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1 THE SYNTAX OF ITALIAN FREE RELATIVE CLAUSES: AN ANALYSIS Sabrina Bertollo Guido Cavallo 1. INTRODUCTION In this paper we would like to analyze the syntax of Italian free relative clauses with a [+animate] antecedent. Starting from a brief discussion of the model we will adopt ( 2.1), we will first examine what the cross-linguistic characteristics of this construction are ( 2.2), and we will then concentrate on Italian to describe in detail all the possible configurations and their underlying mechanisms ( 3). We will then focus on the comparison between free relative clauses and indirect questions in Italian ( 4), as this enables us to better understand the nature of the two constructions and to shed some light on the reasons that lead to ungrammaticality in some free relative clauses. 2. THE THEORETICAL FRAMEWORK 2.1 The syntactic model Free relative clauses have been thoroughly described by scientific literature and different models have been proposed. The main points of discussion concerned the nature of this construction, the identification of the constituents which are involved, and their placement in the structure. The deletion of the antecedent was first assumed by Chomsky (1973), who hypothesized that a free relative clause is similar to a restrictive relative clause without a lexicalized head. Bresnan & Grimshaw (1978) argued, instead, that the wh- itself is the head of the free relative clause and is therefore not in a Specifier position. Groos & van Riemsdijk (1981) proposed that the head of a free relative clause is a null category but didn t specify what this category is. Grosu (1994) tried to identify the nature of this constituent and argued that the silent head is a pro. For our analysis we will adopt the model of Benincà (2010) which has been proposed on the basis of Cinque (2003): (i) [ DP _ [ CP who/what THAT you saw]]. In this model the matrix verb governs a silent DP, an empty head, which is not lexicalized, though it is always present in the structure. The embedded verb selects a whargument (chi in Italian) that is assigned a Theta role and a Case and is then moved to the SpecCP. On the basis of the split CP hypothesis, first proposed by Rizzi (1997) and then further refined by Benincà (2001, 2006), the exact collocation of the wh- pronoun can be reconstructed more precisely: the wh- item chi is placed in the Specifier of a very high functional projection, which is different from the position occupied by wh- interrogatives, which are claimed to be lower in the structure. (Generative Grammar in Geneva) 8:59-76, Bertollo & Cavallo
2 60 (ii) SABRINA BERTOLLO AND GUIDO CAVALLO [ Force C [Relwh chi C che] / Frame [HT]C topic [LD] C Oper [Focus] /[Interrwh /Quant] C [ Fin C Evidence for the high position of the wh- relative in CP is provided by Italian examples such as (1) and (2): (1) a. Ho incontrato chi di pane ne mangia molto Have 1stSING met who of bread it eats much I have met who eats a lot of bread b. * Ho incontrato di pane chi ne mangia molto Have 1stSING met of bread who it eats much I have met who eats a lot of bread (2) a. Apprezzo chi le bugie odia, (non la verità) Appreciate 1stSING who the lies hates (not the truth) I appreciate who hates lies (not the truth) b. * Apprezzo le bugie chi odia, (non la verità) Appreciate 1stSING the lies who hates (not the truth) I appreciate who hates lies (not the truth) In (1a) the wh- item chi precedes the left dislocated phrase di pane, which is placed in SpecLD, while the reverse order in (1b), with the wh- being lower than the dislocated item, leads to ungrammaticality. In (2) the same pattern is shown with a Focus, which cannot precede the wh- item as well. Further clues for the high position of the relative item are also supplied by (substandard) German, in which the verb of a relative clause can possibly move to CP, while this is basically excluded in embedded interrogative clauses. (3) a. * Ich weiß nicht, wer hat gewonnen I know not who has won I don t know who has won b. Wer hat Zeit, der ruft mich an Who has time that calls me Who has time ha to call me In (3a) it is clearly shown that the verb of the embedded interrogative cannot access the CP area; this is possibly due to the fact that the interrogative pronoun prevents the verb from doing it. In (3b), instead, since the wh- relative is in an higher position, the movement of the verb is not inhibited The introducers of free relative clauses Languages vary with respect to the way in which they can form a free relative clause and show that different constraints can be at work. Most languages use wh- items (the same they use for interrogatives) to form free relative clauses 1. Some exceptions for this are provided by Latin 2, which uses the pronoun 1 Other strategies such as the insertion of a d- pronoun instead of a wh- were currently used in Old English, as well as in Old German. Free relative clauses however can still be introduced by d- pronouns in Modern German and in some Low German varieties, although certain restrictions apply. The German cases in which a d- pronoun
3 THE SYNTAX OF ITALIAN FREE RELATIVE CLAUSES: AN ANALYSIS 61 quis/quid to introduce an interrogative clause, whereas it adopts qui, quae, quod to form relative clauses, both headed and headless: (4) Non quaero quis hic sit Claudius Not ask 1st Sing who this is Claudius I don t ask who this Claudius is (Cic., verr. 2, 2, 107) (5) Qui amicus est, amat Who friend is, loves Who is a friend, loves (Sen, ep. 4, 35) However this distinction seems to be weakened in Late and High Medieval Latin, in which we can find instances of quis/quid used instead of qui, quae, quod with verbs which would normally select a free relative clause: (6) De meis indumentis quid velis accipe Among my clothes what want 2nd Sing take Of my clothes take the one you want (Chronicon Salernitanum, 32) (7) Assum domine mi, iube quid velis Am here lord my, command what want 2nd Sing I am here, my lord, command what you want (Hrotsvitha, Gall. 139, 18) The verb iubeo in Classical Latin selects a free relative clause, introduced by the whquod, as in the following examples: (8) Renuisti quod iubet alter Refuse 2ndSING you what commands the other one You refuse what another person commands (Hor., ep. 2, 2, 63) (9) Nec faciam quod Cicero facere Atticum iubet Not will-do 1stSING what Cicero to-do Atticus commands I won t do what Cicero orders that Atticus does (Sen., ep. 118, 1) The extension of the wh- interrogative is connected with some semantic properties of a group of verbs which can ideally select both an interrogative and a free relative, depending on the context they are used in. The status of the matrix verb has to be taken carefully into account since it enables to distinguish between a free relative clause and an interrogative and to judge the well-formedness of the sentence. This phenomenon probably indicates the direction of the path from Latin to vernaculars, in which the interrogative form is used for free relative clauses (as happens in Italian). A property that is cross-linguistically shared by free relative clauses is that the syntactic requirements of the embedded verb must be always met: the wh must display the morphological Case selected by the verb of the relative clause. This is a condition of primary importance in most languages, as evidently shown by Latin or German, which have a instead of a wh- item is inserted have recently been analyzed (Fuss &Grewendorf 2012) as headed relative clauses with haplology of the antecedent, but this goes beyond the goals of the present research. 2 Ancient Greek displays the same syntactic behavior of Latin with respect to the pronominal series used to introduce free relative clauses (see below for further discussion).
