Dissonance-Based Eating Disorder Prevention for Body-Dissatisfied Brazilian Cisgender Gay and Bisexual Men: A Randomized Controlled Trial With a 1-Year Follow-Up.

OBJECTIVE: Gay and bisexual men are at an increased risk for eating disorders (EDs) and muscle dysmorphia (MD) compared with their heterosexual counterparts. Existing dissonance-based (DB) EDs prevention programs for this population have been evaluated in the United States; however, these programs have not been evaluated in the Brazilian context. Thus, we investigated the feasibility, acceptability, and efficacy of a DB ED prevention program (i.e., the PRIDE Body Project) among Brazilian cisgender gay and bisexual men. METHOD: Eligible men were randomly assigned to either a DB intervention (n = 74) condition or an assessment-only control (AOC) condition (n = 75). Participants completed measures assessing ED and MD risk and protective factors at baseline, post-intervention, 1-month, 6-month, and 1-year follow-up. Those in the intervention condition also completed acceptability measures. RESULTS: Feasibility and acceptability ratings were highly favorable. Regarding efficacy, post-intervention results were not significant, except for self-objectification, which showed a significantly greater decrease in the DB condition compared with the AOC condition at all time-points of follow-ups (Cohen's d = -0.31 to -0.76). At follow-up, the DB condition showed significantly greater decreases in appearance-ideal internalization, drive for muscularity, self-objectification, ED and MD symptoms at 1-month, 6-month, and 1-year follow-ups (d = -0.33 to -0.92) compared with the AOC condition. Significant increases were observed in the DB compared with the AOC condition for body appreciation at 1-month, 6-month, and 1-year follow-ups (d = 0.31-0.81). DISCUSSION: Results support the feasibility, acceptability, and efficacy of the PRIDE Body Project up to 1-year in Brazilian cisgender gay and bisexual men. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC; available at http://www.ensaiosclinicos.gov.br/) number of registration: RBR-62fctqz.

Preventive Detection of Driver Drowsiness from EEG Signals using Fuzzy Expert Systems / Detección Preventiva de la Somnolencia del Conductor a partir de Señales EEG Mediante Sistemas Expertos Difusos

Abstract Currently, the percentage of traffic accidents has increased, and according to statistics, this percentage will continue to increase every year, so it is necessary to develop new technologies to prevent this kind of accidents. This paper presents a drowsiness detection system based on electroencephalogram (EEG) signals using a pair of channels (Fp1 and Fp2) applied to drivers before entering their vehicles. First, this model detects the relationship between the area under the curve (AUC) of alpha brain waves, an effective parameter for detecting drowsiness. Then, the extracted information is passed to a fuzzy expert system (FES) that classifies the subject's state as "alert" or "sleepy"; the criterion used was a threshold and training with subjective levels. The proposed system was compared with neural network models, such as support vector machine (SVM), K nearest neighbors (KNN), and random forest (RF). Measurements of one hundred and twenty minutes were performed on each of the ten drivers for two days to test the system. The tests confirm that this system is suitable for preventive measures and that the fuzzy system is superior to traditional neural network methods.

Resumen Actualmente, el porcentaje de accidentes de tráfico ha aumentado, y según las estadísticas, este porcentaje seguirá aumentando cada año, por lo que es necesario desarrollar nuevas tecnologías para prevenir este tipo de accidentes. Este trabajo presenta un sistema de detección de somnolencia basado en señales de electroencefalograma (EEG) utilizando un par de canales (Fp1 y Fp2) aplicado a los conductores antes de entrar en sus vehículos. En primer lugar, este modelo detecta la relación entre el área bajo la curva (AUC) de las ondas cerebrales alfa, un parámetro eficaz para detectar la somnolencia. A continuación, la información extraída se pasa a un sistema experto difuso (FES) que clasifica el estado del sujeto como "alerta" o "somnoliento"; el criterio utilizado fue un umbral y el entrenamiento con niveles subjetivos. El sistema propuesto se comparó con modelos de redes neuronales, como la máquina de vectores de soporte (SVM), K vecinos más cercanos (KNN) y el bosque aleatorio (RF). Se realizaron mediciones de ciento veinte minutos en cada uno de los diez conductores durante dos días para probar el sistema. Las pruebas confirman que este sistema es adecuado para las medidas preventivas y que el sistema difuso es superior a los métodos tradicionales de redes neuronales.

