Halliday\u27s Functional Grammar: Philosophical Foundation and Epistemology

It is difficult to track the philosophy foundation and epistemology of systemic functional grammar (SFG) formulated by Halliday in the 1980s as this kind of grammar views language as a systemic resource for meaning. Besides, it has had global impacts on linguistics and flourished in contemporary linguistic theory. Anyone who is familiar with Halliday\u27s work realizes that his SFG is an approach designed to analyze English texts. Halliday (1994: xv) explicitly states that “to construct a grammar for purposes of text analysis: one that would make it possible to say sensible and useful things about any text, spoken or written, in modern English.” The aim of this study is not about the applicability of SFG to text analysis as many researchers and scholars do. Our efforts are made to clarify the philosophical foundation of Halliday\u27s SFG. The paper presents on triangle: (i) language, mind and world; (ii) and empiricism in Halliday\u27s SFG

Miniaturized multisensor system with a thermal gradient: Performance beyond the calibration range

Two microchips, each with four identical microstructured sensors using SnO2 nanowires as sensing material (one chip decorated with Ag nanoparticles, the other with Pt nanoparticles), were used as a nano-electronic nose to distinguish five different gases and estimate their concentrations. This innovative approach uses identical sensors working at different operating temperatures thanks to the thermal gradient created by an integrated microheater. A system with in-house developed hardware and software was used to collect signals from the eight sensors and combine them into eight-dimensional data vectors. These vectors were processed with a support vector machine allowing for qualitative and quantitative discrimination of all gases after calibration. The system worked perfectly within the calibrated range (100% correct classification, 6.9% average error on concentration value). This work focuses on minimizing the number of points needed for calibration while maintaining good sensor performance, both for classification and error in estimating concentration. Therefore, the calibration range (in terms of gas concentration) was gradually reduced and further tests were performed with concentrations outside these new reduced limits. Although with only a few training points, down to just two per gas, the system performed well with 96% correct classifications and 31.7% average error for the gases at concentrations up to 25 times higher than its calibration range. At very low concentrations, down to 20 times lower than the calibration range, the system worked less well, with 93% correct classifications and 38.6% average error, probably due to proximity to the limit of detection of the sensors

Isogeometric analysis of linear isotropic and kinematic hardening elastoplasticity

Material nonlinearity is of great importance in many engineering problems. In this paper, we exploit NURBS-based isogeometric approach in solving materially nonlinear problems, i.e. elastoplastic problems. The von Mises model with linear isotropic hardening and kinematic hardening is presented, and furthermore the method can also be applied to other elastoplastic models without any loss of generality. The NURBS basis functions allow us to describe exactly the curved geometry of underlying problems and control efficiently the accuracy of approximation solution. Once the discretized system of non-linear equilibrium equation is obtained, the Newton-Raphson iterative scheme is used. Several numerical examples are tested. The accuracy and reliability of the proposed method are verified by comparing with results from ANSYS Workbench software

Pharmacist-Led Intervention to Enhance Medication Adherence in Patients With Acute Coronary Syndrome in Vietnam:A Randomized Controlled Trial

Background: Patient adherence to cardioprotective medications improves outcomes of acute coronary syndrome (ACS), but few adherence-enhancing interventions have been tested in low-income and middle-income countries. Objectives: We aimed to assess whether a pharmacist-led intervention enhances medication adherence in patients with ACS and reduces mortality and hospital readmission. Methods: We conducted a randomized controlled trial in Vietnam. Patients with ACS were recruited, randomized to the intervention or usual care prior to discharge, and followed 3 months after discharge. Intervention patients received educational and behavioral interventions by a pharmacist. Primary outcome was the proportion of adherent patients 1 month after discharge. Adherence was a combined measure of self-reported adherence (the 8-item Morisky Medication Adherence Scale) and obtaining repeat prescriptions on time. Secondary outcomes were (1) the proportion of patients adherent to medication; (2) rates of mortality and hospital readmission; and (3) change in quality of life from baseline assessed with the European Quality of Life Questionnaire - 5 Dimensions - 3 Levels at 3 months after discharge. Logistic regression was used to analyze data. Registration: ClinicalTrials.gov (NCT02787941). Results: Overall, 166 patients (87 control, 79 intervention) were included (mean age 61.2 years, 73% male). In the analysis excluding patients from the intervention group who did not receive the intervention and excluding all patients who withdrew, were lost to follow-up, died or were readmitted to hospital, a greater proportion of patients were adherent in the intervention compared with the control at 1 month (90.0% vs. 76.5%; adjusted OR = 2.77; 95% CI, 1.01-7.62) and at 3 months after discharge (90.2% vs. 77.0%; adjusted OR = 3.68; 95% CI, 1.14-11.88). There was no significant difference in median change of EQ-5D-3L index values between intervention and control [0.000 (0.000; 0.275) vs. 0.234 (0.000; 0.379); p = 0.081]. Rates of mortality, readmission, or both were 0.8, 10.3, or 11.1%, respectively; with no significant differences between the 2 groups. Conclusion: Pharmacist-led interventions increased patient adherence to medication regimens by over 13% in the first 3 months after ACS hospital discharge, but not quality of life, mortality and readmission. These results are promising but should be tested in other settings prior to broader dissemination

