Composing musical branes

This paper presents the compositional logic of my most recent piece, braneworlds, a 15-minute work for seven musicians, according to three basic concepts: musical space, polymorphic counterpoint, and ‘branes’, as inspired by the popular book Warped Passages by experimental physicist Lisa Randall. The idea of musical space is outlined, in which musical parameters—conceived broadly as variable characteristics of music—are taken as dimensions and each work may define its own set of basic dimensions. Musical identities or objects are formed, located at different points within this space. The idea of ‘polymorphic counterpoint’, in which larger-scale internally-elaborated musical structures, rather than lines or points, are superimposed, is drawn upon as a method for exploring in a particularly direct manner the different degrees of identity and difference between objects along the different dimensions. To give this a clear structure across time, the work draws upon the concept of ‘branes’—lower-dimensional ‘slices’ of higher-dimensional realities—from theoretical physics. This is metaphorically adopted in this work to mean musical structures that are fixed for the duration of the work on one or more parameters, but free with regard to others. In braneworlds, four core parameters are chosen to construct the musical space: temporal division, register, pitch, and dynamic contour. Within these, four branes are constructed to which groups of instruments are assigned. These branes fix these instrumental groups with regard to two parameters, but allow them freedom with regard to the other parameters. The branes are also constructed in a complementary sense, such that different groups occupy different ‘ends’ of the musical space, denying the possibility of a number of textures, but also allowing for a wide exploration of identity and difference. In the course of composing the work, a number of weaknesses and gaps in the compositional logic were uncovered, such as the problem of intermediate values, hierarchies of parameters, and the impact of the sectional form on identity relations. Nonetheless, the logic of the construction of braneworlds provides a relatively systematic way of exploring possible relations of identity and difference between musical objects within a constrained space

Indifference and determination: Kant’s concept/intuition distinction and Hegel’s doctrine of being

This thesis considers Kant’s concept/intuition model of objective determination [Bestimmung] as presented in the Critique of Pure Reason (1781/87) and Hegel’s critical transformation of that model in “The Doctrine of Being,” the first book of the Science of Logic (1812-16/32). Although subject to competing interpretation, the Critique’s “Transcendental Logic” advances the “togetherness principle,” namely, that both intuitional representations (logically characterised by singularity and immediacy) and concepts (mediate and general representations) are required for determinate cognition of empirically real objects. It is often claimed that Hegel’s Logic vitiates this principle via a conceptualist reduction of intuition to conceptual form. I argue that this view misses a central motivation of the Doctrine of Being (or “Being Logic”). My thesis is that the Being Logic begins by ontologically generalising the logical structure of Kant’s concept/intuition distinction, deriving from the being of thought the inseparability of mediation and immediacy in any determinacy whatsoever. From this understanding of determinacy, the Being Logic then derives the minimal logical form of the qualitative determination of singular immediacies (or “somethings”). For Hegel, something in its immediacy is “indifferent” [gleichgültig] to other such somethings in the sense that they cannot be qualitatively distinguished. Hegel follows Kant’s Transcendental Logic in arguing that qualitative determination requires the conceptual mediation of singular somethings; unlike Kant, Hegel accounts for such mediation without constitutive reference to conceptuality understood as an independently articulable propositional form. Thus, rather than advance a one-sided conceptualism, Hegel’s Doctrine of Being provides a logical corrective to Kant’s tendency to present the respective cognitive contributions of concepts and intuitions as independently determinate, as well as to “two-stage” interpretations of Kant that argue for some form of concept/intuition separability. Instead, Hegel’s Being Logic constitutes a systematic derivation and ontological generalisation of Kant’s togetherness principle

Application of classic grounded theory in nursing studies: A qualitative systematic review protocol

