Czas i przestrzeń w metafizyce Witkiewicza a pierwotność ontologiczna indywiduów. Ujęcie z perspektywy wybranych wątków współczesnej metafizyki analitycznej

This paper reconstructs two distinct interpretations of Stanisław Ignacy Witkiewicz’s philosophy of time and space and his concept of space-time, absolutist and relational. According to the first one mentioned, both space and time exist independently of individuals, whereas the other assumes the ontological priority of the individuals. The interpretations are associated with variants of priority monism and priority pluralism drawn from the contemporary analytic metaphysics. I argue that the absolutist interpretation ends up in a contradiction, irrespective of which of the two positions is accepted. The conclusion is drawn that it is the relational interpretation of Witkiewicz’s philosophy of time and space that should be preferred.Artykuł rekonstruuje dwie odmienne interpretacje filozofii czasu i przestrzeni (czaso-przestrzeni) Stanisława Ignacego Witkiewicza – absolutystyczną i relacyjną. Według interpretacji absolutystycznej czas i przestrzeń uznaje się za niezależne od indywiduów. Interpretacja relacyjna natomiast przypisuje prymat bytowy indywiduum, a czas i przestrzeń traktuje jako bytowo zależne. Obie interpretacje zestawiam z wariantami monizmu podstaw ontologicznych i pluralizmu podstaw ontologicznych, zaczerpniętymi ze współczesnej metafizyki analitycznej. Argumentuję, że interpretacja absolutystyczna w zestawieniu z którymkolwiek z obu stanowisk prowadzi do sprzeczności. W rezultacie konkluduję, że preferowaną interpretacją Witkiewiczowskiej filozofii czasu i przestrzeni jest interpretacja relacjonistyczna

Self-supervised adversarial masking for 3D point cloud representation learning

Self-supervised methods have been proven effective for learning deep representations of 3D point cloud data. Although recent methods in this domain often rely on random masking of inputs, the results of this approach can be improved. We introduce PointCAM, a novel adversarial method for learning a masking function for point clouds. Our model utilizes a self-distillation framework with an online tokenizer for 3D point clouds. Compared to previous techniques that optimize patch-level and object-level objectives, we postulate applying an auxiliary network that learns how to select masks instead of choosing them randomly. Our results show that the learned masking function achieves state-of-the-art or competitive performance on various downstream tasks. The source code is available at https://github.com/szacho/pointcam

Zastosowanie lewosimendanu u chorych z ostrą niewydolnością serca z objawami małego rzutu minutowego serca: opis serii przypadków

The report presents single centre experience in application of levosimendan in patients with acute heart failure with low cardiacoutput. All patients underwent haemodynamic measurement before and after administration of the drug. Levosimendanimproved haemodynamics and was useful in this subpopulation of patients

Rationale and design of Ferinject® Assessment in patients with IRon deficiency and chronic Heart Failure (FAIR-HF) study: a randomized, placebo-controlled study of intravenous iron supplementation in patients with and without anaemia

Iron deficiency (ID) and anaemia are common in patients with chronic heart failure (CHF). The presence of anaemia is associated with increased morbidity and mortality in CHF, and ID is a major reason for the development of anaemia. Preliminary studies using intravenous (i.v.) iron supplementation alone in patients with CHF and ID have shown improvements in symptom status. FAIR-HF (Clinical Trials.gov NCT00520780) was designed to determine the effect of i.v. iron repletion therapy using ferric carboxymaltose on self-reported patient global assessment (PGA) and New York Heart Association (NYHA) in patients with CHF and ID. This is a multi-centre, randomized, double-blind, placebo-controlled study recruiting ambulatory patients with symptomatic CHF with LVEF < 40% (NYHA II) or < 45% (NYHA III), ID [ferritin < 100 ng/mL or ferritin 100-300 ng/mL when transferrin saturation (TSAT) < 20%], and haemoglobin 9.5-13.5 g/dL. Patients were randomized in a 2:1 ratio to receive ferric carboxymaltose (Ferinject((R))) 200 mg iron i.v. or saline i.v. weekly until iron repletion (correction phase), then monthly until Week 24 (maintenance phase). Primary endpoints are (i) self-reported PGA at Week 24 and (ii) NYHA class at Week 24, adjusted for baseline NYHA class. This study will provide evidence on the efficacy and safety of iron repletion with ferric carboxymaltose in CHF patients with ID with and without anaemia

Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

Left ventricular function, congestion, and effect of empagliflozin on heart failure risk after myocardial infarction