4 62 SABRINA BERTOLLO AND GUIDO CAVALLO morphological distinction for Case. In these languages, if this requirement is not met, the clause is always ungrammatical: while the antecedent can remain silent, the wh- must always be expressed and bear the Case assigned by the embedded verb. (10) Cui permittit necessitas sua, circumspiciat exitum mollem Who DAT allows necessity his, looks exit easy The person to whom his personal situation allows it, has to look for an easy way to go out of this (Sen., Ep. 70, 24) (11) Ich lade ein, wemdu geholfen hast. I invite, who DAT you helped have 2nd SING I invite the person you helped Ancient Greek challenges standard assumptions in that it can form free relative clauses with the wh- item bearing the Case of the silent antecedent, as in (12) 3 : (12) ἀλλ εἶα φείδου μηδὲν ὧν ἐπίστασαι But come spare IMP2ndSING nothing Ø which GENPL know IND2ndSING Come, don t spare anything of what you know (Eur., Med. 401) In (12) the wh- is assigned the Genitive, although it should have the Accusative Case as the embedded verb ἐπίσταμαι requires. Contrarily to what is generally observed, the whdisplays the Case that the antecedent should have if it were lexicalized. This could be an instance of attraction directa (Harbert 1989): the wh- receives the Case of the silent antecedent 4. This strategy is helpful for free relative clauses, since it enables to make overt the Case which is higher in the Accessibility Hierarchy (Keenan and Comrie, 1977). In (12) the wh- displays the Genitive Case and not the Accusative, probably because the Structural Case is easily recoverable, while the partitive Genitive would be hard to reconstruct if not lexicalized at some point in the structure. We do not expect to find instances of attraction if the wh- is assigned an Oblique Case by the embedded verb, and the antecedent bears a Structural Case, as shown in (13): (13) καλῶς γ ἂν οὖνδέξαιντό μ οἴκοις ὧν πατέρα κατέκτανον Well prt. PROBABILITY welcome 3rdPLUR me home DAT Ø which GENPL father killed 1stSING They would welcome me well at their home, they whose father I killed! (Eur., Med ) 3 This phenomenon can be marginally observed also in Latin, although these rare cases can be traced back to Greek influences or to verb ellipsis; the influence of Greek is evident in that most examples come from Christian Latin (Hoffmann 1965). In general, in Classical Latin the wh- displays the Case required by the embedded verb, regardless of the fact it is higher or lower in the Accessbility Hierarchy: (i) Praemium proposuit qui invenisset novam voluptatem Prize proposed Ø DAT who NOM should-invent new pleasure He offered a prize to the one who should invent a new pleasure (Cic., Tusc. 5, 20, from Grosu 1994) 4 Attractio hasn t been investigated so far within the cartographic approach. The main issue related to this phenomenon is the transmission of the Case from the higher item (the antecedent) to the lower (the wh-): at some point in the derivation the wh- is claimed to be in a position in which it can receive the Case which has been copied from the antecedent (Bianchi 1999).
5 THE SYNTAX OF ITALIAN FREE RELATIVE CLAUSES: AN ANALYSIS ITALIAN FREE RELATIVE CLAUSES For the present research we will just consider Italian free relative clauses with the [+ animate] feature. Free relative clauses with the [- animate] feature are impossible 5, as shown in the following sentence: (14) * Ho comprato (che) cosa hai consigliato Have 1stSING bought what have 2ndSING suggested I bought what you suggested The wh- (che) cosa cannot be used as the introducer of a free relative clause, but can be used just in interrogatives. Many configurations are instead possible with the [+animate] antecedent. Italian introduces this kind of free relative clauses with the wh- item chi, which is not morphologically distinct for Case: it can serve as subject (15), as object (16), or as other complements (in case of matching of the P which governs the wh-); an instance of the latter use is in (17) (see below for further comments on this type): (15) Invito a cena chi mi è simpatico Invite 1st SING to dinner, who NOM to me is nice I invite for dinner who is nice for me 5 Partial exceptions for this are provided by Italian free relative clauses with [-animate] feature such as: (i) Non ho di che lamentarmi Not have 1ST SING of what to-complain-me I don t have anything to complain about (ii) Non c è di che lamentarsi Not there is of what to-complain-oneself There is nothing to complain about However these apparent counterexamples are only limited to sentences with the verbs avere and esserci and always require an infinitive form. The fact that these cases are only restricted to these verbs is not by chance this seems to be due to the special nature of the verbs, which are not fully lexical. However, this topic needs to be further investigated, due to the peculiarity of the phenomenon. Moreover free relative clauses with a [-animate] antecedent are acceptable with perception verbs, as in (iii) and (iv): (iii) Ho sentito che cosa hai detto! Have 1ST SING heard what have 2ND SING said I heard what you said (iv) Ho visto che cosa hai fatto! Have 1ST SING seen what have 2ND SING done I saw what you did The fact that this kind of configuration is possible only with perception verbs suggests that the status of the embedded clause is ambiguous between a free relative and an interrogative structure, in which the wh-che cosa is fully acceptable, as in (v): (v) Non so che cosa hai fatto Not know 1ST SING what have 2ND SING done I don t know what you did
6 64 SABRINA BERTOLLO AND GUIDO CAVALLO (16) E venuto anche chi hai avvertito ieri Is come also who ACC have 2nd SING told yesterday Even those you have told it yesterday have come for dinner (17) Mario parla solo con chi gli conviene parlare Mario talks only with who IND him it is worth to talk Mario talks only with those he thinks it s worth to talk Given the model we adopt, (15) can be represented as follows: (18) DP Spec D D Ø chi RelwhP Relwh Relwh (che) mi è simpatico Some Northern Italian dialects, as well as substandard Northern Italian must introduce a free relative clause with a wh- item followed by a complementizer che. This possibility, which is very common in dialectal varieties also of Germany and England, is avoided in the standard. (19) Invito a sena chi che me ze simpatico (Paduan) Invite 1st SING to dinner, who NOM that to me is nice I invite for dinner who is nice for me 3.1. The configurations of Italian free relative clauses In this section we will consider all the possible configurations for Italian free relative clauses with a [+animate] antecedent and we will discuss the reasons why certain patterns are possible whereas other are not Both silent antecedent and wh- in a Structural Case In Italian a free relative clause can be formed with both the silent antecedent and the wh- in a Structural Case. Under this configuration Case matching is not required, since the silent antecedent and the wh- item can be attested in one of the following patterns: a. Antecedent Nominative/wh- Nominative b. Antecedent Nominative/wh- Accusative c. Antecedent Accusative/wh- Nominative d. Antecedent Accusative/wh- Accusative This is shown by the following examples:
7 THE SYNTAX OF ITALIAN FREE RELATIVE CLAUSES: AN ANALYSIS 65 (20) Chi mangia troppi dolci ingrassa Who NOM eats too many sweets gets fat Who eats too many sweets, gets fat (21) E venuto chi hai invitato Is come who have 2ndSING invited The person you invited has come (22) Ho incontrato chi ha parlato alla conferenza Have 1st SING met Ø ACC who has talked at the conference I met the person who spoke at the conference (23) Ho incontrato chi hai invitato Have 1st SING met who have 2ndSING invited I have met who you have invited In (20) and (23) there is perfect matching between the Case required by the matrix verb and the Case governed by the embedded verb. As happens in most languages there is no problem in forming free relative clauses under these conditions. In Italian, configurations such as the one proposed in (22) and (23), with the free relative clause being the object of the matrix clause, require that it comes after the matrix, so that the canonical SVO order is respected. For parallel reasons (20) sounds more natural if the relative clause comes first. In (21) the presence of an unaccusative verb allows both the preposing and the postposing of the free relative clause with a light preference for postposing, since the subject is normally found in postverbal position, as in (24): (24) E arrivato Mario Is arrived Mario Mario has arrived However the order can be reversed for pragmatic reasons, as clearly shown by the following sentences: (25) [ FocP Chi ha sbagliato ho punito (non chi è stato onesto) Who has made-a-mistake have 1stSING punished (not who is been honest) I punished who has made a mistake (not who s been honest) (26) [ LDP Chi ha sbagliato l ho punito Who has made-a-mistake him have 1stSING punished I punished who s made a mistake (27) Rischia il diabete [ FocP chi mangia troppi dolci, (non chi preferisce le verdure) Risks the diabetes who eats too-many sweets (not who prefers the vegetables) Who eats too many sweets risks diabetes, (not who prefers vegetables) The possibility of forming free relative clauses also when there is no matching in the Structural Cases is probably due to the fact that Italian doesn t display any morphological distinction for Case on the wh-. This seems to be confirmed by data coming from languages with overt Case morphology. In German, for instance, not everybody would accept free relative clauses such as (28a), while (28b) is perfectly acceptable:
