Unfinished Symphony Research Articles

IMPACT OF REPLACEMENT COAL AND FOSSIL ENERGY BY NUCLEAR ENERGY ON GLOBAL GREENHOUSE GASES EMISSION

Climate change has become one of the important matters that worry humanity worldwide, until local seminars and international conferences have been held for it at the highest levels, such as the level of heads of state. What is worrying about climate change is the increase in the average global temperature until it soon reaches the age of mankind, which has reached 1.5 degrees Celsius until the year 2033 and 2 degrees Celsius until the year 2059, as an inevitable result of the increase in carbon emissions resulting from electricity generation, industry and vehicle exhaust, which were estimated at about 1000 gigabytes of tons until the year 2060, in which the production of electrical energy contributes by more than 50%. On the other hand, the unjust encroachment on forests, this is the lung of the world. Since electric power generation is responsible for more than half of the global emissions of carbon gases, this research aims to study the carbon emissions resulting from electric power generation with the scenarios of Unfinished Symphony, Modern Jazz and Hard Rock, and trying to reduce the carbon emissions resulting from electric power generation by replacing electricity generation with nuclear energy as an alternative to coal all types, as well as petroleum (fossil fuels), with the stability of the use of natural gas and new and renewable energies according to previous scenarios until the year 2060. The result was, according to the Unfinished Symphony scenario, emissions were about 591.9 gigatons. In contrast, when using nuclear energy as an alternative, the contribution of electricity production by 65% cancels out the improvement in the amount of carbon emissions by 75.1%, with a carbon dioxide productivity of 146.8 gigatons. According to the Jazz scenario, emissions were about 632.1 gigatons. In contrast, when using nuclear energy as an alternative, the contribution of electricity production is 65%, which cancels out the improvement in the amount of carbon emissions by 75.2%, with a carbon dioxide productivity of 156.8 gigatons. According to the Hard Rock scenario, emissions were about (643.3) gigatons. In contrast, when using nuclear energy as an alternative, the contribution of electricity production is 65%, which cancels out the improvement in the amount of carbon emissions by 74.87%, with a production of carbon dioxide that amounted to 161.6 gigatons.

Unfinished symphony

Unfinished symphony

Reply to letters to the editor entitled "Bias, the unfinished symphony" and "Bias estimation for Sigma metric calculation: arithmetic mean versus quadratic mean".

Reply to letters to the editor entitled "Bias, the unfinished symphony" and "Bias estimation for Sigma metric calculation: arithmetic mean versus quadratic mean".

Ментори та Інґеборґ Бахман: письменницька майстерня успішного старту

The article studies the image of a mentor for the development of a novice author on the example of the work of the successful Austrian writer Ingeborg Bachmann (1926–1973). The role of a tutor is analysed from her first texts to the status of a Viennese intellectual in the middle of the 20th century. The direct influence of older writers and artists from the same generation on the formation of her author’s style is gradually investigated. The figure of the first mentor, the Carinthian writer and teacher Joseph Friedrich Perkonig is emphasized in the example of her early story “The Cross of Hondich” („Das Honditschkreuz”, 1943/1944) and “Letters to Felician” („Briefe an Felician”, 1946). The figure of the second mentor, the Austrian repatriate writer Hans Weigel and his writing workshop (“Group 50”) is examined. Attention is focused on H. Weigel’s autobiographical novel “Unfinished Symphony” („Unvollendete Symphonie”, 1951) and I. Bachman’s first novel “Nameless City” („Stadt ohne Namen”) on his consulting during 1947–1952. Attention is turned to the I. Bachman’s acquaintance with Paul Celan in Vienna, started the artistic dialogue between two young authors: the collection of poems “Deferred Time” („Die gestundete Zeit”, 1953) and “Invocation to the Big Dipper” („Anrufung des großen Bären”, 1956) by I. Bachman and “Poppy and Memory” („Mohn und Gedächtnis”, 1952) by P. Celan. The parallel correspondence of the author with H. Weigel and P. Celan is also compared. We study the role of Hans Werner Richter, the leader of the prominent “Group 47”, whose prize (1953) finally convinced the young author to become a professional writer. Communication with the German composer Hans Werner Henze is stressed as a coexistence of “twins in spirit” and successful intermedial tandem.

Bias, the unfinished symphony.

