BENEFICIAL EFFECT OF KETO AMINO ACIDS FOR DIALYSIS PATIENTS

Nutritional status is an important predictor of clinical outcome in dialysed patients. Beside decreased serum protein/albumin,lower BMI with decreased muscle mass is the most significant predictor of morbidity and mortality. Keto amino acids (KA) represent an additional source for protein anabolism influencing indirectly also carbohydrate and lipid metabolism,Ca-P and acid base balance.Additionaly,by concominant metabolic and hemodynamic effect on residual nefrons, KA can help to slow progression of residual renal function (RRF) mainly in peritoneal dialysis patients. We conducted a long-term prospective randomized placebo controlled trial to test whether a modified low-protein diet (LPD) with or without keto acids (KA) would be safe ,well tolerated and associated with an increase of metabolic status and preservation of RRF in peritoneal dialysis (PD). We evaluated a total of 62 PD patients (32M/30F) aged 26-72 yrs with creatinine clearance (Ccr) 7.9-5.7 mL/min/1.73m2 for a period of 12 months. All patients were on modified LPD containing 0.8 protein/kg/IBW/day and 135/kJ/kg/IBW/day. LPD was randomly supplemented with KA at dosage of 100 mg/kg/IBW/day (30 patients, Group I) while 30 patients (Group II) received placebo. We analysed also muscle and fat metabolism by MR spectroscopy (MRS, m.tibialis anterior)) and imagining (MRI,visceral fat).Patients from Group I were before enrolment on conservative management using LPD + KA (0.6g P + 0.1g KA/kg/IBW/day) for longer time (18-48 months, median 28) with good compliance (SGA). Patients from group II were never treated with LPD and KA.All patients were monitored at the beginning of PD and at every 3 months for 12 months.;A neutral or positive long- term nitrogen balance (nPCR in g/kg IBW/day) was achieved in Group I (p<0.05 ).RRF measured as Ccr remained stable in Group I (6.5 ± 2.18 to 5.9 ± 2.54 ml/min, p=NS),while it decreased in Group II (6.7 ± 2.22 to 3.2 ± 1.44 ml/min, p<0.02).There were no differences in Dialysate clearance (DCcr(L/week/1.73 m2).At the end of the study,there were significant differences in Total clearance per week expressed as Dialysate clearance + Residual creatinine clearance (TCcr=DCcr + RCcr), P< 0.01 and Total Kt/Vurea/week,P< 0.01.Serum albumin increased significantly (from 29.5 ± 2,5 to 35.4 ± 3.4 g/L, P< 0.01) in Group I comparing to Group II ( 30.4 ± 3.4 to 31.8 ± 3.5 g/L, P =ŃS).Also urine output was sigificantly higher in Group I (1226 ± 449 mL/day) than in Group II ( 678± 327 mL/day, P< 0.01), respectively).Fat in muscle measured by MR spectroscopy (MRS, m.tibialis anterior) significantly decreased in Group I and was linked to reduced volume of visceral fat measured by MRI (p<0.02). In conclusion, comparing to control Group II, long-term administration of modified LPD+KA was associated in Group I with better metabolic status and residual renal function.(RRF ,diuresis,Total clearance,Total Kt/V (urea),,.S-albumin and nPCR).We confirmed positive changes in muscle mass and fat metabolism measured by MRS and MRI. Long-term administration of KA supplemented diet in dialysed patients was safe and well tolerated.Thus,this regimen may ramarkable increase nutritional status and clinical outcome of dialysed patients

Enterprise support policy and territorial cohesion: The Czech Republic (2007-2013)

The intention of this paper is to evaluate whether the spatial distribution of Structural Funds (SF) for enterprise support interventions follows the relevant territorial cohesion objectives specified in the strategic documents of the Czech Republic in the programming period 2007-2013. The evidence provided suggests mixed results. A relatively high SF allocation to the regions, characterized by strong agglomeration economies and a strong entrepreneurial climate, supports the competitiveness objective, particularly for innovation-oriented interventions. Nevertheless, little support is given to the objective of balanced development because socio-economically disadvantaged regions do not receive a higher SF allocation, in particular traditional industrial regions suffering from industrial decline, high unemployment and with a poor entrepreneurial climate. In this regard, the absorption capacity concept is emphasized as being important for explaining the spatial distribution of SF. © 2017, Editura Universitatii din Bucuresti. All rights reserved.GACR, Grantová Agentura České Republiky; OCIO, Office of Chief Information Officer; UTB, Univerzita Tomáše Bati ve ZlíněCzech Science Foundation [16-22141S