Um estudo sobre as incidências da pulsão oral nas psicoses maníaco-depressivas / Une étude à propos des incidences de la pulsion orale dans les psychoses maniaco-dépressives / A study about the occurrences of oral drive in manic-depressive psychosis

Este artigo apresenta uma discussão sobre as repercussões do modo de funcionamento marcado pela pulsão oral como um elemento decisivo para que alcancemos as bases mais primordiais da psicose maníaco- depressiva. Entendemos que este estudo também pode auxiliar na elucidação da presença de estados melancoliformes e maniformes em configurações neuróticas de maior gravidade, ou ainda, em psicoses não desencadeadas. Nosso recorte temático será desenvolvido a partir do referencial freudiano, conferindo um espaço significativo às contribuições de Karl Abraham. Também contará com a exposição de novas colaborações da psicanálise pós-freudiana, com enfoque nos impactos da voracidade pulsional na vida humana e as consequências psicopatológicas desse tipo de fixação libidinal. Por fim, buscaremos alinhavar pontos levantados com o diferencial das teorizações de Jacques Lacan, resgatando sucintamente princípios de sua teoria da clínica como a relação ao grande Outro, a lógica fantasmática, o objeto a e o significante paterno.

Cet article présente une discussion sur les répercussions du mode de fonctionnement subjectif marqué par la pulsion orale comme un élément fondamental pour comprendre les bases les plus primordiales de la psychose maniaco-dépressive. Nous comprenons que cette étude peut également aider à élucider la présence d'états en format mélancolique et maniaque dans des configurations névrotiques de gravité plus élevée, ou encore, dans des psychoses non déclenchées. Notre découpage thématique sera développé à partir de la théorie freudienne, accordant un espace significatif aux contributions de Karl Abraham. Il inclura également l'exposition de nouvelles collaborations de la psychanalyse post-freudienne, en mettant l'accent sur les conséquences de la voracité pulsionnelle dans la vie humaine et les conséquences psychopathologiques de ce genre de fixation libidinale. Enfin, nous chercherons à relier les points relevés avec la spécificité des théorisations de Jacques Lacan, reprenant brièvement les principes de sa théorie clinique tels que la relation au grand Autre, la logique du fantasme, l'objet a et le signifiant paternel.

This article presents a discussion about the repercussions of the predominance of the oral drive in subjective functioning as a decisive element to reach the primordial bases of manic-depressive psychosis. We understand that this study can also help enlighten the presence of melancholic and manic states in more severe neurotic configurations, or even in untriggered psychoses. Our thematic framework will be based on Freudian theory, giving significant space to the contributions of Karl Abraham. It will also include the exposition of new contributions from post-Freudian psychoanalysis, focusing on the impacts of drive eagerness in human life and the psychopathological consequences of this type of fixation of libido. Finally, we will seek to connect the issues raised with the uniqueness of Jacques Lacan's theorizations, briefly revisiting the principles of his clinical theory such as the relation to the Other, the phantasmatic logic, the object a, and the fatherly signifier.

Physical exercise is essential for increasing ventricular contractility in hypertensive rats treated with losartan.