In laboratory medicine, mathematical equations are frequently used to calculate various parameters including bias, imprecision, measurement uncertainty, sigma metric (SM), creatinine clearance, LDL-cholesterol concentration, etc. Mathematical equations have strict limitations and cannot be used in all situations and are not open to manipulations. Recently, a paper “Bias estimation for Sigma metric calculation: Arithmetic mean versus quadratic mean” was published in Biochemia Medica. In the paper, the author criticized the approach of taking the arithmetic mean of the multiple biases to obtain a single bias and proposed a quadratic method to estimate the overall bias using external quality assurance services (EQAS) data for SM calculation. This approach does not fit the purpose and it should be noted that using the correct equation in calculations is as important as using the correct reagent in the measurement of the analytes, therefore before using an equation, its suitability should be checked and confirmed.

“America, You Great Unfinished Symphony”: Hamilton: An American Musical and the Challenge of Civic Education

With widespread, sustained popularity, Hamilton: An American Musical has become a significant resource for and cultural source of American civic education. The wide-ranging assessments of the Broadway phenomenon exemplify contemporary polarized debates over American history and civic education. However, this article argues that the musical’s account of the American founding has potential to address that polarization. Hamilton depicts America as a “great unfinished symphony,” offering an aspirational understanding of American principles and an appreciative account of the founding. Yet it acknowledges the distance between America’s principles and practices, encouraging further reflection by foregrounding the issue of race in American history. Finally, while some scholars criticize its “Great Man” approach to history, the musical invites its audience to consider the role of leaders and the importance of their character in composing the “great unfinished symphony” that is America.

Long-term factors and trends in the development of the fuel and energy complex of Ukraine

The objective of the paper is to define long-term trends and factors in the development of the world energy industry and their refraction to Ukrainian realities. The article consists of an introduction, three sections, namely: the main trends in the development of the global fuel and energy complex, analysis of the current state, long-term trends and factors in the development of the national fuel and energy complex of Ukraine. Conclusions end the paper. As for the world energy sector it is shown that its modern changes – Grand Transit – are due to the ideology of sustainable development and have the character of an extraordinary change in the technocenosis, the transition from the use of fossil fuels to energy from renewable sources, mainly – wind and photovoltaic nature. Along with the major tendencies of the Great Transition, there is also the trilemization and politicization of energy sector. Trilemization components are: Energy Security, Energy Equity and Environmental Sustainability. There are three scenarios for the development of the global energy – Unfinished Symphony, Modern Jazz and Hardrock, distinguished by the degree of greening and the availability of energy resources. Political motives are becoming more and more significant at all levels – from global to local. Major players are lobbying their interests, there is an activity of structures from the field of nuclear energy, powerful fuel companies, owners of gas transportation and gas distribution infrastructure. In Ukraine, transformation processes are taking place against the backdrop of low environmental acceptability and high depreciation of fuel and energy sector facilities and infrastructure, political and economic instability. The requirements of decarbonization create challenges to the very existence of coal energy, which is the main component of the energy generating fund of the country and the regions, where mines are located. Options for the development of hydrogen/ammonia energy in the form of vertically integrated energy-chemical systems with the nuclear power plants and reformed coal-fired thermal power plants are considered as promising; energy diversification of mining regions; the creation of virtual power plants based on hydrodynamic water heating installations.

Inside the Creaking Baobab in Sindiwe Magona’s When the Village Sleeps (2021)

Bookended by the life of Busisiwe Mhkonto, When the Village Sleeps can be read as an “unfinished symphony”. The musicological analogy is bolstered by the harmonisation of the polyphonic voice register, coupled with the “unachieved” or the “yet to be achieved” implied in Sindiwe Magona’s wake-up call towards education for life. This article is predicated on Milan Kundera’s three categories of the art of the novel—the art of radical divestment, the art of novelistic counterpoint, and the art of the specifically novelistic essay—which, in turn, determine the progression of my argument. This is no dystopian novel— Magona looks beyond the precarity that she depicts in this metatext for uplifting instances that epitomise the central tropes of ubuntu and self-sufficiency. Ultimately, this is a story about youth advocacy that culminates in a programme to teach self-help through a broad-based notion of education for living in South Africa. Magona’s proposed reparation seeks to define a new cultural nationhood through an awakened imaginary.