8 66 SABRINA BERTOLLO AND GUIDO CAVALLO (28) a.?? Ich lade ein, wer kommen will I invite, who NOM come wants I invite who wants to come b. Ich kaufe nur was billig ist I buy only what NOM cheap is I buy only what is cheap Some authors such as Vogel (2001) claim (28a) is not possible because of morphophonological reasons, since there is no identity between the wh- in the Nominative and in the Accusative if the wh- has the [+ animate] feature. When there is morphological identity -this happens for instance with the wh- used for the inanimate (was both for the Nominative and the Accusative) -sentences like (28b) are considered grammatical by all speakers. Instances of this can be found, as claimed in Fuß & Grewendorf (2012), also with a [+animate] antecedent if the free relative clause is introduced by the d- pronoun die, which can be both Nominative and Accusative for the feminine and the plural: (29) Die da stehen, kennen wir nicht Who PL there stand, know we not We don t know the people who were there (30) Die er eingeladen hat, war früher Moderatorin der Tagesthemen Who FEM SING he invited has, was earlier Moderator of-the Tagesthemen The woman who he invited had been the moderator of the Tagesthemen P which governs a silent antecedent and wh- in a Structural Case A second possible configuration is the one in which the silent antecedent is governed by a P and the wh- is in a Structural Case. This type is potentially grammatical with any preposition, regardless of the Case of the wh- (Nominative or Accusative). (31) Ho dato il libro a chi lo ha chiesto Have 1st SING given the book to Ø who NOM it has asked I have given the book to the person who asked for it (32) Ho comprato il regalo per chi hai ospitato Have 1st SING bought the present for Ø who ACC have 2ndSING hosted I have bought the present for the person you have hosted In (31) the P a is selected by the verb of the matrix clause dare and introduces the Beneficiary; the wh- chi serves as the subject of the embedded clause. In (32) the silent antecedent is governed by the preposition per and the wh- receives the Accusative from the verb ospitare, whose subject is a pro. We believe that in Italian constructions like (32) are fully grammatical because of two factors: (i) in (32) chi serves as subject of the embedded clause and fully meets the requirements of the verb ospitare; (ii) thanks to the fact that chi has no morphological mark, it can be at least superficially read as the complement of the P per. This impression is somehow preserved by the fact that the wh- has the same morphological form it would have if it were governed by a preposition, as happens for instance in interrogative clauses, as in (33):
9 THE SYNTAX OF ITALIAN FREE RELATIVE CLAUSES: AN ANALYSIS 67 (33) Dimmi con chi sei andato al mare Tell 2ndSING -me with whom are 2ndSING gone to the seaside Tell me with whom you went to the seaside con. In (33) there is no silent antecedent, since the wh- item chi is directly governed by the P The structure of (32) is provided in (34): (34) PP P P per DP D D Ø Spec chi RelwhP Relwh Relwh In (34) the scheme highlights the fact that the wh- chi can be reinterpreted as the complement of the matrix verb as well as the subject of the embedded clause. Note that this pattern doesn t violate the theta criterion: as expected, the wh- is assigned only one thematic role, which is the Theme: it only superficially fills the gap left by the silent antecedent, which is assigned the Beneficiary. The possible reinterpretation of the wh- as the superficial complement of the P seems to be a key factor and this can be proved if we observe free relative clauses in which the antecedent and the wh- are governed by two different prepositions: (35) * Ho letto l articolo di con chi hai lavorato Have 1stSING read the article of with who have 2ndSING worked I have read the article of the person you worked with The sentence in (35) is decidedly ungrammatical because the wh- chi cannot be read as the complement of the P di since it is governed by the P con which blocks the relation with the matrix clause: it is an intervener in the terms of Rizzi s Relativized Minimality (Rizzi 1990) The configuration in which the silent antecedent is governed by a P and the wh- is in a Structural Case leads to ill-formedness in some other languages such as German 6, as shown in (36); however if the P selects the same Case required by the embedded verb, the sentence improves (see 37): 6 It is generally said that this configuration is impossible in German because the antecedent cannot keep silent if it is lower in the Accessibility Hierarchy (Keenan & Comrie 1977) than the wh-.
10 68 SABRINA BERTOLLO AND GUIDO CAVALLO (36) * Ich kaufe ein Geschenk für wer mich geschimpft hat I buy a present for Ø who NOM me injured has I buy a present for the person who has injured me (37) Ich kaufe ein Geschenk fürwen ich liebe I buy a present for Ø who ACC I love I buy a present for the person I love (37) is marginally acceptable, surely more acceptable than (36), because the same surface impression we described for Italian takes place for German, too. Morphological identity between the actual wh- and the form that the wh- would have if it were governed by the preposition re-establishes a kind of surface grammaticality. This means that the fact that the form chi could be used for both functions rescues the acceptability of the sentence, which would otherwise be lost. There are however languages such as Classical Latin and Old Italian which admit the sequence of a preposition, which governs a silent antecedent, followed by a wh- in the Case required by the embedded verb, although it is not the same of the antecedent. These languages maintain, with different degrees, a morphological distinction for Case which helps to disambiguate the sentence and to properly interpret each item. This is convincingly shown for Old Florentine in Benincà(2010): (38) Zappa a chi la tiene e spada a cui s aviene Hoe to Ø who NOM it has and sword to whom IND.OBJ. it suits The hoe suits who can carry it and the sword suits who deserve it (Garzo, Proverbi, p. 313) In Old Florentine chi served only as the Nominative wh-, for the Accusative and for the indirect Case the form was cui as is evident from the second part of (38) spada a cui s aviene. It is therefore clear that the P a in (38) governs a silent antecedent and cannot directly govern the wh- item chi, which otherwise would have had the form cui. A similar configuration is attested in Latin as well (see 39): (39) Scipio cum quos paulo ante nominavi interiit Scipio with Øwho ACCPL. a short time ago cited 1st SING died 3rd SING Scipio died with those who I have just cited (B. Afr. 96.2) P which governs a silent antecedent and wh- governed by a P This configuration is the most problematic in Italian, since it deeply affects the interface between syntax and semantics. As has been shown in (35) this configuration is impossible if the antecedent and the whare governed by two different prepositions. Anyway, the identity of the two Ps is not sufficient to guarantee the grammaticality of the sentence. This is evident if we compare sentences such as (40), (41) and (42): (40) Ho parlato con chi hai parlato tu Have 1st SING talked with Ø P who IND.OBJ have 2nd SING talked you I talked to the person to whom you talked
