Univerzita Karlova v Praze 1. lékařská fakulta Doktorský studijní program Studijní obor: Experimentální chirurgie MUDr. Filip Thieme Název závěrečné práce Chirurgické modely studia proinflamačního vlivu tukové tkáně v rozvoji aterosklerózy Title Surgical models of the study of the pro-inflammatory effect of adipose tissue in the development of atherosclerosis Typ závěrečné práce Disertační Školitel: doc. MUDr. Jiří Froněk, Ph.D., FRSC Konzultant doc. MUDr. Libor Janoušek, Ph.D. Klinika transplantační chirurgie, IKEM Praha, 2021 Abstract Background: Atherosclerosis is a serious inflammatory systemic disease. Surgery mainly addresses its vascular complications. Conversely, surgery may also lead to the development and acceleration of atherosclerosis, e.g., in a living kidney donor. This would especially be the case in a donor who meets internationally recognized donation criteria but suffers from metabolic syndrome. The effort to refine assessments of living kidney donors in terms of eliminating the risk of developing atherosclerosis is a long-term project. Our aim is to determine risk factors for living kidney donors and to prevent long-term complications after donation. Collecting tissue from a living donor involves not oly subcutaneous tissue (SCAT) but also visceral (VAT) and perivascular tissue (PVAT),...

Vliv spirituality Terezie od Ježíše v životě a díle Marie Dominiky Mazzarellové Abstract This thesis follows the previous bachelor study (The influence of Theresa of Jesus's spirituality on the spiritual formation of S. Mary D. Mazzarello) and it deals with the influence of S. Theresa of Jesus's work in the next period of the life of S. Mary D. Mazzarello - the period when she was the general superior of the Daughters of Mary Help of Christians Institute. The main sources are taken from her correspondence, from the Theresa of Jesus's documents and papers and from the salesian spirituality literature.

<p>Kompjuterizovana tomografija (CT) je jedan od najznačajnijh dijagnostičkih modaliteta, čija upotreba raste iz decenije u deceniju. U ukupnom broju radiolo&scaron;kih pregleda CT je zastupljena sa 5-10%, ali je njen doprinos ukupnoj dozi za populaciju veći od 50%. Osnovni pokazatelji kvaliteta slike i doza, kao i prateći radijacioni rizik zavise od primenjene radiografske tehnike odnosno CT pregleda. U smislu&nbsp; dobre radiolo&scaron;ke prakse i u skladu sa osnovnim principima za&scaron;tite od zračenja, poželjna je primena najniže moguće doze za pacijenta uz održavanje kvaliteta slike i dijagnostičke informacije. Cilj istraživanja jeste definisanje optimalnog protokola pregleda vi&scaron;eslojnom CT za dijagnozu pojedinih regija tela, kao i da se utvrde doze i radijacioni rizik za pacijente pre i nakon optimizacije protokola. Analizom je obuhvaćeno ukupno 437 pacijenata, koji su podeljeni u grupe prema regijama tela koje su snimane: I&ndash;nekontrastni CT glave, II-CT glave sa i.v. kontrastom, III-CT grudnog ko&scaron;a, IV-CT abdomena i karlice i V-CT angio (CT angiografija aortoilijačnog segmenta i donjih ekstremiteta). Studija je izvedena u 2 faze: u I fazi je kori&scaron;ćen standardni protokol za regiju tela koja se snimala, a u II fazi CT pregledi su izvedeni po modifikovanom protokolu (promenom parametra vrednosti mAs), uz minimalne zahteve u pogledu kvaliteta slike.Na osnovu dozimetrijskih&nbsp; pokazatelja procenjena je efektivna doza i radijacioni rizik za pacijente u obe faze. U studiji su kori&scaron;ćene smernice iz Vodiča EUR 16262&nbsp; EN, u kojima su definisani parametri za procenu kvaliteta slike da bi se analizirali različiti anatomski preseci određenih regija tela koji su se snimali. Kvalitet slike za svakog pacijenta je ocenjen pomoću trostepene skale vizualizacije za svaki parametar anatomske regije: 0-detalji su vidljivi, 1-detalji se prikazuju, 2-detalji se jasno prikazuju. Kori&scaron;ćena je subjektivna metoda gde su dva iskusna radiologa vr&scaron;ili interpretaciju slike. Konačna ocena kvaliteta slike svakog pregleda odgovara zbiru svih parametara procenjenih po trostepenoj skali&nbsp; vizualizacije. Zatim je za potrebe izračunavanja veličine FOM (figure of merit) izračunata