The Shakespearean object : psychoanalysis, subjectivity and the gaze

Through a close analysis of four plays by Shakespeare, this thesis argues that the question of subjectivity ultimately comes to be negotiated around a structural impasse or certain points of opacity in each of the text's signifying practices. Challenging assumptions about the utatively "theatrical" contexts of Richard III, Richard II, Hamlet and Antony and Cleopatra, I argue that, to varying degrees, the specular economy of each play is in fact traversed by a radical alterity that constitutively gives rise to a notion of subjectivity commonly referred to as "Shakespearean". Elaborating upon the work of both Jacques Lacan and Jacques Derrida, I argue that "subjectivity" in the plays is, rather, the articulated confrontation with a non-dialectizable remainder that haunts each text from within. Crucially in this respect I relate each of the texts to Lacan's account of the "gaze" as a species of what he calls the object a: an alien kernel of jouissance exceeding all subjective mediation yet, paradoxically, also that which confers internal consistency both to subjectivity and to the very process of symbolization as such. I am, moreover, also concerned to read the work of Jacques Derrida as providing an illuminating context for how this incursion of alterity that he terms differance (what Lacan calls the Real) may be read as the unacknowledged support of subjectivity. The thesis concludes with a consideration of how this analysis of the Shakespearean object, rather than succumbing to the heady pleasures of an unfettered textuality, opens, ineluctably, onto a rethinking of the very category of the "political" itself

Surgical site infections after emergency hernia repair: substudy from the Management of Acutely Symptomatic Hernia (MASH) study

Introduction Acutely symptomatic abdominal wall and groin hernias (ASH) are a common acute surgical presentation. There are limited data to guide decisions related to surgical repair technique and use of antibiotics, which can be driven by increased risk of surgical site infection (SSI) in this group. This study aims to report rates of SSI following ASH repair and explore the use of patient-reported outcome measure reporting in this setting. Methods An 18-week, UK-based, multicentre prospective cohort study (NCT04197271) recruited adults with ASH. This study reports operatively managed patients. Data on patient characteristics, inpatient management, quality of life, complications, and wound healing (Bluebelle score) were collected. Descriptive analyses were performed to estimate event rates of SSI and regression analysis explored the relationship between Bluebelle scores and SSI. The 30 and 90-day follow-up visits assessed complications and quality of life. Results The MASH study recruited 273 patients, of whom 218 were eligible for this study, 87.2 per cent who underwent open repair. Mesh was used in 123 patients (50.8 per cent). Pre- and postoperative antibiotics were given in 163 (67.4 per cent) and 28 (11.5 per cent) patients respectively. There were 26 reported SSIs (11.9 per cent). Increased BMI, incisional, femoral, and umbilical hernia were associated with higher rates of SSI (P = 0.006). In 238 patients, there was a difference in healthy utility values at 90 days between patients with and without SSI (P = 0.025). Also, when analysing 191 patients with Bluebelle scores, those who developed an SSI had higher Bluebelle values (P < 0.001). Conclusion SSI is frequent in repair of acutely symptomatic hernia and correlates with BMI and site of hernia

Access of viral proteins to mitochondria via mitochondria-associated membranes

By exploiting host cell machineries, viruses provide powerful tools for gaining insight into cellular pathways. Proteins from two unrelated viruses, human CMV (HCMV) and HCV, are documented to traffic sequentially from the ER into mitochondria, probably through the mitochondria-associated membrane (MAM) compartment. The MAM are sites of ER-mitochondrial contact enabling the direct transfer of membrane bound lipids and the generation of high calcium (Ca(2+)) microdomains for mitochondria signalling and responses to cellular stress. Both HCV core protein and HCMV UL37 proteins are associated with Ca(2+) regulation and apoptotic signals. Trafficking of viral proteins to the MAM may allow viruses to manipulate a variety of fundamental cellular processes, which converge at the MAM, including Ca(2+) signalling, lipid synthesis and transfer, bioenergetics, metabolic flow, and apoptosis. Because of their distinct topologies and targeted MAM sub-domains, mitochondrial trafficking (albeit it through the MAM) of the HCMV and HCV proteins predictably involves alternative pathways and, hence, distinct targeting signals. Indeed, we found that multiple cellular and viral proteins, which target the MAM, showed no apparent consensus primary targeting sequences. Nonetheless, these viral proteins provide us with valuable tools to access the poorly characterized MAM compartment, to define its cellular constituents and describe how virus infection alters these to its own end. Furthermore, because proper trafficking of viral proteins is necessary for their function, discovering the requirements for MAM to mitochondrial trafficking of essential viral proteins may provide novel targets for the rational design of anti-viral drugs