11 THE SYNTAX OF ITALIAN FREE RELATIVE CLAUSES: AN ANALYSIS 69 (41)? Ho dato il vocabolario a chi hai prestato gli altri libri Have 1st SING given the vocabulary to who have 2ndSING lent the other books I have given the vocabulary to the person you have lent the other books (42) * Ho comprato la torta per chi soffri Have 1st SING bought the cake for who suffer 2ndSING I have bought the cake for the person you suffer for (40) is grammatical for most speakers, as there is full identity between the embedded and the matrix verb with the selection of the same P and of the same thematic role. In (41) both the matrix and the embedded verb independently select the P a and assign the same thematic role, the Beneficiary; in fact the two verbs dare (to give) and prestare (to lend) have a certain semantic contiguity, although they are not fully overlappable; this guarantees that the sentence is partially acceptable. In (42) there are two different verbs which select the same P but different thematic roles: the verb comprare (to buy) selects a Beneficiary, while the verb soffrire (to suffer) selects in this context a Cause;this leads to the total ungrammaticality of the sentence. From the examples above it becomes clear that this kind of configuration, with a P assigned by the two verbs, involves an acceptability scale based on semantic and syntactic factors: the more different the thematic roles assigned by the two verbs are, the less acceptable the sentence is, although there is preposition matching. This can be schematized as follows: (43) Acceptable Thematic roles: totally identical P matching Thematic roles:totally different Not Acceptable The semantic mismatching does not necessarily lead to ungrammaticality in all the configurations; this is proved by free relative clauses in which both the antecedent and the whare assigned a Structural Case but there is no matching between the thematic roles. A sentence like (44), in which the wh- is the Experiencer and the silent antecedent is the Agent, is perfectly grammatical: (44) Chi si annoia troppo a teatro, se ne va prima che finisca lo spettacolo Who gets-bored too-much at theatre, goes away before ends the show Who gets to bored at theatre goes away before the show ends In (45) both the silent antecedent and the wh- are in the Accusative: (45) Maria adorava chi hai ucciso Maria adored who have 2ndSING killed Maria adored who you killed Even though the thematic roles assigned to the object of adorare and uccidere are different, the sentence is perfectly grammatical. When the embedded and the matrix verb assign two different prepositions, and the free relative clause is therefore not acceptable, speakers adopt different strategies to form
12 70 SABRINA BERTOLLO AND GUIDO CAVALLO grammatical sentences to convey the same message. One possible way to restore the grammaticality of sentences like (42) is to insert a light head, such as colui, as antecedent: (46) Ho comprato la torta per colui per cui soffri Have 1st SING bought the cake for the one for who suffer 2ndSING I have bought the cake for the one you suffer for Otherwise it is possible to use a form such as la persona, a noun which generically refers to a human being: (47) Ho comprato la torta per la persona per cui soffri Have 1st SING bought the cake for the person for who suffer 2ndSING I have bought the cake for the person you suffer for Speakers may choose to rephrase also sentences like (41) in order to make them sound more natural: (48) Ho dato il vocabolario alla persona/a colui a cui hai prestato il libro Have 1st SING given the vocabulary to the person/the one who have 2ndSING lent the other books I have given the vocabulary to the person/the one you have lent the other books It s quite hard to establish if light headed relative clauses, whose head is either a pronoun (colui/quello, with no deictic content) or a noun generically referring to a human being such as la persona, can be really considered a semantic equivalent of free relative clauses. There are cases in which they are, depending on the information which can be inferred about the context or on the basis of the world-knowledge, and cases in which the interpretation is not exactly the same. Therefore (49): (49) Chi guidava l autobus delle di ieri era certamente ubriaco Who drove the bus of-the of yesterday was certainly drunk Who drove yesterday s bus was certainly drunk can be rephrased as (50): (50) Colui che guidava l autobus delle di ieri era certamente ubriaco The one who drove the bus of-the of yesterday was certainly drunk The one who drove yesterday s bus was certainly drunk (51) La persona che guidava l autobus delle di ieri era certamente ubriaca The person who drove the bus of-the of yesterday was certainly drunk The person who drove yesterday s bus was certainly drunk since it is well-known that only one person at a time drives a bus; moreover, the event is placed in a specific time and refers to a specific person. In cases like this, the free relative clause and the light headed relative are semantically equivalent; anyway, in most cases the two different structures give rise to different nuances of meanings, as in the following sentences:
13 THE SYNTAX OF ITALIAN FREE RELATIVE CLAUSES: AN ANALYSIS 71 (52) Chi ama la musica compra molti CD Who loves the music buys many CDs Who loves music buys many CDs (53) Colui che ama la musica compra molti CD The one who loves the music buys many CDs The one who loves music buys many CDs (54) Coloro che amano la musica comprano molti CD The ones who love the music buy many CDs The ones who love music buy many CDs These sentences show that the wh- item chi can refer both to a singular and to a plural entity, mostly when the context is not specific and the world-knowledge doesn t prevent the sentence from being interpreted as referring to any people who find themselves in that situation Silent antecedent in a Structural Case and wh- governed by a P In Italian free relative clauses with the silent antecedent in a Structural Case and the whgoverned by a P are basically impossible, as (55) shows: (55) * Ho incontrato con chi hai viaggiato Have 1st SING met Ø ACC with who IND.OBJ have 2ndSING travelled I have met the one with whom you travelled In (55) the matrix verb selects a direct object, which is not lexicalized; the embedded verb selects a PP, whose head is con, which can in no way be read as the complement of incontrare. For (32) (here repeated as (56)): (56) Ho comprato un regalo per chi hai ospitato we argued that the sentence was grammatical because the wh- item, being morphologically indistinct for case, could be superficially read both as the complement of the P per (governed by the matrix verb) and as the object of the embedded verb. In (55) we have the reverse order, and the sentence is ungrammatical, as can be seen in (57): (57) * [ IP ho incontrato [ DP Ø [ CP [ PP con [ RelwhP chi]] C [ IP hai viaggiato ]]]] In (57) it is clear that the preposition con is inserted in the complex CP and its presence prevents the wh- from being, at least superficially, read as the complement of the matrix verb. Italian cannot recover the silent antecedent and is obliged to lexicalize it. The consequence of this morpho-syntactic constraint affects semantics, since the obligatory lexicalization of the antecedent forces the speaker to be more precise and to make explicit the grammatical number of the referent, which in a free relative clause can, as already noted, remain ambiguous: (58) Ho incontrato la persona/colui con cui hai viaggiato Have 1st SING met the person/the one with who IND.OBJ have 2nd SING travelled I have met the person/the one with whom you travelled
14 72 SABRINA BERTOLLO AND GUIDO CAVALLO (59) Ho incontrato le persone/coloro con cui hai viaggiato Have 1st SING met the people/the ones with who IND.OBJ have 2nd SING travelled I have met the people/the one with whom you travelled Parallelly to what we observed for free relative clauses with the [-animate] feature, partial exceptions for the ungrammaticality of the configuration with the silent antecedent in a Structural Case and the wh- governed by a P can be provided by sentences such as (60) and (61) 7 : (60) Non ho a chi chiedere aiuto Not have 1stSING to who to-ask help There s nobody I can ask for help (61) Non c è di chi fidarsi in questo posto Not there is of who to-trust in this place There is nobody you can trust in this place As we noted for the sentences with a [-animate] antecedent, this configuration is possible only with the verbs avere and esserci, which have a peculiar status and cannot be assimilated to the other lexical verbs. The fact that the constraints on this configuration are language specific is proved by the grammaticality of this construction in other languages and in earlier stages of Italian as well. See the following sentences: (62) Qui amat quoi odio ipsus est, bis facere stulte duco Who loves Ø ACC who DAT hate himself is, twice behave in a silly waythink 1STSING Who loves the person by whom he is hated, I think that he is definitely silly (Terence, Hecyra, 343) (63) Ich habe eingeladen, wem ich zu Dank verpflichtet bin I have 1st SING invited, who DAT I to thanks obliged am I have invited the person I have to thank (64) Villania in cui regna, cortesia lo disdegna Villainy in whom reigns courtesy him disdains Courtesy disdains those, in whom villainy reigns (Garzo, Proverbi, cited in Benincà 2010) In the Latin sentence in (62) the antecedent (in the Accusative) is kept silent although the wh- bears the Dative Case (an Oblique Case); in the German sentence in (63) the syntactic configuration is the same of Latin. In (64) the antecedent is in the Accusative Case and the wh- is contained in a PP. All these sentences cannot be translated into Italian if the antecedent is not lexicalized. 4. FREE RELATIVE CLAUSES COMPARED TO INDIRECT QUESTIONS To better understand the nature of Italian free relative clauses it can be helpful to compare them with indirect question, which are introduced by the same series of pronouns, chi/che 7 For a comment on this type see footnote 5.