APPROACHES TO DATA MODELLING IN GIS

Spatial data, regardless incoming sources and methods, define and describe particular data model of environment. As an objective of this paper, process of data modelling with several approaches is briefly discussed. Emphasis is given to object-oriented data model. Data model of environment is a starting point in process of digital maps, databases and GIS creation. In presence, creation of new digital data models is needed, as well as the conversion and actualisation of existing analogue models. Present spatial databases are of different purpose and structure. They also use various sources of spatial data. The most often it is the case of multiscale data from maps, photogrammetric and satellite images or geodetic data of various structure and accuracy. For management and implementation digital spatial data various technologies are used. They can be aimed at automated mapping (AM) or geoinformation systems (GIS). In the following discussion of digital spatial data we will follow two basic assumptions. First one is that data capture, maintenance and usage is supported by computer technologies. Secondly, acceptance of specific differences of digital maps from spatial databases of GIS is needed. We will come from an idea that presentation of data in the form of maps is one of GIS outcomes, however, information functions of GIS are much more wider and flexible

Management of European projects by Czech and Slovak entrepreneurs in Bíle-Biele Karpaty Euroregion

The paper deals with the issue of managing structural funds in Zlínský and Trenčiansky Regions on the Czech-Slovakian border with the focus on success of targeting funds to local entrepreneurs, especially small and medium ones. An expansive dataset was used to evaluate the process and to compare it with relative advancement of the regions in terms of their economic and social development as described by the development index created by the authors and based on the regional policy of Zlínský Region. The results brought forward in this paper are somewhat ambiguous in terms of usefulness of European funding at the most disadvantaged regions, especially Trenčiansky. On the other hand, Zlínský Region, being more successful in supporting the disadvantaged areas, is still slightly less efficient in supporting smaller organizational forms of entrepreneurship. The differences between these two regions are growing even further due to significantly different amount of funds available to them. © 2016, Centre of Sociological Research. All rights reserved

FINANCING OF TRANSPORT PROJECTS: FOCUSED ON REGIONAL OPERATIONAL PROGRAMMES

The theme transport is firmly positioned in the content of regional operational programmes, important development documents of Czech cohesion regions. This article analyzes transport projects of six regional operational programmes approved until April 2011, excluding in one of the previous issues of this journal evaluated ROP Central Moravia. The findings of our analysis point at different strategies applied in particular regional operational programmes considering the number and budgets of supported projects. Furthermore, the general preference of the projects related to construction and modernization of roads to the projects related to sustainable urban system was shown. Public sector institutions are the decisive applicants of transport projects supported from regional operational programmes but the importance of particular public institutions is different based on the programmes. Finally, spatial impacts are ambivalent, without an opportunity to generalize them

In vivo visualization of cells labeled with superparamagnetic iron oxides by a sub-millisecond gradient echo sequence

Object: In vivo magnetic resonance imaging (MRI) of iron-labeled pancreatic islets (PIs) transplanted into the liver is still challenging in humans. The aim of this study was to develop and evaluate a double contrast method for the detection of PIs labeled with superparamagnetic iron oxide (SPIO) nanoparticles. Materials and methods: A double-echo three-dimensional (3D) spoiled gradient echo sequence was adapted to yield a sub-millisecond first echo time using variable echo times and highly asymmetric Cartesian readout. Positive contrast was achieved by conventional and relative image subtraction. Experiments for cell detection efficiency were performed in vitro on gelatin phantoms, in vivo on a Lewis rat and on a patient 6months after PI transplantation. Results: It was demonstrated that the proposed method can be used for the detection of transplanted PIs with positive contrast in vitro and in vivo. For all experiments, relative subtraction yielded comparable and in some cases better contrast than conventional subtraction. For the first time, positive contrast imaging of transplanted human PIs was performed in vivo in patients. Conclusion: The proposed method allows 3D data acquisition within a single breath-hold and yields enhanced contrast-to-noise ratios of transplanted SPIO labeled pancreatic islets relative to negative contrast images, therefore providing improved identification