Jim Wood

Pericarditis Associated with Renal Failure: Evolution and Management

The presence of pericarditis in a patient with renal failure in the predialysis era was synonymous with impending death. Although the prognosis for affected patients has improved dramatically with advances in dialytic therapy, most practitioners will attest that pericarditis remains a significant source of morbidity and even mortality in patients with end-stage renal disease (ESRD). The presentation of pericardial disease in ESRD patients varies, but may consist of chest discomfort of a pleuritic nature, dyspnea or orthopnea, cough, and less specific symptoms such as fever, musculoskeletal pain, malaise, and headaches. Although not uniformly present, physical findings such as a pericardial rub and low-grade fever are frequently seen. The presence of a pericardial effusion may produce signs such as pulsus paradoxus (defined as an inspiratory drop in systolic blood pressure of more than 10 mmHg), electrical alternans (a beat-tobeat alternation in voltage height on electrocardiogram), enlarged cardiac silhouette on chest radiograph, muffled heart sounds, hypotension, and evidence of venous congestion. However, a significant number of patients with ESRD treated with maintenance dialysis develop pericarditis with no accompanying symptoms or signs (1). Richard Bright first described the entity of pericarditis in uremic patients in a classic report in 1836 (2). Subsequent autopsy reports of patients with ESRD in the predialysis era indicated that nearly half had evidence of pericarditis on postmortem examination (3). Data from 10–20 years ago suggest that 11.8–21% of chronic dialysis patients would eventually develop pericardial disease (4–6), predictions that have not been borne out; pericarditis in the chronic dialysis patient is now rarely encountered. When pericarditis evolves in the context of renal failure, it presents an associated mortality of 1.5% (6). Treatment has traditionally involved increasing the frequency of dialysis—so-called “daily dialysis,” usually performed five to seven times per week. Nephrologists have found that pericarditis developing prior to commencement of maintenance dialysis in a uremic patient (or after only a short period of dialysis in such a patient) tends to respond well to this intense dialytic intervention. In contrast, daily dialysis produces a lower rate of resolution of pericarditis in patients receiving maintenance dialysis for a prolonged period of time; a surgical approach is frequently needed in this setting.

