Factive And Assertive Attitude Reports

This dissertation investigates the semantics, pragmatics, and syntax of propositional attitude reports; in particular, how assertion and presupposition are reflected in these different parts of the grammar. At the core of the dissertation are factive attitude reports, involving predicates like know, discover, realize, resent, appreciate, and like. Since Stalnaker (1974), factivity is taken to encompass both the discourse status of the embedded proposition p as Common Ground and the projection of the inference that the speaker is committed to p from the scope of operators—in both cases, unlike asserted content. Syntactically, factivity and assertion are argued to provide the semantic-pragmatic underpinnings for a range of complementation patterns (Kiparsky and Kiparsky 1970, Hooper and Thompson 1973, Rizzi 1997, a.o.). The central contributions of the dissertation are: (i) demonstrating what precise dimensions of assertion and presupposition are reflected in the syntax and semantics of clausal embedding, and (ii) decomposing the classically multifaceted notion of factivity into a set of more specific theoretical notions; importantly, dissociating the discourse status of p and the projection-prone speaker commitment inference. We attribute the speaker commitment inference to a lexical presupposition of an evidential modal base that entails p. We argue that this evidential base is always anchored to a Judge, which, depending on the type of factive predicate, is bound by different individuals. In the case of doxastic factives like discover, the judge is bound by the speaker, whereas in the case of emotive factives like appreciate, it is bound by the attitude holder, and for fact that nominals, it is realized as an index on the noun. The discourse status of p, we attribute to a separate dimension of discourse new vs. Given content (in the sense of Schwarzschild 1999), which cross-cuts both factive and non-factive verbs. Among the predicates which treat their complements as Given, we differentiate between the requirement (of response predicates like accept and not say) that p has an antecedent in the discourse, and the requirement (of emotive factives like resent and appreciate) that the situation or individual providing the attitude holder’s evidential basis for p is contextually accessible. We further argue for a fundamental semantic distinction between primarily acquaintance-based predicates —which include both factives (evidentials) like discover and non-factives like fear— and fundamentally doxastic or epistemic predicates, like believe and trust. Making these distinctions allows us to account for a wide range of apparently connected, yet clearly disparate empirical phenomena, some of which represent open problems in the literature and some of which are new observations made in the dissertation. Importantly, we are able to capture: (i) the dissociation of the discourse status of p and the commitment-to-p inference in doxastic factives (Chapters 3 and 5); (ii) a number of asymmetries between doxastic and emotive factives regarding their apparent entailment properties, interactions with operators, and sensitivities to contextual effects (Chapter 5); (iii) variations in entailment and argument-structural patterns across verbs like know and believe (Chapter 4); and (iv) the distribution of a set of proposed syntactic correlates of assertion and presupposition; in particular, V-to-C movement, wh-extraction, and selection for DP vs. CP-complements (Chapters 2 and 3)

Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar : A nationwide observational study

This is a pre-copyedited, author-produced pdf of an article accepted for publication in International Journal of Cardiology following peer review. The version of record, 'Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar: A nationwide observational study', F. B. Irfan, et.a., International Journal of Cardiology, Vol 223, pp 1007-1013, November 2016, first published on line on August 24, 2016, is available on line via doi: http;//dx.doi.org/10.1016/j.ijcard.2016.08.299 © 2016 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Background Out-of-hospital cardiac arrest (OHCA) studies from the Middle East and Asian region are limited. This study describes the epidemiology, emergency health services, and outcomes of OHCA in Qatar. Methods This was a prospective nationwide population-based observational study on OHCA patients in Qatar according to Utstein style guidelines, from June 2012 to May 2013. Data was collected from various sources; the national emergency medical service, 4 emergency departments, and 8 public hospitals. Results The annual crude incidence of presumed cardiac OHCA attended by EMS was 23.5 per 100,000. The age-sex standardized incidence was 87.8 per 100,000 population. Of the 447 OHCA patients included in the final analysis, most were male (n = 360, 80.5%) with median age of 51 years (IQR = 39–66). Frequently observed nationalities were Qatari (n = 89, 19.9%), Indian (n = 74, 16.6%) and Nepalese (n = 52, 11.6%). Bystander cardiopulmonary resuscitation (CPR) was carried out in 92 (20.6%) OHCA patients. Survival rate was 8.1% (n = 36) and multivariable logistic regression indicated that initial shockable rhythm (OR 13.4, 95% CI 5.4–33.3, p = 0.001) was associated with higher odds of survival while male gender (OR 0.27, 95% CI 0.1–0.8, p = 0.01) and advanced cardiac life support (ACLS) (OR 0.15, 95% CI 0.04–0.5, p = 0.02) were associated with lower odds of survival. Conclusions Standardized incidence and survival rates were comparable to Western countries. Although expatriates comprise more than 80% of the population, Qataris contributed 20% of the total cardiac arrests observed. There are significant opportunities to improve outcomes, including community-based CPR and defibrillation training.Peer reviewe