vrednost indeksa ocene kvaliteta slike (zbir svih&nbsp; ocena parametra/brojem parametara). Vrednost FOM je izračunata kao količnik indeksa ocene kvaliteta slike i efektivne doza po pacijentu. Prosečna vrednost FOM za svaku grupu ispitanika nam je poslužila kao relativni pokazatelj za upoređivanje između neoptimizovane i optimizovane grupe ispitanika za isti tip pregleda. Poređenjem vrednosti efektivne doze u prvoj i drugoj fazi istraživanja kvantifikovano je smanjenje radijacionog opterećenja za pacijente nakon optimizacije protokola. Rezultati su pokazali da je optimalnim izborom protokola u&nbsp;&nbsp; smislu parametara ekspozicije (smanjenjem vrednosti mAs) moguće značajno smanjiti dozu zračenja kod pregleda glave za 7,5%, kod pregleda glave sa angiografijom za 7%, kod pregleda grudnog ko&scaron;a za 40%, kod pregleda abdomena i karlice za 25%. Grupa CT angio&nbsp; nije mogla da bude optimizovana, jer aparat nije prihvatao promenu kvaliteta slike kod zadatih parametara optimizacije. Primenom standardnih protokola postiže se kvalitet slike bolji nego &scaron;to je neophodno, a samim tim i veća doza zračenja nego &scaron;to je potrebno. Optimalnim izborom protokola u smislu parametara ekspozicije moguće je značajno smanjiti dozu zračenja, uz održavanje kvaliteta slike koji je dovoljan za adekvatnu radiolo&scaron;ku interpretaciju slike.</p> / <p>Computed&nbsp; tomography (CT) is one of the most significant diagnostic methods whose application has been increasing from decade to decade.&nbsp; Among the total number of radiological examinations CT accounts for 5-10%, however, its contribution in the whole dosage for the population is greater than 50%. Main indicator of the quality of images and dosages as well as the accompanying irradiation risk depend on applied radiographic technique that is CT examination. In the sense of good radiological practice and in accordance with basic principles of protection from irradiation, the application of the lowest possible dosage for a patient together with preserving the quality of image and diagnostic information are mostly welcomed. The goal of the research is to define the optimum examination protocol by multislice CT in diagnostics of certain body regions as well as to determine dosages and irradiation risk for patients both before and after protocol optimization. The analysis has included 437 patients divided into groups according to body regions which have been scanned: I-unenhanced head CT, II contrast enhanced head CT, III&ndash;chest CT, IV&ndash;abdomen and pelvis CT and&nbsp; V&ndash;angio CT (CT angiography of aortoiliac segment and lower extremities). The study has been conducted in 2 phases: in the first phase standard protocol for the scanned body region has been applied, and in the second phase CT examinations have been carried out according to the modified&nbsp; protocol&nbsp; (by change of parameters of values mAs)&nbsp; with minimum&nbsp; requirements&nbsp; regarding&nbsp; the&nbsp; image&nbsp; quality. On&nbsp; the&nbsp; basis&nbsp; of&nbsp; dosimetric&nbsp; indicators&nbsp; the&nbsp; efficient&nbsp; dosage&nbsp; and&nbsp; irradiation&nbsp; risk&nbsp; for&nbsp; the patients in both phases have been assessed. In the study the guidelines form the Guide EUR&nbsp; 16262&nbsp; EN&nbsp; have&nbsp; been&nbsp; observed&nbsp; where&nbsp; parameters for&nbsp; the&nbsp; assessment&nbsp; of&nbsp; image quality&nbsp; have&nbsp; been&nbsp; defined&nbsp; in&nbsp; order&nbsp; to&nbsp; analyze&nbsp; different&nbsp; anatomic&nbsp; cross sections of certain body&nbsp; regions.&nbsp; Image quality&nbsp; for&nbsp; each&nbsp; patient&nbsp; was&nbsp; assessed&nbsp; by&nbsp; three-level visualization&nbsp; scale&nbsp; for&nbsp; each&nbsp; parameter&nbsp; of&nbsp; anatomic&nbsp; region:&nbsp; 0&ndash;details&nbsp; are&nbsp; visible, 1&ndash;details are&nbsp; presented,&nbsp; 2&ndash;details are clearly&nbsp; presented.