15 THE SYNTAX OF ITALIAN FREE RELATIVE CLAUSES: AN ANALYSIS 73 cosa. Differently from free relative clauses, Italian embedded interrogatives can be introduced by any kind of wh-, regardless of the fact that it is governed or not by a preposition: (65) * Anna ha incontrato a chi hanno dato il premio Anna has met Ø ACC to who have 3rd PL. given the prize Anna has met the person to whom they gave the prize (66) Anna non sa a chi hanno dato il premio Anna not knows, to who IND.OBJ have 3rd PL. given the prize Anna doesn t know to whom they gave the prize In (65), which is a free relative clause, the verb of the matrix clause lacks its argument, which is silent; as we expect, the sentence is ungrammatical. (66) is instead grammatical, but the embedded clause is not a free relative clause: it is an indirect question. This means that the PP a chi is the indirect object of the embedded verb, but there is no silent antecedent and the wh- has no relation at all with the matrix verb. The verb of the matrix clause takes as its argument the whole CP introduced by the prepositional wh-. We can schematize the relations above as follows: (67) * V Ø ACC -P + wh- V (68) V CP If the verb of the matrix clause can select an indirect question, sentences like (65) can be interpreted as grammatical, as the following examples show: (69) * Ho aspettato a chi hai dato il biglietto del teatro Have 1stSING waited to who have 2ndSING given the ticket of-the theatre I have waited for the person who you gave the ticket for the theatre (70) Ho visto a chi hai dato il biglietto del teatro Have 1stSING seen to who have 2ndSING given the ticket of-the theatre I have seen who you gave the ticket for the theatre In (69) the verb aspettare cannot select an interrogative clause and, therefore, the embedded clause is interpreted as a free relative, which in not grammatical. (70) can be considered grammatical in that vedere selects an interrogative clause(which is possible, differently from aspettare). The interpretation of (70) as a free relative clause is always ungrammatical and the speaker is forced to rephrase the sentence as a light headed relative. We will give the two structures of (70) as (71) and (72): (71) * [ IP ho visto [ DP Ø [ CP [ PP a [ RelwhP chi]] C [ IP ( )]]]] (72) [ IP ho visto [ CP [ PP a [ IntP chi]] C [ IP ( ) ]]] This asymmetry between free relative clauses and indirect questions supports the idea that Italian does not have a restriction on the wh- per se; Italian free relative clauses suggest that the antecedent and the wh- are not completely blind to each other, although they receive Case independently: if there is no antecedent there is no restriction on the wh-. Any constraint
16 74 SABRINA BERTOLLO AND GUIDO CAVALLO is strictly dependent on the one hand on the relation between the antecedent and the wh- item and, on the other hand, on the configuration in which they are inserted. The different restrictions on the wh-, as well as the absence of a silent antecedent in embedded interrogatives, are just some pieces of evidence of a very robust syntactic diversity between free relative clauses and indirect questions. 5. FINAL REMARKS In this last section we would like to summarize and highlight the peculiarities of free relative clauses in Italian. We will make explicit what the underlying mechanisms we argued for are and we will try to define the nature of the main constraint on this construction. Firstly, Italian always introduces free relative clauses with a wh- item, which belongs to the interrogative paradigm; in this it behaves differently from both languages that use two distinct pronominal series to form free relative clauses and interrogatives (like Latin and Ancient Greek), and from languages, such as German, which can introduce free relative clauses also with a d- pronoun belonging to the paradigm of the determiners. The wh- item which Italian uses to introduce free relative clauses is morphologically indistinct and always has to satisfy the requirements of the embedded verb; in Italian there are in fact no cases in which this constraint can be overcome. The immediate consequence for this, is that phenomena of Case attraction are completely impossible. At first glance, it could seem that the only restriction on Italian free relative clauses is on the wh- and that the ungrammaticality of some free relative clauses is due to the mismatch between the Case assigned by the matrix and the embedded verb. A further, and probably ultimate constraint - which can explain the ungrammaticality of some configurations is related to the antecedent; crucially, even though Italian can keep the antecedent silent, it must be somehow recovered in the linear structure of the sentence; the restoration is purely superficial, as the wh- can in no way be syntactically governed by the matrix verb; the fact that chi has no morphological distinction for Case allows for this process. If the superficial restoration fails (i.e. if the wh- is governed by a P and the antecedent is in a Structural Case), the result is the ungrammaticality of the sentence: the preposition prevents the wh- from serving as the superficial object/subject of the matrix (minimality effect). The wh- does not necessarily have to bear a Structural Case to guarantee the wellformedness of the sentence. It can also be governed by a P, provided that there is syntactic matching, i.e. the embedded and the matrix verb independently select the same preposition. In this case it is highly preferable that the thematic roles assigned by the two verbs are the same; semantics plays a decisive role in determining whether this configuration is acceptable or not. Even if the two verbs select the same preposition, a total mismatching between the thematic roles leads to ungrammaticality; different degrees of acceptability are possible depending on the semantic contiguity between the thematic roles. Finally, from a theoretical point of view, we can observe that the presence of a silent antecedent in the syntactic structure of free relative clauses is proved by the asymmetry with indirect questions; the comparison between the two different structures can explain why indirect questions are basically always possible, while free relative clauses undergo certain constraints: the key factor is that in free relative clauses there is a non lexicalized head, which completely lacks in interrogatives.
17 THE SYNTAX OF ITALIAN FREE RELATIVE CLAUSES: AN ANALYSIS 75 REFERENCES Baldi Ph. & Cuzzolin P. (eds.) (2011) New perspectives on Historical Latin Syntax IV: Complex Sentences, Grammaticalization and Typology, Mouton de Gruyter. Berlin New York. Belletti A., Brandi L., Rizzi L. (eds.) (1981)Theory of Markedness in Generative Grammar. Scuola Normale Superiore. Pisa Benincà, P. (2001) The position of Topic and Focus in the left periphery, in G. Cinque & G. Salvi (eds.), Current Studies in Italian Syntax. Essays Offered to Lorenzo Renzi, Elsevier-North Holland, Amsterdam, Benincà, P. (2006) A Detailed Map of the Left Periphery of Medieval Romance, in R. Zanuttini R., Campos H., Herburger E., Portner P. (eds.), Crosslinguistic Research in Syntax and Semantics. Negation, Tense and Clausal Architecture, Georgetown University Press, Washington, Benincà, P. (2010) Headless relatives in some Old Italian varieties, in R. D Alessandro, A. Ledgeway, I. Roberts, Synctactic variation. The dialects of Italy, Cambridge University Press, Cambridge, UK. Benincà, P., (in press). Lexical complementisers and Headless Relatives, in L. Brugè et alii (eds.), Functional Heads., Oxford University Press, New York & Oxford. Bianchi, V., (1999), Consequences of Antisimmetry. Headed Relative Clauses. Mouton De Gruyter, Berlin-New York. Bosco Coletsos, B. & Costa M. (2004) Italiano e tedesco: un confronto, Edizioni dell Orso, Torino, ; Bresnan, J. & Grimshaw, J. (1978) The Syntax of FreeRelatives in English, Linguistic Inquiry 9: Chomsky N. (1973) Conditions on transformations, in: S. Anderson & P. Kiparsky (eds.), A Festschrift for Morris Hall, Holt, Rinehart and Winston, New York. Cinque, G. (2003) The Prenominal Origin of Relative Clauses. Paper presented at the Workshop on Antysimmetry and Remnant Movement, New York University, October 31, November 1, Citko, B. (2004) On Headed, Headless, and Light-Headed Relatives, Natural Language and Linguistic Theory 22, Duden, (2006) Die Grammatik, vol. 4, Mannheim: Dudensverlag. Fuss, E. & Grewendorf, G. (2012) Freie Relativsätze mit d-pronomen, Paper presented at the GGS conference, Freiburg, 17 th 19 th May Groos, A., & van Riemsdijk, H. (1981). Matching Effects in Free Relatives, in: A. Belletti, L. Brandi & L. Rizzi (eds.), Theory of Markedness in Generative Grammar, Scuola Normale Superiore, Pisa Grosu, A. (1994) Three Studies in Locality and Case, Routledge, London and New York. Grosu, A. (1996) The Proper Analysis of Missing P Free Relative Constructions, Linguistic Inquiry 27, Harbert, W., Case Attraction and Hierarchization of Case, in: K. de Jong and Y. No (eds.), Proceedings of ESCOL 89, Hoffman, J. B. (1965), Lateinische Syntax und Stilistik, C. H. Beck, München. Keenan, E. & Comrie, B. (1977) Noun Phrase accessibility and universal grammar, Linguistic Inquiry 8, Larson, R. K. (1987) Missing Prepositions and the Analysis of English Free Relative Clauses, Linguistic Inquiry 18,
18 76 SABRINA BERTOLLO AND GUIDO CAVALLO Pittner, K.(1991) Freie Relativsätze und die Kasushierarchie, in: E. Feldbusch, R. Pogarell & C. Weiß (eds.), Neue Fragen der Linguistik. Akten des 25. Linguistischen Kolloquiums, Padeborn, Max Niemeyer, Tubingen, Rizzi, L., (1990), Relativized Minimality, Cambridge, MIT Press. Rizzi, L.(1997). "The Fine Structure of the Left Periphery," in L. Haegeman, ed., Elements of Grammar. Handbook of Generative Syntax, Kluwer, Dordrecht, Sternefeld, W. (2005) Do Free Relative Clauses Have Quantificational Force?, in: H.-M. Gaertner, S. Beck, R. Eckardt, R. Musan, B. Stiebels (eds.), Between 40 and 60 Puzzles for Krifka. Vogel, R. (2001) Case conflict in German free relative constructions. An optimality theoretic treatment, in: G. Müller e W. Sternfeld, Competition in Syntax, Mouton de Gruyter, Berlin, New York.