The treatment of hypertensive patients with losartan is very common. Despite the reduction in blood pressure, its effects on cardiac contractility and sympathetic autonomic drive are still controversial. In turn, aerobic physical training (APT) also presents an important therapeutic option, providing significant improvements in cardiovascular autonomic control, however little is known about its effects on cardiac contractility, especially when associated with losartan. Therefore, we investigated in spontaneously hypertensive rats (SHR) the effects of losartan and APT on cardiac hemodynamics and functionality, with emphasis on autonomic tonic balance and cardiac contractility. Sixty-four SHR (18 weeks old) were divided into four groups (N = 16): vehicle; vehicle submitted to APT through swimming for 12 weeks; treated with losartan (5 mg·kg-1·d-1) for 12 weeks; and treated with losartan associated with APT. The groups were submitted to cardiac morphological and functional analysis by echocardiography; double blockade of cardiac autonomic receptors with atropine and propranolol; and coronary bed reactivity and left ventricular contractility analyses by the Langendorff technique. APT improved functional parameters and autonomic balance by reducing sympathetic drive and/or increasing vagal drive. In contrast, it promoted a concentric remodeling of the left ventricle (LV). Treatment with losartan reduced sympathetic autonomic drive and cardiac morphological parameters, but there were no significant gains in cardiac functionality and contractility. When combined, the concentric remodeling of the LV to APT was abolished and gains in cardiac functionality and contractility were observed. Our findings suggest that the effects of losartan and APT are complementary and should be applied together in the treatment of hypertension. In spontaneously hypertensive rats, the combination of aerobic physical training with losartan treatment was crucial to greater blood pressure reductions and an increase in left ventricular contractility. Furthermore, losartan treatment prevented the concentric left ventricular remodeling caused by aerobic physical training.

L'anorexie mentale comme addiction, ou le malaise dans la contemporanéité / Mental anorexia as addiction, or the discontent in contemporary society / Anorexia mental como dependência, ou desconforto na contemporaneidade / La anorexia nerviosa como adicción o el malestar en la contemporaneidad

Depuis I'époque de Freud, l'anorexie mentale est une énigme pour la clinique psychanalytique. Cet article vise à montrer le lien entre anorexie et addiction, en soulignant le style de jouissance addictive comme typique de la société consumériste. Le symptôme anorexique se présent donc comme solution subjective au malaise dans la civilisation contemporaine. A travers deux cas cliniques, les implications diagnostiques seront aussi montrées, en relevant de la position singulière sujetpar rapport à l'Autre et à la jouissance.

Desde la época de Freud, la anorexia nerviosa ha sido un enigma para la clínica psicoanalítica. Este artículo pretende mostrar el vínculo entre la anorexia y la adicción destacando el estilo adictivo de goce como propio de la sociedad consumista. El síntoma anoréxico se presenta como una solución subjetiva al malestar de la civilización contemporánea. A partir de dos casos clínicos, se mostrarán las implicaciones diagnósticas, centrándose en la posición singular del sujeto con relación al Otro y al goce.

Resumos Since the time of Freud, anorexia nervosa has puzzled the psychoanalytic clinic. This article aims to show the link between anorexia and addiction, highlighting the style of addictive pleasure as typical of consumer society. The anorexic symptom therefore presents itself as a subjective solution to the malaise of contemporary civilization. Two clinical cases are used to illustrate the diagnostic implications, focusing on the singular position of the Subject in relation to the Other and to pleasure.

Desde a época de Freud, a anorexia nervosa tem sido um enigma para a clínica psicanalítica. Este artigo tem como objetivo mostrar a ligação entre anorexia e dependência, destacando o estilo de prazer viciante típico da sociedade consumista. O sintoma anoréxico apresenta-se, portanto, como uma solução subjetiva para o mal-estar da civilização contemporânea. Através de dois casos clínicos, serão também mostradas as implicações diagnosticas, com foco na posição singular do sujeito em relação ao Outro e ao gozo.