&nbsp; A&nbsp; subjective&nbsp; method&nbsp; was applied&nbsp; where&nbsp; two&nbsp; experienced&nbsp; radiologists performed&nbsp; the&nbsp; image interpretation. Final assessment&nbsp; of&nbsp; image quality&nbsp; of&nbsp; every&nbsp; examination corresponds&nbsp; to&nbsp; the&nbsp; sum&nbsp; of&nbsp; all parameters&nbsp; according&nbsp; to&nbsp; three-level&nbsp; visualization&nbsp; scale. Further,&nbsp; for&nbsp; the&nbsp; need&nbsp; of calculation of the size of FOM (figure of merit) the value of the index of assessment of the&nbsp; image&nbsp; quality&nbsp; (sum of all assessments of parameters/number of&nbsp; parameters) has been&nbsp; calculated.&nbsp; The&nbsp; value of&nbsp; FOM&nbsp; has&nbsp; been&nbsp; calculated as a quotient&nbsp; of&nbsp; the&nbsp; image quality assessment index and effective dosage per patient.&nbsp; The average value of FOM for&nbsp; every&nbsp; group&nbsp; of&nbsp; patients&nbsp; has&nbsp; offered us a&nbsp; relative&nbsp; indicator for&nbsp; comparison of&nbsp; non-optimum&nbsp; and optimum group of&nbsp; patients&nbsp; for&nbsp; the&nbsp; same&nbsp; type&nbsp; of&nbsp; examinations.&nbsp; By comparison of values of effective dosage in the first and second phase of the research a decrease in irradiation load for patients after protocol optimization was quantified. The results have&nbsp; shown&nbsp; that&nbsp; by&nbsp; optimum&nbsp; protocol&nbsp; selection&nbsp; in&nbsp; the&nbsp; sense&nbsp; of&nbsp; exposition parameters (by&nbsp; reduction of&nbsp; values of&nbsp; mAs) it is&nbsp; possible to reduce significantly&nbsp; the irradiation dosage at&nbsp; unenhanced head CT examination for 7,5%, at contrast enhanced head CT examination for 7%, at chest CT examination for 40%, at abdomen&nbsp; and pelvis CT examination for 25%. The group CT angio could not be optimized since the device&nbsp; did&nbsp; not&nbsp; accept&nbsp; the&nbsp; change in image quality at set&nbsp; optimization parameters. By application&nbsp; of&nbsp; standard&nbsp; protocols the image quality&nbsp; better&nbsp; than required&nbsp; was&nbsp; achieved and along with this, a higher irradiation dosage occurred than required. By selection of protocol in the sense&nbsp; of&nbsp; exposition parameters it is possible to reduce irradiation dosage significantly along with preserving image quality which is&nbsp; sufficient for adequate radiological image interpretation.</p>

Thesis deals with the evaluation of the impacts of the application of the taxation and exemption on the supply and letting of immovable property. In connection with VAT deduction, the thesis focuses on the correct determination of the proportional and reduction coefficients. The work also evaluates the effects of the application of the taxation and exemption on the reduction coefficient and the VAT deduction adjustment. It also contains an analysis of the impact of the Court of Justice of the EU's and Czech court's decisions on the application of VAT on the supply and letting of immovable property. Based on the impact assessment, the author puts forward recommendations for taxable persons.

I have been interested in the topic I chose for my diploma thesis since I was deciding on my future profession. When it comes to the teaching profession, usually the idea of summer holidays attracts everyone. However, the stress that teachers face in performing this profession is not so much talked about. Therefore, I decided to learn more about this issue. This thesis deals specifically with stress in primary school teachers, to which teachers are increasingly exposed, and the word stress is very often associated with this profession. For several years I personally worked as a teaching assistant in a special school and now I teach Czech to foreigners at a primary school in Pilsen. Also for this reason, I decided to map the stress of primary school teachers. I would like to continue working in this profession, as well as working on my personal growth and finding a way to effectively prevent stress. The thesis is divided into two parts. In the theoretical part, I define the terms load and stress first and cite some well-known authors dealing with this issue. I also describe the symptoms of stress of various kinds and its consequences for our health. In the following chapter I describe individual stressors, which have a significant effect on the teacher's work performance. The chapter describing...