Introduction Classic grounded theory (CGT) is a valuable method for nursing research, but the application of CGT methodology in nursing studies has not been specifically investigated. With the increasing use of CGT in nursing research, attention is now focusing on the quality of studies using this methodology. In this systematic review, we aim to develop an understanding of the application of CGT methodology, specifically appraising the quality of the methodology\u27s application in the field of nursing research. Methods and analysis The reporting of this review will be guided by the Preferred Reporting Items for Systematic and Meta-Analysis guidelines statement and data synthesis guided by the Synthesis Without Meta-analysis guideline. Publications will be uploaded to Rayyan. The quality of each article will be assessed using the Critical Appraisals Skills Programme qualitative research appraisal tool. Analysis of the selected studies will be performed using the Guideline for Reporting and Evaluating Grounded Theory Research Studies, explicitly the CGT guiding principles. Ethics and dissemination Ethical approval is not required because only secondary data will be used in this review. The results of the final study will be published in a peer-reviewed open-access journal

Ethanol for preventing preterm birth in threatened preterm labor

Background Preterm birth is the leading cause of death and disability in newborns worldwide. A wide variety of tocolytic agents have been utilized to delay birth for women in preterm labor. One of the earliest tocolytics utilized for this purpose was ethanol infusion, although this is not generally used in current practice due to safety concerns for both the mother and her baby. Objectives To determine the efficacy of ethanol in stopping preterm labor, preventing preterm birth, and the impact of ethanol on neonatal outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2015) and reference lists of retrieved studies. Selection criteria We included randomized and quasi-randomized studies. Cluster-randomized trials and cross-over design trials were not eligible for inclusion. We only included studies published in abstract form if there was enough information on methods and relevant outcomes. Trials were included if they compared ethanol infusion to stop preterm labor versus placebo/control or versus other tocolytic drugs. Data collection and analysis At least two review authors independently assessed studies for inclusion and risk of bias. At least two review authors independently extracted data. Data were checked for accuracy. Main results Twelve trials involving 1586 women met inclusion criteria for this review. One trial did not report on the outcomes of interest in this review. Risk of bias of included studies: The included studies generally were of low quality based on inadequate reporting of methodology. Only three trials had low risk of bias for random sequence generation and one had low risk of bias for allocation concealment and participant blinding. Most studies were either high risk of bias or uncertain in these key areas

Support for mothers, fathers and families after perinatal death (Review)

Backgroun

Vaginal progesterone pessaries for pregnant women with a previous preterm birth to prevent neonatal respiratory distress syndrome (the PROGRESS Study): A multicentre, randomised, placebo-controlled trial