Review: Battle Green Vietnam: The 1971 March on Concord, Lexington, and Boston, by Elise Lemire

Review: <i>Battle Green Vietnam: The 1971 March on Concord, Lexington, and Boston</i>, by Elise Lemire

Completing the Great Unfinished Symphony of Cancer Together: The Importance of Immigrants in Cancer Research

Recent changes in U.S. immigration policy are adversely affecting biomedical science, at a time when biomedical research is most sorely needed on multiple fronts. Here we discuss the immense contributions of immigrants to cancer research and the adverse impact that current administration policies will have on successful cancer research.

Третий фортепианный концерт П. И. Чайковского и проблема цикличности

The article examines one of Piotr Tchaikovsky’s last compositions – the Concerto for Piano and Orchestra No. 3, its creation, comprehension and performance. The genre-related and, as a result, the cyclic issues of this compositions not possessing univocal interpretation in contemporary scholarly literature come out to the foreground. Having been relegated to the periphery of performance practice, the Third Piano Concerto has acquired the reputation of an “unsuccessful composition” and has disappeared from the repertoire of pianists for a lengthy period of time. However, the interest in its “symphonic prototype” – the unfinished symphony in E-flat major – as well as its edition by Semyon Bogatyryov and its performance have once again aroused interest in the concerto. The issue of cyclicity of this composition has substantially become sharpened: some performers incline towards the one-movement version, while others prefer the three-movement version. In this context the necessity arose of carrying out the analysis of the authorial genre-related terminology and the attention towards epistolary material (letters of Piotr and Modest Tchaikovsky, Alexander Siloti, Sergei Taneyev, Mitrofan Belyayev), which had direct connection to the fate of the Third Piano Concerto. The outcome of the work was the conclusion about the validity of the existence of the three-movement version as the Third Piano Concerto, while the genre status of the one-movement must be reexamined. Keywords: Tchaikovsky’s Third Piano Concerto, Andante and Finale, Konzertstuck, unfinished symphony, Louis Diemer, late romantic art.

(Ne)poznati skladatelj Marcel Tyberg (1893-1944)

Marcel Tyberg (1893-1944) composer, organist and music teacher, was born into a musical family of Polish origin in Vienna, Austria. In the year 1910, the Tyberg family moved away from Vienna and settled in Volosko, a resort on the Kvarner Bay, at that time part of the Austrian territory of the Austro-Hungarian Empire. Tyberg and his wife had performed in Opatija in the year 1903, before having moved there. Marcelo Tyberg, the father, was the principal teacher of the »Hertzka« music school in Vienna (1881-1882), orchestra leader at the Regional Theatre and the headmaster of the music school (1983-1987) in Lemberg, the capital at that time of the Austrian Province of Galicia, today’s Lavov in Ukraine. Wanda Tyberg was an accomplished pianist with a rich concert career. She studied in Vienna in the class of the famous pianist Theodor Leschetizky. The first performances of Marcel Tyberg’s works were recorded in the early 1920s, when his mother Wanda Tyberg performed his Sonata and Legend for Piano, while the Rijeka branch of the Italian Orchestral Association performed his first orchestral piece, Symphony No. 1 in C Minor at the G. Verdi Municipal Theatre in Rijeka. Marcel Tyberg left an imposing music opus, three Symphonies, a Scherzo and Finale for Schubert’s Unfinished Symphony, Masses, one Piano Trio, two Piano Sonatas, two Studies for Piano, a Legend for Piano, a String Sextet, 36 Solo Songs, a Te Deum for Choir, Soloists and Organ, and other compositions. From 1938, his musical activities become overshadowed by the daily repressive and persecuting practices of the Italian Kingdom Fascist regime. Namely, in February 1939, due to the Jewish origin of one of his parents and in spite of his being Catholic, Marcel Tyberg was entered into the Fascist registry of the »Jewish race« for the Municipality of Opatija. It was on the basis of this evidence that he was arrested in Opatija on 4 July 1944, during the period of German occupation which had been established in the autumn of 1943. Soon afterwards, he was deported to the Nazi camp Risiera di San Sabba in Trieste, and then to the Auschwitz concentration camp. Other details of his Calvary are still unknown. The composer’s musical legacy is in the United States today. Namely, while anticipating a possible deportation, Tyberg allegedly entrusted his works to Milan Mihich, who later immigrated to the U.S. His son, Enrico Mihich, continued safeguarding them. Owing to his efforts, the Tyberg Musical Legacy Fund was later established at the Foundation for Jewish Philanthropies in Buffalo, with the aim of obtaining the funds for their publication. Recent research on the life and work of Marcel Tyberg in the Kvarner region has uncovered the autograph of 26 Preludes for Organ, the work that Tyberg wrote for his Rijeka friends, the pianist Wilma and the organist Remo Venucci.