ŠPITÁLKA CONCEPT Urban design of Špitálka is trying to create a new residential neighborhood near the center. The combination of old residential and multifunctional buildings is logically complemented by a new one. New residential units replace the post-industrial parts of the emerging brownfield. This does not mean, however, an extensive rehabilitation of the historical building structure. Every object is thoroughly analyzed, considered for its new fulfillment. The basics are connections between old and new buildings. Keeping the high-rise building and many historic buildings creates a prerequisite for preserving Genia loci of that place to the fullest extent possible. At the same time, with new interventions, it is meaningfully and functionally clarified, logically linked, creating new specifications and qualities of space for a good living in the city. It is also about improving the cycling and pedestrian traffic to the city center, street views of Brno's dominant landmarks (Petrov, Kostel sv.), enlarging of the uncomfortably narrow Cejl street, or cultivating the public space with greenery (alleyways, parking lots, parks, . Individual urban blocks offer variable options for typological solutions. The place has the ambition to create a diverse residential neighborhood for private owners, tenants, social and cooperative housing. The goal is not to create formal gestures, but to adequately supplement and sensitively replace the broken parts of the neighborhood.

Predicting the passenger flow inside a city is a vital component of the intelligent transportation management system. The proposal for a new residential area, an office space, post­pandemic policy implications for work from home, behavioral changes for revised traffic patterns, infrastructural improvements, require a visual and analytical backing which can be provided through a macro simulation model. This research explores the performance of the Machine learning (ML) based transport model against the predictions provided by the traditional Spatial Interaction Models (SIM) for the city of Oslo. The transport models and their parameters are analyzed for sensitivity analysis and scenario analysis to derive city character. Furthermore, the derived model is deployed over an interactive dashboard for analytical and their practical visualizations through infographics. The results show that the ML model outperforms the SIM. Although the traditional SIM has a clear advantage of being interpreted by design and requiring a few parameters, it suffers from its inability to accurately capture the structure of real flows and greater variability as compared to the ML model. Extensive statistical analyses are conducted to obtain significant results and realize the pros and cons of both the models which question the validity of results for the ML model over SIM. With this thesis, we discuss the potential of ML model detected trends of passenger flows, andtheir capacity to simulate city development­related scenarios for the traffic flows within the city.

金融機構在承做住宅抵押貸款時，面臨兩種風險，分別是提前清償及違約。這兩種借款人風險行為對金融機構的資產管理產生相當大的影響，尤其在不動產證券化的推動上，都是評價證券價格的關鍵因子，因此，討論借款者提前還款與違約行為，是近年不動產證券化領域中重大議題。 借款人決定提前清償及違約與否，除了與借款人特性之外尚有房屋特性與財務選擇上的特性，且有許多影響因子並非維持在貸款起始的狀態，而是會在貸款存續期間內隨著時間遷移有所改變，因此，本文在進一步研究影響借款人行為時，處理時間相依變數，利用動態調整過後的變數來分析借款人提前清償及違約風險行為，觀察借款人特徵、房屋型態及貸款條件等變數與借款人風險行為的關係並進行證券價格MBS的評價。 實證結果顯示，借款人特徵部分並不會影響提前清償但會影響違約風險。且借款者在財務選擇上面，會有落後反映的現象，亦即隨著時間的經過，借款者才會選擇有利於自己的財務決策，且雖然本國貸款為浮動利率貸款，但是影響借款者最深的仍然是利率相關因素，且觀察到借款者對於財務上面的好處比壞處有更敏感的現象，顯示出借款者比較趨近於風險愛好者。 在MBS評價上發現，影響價格的最重要因素在於放款的品質，因此，要真正落實抵押住宅證券化的實行，關鍵在於金融機構必須篩選優良放款進行證券化，才能吸引投資人，增加住宅抵押貸款證券化發行的可行性。

