa dijagnozom TOS su starije, imaju vi&scaron;e problema sa spavanjem i veću nesposobnost ruke, ramena i &scaron;ake. Nije se pokazala razlika u hronotipizaciji kod osoba sa TOS u odnosu na kontrolnu grupu. Takođe može se zaključiti da osobe koje imaju izraženu nesposobnost ruku, ramena i &scaron;ake imaju značajno veću &scaron;ansu da imaju sindrom gornjeg otvora grudnog ko&scaron;a. Ove osobe pri tom imaju i veću &scaron;ansu da razviju depresiju i poremećaj spavanja, te se zaključuje da ova dva parametra svoj uticaj na TOS ostvaruju preko problema sa funkcionisanjem ruke, ramena i &scaron;ake. Dobar prediktor za postavljanje dijagnoze TOS može biti testiranje osoba DASH skalom. Zaključak - Rezultati studije mogu biti putokaz daljim istraživanjima, koja bi otvorila vrata formiranju protokola i opservaciji kvaliteta života osoba sa sindroma gornjeg otvora grudnog ko&scaron;a, sa posebnim osvrtom na poremećaje spavanja.</p> / <p>Etiology of thoracic outlet syndrome (TOS) is an association of several factors which are the result of disruption in the anatomical-topographical relations, in the level of superior thoracic aperture: costoclavicular space, anterior scalene aperture, as well as the mechanics of rib joints and cartilage, causing narrowing of space through which the neurovascular structures pass, their compression, and thus the irritation of neurovascular structures. Thoracic outlet syndrome is a complex of symptoms caused by the compression of the brachial plexus, subclavian vein, subclavian artery and sympathetic fibres, which is characterized by pain, parasthesias, muscle weakness and a feeling of discomfort in the arm / arms, which increases with raising the arm/arms or by excessive head and neck movements leading to a reduction of functional capabilities of the hands / arms and difficulties in everyday activities. In addition, patients often have expressed tachycardia, feeling of tightness in the chest, headache, dizziness, tinnitus. These problems are more pronounced at night and sometimes lead to sleep disorders (difficulty in falling asleep, snoring, coughing, feeling hot/cold, apnea, day/night rhythm disorder - Morningness/Eveningness disorder, etc.). As a result of poor sleeping depressive symptoms may occur. In the available bibliography, sleep and quality of sleep are mainly viewed through other diseases and conditions. The study included a total number of 181 (one hundred eighty one) people. Out of that 53 men and 128 women. The test group consisted of 82 patients diagnosed with TOS, and 99 healthy persons of both genders who had no symptoms of TOS, and constitute the control group. Groups were equalled by gender and age (18 to 65). Throughout the study subjects underwent clinical examination - both physical and neurological. This included an assessment of posture of the patient (observation of muscles in region of the neck, shoulders and arms - trophic, muscle tone, consistency, mobility and contractility), observation of changes on the skin (with a special emphasis on skin colour changes, trophic changes of the skin, nails and skin temperature of arms - hands), reflex testing, sensitivity testing in regions of innervations which correspond to spinal roots of the brachial plexus. Moreover, an analysis was conducted on the body composition analysis (body height, body weight, body mass index) as well as provocative tests (Adson manoeuvre, the Roos test, Halstead test, Elvy test and Costoclavicular test). Radiology scan of the cervical spine as well as oscillograph testing was conducted as a part of the test. The subjects were asked to fulfil the following questionnaires: Questionnaire on Disabilities of the Arm, Shoulder and Hand (DASH), Pittsburgh Sleep Quality Index (PSQI), The Morningness / Eveningness Questionnaire (MEQ), Beck Questionnaire on Depression (BDI II). Finally the subjects answered questions that researcher had drawn up in order to evaluate different aspects of sleep. The results showed that the scales used were reliable. It proved that persons diagnosed with TOS in addition to numerous symptoms also had problems with sleep. By analyzing the results it was concluded that people diagnosed with TOS are older, have more problems with sleep and greater disability of arms, shoulders and hands. There was no difference in Morningness/Eveningness type in patients with TOS in comparison to the control group. It can also be concluded that people who have pronounced disability of arms, shoulders and hands have a significantly greater chance of having thoracic outlet syndrome. These persons are more likely to develop depression and sleep disorders therefore those two entities impact TOS through the problems with the functioning of the arms, shoulders and hands. A good predictor in diagnosis of TOS may be testing people with DASH scale. The study findings can serve as a guideline for further research, opening the door into forming protocols and observation of the quality of life of people with the thoracic outlet syndrome, with special emphasis on sleep disorders.</p>