THE SOUTHERN DATIVE PRESENTATIVE MEETS MECHANICAL TURK

this article introduces the southern dative presentative, an understudied construction that varies across speakers of American english. the authors discuss similarities and differences between this construction and the better-studied personal dative construction and compare the Southern dative presentative with similar constructions cross-linguistically. they then present the results of a nationwide acceptability judgment survey administered on Amazon mechanical turk. the results show that Southern dative presentatives are alive and well in Southern dialects of American english. in the process, they also illustrate the usefulness of Amazon mechanical turk (and similar crowdsourcing platforms) for the study of dialect variation in the domain of syntax. keywords: dative constructions, dialect variation, Amazon mechanical turk, dialect syntax, personal dative, presentatives a substantial body of work has documented the syntactic, semantic, and pragmatic properties of personal dative constructions in American english (Wolfram and Christian 1976, 121–24; Webelhuth and Dannenberg 2006; Conroy 2007; Horn 2008, 2013; Hutchinson and Armstrong 2014). Some examples are given in (1), where the italicized pronouns are the so-called “personal datives,” which are co-referential with the (underlined) subject:1 1. a. We had us a cabin.... [Christian 1991, 11] b. i love me some baked beans. [Webelhuth and Dannenberg 2006, 39] c. i need me a screwdriver. d. He loves him some baseball. [Hutchinson and Armstrong 2014, 179] in this article, we focus on another construction that exhibits what appears to be a dative pronoun but has received almost no attention in the literature since it was briefly mentioned in 1946, in an American Speech article by fred Dudley.2 Dudley’s (1946, 271) two examples are given in (2a) and (2b), an American Speech Published by Duke University Press american speech 90.3 (2015) 292 example from montgomery and Hall (2004, lvi) is given in (2c), while (2d) and (2e) are examples provided as native speaker judgments by the fourth author of this article: 2. a. Here’s you some money. b. kelley, here’s you a nice easy one. c. Here’s ye (singular) a light. d. Here’s you a piece of pizza. e. Here’s me a good pair of jeans. Dudley (1946) views such sentences as related to those containing personal dative pronouns, an intuition shared by speakers who find them acceptable today. We will refer to them with the label southern dative presentatives, for several reasons that we will mention here and elaborate upon over the course of the article. first, they are attested more robustly in the South of the united States than in other areas. Second, they are instances of presentatives, i.e. clauses that function to bring some entity (or sets of entities, or events) to the attention of the interlocutor(s). third, they contain a pronoun that would be a dative pronoun in other languages in which presentatives are attested and, as suggested by Dudley, seems to be related to the so-called dative pronoun found in personal dative constructions. montgomery and Hall (2004) take (2c) to represent an “ethical dative,” and Liberman (2009) speculates along similar lines for a related example, Here’s you a bowl of soup. our in-progress investigation reveals that Southern dative presentatives are not a species that went extinct, but rather are alive and well as part of the grammar of some (though not all) speakers of Southern American english, let alone American english generally. in this article, we shed light on their properties, comparing and contrasting them with personal datives and (to some extent) with presentatives in other languages. moreover, we will show that they can be fruitfully investigated using a relatively new methodology, utilizing surveys distributed through Amazon mechanical turk. We discuss the reliability of this methodology extensively, showing that it can give us useful information not only about the geographical distribution of a certain construction, but also about other aspects of the grammar of the speakers who accept it—in particular, implicational relations with other types of sentences they are likely to accept or reject. We view this work as the beginning of a thorough investigation of Southern dative presentatives, which in turn is part of the broader research goal of the Yale Grammatical Diversity Project (http://microsyntax.sites.yale.edu/phenomena): to provide a careful description and analysis of the many facets of morphosyntactic variation exhibited by the varieties of english spoken in North America today. American Speech Published by Duke University Press Southern Dative Presentative Meets Mechanical Turk 293 PerSonal DaTiveS, PreSenTaTiveS, anD SouThern DaTive PreSenTaTiveS Personal Datives (PDs), attested largely in Southern and Appalachian varieties of u.S. english, are so-called despite the fact that english has lacked a true dative case since the fourteenth century. the label is motivated by the fact that in other languages, including french (3a), italian (3b), and Westphalian German (3c), a pronoun with somewhat similar properties in the same position would be marked as dative.3 in examples like (3), such pronouns must be coreferential with the subject. 