A Response to Eiko Otake in Four Movements

A Response to Eiko Otake in Four Movements Tyran Grillo (bio) Every moment happens twice: inside and outside, and they are two different histories. —Zadie Smith, White Teeth (2000) 1 History is telepathy. It externalizes the internal, balancing affect and prescription. History is a performative enterprise, and as such requires the comingling of directors and viewers. It is a clash of ocean and continent so destructive that only relics remain to memorialize those who produced them. Few artists more acutely understand that history begins and ends with the body than Eiko Otake, whose dancing feeds on awareness that biographies are at once written across and erased from skins by frictions of possibility. Whereas history attempts to atone for violence, only to taint itself with illusions of seamless distraction, Otake finds herself profoundly dislocated. She upsets the dangers of universality, severing the tidal pull of wholesale philosophies. To place herself somewhere is to participate in the formation of collective experience. In her 2014 piece A Body in Fukushima, Otake traveled to post-3/11 landscapes before revisiting them in 2016. Her interventions undermined documentary impulses with quiet theory. When re-presenting this work to an audience, she treats herself as projection screen, reconfiguring the still image as it hugs itinerant surface, thereby challenging the notion of a stagnant archive. If the body is one link in a chain of scars, then history must be alive, bearing witness to deaths of things. Its choreographies necessitate languages of preservation; its decay slowed to rates undetectable except in retrospect. Otake removes a layer, and with it a barrier to personal experience. She drags her clothing, which like the past leaves her when she lets go. Otake's movements whisper, "I was never alone when I did not exist, for I was omnipresent." She is rescuing her own memory from this state of nothingness, using her comportment to delocalize the flesh. We are caught in her net. 2 History is an unfinished symphony. It thrives on thematic recapitulations, each divergent from those preceding it. History makes time tangible, slotting events into quantifiable sequences to be shaped and moved around in storyboard fashion. It reminds us that invisibility is vital to manifesting survivals of the visible. A flame needs oxygen to burn, and it's [End Page 77] all the body can do to flicker noticeably before its pilot light goes out. Human beings are tenacious when it comes to remembrance. In response, and unraveling any allegiances to the speed of thought, Otake engages with after-images of herself, bodily and spiritually plastic. She knows that depths of expression go as far as the technology of muscles will allow, and that memory is a traumatic clockwork of mortality. Birth is not the beginning of life, but the end of death. It is the resurrection in miniature of every event leading to it, a harbinger of things to come. Even as listening is a form of support, so is remembrance the scaffolding of motion. Things shimmer when recalled, internal organs rippling with the excitement of self-projection. If Otake flits at the edge of poetry, she also toes the line of exposition. Laying her body on a horizontal plane is akin to committing words to page. Both acts position her at a temporal crossroads where speech lets the blood of future compilation. (Even yesterday is drawn with pigments different from today's.) The idea of witnessing pervades nonetheless, as if one could stand beneath skies of the past and feel present in the making of future text. 3 History is an ongoing conversation within and around a body whose parts have tricked themselves into thinking they are independent. Otake has shown us that footprints are more distinct than fingerprints, because they are explicitly part of their environments—proof that ambulation is achievable only in tutti. Every gesture has baggage, its byproducts the indeterminate effluvia of politics. Our discomforts are inherited through shared awareness of finitude. Pressures of human contact are inherent to the voice. Simplicities of details beg for explanation by the very means of their production. We are our own informants, neurons in a greater brain, struggling to build the strongest pathways possible before we forget...

The Unfinished Symphony: Golimumab Therapy for Anti-Tumour Necrosis Factor Refractory Crohn's Disease.