Made available in DSpace on 2015-02-24T20:13:54Z (GMT). No. of bitstreams: 1 JoaoMGR_DISSERT.pdf: 11548329 bytes, checksum: b018f7ac6bfdefc0440cb7355ab6ae06 (MD5) Previous issue date: 2011-12-08 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The circadian behavior associated with the 24 hours light-dark (LD) cycle (T24) is due to a circadian clock , which in mammals is located in the hypothalamic suprachiasmatic nucleus (SCN). Under experimental conditions in which rats are espoused to a symmetric LD 22h cycle (T22) the two SCN regions, ventrolateral (vl) and dorsomedial (dm), can be functionally isolated, suggesting that each region regulates distinct physiological and behavioral components. The vl region regulates the locomotor activity and slow wave sleep (SWS) rhythms, while the dm region assures the body temperature and paradoxical sleep (PS) rhythms regulation. This research aimed to deepen the knowledge on the functional properties of circadian rhythmicity, specifically about the internal desynchronization process, and its consequences to locomotor activity and body temperature rhythms as well as to the sleep-wake cycle pattern in rats. We applied infrared motion sensors, implanted body temperature sensors and a telemetry system to record electrocorticogram (ECoG) and electromyogram (EMG) in two rat groups. The control group under 24h period LD cycle (T24: 12hL-12hD) to the baseline record and the experimental group under 22h period LD cycle (T22: 11hL- 11hD), in which is known to occur the uncoupling process of the circadian locomotor activity rhythm where the animals show two distinct locomotor activity rhythms: one synchronized to the external LD cycle, and another expressed in free running course, with period greater than 24h. As a result of 22h cycles, characteristic locomotor activity moment appear, that are coincidence moments (T22C) and non coincidence moments (T22NC) which were the main focus or our study. Our results show an increase in locomotor activity, especially in coincidence moments, and the inversion of locomotor activity, body temperature, and sleep-wake cycle patterns in non coincidence moments. We can also observe the increase in SWS and decrease in PS, both in coincidence and non coincidence moments. Probably the increases in locomotor activity as a way to promote the coupling between circadian oscillators generate an increased homeostatic pressure and thus increase SWS, promoting the decreasing in PS / O comportamento circadiano associado ao ciclo di?rio de 24 horas deve-se ? a??o de um rel?gio circadiano que em mam?feros se localiza nos n?cleos supraquiasm?ticos do hipot?lamo (NSQs). Sob condi??es experimentais em que ratos s?o submetidos a um ciclo claro-escuro (CE) sim?trico de 22h (T22) as regi?es ventrolateral (vl) e dorsomedial (dm) dos NSQs podem ser separadas funcionalmente, sugerindo que cada regi?o regula vari?veis fisiol?gicas distintas. A regi?o vl regula os ritmos de atividade e sono de ondas lentas (SOL), enquanto a regi?o dm ? respons?vel pelo ritmo da temperatura corporal e sono paradoxal (SP). A investiga??o desenvolvida no presente trabalho visou aprofundar o conhecimento sobre as propriedades funcionais da ritmicidade circadiana, mais especificamente sobre o processo da dessincroniza??o interna e as suas implica??es no ritmo de atividade locomotora, temperatura corporal e padr?o do ciclo sono-vig?lia em ratos. Com este objetivo, foram utilizados sensores de movimentos por infravermelho e implantados sensores para temperatura corporal, al?m disso o sistema de telemetria foi utilizado para o registro de par?metros fisiol?gicos de eletrocorticograma (ECoG) e eletromiograma (EMG), em dois grupos de animais. O grupo controle sob ciclo claro-escuro com per?odo de T24 (12h claro: 12h escuro), para o registro basal das vari?veis em an?lise; e o grupo experimental sob ciclo claro-escuro com per?odo de T22 (11h claro: 11h escuro), no qual se sabe que ocorre o desacoplamento do