AbstractSyfte. Att: beskriva sjuksköterskors erfarenheter av att arbeta i glesbygd med jour på distans.Bakgrund. Jour på distans innebär att sjuksköterskor, med stöd av läkare på di-stans, omhändertar patienter med olika slags akuta symtom. Frånvaron av nationella studier, rörande sjuksköterskors erfarenhet av jour på distans i kombination med behovet av att hitta nya sätt att bedriva vård i glesbygd, borde medföra ett intresse för studien.Design: Deskriptiv intervjustudie med kvalitativ ansats.Metod. Intervjuer genomfördes med 9 sjuksköterskor, vilka arbetar vid 2 olika häl-socentraler belägna i nordligaste delen av Sverige. Intervjuerna genomfördes våren 2017. Materialet analyserades med kvalitativ innehållsanalys.Resultat. Analysen resulterade i de 4 kategorierna rollutveckling, fördelar för pati-enten, stöd samt osäkerhet. Sjuksköterskor beskriver sig ha ett arbete som på olika sätt medför rollutveckling. Fördelar för patinten framställs bestå av exempelvis mins-kat behov av resor samt möjlighet att få snabb bedömning utan att alltid behöva åka till sjukhus. Kategorin stöd belyser betydelsen av tillit från läkare och fungerande teknik. Sista kategorin påvisar att vissa situationer medför känslor av osäkerhet hos sjuksköterskan, som exempelvis när läkare har dålig kunskap om jour på distans.Slutsats. Resultatet påvisar att jour på distans, sett ur sjuksköterskornas perspektiv, är ett bra sätt att tillvarata befintlig personal och teknik i syfte att tillhandahålla vård under jourtid i glest befolkade områden. Arbete med jour på distans kräver sjukskö-terskor med god kunskap och erfarenhet och studien påvisar även betydelsen av ut-bildning samt stöd från läkaren.

<p>Valorizacija permeata kao sporednog proizvoda industrije mleka je od izuzetnog ekolo&scaron;kog, ekonomskog i tehnolo&scaron;kog značaja.<br />Cilj doktorske disertacije je razvoj tehnolo&scaron;kog procesa prerade permeata, kao sporednog proizvoda dobijenog nakon ultrafiltracije mleka tokom proizvodnje feta sira i svežeg (&bdquo;mladog&ldquo;) sira. Ispitana je mogućnost enzimske hidrolize laktoze u permeatu kori&scaron;ćenjem enzima &beta;-galaktozidaze izolovanog iz Kluyveromyces lactis u koncentraciji 0,1, 0,3 i 0,5 g/100g na temperaturama 20&ordm;, 30&ordm; i 40 &ordm;C. Praćene su promene sadržaja laktoze, D&ndash;galaktoze i D&ndash;glukoze u vremenskim intervalima tokom 60 minuta. Posebna faza istraživanja obuhvatila je matematičko modelovanje i kinetiku procesa hidrolize laktoze u permeatu pod dejstvom &beta; &ndash;galaktozidaze i primenu hidrolizovanog permeata u proizvodnji mlečnih napitaka po odabranoj formulaciji. Predložen je tehnolo&scaron;ki proces proizvodnje napitka na bazi hidrolizovanog permeata sa dodatkom voćnih baza. Utvrđeni su parametri kvaliteta i trajnosti napitaka tokom 60 dana skladi&scaron;tenja.<br />Na temperaturi 40&deg;C dodatkom enzima &beta; -galaktozidaze u koncentraciji 0,1g/100g za 60 minuta postiže se 100% stepen hidrolize prisutne laktoze u permeatu. Sa većom koncentracijom enzima, 0,3 g/100g odnosno 0,5g/100g, na istoj temperaturi, isti efekat se postiže za 20 minuta.<br />Ispitivanjem kinetike hidrolize laktoze potvrđena je kinetika prvog reda. Generalno posmatrano visoki koeficijenti determinacije pokazuju dobro poklapanje eksperimentalnih rezultata i matematičkog modela reakcije prvog reda. Vrednosti se kreću od 0,974 (temperatura 20&deg;C) do preko 0,990 (na temperaturama 30&deg;C i 40&deg;C) pri koncentraciji enzima 0,1g/100g.<br />Proizvedeni napici od hidrolizovanog permeata su delaktozirani i ne sadrže mlečnu mast. Od ukupnih &scaron;ećera u svim napicima vi&scaron;e od 50% čini glukoza: 50,16% - napitak &scaron;umsko voće, 50,42% - napitak pomorandža/&scaron;argarepa, 54,65% - napitak multivitamin, odnosno 55,13% - napitak crveno voće.<br />Najveći sadržaj vitamina C nakon proizvodnje imao je napitak sa dodatkom voćne baze multivitamin 0,3972 mg/100g, zatim &scaron;umsko voće 0,2887 mg/100g i pomo-randža/&scaron;argarepa 0,1999 mg/100g.