Towards to a modern higher education institutions in Poland

Since the dawn of time, universities have contributed significantly to the economic development. However, presently operating higher education institutions are characterized by a significant diversity of goals, missions and functions, which significantly go beyond the ones traditionally assigned to this type of institution

Push-Pull Locomotion for Vehicle Extrication

For applications in which unmanned vehicles must traverse unfamiliar terrain, there often exists the risk of vehicle entrapment. Typically, this risk can be reduced by using feedback from on-board sensors that assess the terrain. This work addressed the situations where a vehicle has already become immobilized or the desired route cannot be traversed using conventional rolling. Specifically, the focus was on using push-pull locomotion in high sinkage granular material. Push-pull locomotion is an alternative mode of travel that generates thrust through articulated motion, using vehicle components as anchors to push or pull against. It has been revealed through previous research that push-pull locomotion has the capacity for generating higher net traction forces than rolling, and a unique optical flow technique indicated that this is the result of a more efficient soil shearing method. It has now been found that pushpull locomotion results in less sinkage, lower travel reduction, and better power efficiency in high sinkage material as compared to rolling. Even when starting from an "entrapped" condition, push-pull locomotion was able to extricate the test vehicle. It is the authors' recommendation that push-pull locomotion be considered as a reliable back-up mode of travel for applications where terrain entrapment is a possibility

Benefit of "Push-pull" Locomotion for Planetary Rover Mobility

As NASAs exploration missions on planetary terrains become more aggressive, a focus on alternative modes of locomotion for rovers is necessary. In addition to climbing steep slopes, the terrain in these extreme environments is often unknown and can be extremely hard to traverse, increasing the likelihood of a vehicle or robot becoming damaged or immobilized. The conventional driving mode in which all wheels are either driven or free-rolling is very efficient on flat hard ground, but does not always provide enough traction to propel the vehicle through soft or steep terrain. This paper presents an alternative mode of travel and investigates the fundamental differences between these locomotion modes. The methods of push-pull locomotion discussed can be used with articulated wheeled vehicles and are identified as walking or inchinginch-worming. In both cases, the braked non-rolling wheels provide increased thrust. An in-depth study of how soil reacts under a rolling wheel vs. a braked wheel was performed by visually observing the motion of particles beneath the surface. This novel technique consists of driving or dragging a wheel in a soil bin against a transparent wall while high resolution, high-rate photographs are taken. Optical flow software was then used to determine shearing patterns in the soil. Different failure modes were observed for the rolling and braked wheel cases. A quantitative comparison of inching vs. conventional driving was also performed on a full-scale vehicle through a series of drawbar pull tests in the Lunar terrain strength simulant, GRC-1. The effect of tire stiffness was also compared; typically compliant tires provide better traction when driving in soft soil, however its been observed that rigid wheels may provide better thrust when non-rolling. Initial tests indicate up to a possible 40 increase in pull force capability at high slip when inching vs. rolling

Comparison of temperature measurements in esophagus and urinary bladder in comatose patients after cardiac arrest undergoing mild therapeutic hypothermia

Background: Mild therapeutic hypothermia (MTH) is a recommended method of treatment for comatose out-of-hospital cardiac arrest (OHCA) survivors. However, the proper site of temperature measurement in MTH is still not defined. The aim of this study was to compare temperature measurements in the esophagus and urinary bladder in comatose post-OHCA patients treated with MTH.Methods: This temperature comparison protocol was a part of a prospective, observational, multicenter cohort study. The study population included 36 unconscious patients after resuscitation for OHCA. The patient’s core temperature was independently measured every hour during MTH in the urinary bladder and in the esophagus.Results: The mean temperature was lower in the esophagus (differences during induction phase: 1.04 ± 0.92°C, p < 0.0001; stabilization phase: 0.54 ± 0.39°C, p < 0.0001; rewarming phase: 0.40 ± 0.47°C, p < 0.0001). Nevertheless, a strong correlation between both sites was found (R2 = 0.83, p < 0.001). The decrease in temperature observed in the esophagus during the induction phase was faster when compared with the urinary bladder (1.09 ± 0.71°C/h vs. 0.83 ± 0.41°C/h; p = 0.002). As a consequence, time to reach temperature < 34.0°C was longer when temperature was measured in the urinary bladder (the difference between medians of the time 1.0 [0–1.5] h, p < 0.001).Conclusions: Urinary bladder temperature measurements may lag behind temperature changes measured in the esophagus. Monitoring temperature simultaneously in the esophagus and in the urinary bladder is an accessible and reliable combination, although esophageal measurements seem to better reflect the dynamics of temperature changes, thus it seems to be more appropriate for MTH control. ClinicalTrials.gov Identifier: NCT0261193