Pulsão de Morte e Sublimação: A (Re)invenção da Vida nas Dobras da Racionalidade Técnico-Científica / Death Drive and Sublimation: The (Re)invention of Life in the Folds of Technical-Scientific Rationality / Pulsión de Muerte y Sublimación: (Re)invención de la Vida en las Doblas de la Técnica

O advento das biotecnologias no mundo contemporâneo, em particular das Novas Tecnologias Reprodutivas (NTR's), liberando a sexualidade dos antigos imperativos da procriação, nos oferece uma prova contundente da abertura ilimitada da vida à transformação das condições em que as normas vitais engajam os organismos no processo de individuação. Mais do que isso, evidencia o caráter essencialmente contingente da ligação entre vida, morte e sexualidade. O objetivo deste trabalho é examinar a fecundidade da concepção freudiana de sublimação - lida sob o registro das transformações que a ela se impõem com o advento do conceito de pulsão de morte (1920) - em subsidiar uma reflexão ética e política acerca dos efeitos da incidência das Novas Tecnologias Reprodutivas (NTR's) nos campos da reprodução, da sexualidade e do laço social. Nossa hipótese é a de que o fenômeno das biotecnologias desvela, sob a cobertura do temor, tão frequentemente evocado por alguns de nossos contemporâneos, de dilapidação das instituições e dos modos de vida sobre os quais acreditávamos poder fundar nossa fantasmática "humanidade", a infinita potência da vida em recriar-se diante d'isso que quer destruí-la.

The advent of biotechnologies in the contemporary world, particularly New Reproductive Technologies (NTRs), freeing sexuality from the old imperatives of procreation, offers us overwhelming proof of the unlimited opening up of life to the transformation of conditions in which vital norms engage the organisms in the individuation process. Even more so, it highlights the essentially contingent character of the connection between life, death, and sexuality. The aim of this study is, therefore, to examine the fruitfulness of the Freudian conception of sublimation, read under the register of the transformations imposed upon this notion with the advent of the death drive concept (1920), in subsidizing an ethical and political reflection on the effects of the incidence of NTRs in the reproduction, sexuality and social bond fields. Our hypothesis is that the biotechnologies phenomenon reveals, under the cover of fear, so often evoked by some of our contemporaries, of institutional dilapidation and ways of life in which we believed we could establish our fantastic "humanity", the infinite life's power to recreate itself in the face of that which wants to destroy it.

La llegada de las biotecnologías en el mundo contemporáneo, en particular de las Nuevas Tecnologías Reproductivas (NTR's), liberando la sexualidad de los imperativos de la procreación, nos ofrece una prueba contundente de la abertura ilimitada de la vida a la transformación de las condiciones en que las normas vitales capacitan el organismo a la individuación. Más allá de eso, se evidencia el carácter esencialmente contingente de la ligación entre vida, muerte y sexualidad. El objetivo de este estudio es examinar la fecundidad de la concepción freudiana de sublimación - leída bajo el registro de las transformaciones que a ella se imponen con la llegada del concepto de pulsión de muerte (1920) - en subsidiar una reflexión ética y política acerca de los efectos de la incidencia de las Nuevas Tecnologías Reproductivas (NTR's) en los campos de la reproducción, de la sexualidad y del lazo social. Nuestra hipótesis es que el fenómeno de las biotecnologías desvela, bajo la cobertura del temor, tan frecuentemente evocado por algunos de nuestros contemporáneos, de dilapidación de las instituciones y de los modos de vida sobre los cuales creíamos poder fundar nuestra fantasmática "humanidad", la infinita potencia de la vida en recrearse de ante d'eso que quiere destruirla.

A High-Performance and Cost-Effective Field Programmable Gate Array-Based Motor Drive Emulator.

This work presents a hardware-based digital emulator capable of digitally driving a permanent magnet synchronous machine electronic setup. The aim of this work is to present a high-performance, cost-effective, and portable complementary solution when new paradigms of electronic drive design are generated, such as machine early failure detection, fault-tolerant drive, and high-performance control strategy implementations. In order to achieve the high performance required by the digital emulator, the electronic drive models (permanent-magnet synchronous machine, voltage-source inverter, motor-control strategy) are digitally described in Verilog hardware description language and implemented on a field programmable gate array (FPGA) digital platform using two approaches: parallel and sequential methods. The results obtained show the effectiveness of the digital emulator design, and the resources used by the solution presented can be implemented on a low-cost digital platform that reveals a cost-effective operation of the solution presented.