Soluble urokinase plasminogen activator receptor and lactate as prognostic biomarkers in patients presenting with non-specific chief complaints in the pre-hospital setting - the PRIUS-study

Background: Emergency Medical Services (EMS) are faced daily with patients presenting with non-specific chief complaints (NSC). Patients presenting with NSCs often have normal vital signs. It has previously been established that NSCs may have a serious underlying condition that has yet to be identified. The aim of the current study was to determine if soluble urokinase plasminogen activator receptor (suPAR) and lactate could be used to identify serious conditions among patients presenting with NSCs to the EMS. The secondary aim was to describe the prognostic value for mortality in the group. Method: A blinded prospective observational cohort study was conducted of patients brought to the ED by ambulance after calling the national emergency number 112 and who were assessed as having NSC by the EMS. Biomarkers were measured during index EMS assessment before transportation to the ED. Patients were followed via EMS and hospital electronic health records. Descriptive and logistic regression analyses were used. Results: A total of 414 patients were included, with a median age of 82 years. A serious condition was present in 15.2% of the patients. Elevated suPAR above 3 ng/ml had a positive likelihood ratio (LR+) of 1.17 and a positive predictive value (PPV) of 17.3% as being predictive of a prevalent serious condition. Elevated suPAR above 9 ng/ml had LR+ 4.67 and a PPV of 16.7% as being predictive of 30-day mortality. Lactate was not significantly predictive. Conclusion: Pre-hospital suPAR and lactate cannot differentiate serious conditions in need of urgent treatment and assessment in the ED among patients presenting with non-specific chief complaints. suPAR has shown to be predictive of 30-day mortality, which could add some value to the clinical assessment.Peer reviewe

Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar

Background Cardiac arrests in admitted hospital patients with trauma have not been described in the literature. We defined "in-hospital cardiac arrest of a trauma" (IHCAT) patient as "cessation of circulatory activity in a trauma patient confirmed by the absence of signs of circulation or abnormal cardiac arrest rhythm inside a hospital setting, which was not cardiac re-arrest." This study aimed to compare epidemiology, clinical presentation, and outcomes between in- and out-of-hospital arrest resuscitations in trauma patients in Qatar. It was conducted as a retrospective cohort study including IHCAT and out-of-hospital trauma cardiac arrest (OHTCA) patients from January 2010 to December 2015 utilizing data from the national trauma registry, the out-of-hospital cardiac arrest registry, and the national ambulance service database. Results There were 716 traumatic cardiac arrest patients in Qatar from 2010 to 2015. A total of 410 OHTCA and 199 IHCAT patients were included for analysis. The mean annual crude incidence of IHCAT was 2.0 per 100,000 population compared to 4.0 per 100,000 population for OHTCA. The univariate comparative analysis between IHCAT and OHTCA patients showed a significant difference between ethnicities (p=0.04). With the exception of head injury, IHCAT had a significantly higher proportion of localization of injuries to anatomical regions compared to OHTCA; spinal injury (OR 3.5, 95% CI 1.5-8.3, pPeer reviewe