Published: September 26, 2017Background: Neonatal respiratory distress syndrome, as a consequence of preterm birth, is a major cause of early mortality and morbidity. The withdrawal of progesterone, either actual or functional, is thought to be an antecedent to the onset of labour. There remains limited information on clinically relevant health outcomes as to whether vaginal progesterone may be of benefit for pregnant women with a history of a previous preterm birth, who are at high risk of a recurrence. Our primary aim was to assess whether the use of vaginal progesterone pessaries in women with a history of previous spontaneous preterm birth reduced the risk and severity of respiratory distress syndrome in their infants, with secondary aims of examining the effects on other neonatal morbidities and maternal health and assessing the adverse effects of treatment. Methods: Women with a live singleton or twin pregnancy between 18 to <24 weeks' gestation and a history of prior preterm birth at less than 37 weeks' gestation in the preceding pregnancy, where labour occurred spontaneously or in association with cervical incompetence or following preterm prelabour rupture of the membranes, were eligible. Women were recruited from 39 Australian, New Zealand, and Canadian maternity hospitals and assigned by randomisation to vaginal progesterone pessaries (equivalent to 100 mg vaginal progesterone) (n = 398) or placebo (n = 389). Participants and investigators were masked to the treatment allocation. The primary outcome was respiratory distress syndrome and severity. Secondary outcomes were other respiratory morbidities; other adverse neonatal outcomes; adverse outcomes for the woman, especially related to preterm birth; and side effects of progesterone treatment. Data were analysed for all the 787 women (100%) randomised and their 799 infants. Findings: Most women used their allocated study treatment (740 women, 94.0%), with median use similar for both study groups (51.0 days, interquartile range [IQR] 28.0-69.0, in the progesterone group versus 52.0 days, IQR 27.0-76.0, in the placebo group). The incidence of respiratory distress syndrome was similar in both study groups-10.5% (42/402) in the progesterone group and 10.6% (41/388) in the placebo group (adjusted relative risk [RR] 0.98, 95% confidence interval [CI] 0.64-1.49, p = 0.912)-as was the severity of any neonatal respiratory disease (adjusted treatment effect 1.02, 95% CI 0.69-1.53, p = 0.905). No differences were seen between study groups for other respiratory morbidities and adverse infant outcomes, including serious infant composite outcome (155/406 [38.2%] in the progesterone group and 152/393 [38.7%] in the placebo group, adjusted RR 0.98, 95% CI 0.82-1.17, p = 0.798). The proportion of infants born before 37 weeks' gestation was similar in both study groups (148/406 [36.5%] in the progesterone group and 146/393 [37.2%] in the placebo group, adjusted RR 0.97, 95% CI 0.81-1.17, p = 0.765). A similar proportion of women in both study groups had maternal morbidities, especially those related to preterm birth, or experienced side effects of treatment. In 9.9% (39/394) of the women in the progesterone group and 7.3% (28/382) of the women in the placebo group, treatment was stopped because of side effects (adjusted RR 1.35, 95% CI 0.85-2.15, p = 0.204). The main limitation of the study was that almost 9% of the women did not start the medication or forgot to use it 3 or more times a week. Conclusions: Our results do not support the use of vaginal progesterone pessaries in women with a history of a previous spontaneous preterm birth to reduce the risk of neonatal respiratory distress syndrome or other neonatal and maternal morbidities related to preterm birth. Individual participant data meta-analysis of the relevant trials may identify specific women for whom vaginal progesterone might be of benefit. Current Clinical Trials ISRCTN20269066.Caroline A. Crowther, Pat Ashwood, Andrew J. McPhee, Vicki Flenady, Thach Tran, Jodie M. Dodd, Jeffrey S. Robinson, for the PROGRESS Study Grou

Making stillbirths count, making numbers talk - issues in data collection for stillbirths.

BACKGROUND: Stillbirths need to count. They constitute the majority of the world's perinatal deaths and yet, they are largely invisible. Simply counting stillbirths is only the first step in analysis and prevention. From a public health perspective, there is a need for information on timing and circumstances of death, associated conditions and underlying causes, and availability and quality of care. This information will guide efforts to prevent stillbirths and improve quality of care. DISCUSSION: In this report, we assess how different definitions and limits in registration affect data capture, and we discuss the specific challenges of stillbirth registration, with emphasis on implementation. We identify what data need to be captured, we suggest a dataset to cover core needs in registration and analysis of the different categories of stillbirths with causes and quality indicators, and we illustrate the experience in stillbirth registration from different cultural settings. Finally, we point out gaps that need attention in the International Classification of Diseases and review the qualities of alternative systems that have been tested in low- and middle-income settings. SUMMARY: Obtaining high-quality data will require consistent definitions for stillbirths, systematic population-based registration, better tools for surveys and verbal autopsies, capacity building and training in procedures to identify causes of death, locally adapted quality indicators, improved classification systems, and effective registration and reporting systems

Modeling the dynamic rupture propagation on heterogeneous faults with rate- and state-dependent friction