Entre Freud e Abraham: um estudo das pulsões e das relações de objeto nas fundações da psicanálise / Between Freud and Abraham: a study of drives and object relations in the foundations of psychoanalysis / Entre Freud y Abraham: un estudio de las pulsiones y relaciones de objeto en las fundaciones del psicoanálisis

Buscamos neste ensaio apresentar algumas das principais transformações pelas quais passou a psicanálise no seu desenvolvimento histórico. Nesse movi-mento, os chamados paradigmas pulsional e objetal foram se estabelecendo como principais referências ao campo psicanalítico. Nossa intenção principal foi conhecer como a relação de objeto está presente na teoria pulsional de Freud, sobretudo na primeira tópica. Ademais, saber como a dinâmica pulsional e o objeto se apresentam no pensamento de um dos principais psicanalistas da primeira geração, Karl Abraham. Como desdobramento deste estudo, apre-sentamos alguns dos efeitos de como a noção de objeto, presente nas teorias desses paradigmas, pode fundamentar diferentes noções de desenvolvimento, de psicopatologia e de manejo clínico em nossa contemporaneidade. (AU)

In this essay, we aim to present some of the key transformations that psycho-analysis has undergone in its historical development. In this movement, the concepts of drive and object paradigms were established as main references to the psychoanalytic field. Our primary objective was to explore the presence of object relations in Freud's drive theory, especially in the first topography. Moreover, we seek to know how the dynamic of drives and the object are present in the thinking of one of the leading psychoanalysts of the first genera-tion, Karl Abraham. As an extension to this study, we point out some of the effects of how the notion of object, included in the theories of these paradigms, can underpin various concepts of development, psychopathology, and clinical practice in contemporary psychoanalysis. (AU)

En este ensayo buscamos presentar algunas de las principales transfor-maciones que ha sufrido el psicoanálisis en su desarrollo histórico. En este movimiento, los denominados paradigmas pulsionales y objetal se estable-cieron como referencias principales al campo psicoanalítico. Nuestra inten-ción principal era saber cómo está presente la relación de objeto en la teoría pulsional de Freud, especialmente en la primera tópica. Además, saber cómo la dinámica pulsional y el objeto se presentan en el pensamiento de uno de los principales psicoanalistas de la primera generación, Karl Abraham. Como consecuencia de este estudio, presentamos algunos de los efectos de cómo la noción de objeto, presente en las teorías de estos paradigmas, puede soportar diferentes nociones de desarrollo, psicopatología y manejo clínico en nuestros tiempos contemporáneos.

Crímenes del futuro. Primer plano del cuerpo / Crimes of the Future. Close-up of the Body

En "Crímenes del futuro", David Cronenberg pone a jugar el cruce de las variables cuerpo y tecnología. El cuerpo, como campo de intervención y transformación por la acción de la tecnología, se ofrece al espectador a modo de presentación artística. El guion de la película es abordado a través de un recorrido, por momentos irónico, por momentos "monstruoso", tomando en cuenta los cruces con el discurso del psicoanálisis. Se acentúan así las distintas maneras de gozar del ser humano con y del cuerpo, ubicándolo siempre en primer plano

In "Crimes of the future", David Cronenberg brings to play the intersection of the variables body and technology. The body, as a field of intervention and transformation by the action of technology, is offered to the viewer as an artistic presentation. The film's script is approached through a journey, at times ironic, at times "monstrous", taking into account the intersections with the discourse of psychoanalysis. Thus, the different ways of enjoying the human being with and of the body are accentuated, always placing it in the foreground

Bergson e a clínica psicanalítica / Bergson and the psychoanalytical clinic / Bergson e la clínica psicanalítica