<br />Najveću vrednost antioksidativne aktivnosti nakon proizvodnje pokazali su uzorci napitka sa multivitaminom i &scaron;umskim voćem. Tokom perioda skladi&scaron;tenja dolazi do smanjenja DPPH vrednosti. Najmanji pad je u napitku sa pomorandžom / &scaron;argarepom (smanjenje za 17%), a najveći u napitku sa &scaron;umskim voćem (za 39%). Analizirani uzorci sadrže ukupnih polifenola u intervalu od 47,84 do 120,38 mg GAE/l u zavisnosti od vrste napitka, odnosno dodatih voćnih baza.<br />Generalno može se zaključiti da se prime-njenim tehnolo&scaron;kim procesom dobijaju napici stabilnog fizičko-hemijskog sastava tokom 60 dana skladi&scaron;tenja, visoke nutritivne i niske energetske vrednosti.</p> / <p>Valuation of the permeate as a by-product of the dairy industry is of great ecological, economic and technological importance.<br />The aim of the PhD thesis is the development of the technological process of refining permeate, as a by-product obtained after ultrafiltration of milk during the production of feta cheese and fresh cheese. The possibility of enzymatic hydrolysis of the lactose in the permeate using the enzyme &beta;-galactosidase isolated from Kluyveromyces lactis in a concentration of 0.1, 0.3 and 0.5 g / 100 g at a temperature of 20&deg;, 30&deg; and 40&deg; C was examined. Changes in the content of lactose, D-galactose and D-glucose at intervals of 60 minutes were monitored. A special stage of the research included mathematical modeling and kinetics of lactose hydrolysis in the permeate under the influence of &beta;-galactosidase and application of hydrolyzed permeate in the production of dairy products under the selected formulation. A technological process of producing a beverage on the basis of hydrolyzed permeate with the addition of fruit bases was suggested. Quality and durability parameters were determined for drinks during the 60 days of storage.<br />Addition of the enzyme &beta;-galactosidase at a concentration of 0.1 g / 100 g for 60 minutes at a temperature of 40 &deg; C a 100% degree of hydrolysis of lactose is achieved, present in the permeate. With a higher concentration of enzyme, 0.3 g / 100 g or 0.5 g / 100g, at the same temperature, the same effect can be achieved in 20 minutes.<br />By examining the kinetics of lactose hydrolysis the first order kinetics was confirmed. Generally high coefficients of determination show good correspondence between the experimental results and the mathematical model of the first order reaction. Values range from 0.974 (at a temperature of 20&deg; C) up to over 0.990 (at temperatures 30&deg; C and 40&deg; C) at a an enzyme concentration of 0.1g / 100g.<br />Beverages produced from hydrolyzed permeate are lactose-free and fat-free products. More than half of the total sugar content in all beverages consists of glucose: 50.16%-forest fruit beverage, 50.42%-beverage orange/carrot, 54.65% beverage multivitamin and 55.13% - beverage red fruit.<br />The highest vitamin C content after production was in a beverage with the addition of fruit base multivitamin (0.3972 mg/100g), followed by forest fruit (0.2887 mg/100g) and orange/carrot (0.1999 mg/100g).<br />Beverage samples with multivitamin and forest fruits showed the highest value of antioxidant activity after production. During the storage period there is a reduction of DPPH values. The smallest decrease was in the beverage with orange/carrot (decreased 17%), and the biggest in the beverage with forest fruit (39%). The content of polyphenols in analyzed samples ranges from 47.84 to 120.38 mg GAE/L depending on the type of beverage and added fruit base.<br />Overall it can be concluded that the applied technological process gives beverages of stable physical and chemical content during the 60 days of storage, of high nutritional value and low energy.</p>