Golimumab is approved for the treatment of moderate-to-severely active ulcerative colitis. However, there have been no formal trials to assess its utility in Crohn's disease [CD]. Our aim was to determine the efficacy and safety of golimumab in patients with anti-tumour necrosis factor [TNF] refractory CD. Patients with CD treated with golimumab between 2010 and 2017 were included in a retrospective observational study. The vast majority of patients failed two anti-TNF agents. Clinical response was defined as a significant reduction in symptoms and biochemical markers of CD, and no requirement for surgery or introduction of immune-suppressants. Forty-five patients were included, with a median follow-up of 22 months [interquartile range 12-34] following initiation of golimumab. Induction and maintenance regimens were generally higher than standard dosing with first month cumulative doses of 400 mg and above in 75% of the patients. Monthly maintenance doses ≥200 mg were administered in 52% of patients. Clinical response at 3 months was achieved in 35/45 [77.7%] patients. The cumulative probabilities that patients with an initial response maintained their clinical response for 12 and 36 months after introduction of golimumab were 81% and 64%, respectively. Endoscopic improvement and mucosal healing at 12 months was achieved in 73% and 47% of patients, respectively. This study demonstrates the efficacy of golimumab in anti-TNF refractory CD patients. Further studies should be performed in CD to formally assess the efficacy of golimumab in a randomized controlled trial and to establish the optimal dosing regimen.

31 The quality improvement QIP – improving multidisciplinary staff engagement with quality improvement in the RVH emergency department

In recent years the RVH Emergency Department (ED) had been under intense pressure and public scrutiny. This led to a demoralised workforce who had become disengaged with quality improvement (QI)....

Works of Louise-Victorine Ackermann: My Life, First Poems, Philosophical Poems - Translated from French and with a Philosophical Essay by Fritz Dufour

Louise Victorine-Ackermann was a French poet. Her works were originally written in French, in verses and in rhymes. But the translations that I propose to you, the reader, are not in rhymes. This is purposely done to keep intact the goal the author wants to accomplish. Any attempt to keep the original format by translating the poems in rhymes would have distorted the work as the new version would be likely to take on new meanings and thus mislead the reader about Ackermann’s true emotions. It would tantamount, on my part, to try to complete an unfinished symphony. In poems, the constitutive elements of a clause are sometimes not ordered. This makes translating poems very challenging. Although I strived to render, to the best of my ability, a faithful translation of the work, at times I couldn’t help to also be transparent, meaning prioritize sense-for-sense translation instead of word for word translation, which is a normal aspect of any translation process. Reading this outstanding work is transcendental. I compare it to walking inside an empty cathedral, sitting by the seaside alone or lying on your back to gaze at the stars on a balmy summer night. I had a unique experience reading My life – First poems – Philosophical poems. I hope you will too. I invite you to enjoy to the last verse this powerful work from Louise-Victorine Ackermann! (Also, please read my essay at the end, starting at page 152 – or you may read it first to better appreciate Ackermann’s work). What, who, where, when, why, and how are probably the immediate questions to which you’d like to have answers if you’re reading this essay. If you’ve read the section entitled My life, I’m assuming you already have an idea regarding the first four questions and you’re more interested in the last two. Let me start by saying there is no simple and clear-cut answer to any of these questions. But, before I get to the above-mentioned questions, I’d like to take the opportunity to say what this essay is, meaning what kind or what form of essay is it, in addition to being philosophical in terms of content. As far as the form is concerned, it’s two-pronged. First, it’s a dialectic essay. On the several topics addressed, I present a thesis – short but to the point – and an argument. Then I attempt to object to my own argument, to which I object with a counterargument, but then I counter the counterargument with a final and new argument. This is a technique called Chinese dragon strategy. Second, the essay is critical. Like the work itself, my arguments, although protean, revolve around a recurring issue: suffering and pain.