O presente artigo procura conjugar aspectos da filosofia bergsoniana com determinantes fundamentais do pensamento analítico, avaliando assim o benefício clínico e ético de suas interações. Para tanto, fará a investigação incidir, especialmente, sobre as noções de "impulso vital" e de "pulsão". O retorno a si, a multiplicidade virtual, os atos livres, a decifração pragmática da força, são temas que se interpenetram de tal modo nas duas experiências do pensamento, que suas intersecções geram - assim o pretendemos - abordagens mais nuançadas dos problemas analíticos, compreendendo uma retomada essencial da perspectiva ética, não mais situada a propósito do inconsciente, mas constituindo o seu plano

This paper combines aspects of Bergsonian philosophy with fundamental determinants of analytical thinking, thus evaluating the clinical and ethical benefits of their interactions. To do so, the investigation will focus, especially, on the notions of "vital impulse" and "drive". The return to oneself, the virtual multiplicity, the free acts, the pragmatic deciphering of force, are themes that interpenetrate themselves in such a way in the two experiences of thought, that their intersections generate - as intended - more nuanced approaches to analytical problems, involving an essential resumption of the ethical perspective, no longer situated in relation to the unconscious, but constituting its plan

Este artículo busca combinar aspectos de la filosofía bergsoniana con determinantes fundamentales del pensamiento analítico, evaluando así los beneficios clínicos y éticos de sus interacciones. Por tanto, la investigación se centrará en las nociones de "impulso vital" y "pulsión". El retorno a uno mismo, la multiplicidad virtual, los actos libres, el desciframiento pragmático de la fuerza, son temas que se interpenetran de tal manera en las dos experiencias de pensamiento, que sus intersecciones generan - como pretendo - aproximaciones más matizadas a problemas analíticos, involucrando una reanudación esencial de la perspectiva ética, que ya no se sitúa en relación con el inconsciente, sino que constituye su plan.

Cuarto de vuelta a la tuerca: trabajo y socialización en Freud / Advance a little further: work, market, and socialization in Freud / Uma nova reviravolta: trabalho, mercado e socialização em Freud

Pese a las críticas más férreas y actuales por parte de muchas de las disciplinas psi al psicoanálisis insisto en que Freud no está superado. En este artículo intento una aproximación subversiva a la lectura de Freud focalizándola en sus desarrollos respecto del trabajo y la pulsión. Matizando un recorrido puntual por algunos de sus escritos propiamente psicoanalíticos intento rescatar la importancia del concepto de trabajo en la obra de Freud para poder delimitar la necesidad no sólo de un retorno a Freud sino de una lectura económica más allá de la conocida tópica freudiana. Es decir, el concepto de trabajo y de fuerza se encuentran en muchos de los escritos centrales del pensamiento freudiano y por eso es posible hacer una nueva relación entre Freud y Marx. El recorrido por el pensamiento freudiano retoma postulados referentes al trabajo de sueño y de chiste mediante los mecanismos de condensación y desplazamiento y, ulteriormente, recupera la relación entre fuerza y pulsión para poder matizar una respuesta radical desde el pensamiento freudiano a los embates del sistema capitalista. Para esto a lo largo del escrito abordo la noción de socialización a modo de bisagra que permite hilvanar la noción de trabajo en Freud.

Beyond the strongest and most current criticism from many of the psi disciplines to psychoanalysis, I insist that Freud is not overcome. In this article, I try a subversive approach to Freud's work focusing on his developments regarding work and drive. By clarifying a timely tour of his proper psychoanalytic writings, I tried to rescue the importance of the concept of work in Freud's work in order to delimit the need not only for a return to Freud but for an economic reading beyond the well-known Freudian topic. That is, the concept of work and strength are found in many of the central writings of Freudian thought and that is why it is possible to make a new relationship between Freud and Marx. In this sense, Freudian thought takes up postulates referring to dream and joke, work through the mechanisms of condensation and displacement, and recovers the relationship between force and drive to qualify a radical response from Freudian thought to the onslaught of the capitalist system. For this purpose, across this paper, I try to articulate the notion of socialization as a hinge that allows us to combine with Freud's work concept.