3. a. Je me bois une petite tasse de café. i refl.dat drink a small cup of coffee lit. ‘i drink (to) me a little cup of coffee.’ [Pierre Larrivée, pers. comm., mar. 31, 2004] b. Gianni si beve un caffè. Gianni refl.dat drinks a coffee lit. ‘Gianni drinks him(self) a coffee.’ [Campanini and Schäfer 2011] c. ich trinke mir jetzt einen kaffee. i drink refl.dat now a coffee lit. ‘i drink (to) me now a coffee’ PDs have attracted increasing attention in the syntactic literature recently (see Hutchinson and Armstrong 2014 for a recent proposal and a review of related work).4 the sentences in (4) exemplify what we call Southern dative presentatives (SDPs): 4. a. Here’s you a piece of pizza. b. Where’s me a screwdriver? unlike PDs, SDPs and their syntactic properties have, to our knowledge, remained unexamined, except for brief mentions in Dudley (1946), montgomery and Hall (2004), Liberman (2009), and Horn (2014). from a theoretical perspective, these constructions are interesting in light of a growing body of work focusing on the syntactic and semantic properties of noncore or “extra” arguments (Pylkkänen 2002, 2008; Cuervo 2003; mcfadden 2004; Hole 2005; mcintyre 2006; Schäfer 2008; Lambert 2010; Haddad 2011; Bosse, Bruening, and Yamada 2012; Wood and marantz 2015). from a dialectological perspective, there has been no discussion prior to the present study of the current status of SDPs, who uses them, or where they are used. American Speech Published by Duke University Press american speech 90.3 (2015) 294 our preliminary research, based on internet searches and in-depth conversations with several native speakers, supports the connection between PDs and SDPs suggested by Dudley (1946), since there seem to be several similarities between the two constructions. for example, in both SDPs and PDs, the dative is a weak pronoun that cannot be stressed, modified, or coordinated (Cardinaletti and Starke 1999).5 in both cases, the pronoun is immediately adjacent to the verbal form, whether it is a lexical verb as in PDs or the copula in SDPs. in neither case is the dative an argument selected by the verb. moreover, the two constructions can be functionally quite similar. Consider the attested example in (5), where the SDP in bold was the title of a (now inaccessible) blog post. in that post, the author went on to express the same idea with the italicized PD: 5. Where’s me a digital camera? [...] After seeing the cool crab in a stream that idig posted, I wish I had me a digital camera to show off some of my cool finds. finally, there is at least a tentative geographical match between the reported isogloss for PDs and the region in which SDPs are principally attested, more on which will be said below. However, there are important differences between PDs and SDPs as well. first, while the PD pronoun must be coreferential with the subject, the SDP pronoun is not coreferential with any (overt) argument, and is, for many speakers at least, restricted to the speaker (me), hearer (you), or both (us); some speakers, however, do appear to accept third-person pronouns, as Greg Johnson first pointed out to us. Second, PDs have been argued to have no effect on the truth-conditional meaning of a sentence (Horn 2008, 2013), while SDPs seem to affect such meaning at least sometimes. for example, John needs him a new car is truth-conditionally identical to John needs a new car, while Here’s you a piece of pizza may express a distinct proposition from Here’s a piece of pizza. the former guarantees that the pizza is for the hearer, while no such guarantee is made in the latter. third, as an anonymous reviewer points out, an alternative version of the SDP construction is typically available using a benefactive prepositional phrase, as in Here’s a piece of pizza for you. in contrast, a PD sentence such as I need me a screwdriver cannot be paraphrased by a sentence with a prepositional phrase, as in I need a screwdriver for me. fourth, unlike personal datives, the SDP cannot occur in embedded, negated, or yes-no question environments, as in (6):6 6. a. *i’m pleased that here’s you a new printer. b. *Here isn’t you a new printer. c. *Is here you a new printer? American Speech Published by Duke University Press Southern Dative Presentative Meets Mechanical Turk 295 the constraints illustrated in (6) are likely related to the “here-and-now” nature of the SDP construction—the fact that it is a presentative construction—and hold for sentences like (6) even if the dative is removed. We will round out our description of the SDP by turning to the general properties of presentative constructions. As implied by the terminology that we choose, SDPs fall into a class of constructions known as p