We investigate the effects of non-uniform distribution of constitutive parameters on the dynamic propagation of an earthquake rupture. We use a 2D finite difference numerical method and we assume that the dynamic rupture propagation is governed by a rate- and state-dependent constitutive law. We first discuss the results of several numerical experiments performed with different values of the constitutive parameters a (to account for the direct effect of friction), b (controlling the friction evolution) and L (the characteristic length-scale parameter) to simulate the dynamic rupture propagation on homogeneous faults. Spontaneous dynamic ruptures can be simulated on velocity weakening (a < b) fault patches: our results point out the dependence of the traction and slip velocity evolution on the adopted constitutive parameters. We therefore model the dynamic rupture propagation on heterogeneous faults. We use in this study the characterization of different frictional regimes proposed by Boatwright and Cocco (1996) based on different values of the constitutive parameters a, b and L. Our numerical simulations show that the heterogeneities of the L parameter affect the dynamic rupture propagation, control the peak slip velocity and weakly modify the dynamic stress drop and the rupture velocity. Moreover, a barrier can be simulated through a large contrast of L parameter. The heterogeneity of a and b parameters affects the dynamic rupture propagation in a more complex way. A velocity strengthening area (a > b) can arrest a dynamic rupture, but can be driven to an instability if suddenly loaded by the dynamic rupture front. Our simulations provide a picture of the complex interactions between fault patches having different frictional properties and illustrate how the traction and slip velocity evolutions are modified during the propagation on heterogeneous faults. These results involve interesting implications for slip duration and fracture energy

Association between maternal sleep practices and late stillbirth – findings from a stillbirth case‐control study

Objective: To report maternal sleep practices in women who experienced a stillbirth compared to controls with ongoing live pregnancies at similar gestation. Design: Prospective case-control study. Setting: 41 maternity units in the United Kingdom. Population: Women who had a stillbirth ≥28 weeks’ gestation (n=291) and women with an ongoing pregnancy at the time of interview (n=733). Methods: Data were collected using an interviewer-administered questionnaire which included questions on maternal sleep practices before pregnancy, in the four weeks prior to and on the night before the interview/stillbirth. Main outcome measure: Maternal sleep practices during pregnancy. Results: In multivariable analysis, supine going-to-sleep position the night before stillbirth had a 2.3-fold increased risk of late stillbirth (adjusted Odds Ratio (aOR) 2.31, 95%CI 1.04-5.11) compared to the left side. In addition, women who had a stillbirth were more likely to report sleep duration less than 5.5 hours on the last night (aOR 1.83, 95%CI 1.24-2.68), getting up to the toilet once or less (aOR 2.81, 95%CI 1.85-4.26) and a daytime nap every day (aOR 2.22, 95%CI 1.26-3.94). No interaction was detected between supine going-to-sleep position and a small for gestational age infant, maternal body mass index or gestation. The population attributable risk for supine going-to sleep position was 3.7% (95% CI 0.5-9.2). Conclusions: This study confirms that supine going-to-sleep position is associated with late stillbirth. Further work is required to determine whether intervention(s) can decrease the frequency of supine going to sleep position and the incidence of late stillbirth

How do late terminations of pregnancy affect comparisons of stillbirth rates in Europe? Analyses of aggregated routine data from the Euro-Peristat Project

Objective: To describe how terminations of pregnancy at gestational ages at or above the limit for stillbirth registration are recorded in routine statistics and to assess their impact on comparability of stillbirth rates in Europe. Design: Analysis of aggregated data from the Euro-Peristat project. Setting: Twenty-nine European countries. Population: Births and late terminations in 2010. Methods: Assessment of terminations as a proportion of stillbirths and derivation of stillbirth rates including and excluding terminations. Main outcome measures: Stillbirth rates overall and excluding terminations. Results: In 23 countries, it is possible to assess the contribution of terminations to stillbirth rates either because terminations are rare occurrences or because they can be distinguished from spontaneous stillbirths. Where terminations were reported, they accounted for less than 1.5% of stillbirths at 22+ weeks in Denmark, between 13 and 22% in Germany, Italy, Hungary, Finland and Switzerland, and 39% in France. Proportions were much lower at 24+ weeks, with the exception of Switzerland (7.4%) and France (39.2%). Conclusions: Terminations represent a substantial proportion of stillbirths at 22+ weeks of gestation in some countries. Countries where terminations occur at 22+ weeks should publish rates with and without terminations in order to improve international comparisons and the policy relevance of stillbirth statistics. Tweetable abstract: For valid comparisons of stillbirth rates, data about late terminations of pregnancy are needed