ritmo circadiano de atividade locomotora e os animais apresentam dois componentes distintos de atividade: um sincronizado ao ciclo claro-escuro; e outro que se expressa em livre curso, com per?odo maior que 24h. Em decorr?ncia do protocolo de dessincroniza??o for?ada, surgem momentos caracter?sticos no perfil de atividade locomotora: momentos de coincid?ncia (T22C) e de n?o coincid?ncia (T22NC), que foram o foco principal do nosso estudo. Podemos observar o aumento de atividade locomotora principalmente em momentos de coincid?ncia, e a invers?o do padr?o de atividade locomotora, temperatura corporal e ciclo sono-vig?lia em momentos de n?o coincid?ncia. Podemos ainda observar o aumento do SOL e diminui??o do SP, tanto em momentos de coincid?ncia como em momentos de n?o coincid?ncia. ? prov?vel que o aumento da atividade locomotora como forma de facilitar o acoplamento entre os osciladores circadianos gere um aumento da press?o homeost?tica e com isso aumento de SOL, e diminui a dura??o de SP

Made available in DSpace on 2014-12-17T15:36:53Z (GMT). No. of bitstreams: 1 AnaPLM.pdf: 607381 bytes, checksum: 38ed8ff61bb80d4aa7e083e73b98e3f8 (MD5) Previous issue date: 2008-06-04 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The sleep onset and offset delay at adolescence in relation to childhood. Besides biological causes, some external factors as academic obligations and socialization contributes, increasing the burden of school and socialization. However, morning school schedules reduce sleep duration. Besides light strong effect, studies in humans have indicated that exercise influence circadian synchronization. To evaluate the effect of the morning exercise under sunlight on sleep-wake cycle (SWC) of adolescents, 160 high school students (11th year) were exposed to the following conditions: lesson in usual classroom (Group C), lesson in swimming pool exposed to sunlight (Group E), half of them carrying through physical activity (EE) and the other resting (EL). Each experimental group met two stages: assessment of SWC 1 week before and 1 week during the intervention, which was held in Monday and Wednesday between 7:45 and 8:30 am. In the baseline, there were applied the questionnaires "Health and Sleep" and cronotype evaluation (H & O). In addition, students were evaluated before and during the intervention by "Sleep Diary", "Karolinska Sleepiness Scale" (KSS), Psychomotor Vigilance Test (PVT) and actimetry. During the intervention, there was a delay in wake-up time on the weekend and a trend to greater sleep duration on week for the three groups. At the weekend, only the groups EE and EL increased sleep duration. There was no difference in bedtime, irregularity of sleep schedules and nap variables. The sleepiness showed a circadian pattern characterized by higher alertness levels at 11:30 am and sleepiness levels at bedtime and wake-up time on week. On weekends there were higher levels of alertness in these times. In the days of intervention, there was an increase of sleepiness at 11:30 am for groups EL and EE, which may have been caused by a relaxing effect of contact with the water of the pool. In addition, the group EE showed higher alert levels at 14:30 pm on Monday and at 8:30 am in the Wednesday, possibly caused by exercise arousal effect. The reaction time assessed through the TPV did not vary between the stages. The sleep quality improved in the three groups in the second stage, making impossible the evaluation of intervention effect. However, the sleep quality increased on Monday and Tuesday only on the group EE. From the results, it is suggested that the intervention promoted effects on the sleepiness at some day hours. In other SWC variables there were no effects, possibly due to a large SWC irregularity on weekends. Thus, the evaluation of higher weekly frequency EF is necessary, since only two days were insufficient to promote greater effect on adolescents SWC / Na adolesc?ncia h? uma tend?ncia a dormir e acordar mais tarde em rela??o ? inf?ncia. Embora esta caracter?stica tenha causas biol?gicas, alguns fatores externos podem favorec?