Background Empagliflozin reduces the risk of heart failure (HF) hospitalizations but not all-cause mortality when started within 14 days of acute myocardial infarction (AMI). Objective To evaluate the association between left ventricular ejection fraction (LVEF), congestion, or both on outcomes and the impact of empagliflozin in reducing HF risk post-MI. Methods In the EMPACT-MI trial, patients were randomized within 14 days of an AMI complicated by either newly reduced LVEF&lt;45%, congestion, or both to empagliflozin 10 mg daily or placebo and followed for a median of 17.9 months. Results Among 6522 patients, the mean baseline LVEF was 41%+9%; 2648 patients (40.6%) presented with LVEF&lt;45% alone, 1483 (22.7%) presented with congestion alone, and 2181 (33.4%) presented with both. Among patients in the placebo arm, multivariable adjusted risk for each 10-point reduction in LVEF included all-cause death or HF hospitalization (hazard ratio [HR] 1.49; 95%CI, 1.31-1.69; P&lt;0.0001), first HF hospitalization (HR, 1.64; 95%CI, 1.37-1.96; P&lt;0.0001), and total HF hospitalizations (rate ratio [RR], 1.89; 95%CI, 1.51-2.36; P&lt;0.0001). Presence of congestion was also associated with a significantly higher risk for each of these outcomes (HR 1.52, 1.94, and RR 2.03, respectively). Empagliflozin reduced the risk for first (HR 0.77, 95%CI 0.60-0.98) and total (RR 0.67, 95%CI 0.50-0.89) HF hospitalization, irrespective of LVEF or congestion or both. The safety profile of empagliflozin was consistent across baseline LVEF and irrespective of congestion status. Conclusions In patients with AMI, severity of LV dysfunction and the presence of congestion was associated with worse outcomes. Empagliflozin reduced first and total HF hospitalizations across the range of LVEF with and without congestion

Effect of empagliflozin on heart failure outcomes after acute myocardial infarction: insights from the EMPACT-MI trial

Background: Empagliflozin reduces the risk of heart failure events in patients with type 2 diabetes at high cardiovascular risk, chronic kidney disease, and in those with prevalent heart failure irrespective of ejection fraction. While EMPACT-MI showed empagliflozin does not reduce the risk of the composite of hospitalization of heart failure and all-cause mortality, the impact of empagliflozin on first and recurrent heart failure events in patients after myocardial infarction is unknown. Methods: EMPACT-MI was a double-blind, randomized, placebo-controlled, event-driven trial that randomized 6522 patients hospitalized for acute myocardial infarction at risk for heart failure based on newly developed left ventricular ejection fraction of &lt;45% and/or signs or symptoms of congestion to receive empagliflozin 10 mg daily or placebo within 14 days of admission. In prespecified secondary analyses, treatment groups were analyzed for heart failure outcomes. Results: Over a median of follow-up of 17.9 months, the risk for first heart failure hospitalization and total heart failure hospitalizations was significantly lower in the empagliflozin compared with the placebo group (118 (3.6%) vs. 153 (4.7%) patients with events, HR 0.77 [95% CI 0.60, 0.98], P=0.031 for first heart failure hospitalization and 148 vs. 207 events, RR 0.67 [95% CI 0.51, 0.89], P=0.006 for total heart failure hospitalizations). Subgroup analysis showed consistency of empagliflozin benefit across clinically relevant patient subgroups for first and total heart failure hospitalizations. Post-discharge need for new use of diuretics, renin-angiotensin modulators, and mineralocorticoid receptor antagonists were less in patients randomized to empagliflozin than placebo (all p&lt;0.05). Conclusions: In patients after acute myocardial infarction with left ventricular dysfunction or congestion, empagliflozin reduced the risk of heart failure

Passive safety solutions in railway vehicles

Celem pracy jest omówienie problematyki bezpieczeństwa (biernego) pasywnego w pojazdach kolejowych, w tym przede wszystkim przedstawienie aktualnych rozwiązań elementów absorbujących energię zderzenia. W kolejnych punktach wskazano podstawowe funkcje pełnione przez systemy bezpieczeństwa pasywnego oraz omówiono źródło obowiązujących przepisów. Wymieniono scenariusze zderzeniowe oraz omówiono podstawowe kryteria oceny konstrukcji pojazdu. Ostatecznie przedstawiono wybrane rozwiązania układów bezpieczeństwa biernego stosowane wybranych typach lokomotyw oraz zespołów trakcyjnych.The aim of the article is to discuss the issues of passive safety in railway vehicles. Current design of the elements absorbing collision energy is presented. Basic functions performed by passive safety systems are indicated and the source of the applicable regulations is discussed. Crash scenarios are listed and the basic criteria for vehicle structure assessment are discussed. Some solutions of passive safety systems used in selected types of locomotives and multiple units are presented