The results of salvage surgery combined with reirradiation in nodal recurrence of larynx cancer

The recurrence in the regional lymph nodes of patients after total laryngectomy and postoperative radiotherapy is a still serious therapeutic problem. The conditions that are altered following the combined primary treatment make it difficult to achieve satisfactory results of the second surgical treatment.The aim of our study was to evaluate the outcome of a salvage operation (lymphadenectomy) and reirradiation in 50 patients with recurrence in regional lymph nodes (rN). Beetwen 1991 and 1996, 650 patients with larynx carcinoma were treated in our institiutions. All patients during the primary irradiation received a total dose of about 60 Gy. In the case of regional recurrence (rN) patients had selective lymphadenectomy and reirradiation (total dose 40 Gy) when capsulae were found to be infiltrated. The survival rates were for 1, 2 and 3 years : 34 (68%), 22 (44%), only 9 (18%) respectivly. This strategy of a second combined treatment had a good tolerance level, without any unacceptable side effects (complications)

Multi vegetation model evaluation of the Green Sahara climate regime

During the Quaternary, the Sahara desert was periodically colonized by vegetation, likely because of orbitally induced rainfall increases. However, the estimated hydrological change is not reproduced in climate model simulations, undermining confidence in projections of future rainfall. We evaluated the relationship between the qualitative information on past vegetation coverage and climate for the mid-Holocene using three different dynamic vegetation models. Compared with two available vegetation reconstructions, the models require 500–800 mm of rainfall over 20°–25°N, which is significantly larger than inferred from pollen but largely in agreement with more recent leaf wax biomarker reconstructions. The magnitude of the response also suggests that required rainfall regime of the early to middle Holocene is far from being correctly represented in general circulation models. However, intermodel differences related to moisture stress parameterizations, biases in simulated present-day vegetation, and uncertainties about paleosoil distributions introduce uncertainties, and these are also relevant to Earth system model simulations of African humid periods

A new approach to ticagrelor-based de-escalation of antiplatelet therapy after acute coronary syndrome. A rationale for a randomized, double-blind, placebo-controlled, investigator-initiated, multicenter clinical study

© 2021 Via Medica. This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license. https://creativecommons.org/licenses/by/4.0/The risk of ischemic events gradually decreases after acute coronary syndrome (ACS), reaching a stable level after 1 month, while the risk of bleeding remains steady during the whole period of dual antiplatelet treatment (DAPT). Several de-escalation strategies of antiplatelet treatment aiming to enhance safety of DAPT without depriving it of its efficacy have been evaluated so far. We hypothesized that reduction of the ticagrelor maintenance dose 1 month after ACS and its continuation until 12 months after ACS may improve adherence to antiplatelet treatment due to better tolerability compared with the standard dose of ticagrelor. Moreover, improved safety of treatment and preserved anti-ischemic benefit may also be expected with additional acetylsalicylic acid (ASA) withdrawal. To evaluate these hypotheses, we designed the Evaluating Safety and Efficacy of Two Ticagrelor-based De-escalation Antiplatelet Strategies in Acute Coronary Syndrome — a randomized clinical trial (ELECTRA-SIRIO 2), to assess the influence of ticagrelor dose reduction with or without continuation of ASA versus DAPT with standard dose ticagrelor in reducing clinically relevant bleeding and main-taining anti-ischemic efficacy in ACS patients. The study was designed as a phase III, randomized, multicenter, double-blind, investigator-initiated clinical study with a 12-month follow-up.Peer reviewedFinal Published versio

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402