The Yale Grammatical Diversity Project: Morphosyntactic variation in North American English

Abstract The Yale Grammatical Diversity Project approaches the empirical domain of North American English from the perspective of generative microcomparative syntax. In addition to eliciting judgments from speakers of particular varieties, we also conduct large-scale surveys, map the results of those surveys geographically, conduct statistical tests taking geography and other social variables into account, and look for theoretically significant linguistic correlations. In all cases, we do this with the primary goal of understanding variation between speakers at the individual level. While our goals and methodologies are informed by our theoretical perspective, we expect that our work and results will be of interest to linguists working in other frameworks and even to the public more generally. This article outlines the goals and methodologies of the project and describes in broad strokes some of the results obtained so far, as well as some of the ways we have shared our findings with others, inside and outside academia.

The Morphosyntax of -st

This chapter provides a detailed look at the morphosyntax of the -st morpheme which marks many argument structure alternations and plays a major role in much of the rest of the book. The primary goal here is to defend the view that -st has the morphosyntax of a clitic, rather than a suffix. While the clitic analysis has been around for some time, there is also a long tradition arguing that it is a suffix with no systematic syntactic function. The point of this chapter is to demonstrate that there are no valid arguments against a clitic analysis of -st, and there are several fairly strong arguments in favor of such an analysis. The arguments here are mostly cross-linguistic, rather than language internal ones: every property claimed to disqualify -st as a clitic is also found as a property of elements that are uncontroversially considered to be clitics. The fact that -st behaves like clitics cross-linguistically paves the way for the analysis developed in subsequent chapters, where -st is argued to be an expletive clitic that occupies various argument positions syntactically, with different semantic effects in different positions. The chapter closes with a survey of various possible clitic analyses that are compatible with the results in subsequent chapters.

More on the Syntax of -st Verbs

This chapter details aspects of the morphosyntax of the -st clitic that played such an important role in Chaps. 3– 5 but were not directly relevant to the analysis and argumentation there. Its purpose is both to support the general view of -st presented in previous chapters, as well as to provide a broader picture of Icelandic morphosyntax, which should allow for more thorough comparisons with other languages. Section 6.2 focuses on verbs which seem to be derived from nouns by using the -st clitic. It is argued that this is not quite the right characterization: rather, denominal verbs tend to be syntactically transitive, so in order to form semantic intransitives, some kind of expletive argument must be used. English uses it (in sentences like He’s guitaring it up), while Icelandic uses -st. This is consistent with, and evidence in favor of, the claim that -st is an expletive clitic that occupies an argument position. Section 6.3 turns to generic middles and so-called modal passive -st verbs, where, with certain modals, -st verbs seem to be interpreted as passive. It is argued that these facts support the analysis of -st anticaustives in Chap. 3, where the impossibility of anticausativizing agentive verbs was taken to be a basically semantic constraint. Section 6.4 reviews a similar data set with -st verbs that are licensed in the presence of the causative verb lata ‘let’; the facts there point in a similar direction as in Sect. 6.5. Section 6.6 takes a brief look at reciprocal -st verbs, and proposes that they may have either anticausative or reflexive morphosyntax. It is proposed that the reciprocal reading should be analyzed as a particular interpretation of v, rather than as an interpretation of Voice, as in some other recent analyses. Section 6.6 takes a final look at reflexive -st verbs that did not fit directly into the discussion in Chaps. 3– 5, and proposes various ways that they may be integrated with the overall views presented there.

Applicatives and Applied Datives

Chapter 5 focuses on dative arguments that are introduced by Appl(icative) heads; such arguments have played a major role in the theory of argument structure in recent years, and they are a robust aspect of Icelandic syntax. Sect. 5.1 provides an overview of different kinds of applicative structures, and argues that Icelandic does not have so-called “high applicatives,” but does have “low” and “high-low” applicatives. Sect. 5.2 turns to the analysis of valency reduction in ApplP structures. It starts by studying structures closer to those studied in Chap. 3, where the external argument is prevented from merging, forming “anticausatives” of ditransitives. Here, an important morphosyntactic property of Appl is revealed: while the dative case of direct objects is systematically lost (as shown in Chap. 3), the dative case of arguments introduced by Appl is retained. This, it is proposed, underlies a somewhat surprising gap in the overall set of structures: while -st can merge in SpecVoiceP, and SpecpP, it generally cannot merge in SpecApplP. Given the analysis in Chap. 4, we know exactly what the empirical situation would look like if -stcould merge in SpecApplP, and that is simply not what we find.

pP Internal Argument—Figure Reflexives and Object ‘Demotion’