P615 The unfinished symphony: golimumab is efficient in patients with refractory Crohn's disease

P615 The unfinished symphony: golimumab is efficient in patients with refractory Crohn's disease

Hamilton’s America: An Unfinished Symphony with a Stutter (Beat)

Hamilton’s America: An Unfinished Symphony with a Stutter (Beat) Ariel Nereson (bio) Hamilton. The Public Theater, New York, April 12, 2015. How does a bastard, orphan, son of a whore and a Scotsman, dropped in the middle of a forgotten Spot in the Caribbean by providence, impoverished, in squalor, Grow up to be a hero and a scholar? Lin-Manuel Miranda is no stranger to success on Broadway—his musical In the Heights garnered him four 2008 Tony Awards and a Grammy Award.1 In 2016 Miranda almost tripled his success: the juggernaut musical Hamilton, for which he wrote the music and lyrics, and starred as Alexander Hamilton, won eleven 2016 Tony Awards, including Best Musical, Best Book, and Best Score.2 Inspired by the historian Ron Chernow’s 2005 biography Alexander Hamilton and beginning as “The Hamilton Mixtape” performed as a short rap by Miranda for President Barack Obama at the White House in 2009,3 Hamilton’s connection to contemporary American politics via its unique perspective on the nation’s founding has garnered the production endless accolades from various popular media outlets and a steady stream of celebrity attendees from Beyoncé and Jay-Z to the Obamas and a slew of Treasury secretaries, including the current secretary, Jacob J. Lew.4 While this review is of the Public Theater production (direction by Thomas Kail, choreography by Andy Blankenbuehler, and music direction by Alex Lacamoire) that enjoyed a thrice-extended run from January 20 to May 3, 2015, much of my commentary remains relevant for its transfer to the Richard Rogers Theatre on Broadway in July 2015, where it continues a sold-out run and has reinvented the concept of the rush line as a performance venue in itself. Since January 2015, Miranda has been awarded a MacArthur “genius” grant, the 2016 Pulitzer Prize for Drama, the 2016 Edward M. Kennedy Prize for Drama [End Page 1045] Inspired by American History, the George Washington Book Prize, and the Original Broadway Cast Recording has won a Grammy and reached number one on the Billboard Rap chart.5 Hamilton’s primary interventions into the story of the founding fathers revolve around casting choices and the use of rap and hip-hop as the dominant musical genres. Both the nontraditional casting and music reinvent dominant modes of storytelling, advancing Miranda’s thesis of “history being up for grabs, and the teller being just as important as the subject.”6 While seemingly universally lauded by popular critics, a recent critical conversation among historians and cultural critics has emerged, positioning two lines of primary inquiry: Hamilton as art/entertainment, and Hamilton as history. Yet these lines continually intersect in the experience of the production, creating a web wherein they produce meaning interdependently, not as fragments, complicating the critical division. Hamilton tells the story of “10-dollar founding father without a father” Alexander Hamilton (Miranda), bookended by two encounters with Aaron Burr (Leslie Odom Jr.): the first meeting between the men in New York City in 1776, where Hamilton seeks Burr’s advice at climbing the political ladder, and the last, their infamous duel in 1804.7 Act 1 addresses the Revolutionary War, act 2 the aftermath of governing. The entire show is sung (rapped, etc.) through, making the cast recording a good option for a relatively complete version of the show if a live Broadway viewing is not in your future. The musical opens with several historical figures—Burr, Jefferson (Daveed Diggs), Madison (Okieriete Onaodowan), George Washington (Christopher Jackson), John Laurens (Anthony Ramos), Eliza Hamilton (Phillipa Soo)—ruminating on Hamilton’s unlikely survival and success, introducing both the central figure and the critical interplay between history and historiography that runs throughout the performance. Burr’s opening lines, which began this review, introduce a man who was raised by a single mother out of wedlock and, crucially for this production, came to the colonies as an immigrant believing in the promise “In New York you can / be a new man.”8 “Alexander Hamilton” paints Hamilton as saved from a life of poverty and insignificance largely by his skill with words: “put a pencil to his temple, connected it to / his brain.” Bolstered by the...

Francis Poulenc: articles and interviews: notes from the heart

’He plays the piano well,’ wrote the society hostess Mme de Saint-Marceaux in her diary on 18 March 1927. ’His compositions are not devoid of talent but he’s not a genius, and I’m afraid he thinks he is.’ Intelligent though the lady was, she got this one spectacularly wrong. Poulenc has in fact outpaced his colleagues in Les Six by many a mile, as singers and instrumentalists all over the world will attest, and while he would never have accepted the title of ’genius’, preferring ’artisan’, a genius is increasingly what he appears to have been. Part of the answer lay in always being his own man, and this independence of spirit shows through in his writings and interviews just as brightly as in his music, whether it’s boasting that he’d be happy never to hear The Mastersingers ever again, pointing out that what critics condemn as the ’formlessness’ of French music is one of its delights, voicing his outrage at attempts to ’finish’ the Unfinished Symphony, writing ’in praise of banality’ - or remembering the affair of Debussy’s hat. And in every case, his intelligence, humour and generosity of spirit help explain why he was so widely and deeply loved. This volume comprises selected articles from Francis Poulenc: J’ecris ce qui me chante (Fayard, 2011) edited by Nicholas Southon. Many of these articles and interviews have not been available in English before and Roger Nichols's translation, capturing the very essence of Poulenc’s lively writing style, makes more widely accessible this significant contribution to Poulenc scholarship.

The theory of reference values: an unfinished symphony

The history of the theory of reference values can be written as an unfinished symphony. The first movement, allegro con fuoco, played from 1960 to 1980: a mix of themes devoted to the study of biological variability (intra-, inter-individual, short- and long-term), preanalytical conditions, standardization of analytical methods, quality control, statistical tools for deriving reference limits, all of them complex variations developed on a central melody: the new concept of reference values that would replace the notion of normality whose definition was unclear. Additional contributions (multivariate reference values, use of reference limits from broad sets of patient data, drug interferences) conclude the movement on the variability of laboratory tests. The second movement, adagio, from 1980 to 2000, slowly develops and implements initial works. International and national recommendations were published by the IFCC-LM (International Federation of Clinical Chemistry and Laboratory Medicine) and scientific societies [French (SFBC), Spanish (SEQC), Scandinavian societies…]. Reference values are now topics of many textbooks and of several congresses, workshops, and round tables that are organized all over the world. Nowadays, reference values are part of current practice in all clinical laboratories, but not without difficulties, particularly for some laboratories to produce their own reference values and the unsuitability of the concept with respect to new technologies such as HPLC, GCMS, and PCR assays. Clinicians through consensus groups and practice guidelines have introduced their own tools, the decision limits, likelihood ratios and Reference Change Value (RCV), creating confusion among laboratorians and clinicians in substituting reference values and decision limits in laboratory reports. The rapid development of personalized medicine will eventually call for the use of individual reference values. The beginning of the second millennium is played allegro ma non-troppo from 2000 to 2012: the theory of reference values is back into fashion. The need to revise the concept is emerging. The manufacturers make a friendly pressure to facilitate the integration of Reference Intervals (RIs) in their technical documentation. Laboratorians are anxiously awaiting the solutions for what to do. The IFCC-LM creates Reference Intervals and Decision Limits Committee (C-RIDL) in 2005. Simultaneously, a joint working group IFCC-CLSI is created on the same topic. In 2008 the initial recommendations of IFCC-LM are revised and new guidelines are published by the Clinical and Laboratory Standards Institute (CLSI C28-A3). Fundamentals of the theory of reference values are not changed, but new avenues are explored: RIs transference, multicenter reference intervals, and a robust method for deriving RIs from small number of subjects. Concomitantly, other statistical methods are published such as bootstraps calculation and partitioning procedures. An alternative to recruiting healthy subjects proposes the use of biobanks conditional to the availability of controlled preanalytical conditions and of bioclinical data. The scope is also widening to include veterinary biology! During the early 2000s, several groups proposed the concept of 'Universal RIs' or 'Global RIs'. Still controversial, their applications await further investigations. The fourth movement, finale: beyond the methodological issues (statistical and analytical essentially), important questions remain unanswered. Do RIs intervene appropriately in medical decision-making? Are RIs really useful to the clinicians? Are evidence-based decision limits more appropriate? It should be appreciated that many laboratory tests represent a continuum that weakens the relevance of RIs. In addition, the boundaries between healthy and pathological states are shady areas influenced by many biological factors. In such a case the use of a single threshold is questionable. Wherever it will apply, individual reference values and reference change values have their place. A variation on an old theme! It is strange that in the period of personalized medicine (that is more stratified medicine), the concept of reference values which is based on stratification of homogeneous subgroups of healthy people could not be discussed and developed in conjunction with the stratification of sick patients. That is our message for the celebration of the 50th anniversary of Clinical Chemistry and Laboratory Medicine. Prospects are broad, enthusiasm is not lacking: much remains to be done, good luck for the new generations!