Design and fabrication of effective gradient temperature sensor array based on bilayer SnO2/Pt for gas classification

Classification of different gases is important, and it is possible to use different gas sensors for this purpose. Electronic noses, for example, combine separated gas sensors into an array for detecting different gases. However, the use of separated sensors in an array suffers from being bulky, high-energy consumption and complex fabrication processes. Generally, gas sensing properties, including gas selectivity, of semiconductor gas sensors are strongly dependent on their working temperature. It is therefore feasible to use a single device composed of identical sensors arranged in a temperature gradient for classification of multiple gases. Herein, we introduce a design for simple fabrication of gas sensor array based on bilayer Pt/SnO2 for real-time monitoring and classification of multiple gases. The study includes design simulation of the sensor array to find an effective gradient temperature, fabrication of the sensors and test of their performance. The array, composed of five sensors, was fabricated on a glass substrate without the need of backside etching to reduce heat loss. A SnO2 thin film sensitized with Pt on top deposited by sputtering was used as sensing material. The sensor array was tested against different gases including ethanol, methanol, isopropanol, acetone, ammonia, and hydrogen. Radar plots and principal component analysis were used to visualize the distinction of the tested gases and to enable effective classification

Enhancing prescribing of guideline recommended medications for ischaemic heart diseases:a systematic review and meta-analysis of interventions targeted at healthcare professionals

Objectives lschaemic heart diseases (IHDs) are a leading cause of death worldwide. Although prescribing according to guidelines improves health outcomes, it remains suboptimal. We determined whether interventions targeted at healthcare professionals are effective to enhance prescribing and health outcomes in patients with IHDs. Methods We systematically searched PubMed and EMBASE for studies published between 1 January 2000 and 31 August 2017. We included original studies of interventions targeted at healthcare professionals to entrance prescribing guideline-recommended medications for IHDs. We only included randomised controlled trials (RCTs). Main outcomes were the proportion of eligible patients receiving guideline-recommended medications, the proportion of patients achieving target blood pressure and target low-density lipoprotein-cholesterol (LDL-C)/cholesterol level and mortality rate. Meta-analyses were performed using the inverse-variance method and the random effects model. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Results We included 13 studies, 4 RCTs (1869 patients) and 9 cluster RCTs (15224 patients). 11 out of 13 studies were performed in North America and Europe. Interventions were of organisational or professional nature. The interventions significantly enhanced prescribing of statinsdipid-lowering agents (OR 1.23; 95% CI 1.07 to 1.42, P=0.004), hut not other medications (aspirin/antiplatelet agents, beta-blockers, ACE inhibitors/angiotensin II receptor blockers and the composite of medications). There was no significant association between the interventions and improved health outcomes (target LDL-C and mortality) except for target blood pressure (OR 1.46; 95% CI 1.11 to 1.93; P=0.008). The evidence was of moderate or high quality for all outcomes. Conclusions Organisational and professional interventions improved prescribing of statins/lipid-lowering agents and target blood pressure in patients with IHDs but there was little evidence of change in other outcomes

Flocculation of Reactive Blue 19 (RB19) using Alum and the Effects of Catalysts Addition

There are a variety of primary coagulants which can be used in a water treatment plant. One of the earliest, and still the most extensively used, is aluminum sulfate, also known as alum. Aluminum Sulfate (Alum) is one of the most commonly used flocculent in waste water treatment processes. Effectiveness of Alum in flocculation process is determined by many factors such as the effluents pH, flocculent dose as well as the use of catalyst to improve efficiency rate of flocculation. Hence special attention to these factors especially the use of catalyst has been brought about by this study. Experiments were carried out using Reactive Blue 19 Dye as the contaminant of waste water and two catalysts namely Calcium Hydroxide (CaOH2) and Poly Aluminum Chloride (PACl) were evaluated. The results obtained proved that indeed after addition of catalysts, removal efficiency rates of Alum can be increased up to 25% using Calcium Hydroxide and up to 35% using Poly Aluminum Chloride compared to Alum alone. The optimum conditions for this study were at pH 5.5 ~7.5, 300 mg/L of Alum 30seconds of rapid mixing time with 300 rpm , 30rpm of mixing rate for 5 minutes and 30 minutes of settling time. Moreover, Alum showed the highest performance under these conditions and using 50 mg/L PACl as catalyst with 98.52% of COD reduction and 90.60% of color reduction. In conclusion, Alum with the support of PACl as catalyst is an effective coagulant, which can reduce the level of COD and Dye Color in Reactive Blue 19 contaminated wastewater