Barrett's esophagus: endoscopic treatments I

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87170/1/j.1749-6632.2011.06049.x.pd

Ethnic differences in out-of-hospital cardiac arrest among Middle Eastern Arabs and North African populations living in Qatar

Peer reviewe

Unmanned aerial vehicles (drones) in out-of-hospital-cardiac-arrest

BACKGROUND: The use of an automated external defibrillator (AED) prior to EMS arrival can increase 30-day survival in out-of-hospital cardiac arrest (OHCA) significantly. Drones or unmanned aerial vehicles (UAV) can fly with high velocity and potentially transport devices such as AEDs to the site of OHCAs. The aim of this explorative study was to investigate the feasibility of a drone system in decreasing response time and delivering an AED. METHODS: Data of Global Positioning System (GPS) coordinates from historical OHCA in Stockholm County was used in a model using a Geographic Information System (GIS) to find suitable placements and visualize response times for the use of an AED equipped drone. Two different geographical models, urban and rural, were calculated using a multi-criteria evaluation (MCE) model. Test-flights with an AED were performed on these locations in rural areas. RESULTS: In total, based on 3,165 retrospective OHCAs in Stockholm County between 2006–2013, twenty locations were identified for the potential placement of a drone. In a GIS-simulated model of urban OHCA, the drone arrived before EMS in 32 % of cases, and the mean amount of time saved was 1.5 min. In rural OHCA the drone arrived before EMS in 93 % of cases with a mean amount of time saved of 19 min. In these rural locations during (n = 13) test flights, latch-release of the AED from low altitude (3–4 m) or landing the drone on flat ground were the safest ways to deliver an AED to the bystander and were superior to parachute release. DISCUSSION: The difference in response time for EMS between urban and rural areas is substantial, as is the possible amount of time saved using this UAV-system. However, yet another technical device needs to fit into the chain of survival. We know nothing of how productive or even counterproductive this system might be in clinical reality. CONCLUSIONS: To use drones in rural areas to deliver an AED in OHCA may be safe and feasible. Suitable placement of drone systems can be designed by using GIS models. The use of an AED equipped drone may have the potential to reduce time to defibrillation in OHCA

Quality of life assessment as a predictor of survival in non-small cell lung cancer

<p>Abstract</p> <p>Background</p> <p>There are conflicting and inconsistent results in the literature on the prognostic role of quality of life (QoL) in cancer. We investigated whether QoL at admission could predict survival in lung cancer patients.</p> <p>Methods</p> <p>The study population consisted of 1194 non-small cell lung cancer patients treated at our institution between Jan 2001 and Dec 2008. QoL was evaluated using EORTC-QLQ-C30 prior to initiation of treatment. Patient survival was defined as the time interval between the date of first patient visit and the date of death from any cause/date of last contact. Univariate and multivariate Cox regression evaluated the prognostic significance of QoL.</p> <p>Results</p> <p>Mean age at presentation was 58.3 years. There were 605 newly diagnosed and 589 previously treated patients; 601 males and 593 females. Stage of disease at diagnosis was I, 100; II, 63; III, 348; IV, 656; and 27 indeterminate. Upon multivariate analyses, global QoL as well as physical function predicted patient survival in the entire study population. Every 10-point increase in physical function was associated with a 10% increase in survival (95% CI = 6% to 14%, p < 0.001). Similarly, every 10-point increase in global QoL was associated with a 9% increase in survival (95% CI = 6% to 11%, p < 0.001). Furthermore, physical function, nausea/vomiting, insomnia, and diarrhea (p < 0.05 for all) in newly diagnosed patients, but only physical function (p < 0.001) in previously treated patients were predictive of survival.</p> <p>Conclusions</p> <p>Baseline global QoL and physical function provide useful prognostic information in non-small cell lung cancer patients.</p