-la: como o aumento da carga escolar e da socializa??o. No sentido contr?rio os hor?rios escolares matutinos representam um dos grandes fatores respons?veis pela priva??o parcial de sono. Ainda que a exposi??o ? luz seja considerada o regulador mais importante do sistema circadiano em mam?feros, estudos em seres humanos indicaram que o exerc?cio f?sico influencia a sincroniza??o circadiana. Por isso, o objetivo do nosso trabalho ? avaliar o efeito do exerc?cio f?sico matinal sob luz solar no ciclo vig?lia-sono (CVS) de adolescentes. O estudo contou com a participa??o de 160 alunos do ensino m?dio (1? e 2? ano), expostos ?s seguintes condi??es: aula na sala habitual (Grupo C), aula na piscina exposto ? luz solar (Grupo E), metade em exerc?cio f?sico (EE) e outra em repouso (EL). Cada grupo experimental cumpriu duas etapas: avalia??o do CVS 1 semana antes e 1 semana durante a interven??o, que foi realizada na 2? e 4? feira entre 7:45 e 8:30 h. Na linha de base foram aplicados os question?rios Sa?de e Sono e de avalia??o do cronotipo (H&O). Al?m disso, os alunos foram avaliados antes e durante a interven??o pelo Di?rio de sono , Escala de Sonol?ncia de Karolinska (ESK), Teste de vigil?ncia psicomotora (TPV) e actimetria. Durante a interven??o, houve atraso no hor?rio de acordar no fim de semana e tend?ncia a maior dura??o do sono na semana nos tr?s grupos. No fim de semana, apenas os grupos EE e EL passaram a dormir mais. N?o houve diferen?a no hor?rio de dormir, na irregularidade dos hor?rios de sono e nas vari?veis do cochilo. A sonol?ncia apresentou um padr?o circadiano caracterizado por maior alerta ?s 11:30 h e maior sonol?ncia nos hor?rios de acordar e dormir na semana, e menor sonol?ncia nos finais de semana. Nos dias de interven??o, houve um aumento da sonol?ncia ?s 11:30 h para os grupos EE e EL, que pode ter sido decorrente de um efeito relaxante do contato com a ?gua da piscina. Al?m disso, o grupo EE apresentou maiores n?veis de alerta ?s 14:30 h na 2? feira e ?s 8:30 h na 4? feira, possivelmente decorrentes de um efeito ativacional do exerc?cio. O tempo de rea??o avaliado por meio do TPV n?o variou entre as etapas. A qualidade do sono melhorou nos tr?s grupos na 2? etapa, impossibilitando avaliar o efeito da interven??o. Entretanto, houve melhora na qualidade do sono na 2? e 3? feira apenas para o grupo EE. A partir dos resultados, sugere-se que a interven??o promoveu efeitos sobre a sonol?ncia em alguns hor?rios. Nas outras vari?veis n?o foram observados efeitos, possivelmente devido a uma grande irregularidade no CVS nos finais de semana. Faz- se necess?rio ampliar o estudo com a realiza??o de exerc?cio f?sico numa freq??ncia semanal maior, visto que apenas dois dias foram insuficientes para promover maiores efeitos no CVS dos adolescentes

Objetivo: Determinar la asociación de la mala autopercepción de la salud bucal con los síntomas del síndrome de apnea obstructiva del sueño (SAOS) en población adulta de los Estados Unidos de América. Materiales y métodos: Se realizó un estudio observacional transversal retrospectivo analítico, con un total de 2348 personas entre las edades comprendidas de 15 a 55 años tomadas de las encuestas National Health Nutrition Examination Survey (NHANES) durante el periodo 2015-2016 realizadas por el Center Disease Control and Prevention (CDC) de los Estados Unidos de América. Para la evaluación de ambas variables se emplearon preguntas de auto reporte. Asimismo, la comparación de la mala autopercepción de salud bucal con las características de los participantes se realizó mediante la prueba estadística Chi cuadrado. Para asociar la mala autopercepción de salud bucal con los síntomas del síndrome de apnea obstructiva del sueño (SAOS) se usó la regresión de Poisson para asociar la razón de prevalencia cruda y ajustada con un nivel de significancia de p < 0.05 e IC (95%). Resultados: Al asociar la mala autopercepción de salud bucal con los síntomas del síndrome de apnea obstructiva del sueño (SAOS), no se encontró asociación estadísticamente significativa p > 0.05. El 9.5% de participantes del sexo femenino tienen una mayor frecuencia de presentar una mala autopercepción de salud bucal en comparación al sexo opuesto. Conclusiones: En el presente estudio se observó que, la autopercepción de salud bucal no está relacionada con los síntomas tales como la somnolencia y ronquidos del síndrome de apnea obstructiva del sueño (SAOS). / Aim: Determine the association of negative self-perception of oral health with symptoms of obstructive sleep apnea syndrome (OSAS) disorders in the population aged 15 to 55 years of the United States of America. Materials and methods: An analytical retrospective cross-sectional observational study was carried out, with a total of 2348 people between the ages of 15 and 55 years taken from the National Health Nutrition Examination Survey (NHANES) during the period 2015-2016 carried out by the Center