Features of trastuzumab-related cardiac dysfunction: deformation analysis outside left ventricular global longitudinal strain

BackgroundCancer therapy-related cardiac dysfunction due to trastuzumab has been well-known for many years, and echocardiographic surveillance is recommended every 3 months in patients undergoing trastuzumab treatment, irrespective of the baseline cardiotoxicity risk. However, the potential harm and cost of overscreening in low- and moderate-risk patients have become great concerns.ObjectivesThis study aimed to identify the incidence of early cancer therapy-related cardiac dysfunction (CTRCD) and the behaviours of left and right heart deformations during trastuzumab chemotherapy in low- and moderate-risk patients.MethodsWe prospectively enrolled 110 anthracycline-naïve women with breast cancer and cardiovascular risk factors who were scheduled to receive trastuzumab. The left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LV-GLS), and right ventricular and left atrial longitudinal strains were evaluated using echocardiography at baseline, before every subsequent cycle and 3 weeks after the final dose of trastuzumab. The baseline risk of CTRCD was graded according to the risk score proposed by the Heart Failure Association (HFA) Cardio-Oncology Working Group and the International Cardio-Oncology Society (ICOS). CTRCD and its severity were defined according to the current European Society of Cardiology (ESC) guidelines.ResultsTwelve (10.9%) patients had asymptomatic CTRCD. All CTRCD occurred sporadically during the first 9 months of the active trastuzumab regimen in both low- and moderate-risk patients. While CTRCD was graded as moderate severity in 41.7% of patients and heart failure therapy was initiated promptly, no irreversible cardiotoxicity or trastuzumab interruption was recorded at the end of follow-up. Among the left and right heart deformation indices, only LV-GLS decreased significantly in the CTRCD group during the trastuzumab regimen.ConclusionsCTRCD is prevalent in patients with non-high-risk breast cancer undergoing trastuzumab chemotherapy. Low- and moderate-risk patients show distinct responses to trastuzumab. The LV-GLS is the only deformation index sensitive to early trastuzumab-related cardiac dysfunction

Influenza A H5N1 and HIV co-infection: case report

<p>Abstract</p> <p>Background</p> <p>The role of adaptive immunity in severe influenza is poorly understood. The occurrence of influenza A/H5N1 in a patient with HIV provided a rare opportunity to investigate this.</p> <p>Case Presentation</p> <p>A 30-year-old male was admitted on day 4 of influenza-like-illness with tachycardia, tachypnea, hypoxemia and bilateral pulmonary infiltrates. Influenza A/H5N1 and HIV tests were positive and the patient was treated with Oseltamivir and broad-spectrum antibiotics. Initially his condition improved coinciding with virus clearance by day 6. He clinically deteriorated as of day 10 with fever recrudescence and increasing neutrophil counts and died on day 16. His admission CD4 count was 100/μl and decreased until virus was cleared. CD8 T cells shifted to a CD27⁺CD28^-phenotype. Plasma chemokine and cytokine levels were similar to those found previously in fatal H5N1.</p> <p>Conclusions</p> <p>The course of H5N1 infection was not notably different from other cases. Virus was cleared despite profound CD4 T cell depletion and aberrant CD8 T cell activation but this may have increased susceptibility to a fatal secondary infection.</p

Establishing and validating noninvasive prenatal testing procedure for fetal aneuploidies in Vietnam

Noninvasive prenatal testing (NIPT) for fetal aneuploidies has been widely adopted in developed countries. Despite the sharp decrease in the cost of massively parallel sequencing, the technical know-how and skilled personnel are still one of the major limiting factors for applying this technology to NIPT in low-income settings. Here, we present the establishment and validation of our NIPT procedure called triSure for detection of fetal aneuploidies.We established the triSure algorithm based on the difference in proportion of fetal and maternal fragments from the target chromosome to all chromosomes. Our algorithm was validated using a published data set and an in-house data set obtained from high-risk pregnant women in Vietnam who have undergone amniotic testing. Several other aneuploidy calling methods were also applied to the same data set to benchmark triSure performance.The triSure algorithm showed similar accuracy to size-based method when comparing them using published data set. Using our in-house data set from 130 consecutive samples, we showed that triSure correctly identified the most samples (overall sensitivity and specificity of 0.983 and 0.986, respectively) compared to other methods tested including count-based, sized-based, RAPIDR and NIPTeR.We have demonstrated that our triSure NIPT procedure can be applied to pregnant women in low-income settings such as Vietnam, providing low-risk screening option to reduce the need for invasive diagnostic tests