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subset: commoncrawl


text:
John J. Curley '60 and Ann Conser Curley '63 Faculty Chair in International Studies, Business and Management
Professor of International Business and Management
Department of International Business and Management
2016 Schumpeter Prize, International Joseph Schumpeter Society, for the book, The Great Knowledge Transcendence: The Rise of Western Science and Technology Reframed (Palgrave Macmillan 2016)
1998 Joseph L Fisher Doctoral Award, The Institute of Public Policy, George Mason University
1988-1989, Visiting scholar, the
Contact: email@example.com
Office: Althouse 211
Phone: 245-1487
IB&M 230 International Organizational Behavi
IB&M 300Creativity, Innovation, and Knowledge Management
IB&M 400 International Business Policy and Strategy
The problem of knowledge and knowledge creation in the very long run and across cultures and civilizations.
Dengjian Jin (2016) The Great Knowledge Transcendence: the Rise of Western Science and Technology Reframed. New York: Palgrave Macmillan
Dengjian Jin (2001) The
Dynamics of Knowledge Regimes: Culture, Technology, and Competitiveness of
Roger R. Stough, Mark E. Maggio, and Dengjian Jin (2001) "Effects of Intelligent Transportation Systems on the Environment and Economic Development at the Metropolitan Level." Journal of Public Affairs Review 2(1): 55-80.
Roger R. Stough, Mark E. Maggio, and Dengjian Jin (2001) "Methodological and
Technical Challenges in Regional Evaluation of ITS: Induced and Direct
Effects." In: Roger R. Stough (ed.) Intelligent
Transport System: Cases and Policies.
James A. Wall, Michael Blum, and Dengjian
Jin (2000) "Response to Diamant's 'Conflict and
Conflict Resolution in
Dengjian Jin, and Roger R. Stough (1998) "Learning and Learning Capabilities in the Fordist and Post-Fordist Age: An Integrative Framework." Environment & Planning A 30: 1255-1278.
James A. Wall, Jr., Michael Blum, Ronda R. Calister, Dengjian Jin, Nam-Hyeon Kim, Dong-Won Sohn (1998) "Mediation in the USA, China, Japan, and Korea." Security Dialogue 29(2): 235-248.
Dengjian Jin, and Kinsley E. Haynes
(1997) "Economic Transition at the Edge of order and Chaos:
Dengjian Jin (1995) "Bounded Governance within Extended Order: the Confucian Advantage of Synergy under Generalized Constitutional Rules." Constitutional Political Economy 6(3): 263-280.
James A. Wall, Jr., Dong-Won Sohn, and Dengjian Jin (1995) "Community and Family
Mediation in the People's Republic of


text:
Solano County Cardiologists
The following Solano County current list of Sutter Health Cardiologists are affiliated with the Sutter Health network. You can filter by city, gender and more to find doctors near you.
Doctors 11 - 12 of 12 - Per page: 10records 25records 50records 100records
David S. Weiland, M.D.2720 Low Court
Fairfield, CA 94534
(707) 427-4900
Specializing inCardiovascular Disease
Accepting new patients
Interventional Cardiology
Accepting new patients
Edward J. Yoon, M.D.Sutter Medical Foundation
2720 Low Court
Fairfield, CA 94534
(707) 427-4900
Doctors 11 - 12 of 12


text:
The Artificial Pancreas
Artificial pancreas, Bionic Pancreas, closed-loop device – the development of automated insulin delivery comes with many names. While the name "artificial pancreas" may bring to mind the dream of an implanted pancreas-substitute that works just like a biological pancreas would, we are still not there yet. Current systems involve the use of devices - insulin pumps, continuous glucose monitors (CGMs), and software algorithms that decide how much insulin (and in some cases, glucagon) to deliver.
See below for an overview of the artificial pancreas field, helpful links to articles on specific product and research updates, and our key questions for the artificial pancreas.
Who is Closing the Loop and How Fast Are They Moving?
Below we include a list of organizations working to bring automated insulin delivery products to market – this includes their plans for pivotal studies and plans for an FDA submission. The organizations are ordered from shortest to longest time to a pivotal study, though these are subject to change. It's not clear how long the FDA process will take for these devices, but we assume ~12 months is a good estimate. Some organizations have not disclosed pivotal study plans and are included further down the list.
Updated: 5.27.16
Company / Academic Group
Latest Timing
- MiniMed 670G pump with built in hybrid closed loop algorithm (requires meal boluses)
- Enlite 3 CGM
FDA submission before end of June 2016; US launch hoped by April 2017
- Tandem t:slim pump with built in predictive low glucose suspend algorithm; Dexcom CGM
- Tandem t:slim pump with built in Hypoglycemia-Hyperglycemia Minimizer algorithm; Dexcom CGM
- Pivotal trial in 2016, potential launch in 2017
- Pivotal study in 2017, potential launch by end of 2018
International Diabetes Closed Loop (IDCL) Consortium (TypeZero, UVA, and nine other academic institutions)
Cellnovo + other undisclosed pump companies
- Commercial version of DiAs hybrid closed loop algorithm that can run on a pump or on a smartphone app.
- Dexcom CGM.
- Trial will use multiple pumps; Cellnovo has signed on thus far.
International Diabetes Closed-Loop Trial to begin later in 2016.
System recently tested in two ski studies in Wintergreen and Breckenridge
- Bionic Pancreas iLet device: dual chambered pump with built-in algorithm; hybrid or fully closed loop; insulin-only or insulin+glucagon; custom infusion set
- Likely to launch as insulin-only product, with glucagon to be optionally added later
Pivotal trial to start in mid-2017
Insulin-only FDA submission by end of 2017.
Insulin+Glucagon FDA submission potentially in 2019.
- Former Asante pump body (disposable), reusable Bluetooth-enabled controller (no screen or buttons) with built-in algorithm
- Dexcom CGM
- Smartphone app to serve as complete user interface.
Pivotal study in first half of 2017, FDA submission by the end of 2017.
Launch by the end of 2018.
- Animas pump with built-in Hypoglycemia-Hyperglycemia Minimizer algorithm
- Dexcom CGM
Pivotal study to begin in 2016, launch by November 2017.
- OmniPod with hybrid closed loop algorithm and built-in Bluetooth
- Smartphone app and/or backup PDM handheld to communicate with pod
- Dexcom CGM
First clinical trials starting later in 2016, in market in late 2018.