Disease Control and Prevention (CDC) of the United States of America. For the evaluation of both variables, self-report questions were used. Likewise, the comparison of the poor self-perception of oral health with the characteristics of the participants was carried out using the Chi square statistical test. To associate poor self-perceived oral health with obstructive sleep apnea syndrome (OSAS) symptoms, Poisson regression was used to associate crude and adjusted prevalence ratios with a significance level of p < 0.05 and CI (95%). Results: When associating poor self-perception of oral health with symptoms of obstructive sleep apnea syndrome (OSAS), no statistically significant association was found p > 0.05. While 9.5% of female participants have a higher frequency of presenting a poor self-perception of oral health compared to the opposite sex. Conclusions: In the present study, it was observed that oral health self-perception is not related to symptoms such as sleepiness and snoring of obstructive sleep apnea syndrome (OSAS) disorders. / Tesis

Les troubles du sommeil constituent un enjeu appréciable dans le domaine orthopédique, puisque ces troubles peuvent non seulement augmenter le risque de chutes et d’accidents de la route, mais également diminuer la densité osseuse et altérer la guérison de patients présentant une ou plusieurs fractures. Il est à cet effet estimé qu’entre 20 % et 40 % de patients présentant une fracture se plaignent de troubles du sommeil 3 mois post-trauma. Toutefois, l’étude du sommeil en phase aigüe suivant une fracture est à ce jour moins documentée. Le présent mémoire présente un projet de recherche clinique qui voulait étudier l’impact du sommeil supérieur sur la récupération de ceux-ci en phase aigüe chez des patients avec une fractures du membre. Toutefois, la situation de pandémie à la COVID-19 a rendu impossible la réalisation de ce projet clinique. La méthode prévue est présentée. L’utilisation d’une montre d’actigraphie sur une période de 14 jours suivant la fracture aurait permis de recueillir plusieurs paramètres du sommeil, en combinaison avec l’utilisation de questionnaires sur la qualité du sommeil, l’intensité de la douleur et la fonction du membre atteint. Un suivi longitudinal (>3 mois) était prévu pour évaluer les troubles du sommeil persistant à travers le temps à l’aide des mêmes questionnaires. En deuxième partie, ce mémoire propose une revue narrative détaillée de la littérature décrivant l’impact des troubles du sommeil sur le risque de chutes, d’accidents de la route et de fractures, en plus de leurs impacts sur la guérison osseuse et les mécanismes sous-jacents chez une population orthopédique. Il fut observé que non seulement une qualité optimale de sommeil permet d’éviter des accidents de la route et par conséquent d’éviter des blessures orthopédiques majeures, mais également est nécessaire à une récupération osseuse post-fracture. Or, de plus amples études permettront une compréhension approfondie des mécanismes qui sous-tendent cette relation. / Sleep disturbances are highly relevant in the orthopedic field, as they can increase the risks of falls, decrease bone density, and lead to poor fracture and health outcomes in patients with fractures. It is estimated that between 20% to 40% of patients presenting one fracture will report difficulty to sleep 3 months following trauma. However, the impact of sleep in the acute phase following fracture is less studied. Therefore, this present thesis aimed to propose a clinical research project evaluating the impact of sleep on the recuperation of patients in the acute phase following fracture. To this end, we will use an actigraphy watch over a 14-day period following fracture to collect various sleep parameters, in combination with questionnaires on sleep quality, pain intensity and function of the fractured limb. A longitudinal follow-up (>3 months) will allow evaluating if sleep difficulties persist over time, using aforementioned questionnaires. The second part of this thesis presents a detailed narrative review of the literature describing the impact of sleep disturbances on falls, motor vehicle accidents and fractures in addition to their impact on fracture outcomes and the underlying physiopathological mechanisms. We observed that not only optimal sleep quality is essential in prevention of motor vehicule accident, but is also a key element to recovery after an orthopedic trauma. Futur research will allow a better understanding of sleep and bone relation.