Apesar das críticas mais ferozes e atuais da psicanálise por muitas das disciplinas psi, insisto que Freud não é superado. Neste artigo, tento uma abordagem subversiva da leitura de Freud, concentrando-se em seus desenvolvimentos em relação ao trabalho e à pulsão. Ao qualificar um tour preciso de seus escritos propriamente psicanalíticos, tento resgatar a importância do conceito de trabalho na obra de Freud, a fim de delimitar a necessidade não apenas de um retorno a Freud, mas de uma leitura econômica além do conhecido tema freudiano. Ou seja, o conceito de trabalho e força são encontrados em muitos dos escritos centrais do pensamento freudiano é por isso que é possível estabelecer uma relação entre Freud e Marx. A jornada pelo pensamento freudiano retoma postulados referentes ao trabalho dos sonhos e chiste através dos mecanismos de condensação e deslocamento e, posteriormente, recupera a relação entre força e pulsão, a fim de qualificar uma resposta radical do pensamento freudiano aos embates do sistema capitalista. Para isso, ao longo da redação, trato da noção de socialização como uma dobradiça que nos permite unir a noção de trabalho em Freud.

Ferenczi's variations on the death drive.

This theoretical paper discusses three variations on the death drive, developed by Sándor Ferenczi. We present a brief history of the use of the term death drive among the first psychoanalysts and argue that, as early as 1913, the notion is used by Ferenczi and serves as a conceptual background for his thinking. During the 1920s, Ferenczi revisits part of this concept, focusing on what he identifies as a primacy of self-destruction. The destructive drive gains an adaptive character responsible for the mortification of parts of the individual, in exchange for the survival of the whole. In this variation, the tendency to regress also arises as the self-destruction drive and the acceptance of unpleasure involves a psychic "reckoning-machine." In the final variation, left unfinished, the death drive at times receives new names, like drive for "conciliation," and at others, the very idea of the death drive is criticized.

On brutal gestures: trauma, destruction, and forms of mental illness.

The Bohemian writer Milan Kundera narrates, more than once, an experience from his years of life under an authoritarian regime. It is the memory of a violent fantasy of rape, one in which libido and destruction are mingled. Based on this memory and how he wrote about it, we present two forms of mental illnesses (by activation and by passivation) and relate them to the model proposed by Green to think about depressive states through passivation. The first form of mental illness, by activation, is the result of an overly successful active defense against anxiety. The second form, by passivation, is a paradoxical reaction to agony in the face of deadly psychic states. Arguing that this second form of mental illness is frequently identified in individuals during periods of political change, we consider that the intricacy between the drives of destruction and the libido, even when it generates fantasies or brutal gestures, can reveal itself as an episodic attempt of an active defense amid the predominance of passivation generated by post-traumatic helplessness.

Psychometric Evaluation of the Drive for Muscularity Scale and the Muscle Dysmorphic Disorder Inventory among Brazilian Cisgender Gay and Bisexual Adult Men.

Despite high levels of muscularity concerns among sexual-minority men, most of the existing literature on the drive for muscularity and muscle dysmorphia focuses on heterosexual men and has mainly been conducted in Western and English-speaking regions. The present study aimed to evaluate the psychometric properties of the Drive for Muscularity Scale (DMS) and the Muscle Dysmorphic Disorder Inventory (MDDI) in Brazilian cisgender gay and bisexual adult men who were 18-50 years old. We evaluated the factor structure of both measures using a two-step, split-sample exploratory (EFA; n = 704) and confirmatory (CFA; n = 705) factor-analytic approach, which supported the original three-factor structure of the MDDI and resulted in a reduced two-factor solution with 13 items for the DMS. Convergent validity was supported through associations of the DMS and the MDDI with eating disorder symptoms, body-ideal internalization, self-objectification beliefs and behaviors, and body appreciation measures. Additionally, we found good internal consistency, and test-retest reliability of both measures. Results support the validity and reliability of the DMS and the MDDI in Brazilian cisgender gay and bisexual adult men and will support future studies exploring these constructs in Brazilian sexual-minority men.

