"The whole body 11bHSD1 activity reflects mainly hepatic expression. Initial studies that relied on measurements of cortisol-to-cortisone metabolites in urine (23,36) should be taken with caution as indicative of 11bHSD1 activity, because several other cortisol and cortisone metabolizing enzymes are deregulated in obesity (36). Of greater importance is the finding of reduced hepatic 11bHSD1 activity measured by the conversion of orally administered cortisone to cortisol (23,37). Thus, 11bHSD1 upregulation in obesity seems not to be a generalized process. In both the whole body and the splanchnic circulation there are no differences between obese and lean subjects regarding cortisol regeneration rates (as measured by [2H4]-cortisol tracer), presumably because an upregulation in adipose tissue is counterbalanced by a downregulation in the liver (15).
The journalist Peter Dizikes, writing in The Boston Globe in 2008, notes that popular culture likes the idea of the butterfly effect, but gets it wrong. Whereas Lorenz suggested correctly with his butterfly metaphor that predictability "is inherently limited", popular culture supposes that each event can be explained by finding the small reasons that caused it. Dizikes explains: "It speaks to our larger expectation that the world should be comprehensible – that everything happens for a reason, and that we can pinpoint all those reasons, however small they may be. But nature itself defies this expectation." 
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