No design details disclosed, but algorithm likely to reside in wireless handheld that controls body-worn patch pump.
- IDCL Consortium Partner (see above)
- Diabeloop consortium partner
- IDCL study starting in 2016
- Diabeloop trials were expected to start at the end of 2015, with European approval programs to run until 2018
Working internally on a new CGM, with future potential application to an artificial pancreas device
"On our agenda"
CGM expected to launch in Europe in 2016
Upcoming long-term studies will use Medtronic's MiniMed 640G/Enlite 3 + Android phone running Cambridge's MPC.
Commercialization plans unknown. Three upcoming studies ranging from three to 24 months in length.
The Bionic Pancreas:
The Bionic Pancreas is the work of Dr. Damiano, Dr. Russell, and their team at Boston University/Massachusetts General Hospital. Notably, this system uses insulin and glucagon, whereas most other systems only use insulin.
test drive - The Bionic Pancreas. Kelly reflects on her transformative experience participating in the Beacon Hill trial of the bionic pancreas for five days.
learning curve - The "Bionic Kids" Put the Artificial Pancreas Through the Rigors of Summer Camp. We visit and report back on the bionic pancreas trials at Camp Clara Barton and Camp Joslin.
new now next - Dr. Ed Damiano Presents Encouraging Data on Two Bionic Pancreas Studies at CarbDM's Second Anniversary.
test drive - Our Bionic Pancreas Journey. A parent reflects on his experience as his daughter becomes the first 6-year old to test the bionic pancreas.
test drive - diaTribe Visits the "Bio-Panky" Kid Trial at Camp Joslin. We visit and report on the bionic pancreas trials, this time in the youngest group tested yet - 6 to 11 year olds.
Conference Updates:
conference pearls - The Human Side of the Artificial Pancreas from ATTD 2015.
conference pearls - Major Progress on the Artificial Pancreas at the American Diabetes Association's 74th Scientific Sessions in San Francisco.
conference pearls - An update from the Advanced Technologies & Treatments for Diabetes (ATTD) Conference 2013.
conference pearls - Workshop on Innovation Toward An Artificial Pancreas hosted by the FDA, NIH, and JDRF.
conference pearls - The American Diabetes Association's 72nd Scientific Sessions - Philadelphia. An update from Dr. Ed Damiano and a closed-loop research meeting sponsored by JDRF and the NIH.
Regulatory News / A Pathway for the Artificial Pancreas:
thinking like a pancreas - You Call That An Artificial Pancreas? Gary Scheiner reflects on the steps toward an artificial pancreas, examines the pros and cons of each stage, and what we can do until it hits the market.
learning curve - Bringing an Artificial Pancreas to Market.
thinking like a pancreas - Triple Your Pleasure: Three Pancreatic Hormones May be Necessary to Fully Close the Loop.
new now next - First-ever Artificial Pancreas Software Receives European Approval.
diaTribe dialogue - Medtronic's MiniMed 670G Hybrid-Closed Loop – Exclusive Interview with 17-Year-Old Trial Participant.
trial watch - Medtronic's Pivotal Trial of its 670G Hybrid Closed Loop System
Artificial Pancreas Trials and Studies:
test drive - UVA's Overnight Closed-Loop Makes for Great Dreams. Kelly participates in UVA's overnight closed loop trial and reports back on an incredible opportunity for the field to move fast, reduce anxiety, and beat timelines.
new now next - Yale Researchers Dose First Patient in Artificial Pancreas Study with Halozyme's Hyaluronidase.
test drive - Kelly and Adam take UVA's DiAs artificial pancreas system home 24/7 for a three-month study. Their key takeaways, surprises, and next steps.
Key Questions for the Artificial Pancreas
Are patient expectations too high? If we expect too much out of first-generation artificial pancreas systems – e.g., "I don't have to do anything to get a 6.5% A1c with no hypoglycemia" – we might be disappointed. Like any new product, early versions of the artificial pancreas are going to have their glitches and shortcomings. Undoubtedly, things will improve markedly over time as algorithms advance, devices get more accurate and smaller, insulin gets faster, infusion sets improve, and we all get more experience with automated insulin delivery. But it takes patience and persistence to weather the early generations to get to the truly breakthrough products. We would not have today's small insulin pumps without the first backpack-sized insulin pump; we would not have today's CGM without the Dexcom STS, Medtronic Gold, and GlucoWatch; we would not be walking around with smartphones were it not for the first brick-sized cellphones. This trial recalibrated our expectations a bit – these systems are going to be an absolutely terrific advance for many patients, but they will not replace everything out of the gate. Let's all remember that devices need to walk first, then run, and it's okay if the first systems are more conservative from a safety perspective.
Overnight-only or 24-hour? There is some debate in the field on this topic, since some believe a night-only system brings additional challenges – e.g., What if someone wears the night-only system during the day? What about people who work the night-shift? Such challenges would not be present during the day, and as this study showed, 24-hour systems do work! However, daytime closed-loop brings higher patient expectations (we can see what the system is doing!) and other unique challenges, such as meals and exercise. The idea of an overnight-only system first is somewhat attractive, especially to build early experience and get an easy win – closed-loop systems at night pretty much always beat patients in the real world. For the most part, everyone in the field is developing 24-hour systems, though we imagine some patients will prefer to wear them at night-only.
Insulin-only or insulin+glucagon? Ultimately, we believe that the question is partially one of patient preferences. There will be some patients who may want the extra glycemic control offered by the dual hormone approach and will be willing to accept a bit more risk or a more aggressive algorithm. We believe the Bionic Pancreas could be especially helpful for those with hypoglycemia unawareness, a sizeable percentage of patients. If the Bionic Pancreas makes it to the market by 2018 with insulin and glucagon, some patients will want to give it a try – we believe a range of options is a good thing for people with diabetes, since all systems and products have pros and cons. Ultimately, cost considerations may present the largest factor in adoption. The Bionic Pancreas certainly brings multiple cost elements to consider – glucagon, a dual-chambered pump, custom infusion sets, potentially higher training, etc. It's hard to know at this point how the relative costs/benefits will exactly compare.
What's the right balance between automation and human manual input? The Holy Grail is a fully-automated, reactive artificial pancreas that requires no meal or exercise input. But insulin ideally needs to get faster to make that a reality. For now, daytime systems need to deal with balancing human input with automation, and as discussed above, there's an associated patient learning curve. How much should artificial pancreas systems ask patients to do? How do we ensure patients do not forget how to manage their diabetes ("de-skilling") as systems grow in their automation abilities?
How will academic groups commercialize their devices? This continues to be an open question for groups like the Bionic Pancreas and Cambridge – who will build and supply the devices, secure FDA approval, manufacture, support training and customer service, etc.? As noted above, TypeZero Technologies licensed DiAs to commercialize a closed-loop system. In mid-April, Medtronic also licensed DreaMed's artificial pancreas algorithm, which was developed by an academic group (DREAM) that later formed the startup. Of course, Medtronic has an advantage, since it has both a pump and CGM in-house; other insulin pump companies will not only need an algorithm, but need to find a CGM supplier, such as Dexcom.
What fraction of patients will be willing to wear some type of artificial pancreas system? Right now, many estimate that ~30% of US type 1s wear a pump, and about 10%-15% wear CGM. There are a lot of reasons why that may be the case, including: cost; hassle factor; no perceived benefit; no desire to switch from current therapy; wearing a device on the body; alarm fatigue; etc. Will an artificial pancreas address enough of these challenges to expand the market?
Will healthcare provider embrace closed-loop systems? Today, healthcare providers lose money when they prescribe pumps and CGM. We need to make sure that closed-loop systems make providers' lives easier, not more complicated.
