The Subject Position in Brazilian Portuguese: the Embedding of a Syntactic Change

One remarkable difference between European and Brazilian Portuguese is related with the setting of the Null Subject Parameter (NSP). While European Portuguese (EP) behaves like a prototypical romance null subject language, contemporary Brazilian Portuguese (BP) is a partially pro-drop system (Duarte 1995; Kato 2000), with preferably overt referential subjects and null expletive subjects in finite clauses, a procedure consistent with a discourse orientation shown by BP (Kato and Duarte 2003). The aim of this paper is to show that the subject position of non-finite clauses begins to show some “side effects” or “by-products” of the ongoing process of change. Our analysis will compare the position of arbitrary subjects of infinitival sentences in EP and BP inspired by the diachronic analysis of Cavalcante (2006) of such structures in Classical Portuguese (from the 16th to the 18th century) and Modern European Portuguese (19th century). According to Cavalcante’s analysis, the use of impersonal clitic SE in variation with a null arbitrary subject in infinitival sentences declines from 20% in Classical Portuguese to 10% in Modern European Portuguese. The examples below illustrate the possible representations of the arbitrary “external argument” of the infinitive: EXAMPLE (1a-c) (1a) illustrates the empty subject; in (1b), the clitic SE could be interpreted as a nominative SE and in (1c), as a passive SE, since the inflected infinitive agrees with the internal argument of abreviar (to shorten). In each case, however, the external argument is suspended and has arbitrary interpretation. The same patterns can be found with tough-movement constructions. In this paper we compare contemporary Brazilian and European Portuguese, using samples from speech and writing. The results for the speech samples reveal that (a) EP exhibits the same pattern observed in the 19th century data (an average of 8% of clitic se); (b) BP, on the other hand, shows an increasing tendency to use overt subjects, specially the nominative pronoun você (you) in variation with impersonal clitic SE, some of the strategies used for arbitrary reference in finite clauses (Kato & Tarallo 1986; Duarte, Barbosa & Kato 2001 among others), a clear evidence of the embedding of the process of change in progress: EXAMPLE (2) As for the written language, a more similar behavior is found for both varieties. Since Brazilian traditional grammars have been built according to the 19th century EP, the rates of clitic SE are close to the ones found for Modern and Contemporary EP and the use of nominative pronouns is extremely rare. A qualitative analysis of se-constructions shows, however, that in EP, the clitic assures an arbitrary reading of the infinitival subject; in BP, on the other hand, such a constraint does not apply

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt