Overvloed en onbehagen : uitdagingen voor de moderne endocrinologie

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Trials, Truth-telling and the Performing Body

In this thesis, I examine the role performance plays in the adversarial criminal jury trial. The initial motivation behind this inquiry was the pervasiveness of a metaphor: why is the courtroom so frequently compared to a theatre? Most writings on this topic see the courtroom as bearing what might be termed a cosmetic resemblance to a theatre, making comparisons, for instance, between elements of costume and staging. I pursue a different line of argument. I argue that performance is not simply an embellishment of the trial process but rather a constitutive feature of the criminal jury trial. It is by means of what I call the performance of tradition that the trial acquires its social significance as a (supposedly) timeless bulwark of authority and impartiality. In the first three chapters I show that popular usage of the term ‘theatrical’ (whether it be to describe the practice of a flamboyant lawyer, or a misbehaving defendant) is frequently laden with pejorative connotations and invariably (though usually only implicitly) invokes comparison to a presupposed authentic or natural way of behaviour (‘not-performing’). Drawing on the work of Michel Foucault and Pierre Bourdieu I argue that, whatever legal agents see as appropriate trial conduct (behaviour that is ‘not-performing’), they are misrecognising the performative accomplishments and demands required of both legal agents and laypersons in the trial. This performance constructs and maintains a gap between legal practitioners and laypersons which is essential to maintaining the status of the legal profession, and which continually positions the trial in legal and popular belief. I then look at specific moments of ‘anxiety’ where alterations to traditional procedure provoke debate as to the otherwise unnoticed or unarticulated value of live performance. In Chapter 4, I examine the growth of the private advocacy training industry that frequently positions lawyers as actors. Resistance to the idea of acting demonstrates the tainted status of performance terminology as well as legal agents’ belief that lawyers are acting naturally. I argue instead that lawyers have always been trained in acting: an habituated performance style I term legal naturalism. In Chapter 5, I examine the television broadcasting of trials. Some legal agents argue that broadcasting risks ‘theatricalising’ the trial—causing participants to ‘act up’. However, this overlooks the fact that the court has a long history as a source of popular entertainment. I argue that resistance to broadcasting also stems from a reluctance to remit control of the trial to external producers. Broadcasting invites greater scrutiny into a process that if not always fair, needs to be believed in as fair and has historically been tightly self-regulated by the legal field, through its reliance on live performance’s ‘essential’ quality—its inability to be captured and subsequent disappearance. In Chapter 6, I examine the debates around CCTV testimony, which demonstrate a consistency of belief in live or ‘face-to-face’ confrontation to produce juridical ‘Truth’ that can be traced back over 800 years. The final chapter of this thesis examines sexual assault trials. This chapter brings together all of these sources of anxiety. Although often termed ‘exceptional’, sexual assault trials highlight how essential live performance is to manufacturing the authority of ‘The Law’ through the weight given to demeanour assessment, and because these trials make visible the sustained symbolic violence characteristic of adversarial criminal trials that is particularly traumatic for sexual assault complainants. Examination of sexual assault trials also reveals the double-edged position of performance in the trial. The exploitation of the symbolic value of live performance is the source of much trauma, yet the performance of tradition is also essential to maintaining popular belief in the adversarial criminal jury trial

Nutrient balances in Field vegetable production systems

In this review paper an overview of the nitrogen (N) and phosphorus (P) cycles in agricultural systems is presented. The information summarized provides general information on the important processes involved as they relate to losses from agricultural systems. Such background information is a prerequisite for designing management strategies to achieve a sustainable balance between reducing the environmental impact of N losses and protecting farmers' profitability. In field vegetable production most N is lost via nitrate leaching because often large amounts of nitrogen remain in the soil after harvest of the crop. This N includes residual soil mineral N and N present in crop residues. Quantitative data are presented on residual soil mineral N, N present in crop residues and nitrate leaching in field vegetable production systems. To combat too high nitrate leaching from agricultural soils the European Commission has issued the Nitrate Directive. Information on this Directive and on how the Dutch government imposed legislation to meet the demands of the Nitrate Directive is given. The project "Farming with a future" is also presented. This new project has been set up in The Netherlands to develop and test environmentally and economically sustainable field crop production systems. As an example of the first results of the project, N balances of two systems of leek production are shown

The cinepheur: post-cinematic passage, post-perceptual passage

This thesis develops a hermeneutic commensurate with the aesthetic and ontological challenges of what Steven Shaviro describes as a post-cinematic media ecology, and Shane Denson describes as an emergent post-perceptual media ecology. I consider canonicity and cinephilia as frustrated efforts to contain and comprehend this new cinematic media object, offering a third unit of interpretation in their place, which I describe as the cinetopic anecdote. I associate the cinetopic anecdote with a particular way of moving between cinema and cinematic infrastructure, which I label cinetopic passage, and with a subject position that I label the cinepheur. Drawing on Walter Benjamin’s theory of the flâneur, I argue that the cinetopic anecdote precludes the extraction of a privileged cinematic moment in the manner characteristic of Christian Keathley’s cinephilic anecdote, but instead compels the cinepheur to instantiate, embody or physically recreate the infrastructural conditions that produced it, dovetailing production and consumption into what Axel Bruns has described as the emergent category of produsage; “unfinished artifacts, continuing process.” Having elaborated the cinetopic anecdote, I apply it to postmodern, post-cinematic and post-perceptual media ecologies, in order to evoke the peculiar forms of attachment and obsession bound up with the Criterion and Netflix platforms. In the process, I draw on Franco Moretti’s conception of distant reading to frame the cinetopic anecdote as a unit of distant viewing, offering distant viewings of Angela Christlieb and Stephen Kijak’s Cinemania, Sidney Lumet’s Garbo Talks and Pier Paolo Pasolini’s Salò, or The 120 Days of Sodom. Just as distant reading takes “the great unread” as its object of enquiry, so the cinetopic anecdote speaks to a media ecology preoccupied by the “great unviewed,” in which cinematic scarcity increasingly ramifies as an elegaic object

Study protocol: a randomised controlled trial on the clinical effects of levothyroxine treatment for subclinical hypothyroidism in people aged 80 years and over

Background: Subclinical hypothyroidism is common in older people and its contribution to health and disease needs to be elucidated further. Observational and clinical trial data on the clinical effects of subclinical hypothyroidism in persons aged 80 years and over is inconclusive, with some studies suggesting harm and some suggesting benefits, translating into equipoise whether levothyroxine therapy provides clinical benefits. This manuscript describes the study protocol for the Institute for Evidence-Based Medicine in Old Age (IEMO) 80-plus thyroid trial to generate the necessary evidence base. Methods: The IEMO 80-plus thyroid trial was explicitly designed as an ancillary experiment to the Thyroid hormone Replacement for Untreated older adults with Subclinical hypothyroidism randomised placebo controlled Trial (TRUST) with a near identical protocol and shared research infrastructure. Outcomes will be presented separately for the IEMO and TRUST 80-plus groups, as well as a pre-planned combined analysis of the 145 participants included in the IEMO trial and the 146 participants from the TRUST thyroid trial aged 80 years and over. The IEMO 80-plus thyroid trial is a multi-centre randomised double-blind placebo-controlled parallel group trial of levothyroxine treatment in community-dwelling participants aged 80 years and over with persistent subclinical hypothyroidism (TSH ≥4.6 and ≤ 19.9 mU/L and fT4 within laboratory reference ranges). Participants are randomised to levothyroxine 25 or 50 micrograms daily or matching placebo with dose titrations according to TSH levels, for a minimum follow-up of one and a maximum of three years. Primary study endpoints: hypothyroid physical symptoms and tiredness on the thyroid-related quality of life patient-reported outcome (ThyPRO) at one year. Secondary endpoints: generic quality of life, executive cognitive function, handgrip strength, functional ability, blood pressure, weight, body mass index, and mortality. Adverse events will be recorded with specific interest on cardiovascular endpoints such as atrial fibrillation and heart failure. Discussion: The combined analysis of participants in the IEMO 80-plus thyroid trial with the participants aged over 80 in the TRUST trial will provide the largest experimental evidence base on multimodal effects of levothyroxine treatment in 80-plus persons to date

Abca1 deficiency protects the heart against myocardial infarction-induced injury

Background and aims We explored the role of ATP-binding cassette transporter A1 (Abca1), in post-myocardial infarction (MI) cardiac injury. Methods In Abca1–/– mice, wild type (WT) mice, and WT mice transplanted with Abca1–/– or WT bone marrow, an MI was induced in vivo. Furthermore, an ex vivo MI was induced in isolated Abca1–/– and WT hearts. Results Twenty-four hours and two weeks after in vivo MI induction, MI size was reduced in Abca1–/– (−58%, p = 0.007; −59%, p = 0.03) compared to WT. Ex vivo MI induction showed no effect of Abca1–/– on infarct size. Interestingly, two weeks after MI, Abca1–/– mice showed higher circulating levels of B-cells (+3.0 fold, p = 0.02) and T-cells (+4.2 fold, p = 0.002) compared to WT. Bone marrow-specific Abca1–/– tended to reduce infarct size (−43%, p = 0.12), suggesting a detrimental role for hematopoietic Abca1 after MI. Conclusions Although Abca1 has a protective role in atherosclerosis, it exerts detrimental effects on cardiac function after MI. Keywords * Abca1 deficiency; * Myocardial infarction; * Immune cells; * Mic

Pioglitazone improves cardiac function and alters myocardial substrate metabolism without affecting cardiac triglyceride accumulation and high-energy phosphate metabolism in patients with well-controlled type 2 diabetes mellitus