Abstract There has been an increase in the number of studies investigating the relationship between chronotype, cognitive abilities and academic achievement in different populations. It has been found that an individual’s natural tendency to prefer morning or evening activities is associated with circadian rhythms. The current literature review aims to further review and explore individual differences in chronotype in relation to cognitive abilities and academic achievement and an overview of current evidence on different moderators in chronotypes. The systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Study Quality Assessment tool for Observational Cohort and Cross-Sectional studies from the National Institute of Health was employed to assess the quality of the studies included. The systematic literature review identified three studies with 2162 health students from various countries that were eligible for inclusion. Due to the heterogeneity of the studies included, a meta-analysis could not be performed. One of the three studies’ reports was marked with fair quality as some data were missing from their report while the other two were marked to be good quality. The research on individual differences in relation to chronotype, cognitive abilities and academic achievement was not conclusive; however, a positive but weak correlation between cognitive abilities and academic achievement was found when GPA score was considered. Additionally, a significant correlation was identified between learning styles and chronotypes with eveningness obtaining a higher percentage in auditory learning than morningness. On the other hand, morningness obtained higher scores on visual learning styles than eveningness. This correlation was influenced by their chronotype. This systematic review observed differences in outcomes, which could not be compared due to the small sample size, more research into the relationship is required to fill the research gap and determine the effects of these inconsistencies in the relationships / Sammanfattning Det har skett en ökning av antalet studier som undersöker sambandet mellan kronotyp, kognitiva förmågor och akademisk utförande i olika populationer och det har visat att en individs naturliga tendens att föredra morgon eller kvälls aktiviteter är förknippad med dygnsrytmer. Den aktuella litteraturöversikten syftar till att ytterligare granska och undersöka kronotyp i relation till kognitiv förmågor och akademisk prestation samt att ge en översikt över aktuella bevis på olika moderator variabler i kronotyper. Den systematiska litteraturen granskning utfördes efter de riktlinjerna i Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) och Study Quality Assessment tool for Observational Cohort and Cross-Sectional studies from the National Institute of Health användas för att bedöma kvaliteten på de inkluderade studierna. Den systematiska översikten identifierade tre studier med 2162 friska individer med olika nationalitet som mötte inklusionskriterierna. På grund av studiernas heterogentitet kunde en meta-analys inte utföras. En av de tre studierna rapporterar var märkt med rimlig kvalitet eftersom vissa data saknades i artikeln medan de andra två bedömdes ha god validitet. Forskningen om sambandet mellan kronotyp, kognitiva förmågor och akademiska presentation var inte övertygande; dock fann man ett positivt, men svagt samband mellan kognitiva förmågor och academiska prestation när GPA-poäng beaktades. Dessutom identifierades en signifikant korrelation mellan inlärningsstilar och kronotyper, där kvällskänslan fick en högre andel i auditiv inlärning än morgonkänslan. Å andra sidan fick morgonen högre poäng på visuella stilar än kvällskänslan. Denna korrelation påverkades av deras kronotype. Denna systematiska översikten observerade skillnader i resultat som inte kunde jämföras på grund av den lilla urvalsstorlekan, mer forskning om sambandet behövs för att fylla forskningsluckan och fastställa effekterna av dessa inkonsekvenser i relationerna