Chapter 4 turns to the structure of internal argument prepositional phrases, arguing that they are syntactically parallel to verb phrases. This is presented in Sect. 4.2: just as a functional head (Voice) provides a position where an argument may (but need not) be added to a vP, so too does a functional head (p) provide a position where an argument may (but need not) be added to a PP. Section 4.3 focuses on self-directed motion verbs which I call “figure reflexives,” and alternations such as I squeezed through the crowd versus I squeezed John through the crowd. ‘John’, in the latter sentence, is introduced by p; I show in this chapter that the syntax of anticausatives proposed in Chap. 3, which revolves around Voice, extends to the syntax of figure reflexives, which revolves around p. The ‘reflexive’ interpretation of figure reflexives derives from the fact that pP is lower than VoiceP, so p may introduce a theta-role which is saturated semantically by an argument in a higher position. After showing how this works, I turn, just as in Chap. 3, to the issue of idiosyncratic lexical roots, and the effects of embedding different roots in different structures. I also show why the “reflexive” interpretation of figure reflexives is distinct from the reflexive interpretation achieved with a reflexive pronoun. Section 4.4 turns to a prediction made by the combination of analyses in Chap. 3 and the first part of Chap. 4, namely, that there should be an alternative interpretation available for the structures presented in Sect. 4.3. It is shown that these alternative interpretations do exist, and there are lexical roots that instantiate them.

DP Internal Argument—The Causative Alternation

Chapter 3 is the first detailed application of the system outlined in Chap. 1, along with the clitic analysis of -st defended in Chap. 2, to Icelandic argument structure alternations. The focus is on causative alternations which involve a single DP internal argument. After a brief overview of the different ways Icelandic marks causative and anticausative verbs in Sects. 3.2 and 3.3 derives several morphological generalizations using the spellout mechanisms presented in Chap. 1. Section 3.4 is a brief, but important detour into the properties of dative direct objects in Icelandic, many of which are quite different from dative objects in many other languages. This is important for the account of case alternations in -st anticausatives, which, in turn, sets the stage for important components of the analyses in Chaps. 4 and 5. Section 3.5 works out the thematic interpretation of the causative alternation. It begins by working out the details of how verbal functional heads are interpreted in the semantics, and then turns to issues of lexical idiosyncrasy that play an important role for the remainder of the book: while the syntactic structures generated in the previous sections are completely productive and predictable, lexical roots can sometimes choose somewhat idiosyncratically among the generable structures, or receive idiomatic interpretations in them. This can give the impression that the argument alternations themselves are more idiosyncratic than they really are, an impression that I argue, here as well as in Chaps. 4 and 5, is misleading. A recurring theme in Chaps. 3, 4, and 5 is that once the idiosyncratic properties of lexical roots are factored out, not only are the syntactic argument structures completely systematic, but their mapping to semantics is too.

Intradialytic Administration of Amphotericin B: Clinical Observations on Efficacy and Safety

Background: Amphotericin B is used commonly to treat fungal infections. Unfortunately, little information exists regarding the use of intravenous amphotericin B in patients with end‐stage renal disease (ESRD). Methods: We retrospectively reviewed the clinical course of patients receiving amphotericin B during hemodialysis (HD). Twenty‐five episodes of systemic fungal infection occurring in 24 patients with ESRD treated with parenteral amphotericin B administered during HD were noted. Patients received a maintenance dose of 0.5 to 1.0 mg/kg amphotericin B intravenously thrice weekly during HD sessions. Twenty‐three patients received either 500 or 1000 mg of amphotericin B, whereas 1 patient with AIDS received a total of 6,500 mg. Results: Intradialytic hypotension developed in 27.7% of HD sessions during treatment with amphotericin B compared with 28.8% of 20 HD sessions evaluated before initiation of amphotericin B therapy. Four patients exhibited a temperature rise greater than 38.8°C during drug infusion (1 episode per patient). Increases in heart rate and ventricular ectopy were rare. Serum potassium concentrations as well as Kt/V and urea reduction ratio did not change significantly. All patients (except the patient with AIDS) resolved their respective fungal infections. Conclusions: Intradialytic administration of amphotericin B was generally well tolerated. Our observations suggest that amphotericin B is effective and safe for outpatient intradialytic therapy when administered according to protocol.