0.001). CONCLUSIONS: In T2DM patients, pioglitazone was associated with improvement in some measures of left ventricular diastolic function, myocardial glucose uptake, and whole-body insulin sensitivity. The functional changes, however, were not associated with myocardial substrate and high-energy phosphate metabolis

Black Europeans, the Indian coolies and empire : colonialisation and christianized Indians in colonial Malaya & Singapore, c. 1870s - c. 1950s

CONTEXT: Patients with thyroid nodules of indeterminate cytology undergo diagnostic surgery according to current guidelines. In 75% of patients, the nodule is benign. In these patients, surgery was unnecessary and unbeneficial because complications may occur. Preoperative fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) was found to have a very high negative predictive value (96%) and might therefore avoid futile surgery, complications, and costs. In the United States, two molecular tests of cytology material are routinely used for this purpose. OBJECTIVE: Five-year cost-effectiveness for routine implementation of FDG-PET/CT was evaluated in adult patients with indeterminate fine-needle aspiration cytology and compared with surgery in all patients and both molecular tests. DESIGN: A Markov decision model was developed to synthesize the evidence on cost-effectiveness about the four alternative strategies. The model was probabilistically analyzed. One-way sensitivity analyses of deterministic input variables likely to influence outcome were performed. SETTING AND SUBJECTS: The model was representative for adult patients with cytologically indeterminate thyroid nodules. MAIN OUTCOME MEASURES: The discounted incremental net monetary benefit (iNMB), the efficiency decision rule containing outcomes as quality-adjusted life-years and (direct) medical cost, of implementation of FDG-PET/CT is displayed. RESULTS: Full implementation of FDG-PET/CT resulted in 40% surgery for benign nodules, compared with 75% in the conventional approach, without a difference in recurrence free and overall survival. The FDG-PET/CT modality is the more efficient technology, with a mean iNMB of euro3684 compared with surgery in all. Also, compared with a gene expression classifier test and a molecular marker panel, the mean iNMB of FDG-PET/CT was euro1030 and euro3851, respectively, and consequently the more efficient alternative. CONCLUSION: Full implementation of preoperative FDG-PET/CT in patients with indeterminate thyroid nodules could prevent up to 47% of current unnecessary surgery leading to lower costs and a modest increase of health-related quality of life. Compared with an approach with diagnostic surgery in all patients and both molecular tests, it is the least expensive alternative with similar effectiveness as the gene-expression classifier

The role of groups as local context in large Enterprise Social Networks: A Case Study of Yammer at Deloitte Australia

Enterprise Social Networking, the application of popular social networking techniques to the workplaces of organisations, is an increasingly common phenomenon. But its nature, benefits and proliferation are not yet fully understood. In this study we investigate ESN communication at the micro-level. We focus on the role of the group feature in structuring and providing context for communication in large ESNs. Our case study is Yammer at Deloitte. In contrast to previous studies we carry out an analysis of communication at the thread (conversation) level, rather than at the level of single messages. This allows us to provide a more contextual understanding of the group aspects of communication. We find that information sharing underpins the majority of communication threads, which speaks to the usefulness of ESN, in particular in the context of knowledge-intensive work. We further uncover differences between network-wide and group-centred communication and derive a framework of four group archetypes, based on different group communication patterns. Our findings are useful for decision-makers in providing a better understanding of the role of groups in providing local contexts for users in large ESNs

23 Questions of fluency in Australian languages revitalisation

Changes in endothelial glycocalyx are one of the earliest changes in development of cardiovascular disease. The endothelial glycocalyx is both an important biological modifier of interactions between flowing blood and the vessel wall, and a determinant of organ perfusion. We hypothesize that deeper penetration of erythrocytes into the glycocalyx is associated with reduced microvascular perfusion. The population-based prospective cohort study (the Netherlands Epidemiology of Obesity [NEO] study) includes 6,673 middle-aged individuals (oversampling of overweight and obese individuals). Within this cohort, we have imaged the sublingual microvasculature of 915 participants using sidestream darkfield (SDF) imaging together with a recently developed automated acquisition and analysis approach. Presence of RBC (as a marker of microvascular perfusion) and perfused boundary region (PBR), a marker for endothelial glycocalyx barrier properties for RBC accessibility, were assessed in vessels between 5 and 25 µm RBC column width. A wide range of variability in PBR measurements, with a mean PBR of 2.14 µm (range: 1.43-2.86 µm), was observed. Linear regression analysis showed a marked association between PBR and microvascular perfusion, reflected by RBC filling percentage (regression coefficient β: -0.034; 95% confidence interval: -0.037 to -0.031). We conclude that microvascular beds with a thick ("healthy") glycocalyx (low PBR), reflects efficient perfusion of the microvascular bed. In contrast, a thin ("risk") glycocalyx (high PBR) is associated with a less efficient and defective microvascular perfusion