Will there be a thriving commercial environment and reimbursement? It's extremely expensive to develop and test closed-loop systems, and companies will only develop them if there is a commercial environment that supports a reasonable business. Reimbursement is a major part of that, and it's hard to know if insurance companies will pay for closed-loop systems – we likely won't know until there is longer-term data on these devices, especially changes in A1c or severe hypoglycemia. We are optimistic that reimbursement will be there, especially if systems can simultaneously lower A1c and reduce hypoglycemia.


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Live. Play. Eat. Shop. Invest. | Uptown Greenville
SPAZZ FEST VI Explodes with Entrepreneurial Gusto
SPAZZFEST continues the annual tradition of a multi-day, multi-venue event honoring the integrity of Greenville's live music community while celebrating it's established and continually growing music scene. This year, Spazzfest promoters partnered with Uptown Greenville to layer the existing popular event by showcasing the region's entrepreneurial spirit and creative culture. Presentations from business and creative thought leaders, investor pitches from entrepreneurs, and a hack-a-thon were just a few of the events that will take place from Thursday, March 19 – Saturday, March 21, 2105 during SpazzFest. It's a recipe of art meets ideas, which meets innovation, which leads to entrepreneurship in Greenville, NC. The event provides an opportunity for seasoned entrepreneurs to share their knowledge, legacy, and passion with young and brilliant start-ups based in our very own region of eastern NC. It is a platform on which entrepreneurs of all types, whether in the business sector, IT or the arts, can connect with one another, share ideas, talk about processes and next steps, enjoy incredible musical talent, and dream about the possibilities of the future, all in Greenville, NC.
'Trep Talk, March 19th, 5pm – 6pm at Crossbones Tavern with Guest Speaker:
Paul Phillbon, owner and craft brew master of Duck Rabbit Craft Beer
Shark Tank @ SpazzFest March19th from 6pm – 9pm at Crossbones Tavern
Pitch your business idea for up to $4,000 in cash prizes
Register here: http://goo.gl/forms/3z6DXMtywh
Hack-a-Thon, March 21, 10am – 10pm, eAudit
Develop a mobile app with some of the area's best coders!
Register at: http://hackathon.eaudit.com/
Golden Tickets to Spazz Fest V are available for purchase at www.spazz-fest.com, as well as The @ Limelight @ Tipsy Teapot and East Coast Music and Video in Greenville. For $50 these tickets include: entrance to all shows every day/night of Spazz Fest, admittance to the Opening Day Barbeque, access to VIP after-party perks, free Sunday morning Endurance Brunch at The Tipsy Teapot.
Spazz Fest operates as a not-for-profit festival directly benefits the performing artists, with additional proceeds being donated to independently owned small businesses and local organizations in Eastern North Carolina.


text:
Weird Wars Rome is a setting and campaign book of adventures of violence and horror in the ancient world, for use with Savage Worlds. It includes new rules for Spoils of War, Campaign Interludes, and Legacies that allow characters to pass down their deeds and treasures to future generations of their bloodline. For War Masters it also also includes a comprehensive Adventure Generator and two mini-Plot Point Campaigns.
Since 2011 I have backed roughly thirty-six roleplay and gaming related kick-starters, many of which we have plugged here on miskatonic.co.uk and indeed back in september, tucked away in a post mainly about an Ice Cream card game we gave the then recently funded Weird Wars Rome a very quick mention. We mentioned it then because unlike most of the others they appeared to be on track to hit their delivery targets, a real rarity when it comes to creative Kickstarter projects (the Ice Cream card game coincidentally was another that delivered bang to schedule). Within days of the Weird Wars Rome Kickstarter completing backers received their PDF copies of the core book and the updates and add ons kept coming. I'm now just waiting for my hard copies to drop through the mailbox and I am incredibly pleased with what has been delivered as a part of this Kickstarter.
The Weird Wars Rome products are now available online to buy through DriveThruRPG or directly from the Pinnacle Store, and so we thought it would be an appropriate time to look a bit more in depth at why you might think about buying a copy!
The PDF core book runs to approximately 100 pages and splits almost equally into two sections, the latter of the two being specifically designed for the War Master (or GM by any other name).
The first half of the book provides key background for players and War Masters alike detailing life in the legions covering everything from daily practicalities of roman military life, through to tactics and politics. Then more of the mechanics of creating your characters. Those familiar with Savage worlds will get everything that they would expect, including a step by step guide to character creation with all of the necessary new occupations, hinderances and edges specific to the milieu. There is an excellent section on equipment for your characters, covering hand to hand and ranged weapons, mundane equipment as well as vehicles such as chariots and galleys and specifics of a number of typical roman siege engines. The first half concludes with some solid historical background material, a gazetteer style overview of the empire and a glossary which will help you and your players make the most of the specific terms that apply to this period.
For the War Master There are additional background hooks, details of campaign interludes, and enough campaign and historical background to allow the War Master to have a good level of comfort with the setting. There are two plot point campaign scenarios; Romes Nightmare and Mountains of Blood which along with the Adventure Generator and the accompanying Bestiary should give War Masters more than enough material to get them started and to introduce their players to the unspoken horrors of the Roman Empire.
Throughout the book good use is made of callouts or sidebar boxes to draw attention to specific points, to answer likely questions or to provide additional information. This can be anything from roman names, to use of female characters or more general historic material such as details of the Roman Emperors and their reigns.
The artwork is high quality, as we come to expect from from games from Pinnacle Entertainment Group. It is clear and evocative and used appropriately throughout the text. Similarly the styling of the pages is nicely done with the aforementioned callouts or sidebars presented in boxes resembling Roman shields.
The core Kickstarter allowed Pinnacle to push ahead with the publication of the core book, specifically the printing of it, but also several additional products to support it –including two double-sided, dry-erase poster maps, custom dice, GM's Screen, and the adventure, Nox Germanica included with the GM screen. Stretch goals, which fell like flies during the early stages of the Kickstarter also facilitated a number of great add ons, all of which are available now for purchase:
- The Weird Wars Rome original soundtrack, "Strength & Honor." which really is fabulously evocative background music to play your game or campaign by.
- The Wellspring, a 12-page adventure set in Britannia 166 AD. The Picts have pushed the legions back to Hadrian's Wall. During the day painted barbarians engage with arrows, spears, and skirmish attacks, seeming to appear as if by magic, then fade into the undergrowth. At night, fellow legionaries vanish and strange cries are heard on the wind. Legion IX is on edge. They've been pushed hard, and are ready to push back. Someone must find the source of the Picts' strength–and destroy it.
- Ten full-color, full-page, ready-to-play archetypes.
- Printable, interior overlays you can print and use with the poster map sets.
- Res Romana: An 8-page supplement by Jack Emmert (of Cryptic Studios) on the role of class and race, the gods, and myths and legends of ancient Rome.
- Creature Feature: Art, background, statistics, Figure Flat, and several adventure seeds featuring the legendary Hydra!
- The Half-Set Sun, a 12-page adventure set in the scorching deserts of Aegyptus.
- Creature Feature: Art, background, statistics, Figure Flat, and several adventure seeds featuring The Cyclops!
- Figure Flats I –Heroes of the Empire: Two full pages of "paper miniatures" including legionaries, medici, and auxilia.
- Figure Flats II –Foes of the Empire: Two full pages of the many foes of Rome, from wild Celts to German barbarians and even charioteers!
I've had the joy, over the last six months or so to see all of this material as it has been produced off the back of the Kickstarter project and it has been a really great set of materials to get my teeth into. When I backed the project I was probably getting a bit jaded with Kickstarter projects that just seem to drag on and on and where updates to expectant backers are few and far between but this one was a breath of fresh air and really has delivered. I'm looking forward to running games of Weird Wars Rome and I'm also looking forward to backing the next Kickstarter that Pinnacle decide to run. I take my hat off to Shane Hensley and everyone who worked on this, its a great setting and its been a real pleasure being able to back it through Kickstarter.
Ia! F'tagn!


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