Validation and measurement invariance of the Muscularity-Oriented Eating Test among Brazilian men and women.

OBJECTIVE: The Muscularity-Oriented Eating Test (MOET) is a 15-item unidimensional scale, designed to assess eating practices that occur in the pursuit of a muscular body. The aim of the present study was to describe the translation and cultural adaptation of the MOET to Brazilian Portuguese, to explore its factor structure and measurement invariance, and to evaluate its internal consistency, three-week test-retest reliability, and convergent validity in a community sample of Brazilian men and women. METHOD: After the back-translation procedure, the Brazilian MOET was administered online to a sample of 1246 adults (634 men and 612 women), along with measures of drive for muscularity, muscle dysmorphia symptoms, muscular/athletic-ideal internalization, disordered eating behaviors, and exercise dependence. RESULTS: Findings from an exploratory factor analysis and a confirmatory factor analysis revealed a one-factor structure and adequate internal consistency for men (ω = 0.86; α = 0.86) and women (ω = .84; α = .83). Measurement invariance across gender was supported. In addition, the scale demonstrated good three week test-retest reliability for both men (ICC = .96; p < .001) and women (ICC = .92; p < .001), and the subscales revealed moderate to large associations with drive for muscularity, muscle dysmorphia symptoms, muscular/athletic-ideal internalization, disordered eating, and exercise dependence. CONCLUSION: This study supports the validity and reliability of the MOET in a community sample of Brazilian men and women and represents an advance in measures of muscularity-oriented disordered eating in Brazilian adults, allowing for future cross-cultural studies in this field. PUBLIC SIGNIFICANCE: The Muscularity-Oriented Eating Test (MOET) is a measure of muscularity-oriented disordered eating, which assess strict adherence to diet rules, including the food's macronutrient content, regulation of protein intake, and eating less or more to influence muscle gain. This study evaluated the validity and reliability of the MOET in a community sample of Brazilian men and women. Our findings represent an advance in measures of muscularity-oriented disordered eating in Brazilian adults.

Does the Other of the Lacan oriented analyst not exist? / O Outro do analista de orientação lacaniana não existe? / L'Autre de l'analyste d'orientation lacanienne n'existe pas? / El Otro del analista de orientación lacaniana no existe?

The structure of the unconscious and the circuit of) drive both indicate that the symbolic and imaginary dimensions merge in the direction of a real referent - that, even in the best formalizations, keeps its singularity - and, at the end of an analysis, may allow the emergence of the "analyst's desire". For their optimal understanding, I used the reports of the Pass device, from the World Association of Psychoanalysis regarding the appearance of the "analyst's desire" in the end of their treatments. I pointed out that, quite contradictorily, today's "singularities" follow a standard. The "analyst's desire" is confused with the "desire to put oneself on display and become a celebrity". This is the conclusion that led me to the ask: which is the post-modern Lacan oriented analyst's Other?

A estrutura do inconsciente e o circuito da pulsão nos indicam que as dimensões do simbólico e do imaginário convergem em direção a um referente real - que, por melhor formalizado que seja, é sempre singular - e, ao final de uma análise, pode dar lugar à emergência do "desejo do analista". Para apreendê-los, recorri aos relatórios do dispositivo do passe da Associação Mundial de Psicanálise e dos testemunhos de analistas sobre o advento do "desejo do analista" ao final de suas análises. Destaquei que, contraditoriamente, as "singularidades" hoje seguem um padrão. O "desejo do analista" confunde-se com o "desejo de exibir-se e de se tornar uma celebridade". Essa conclusão me conduziu a interrogar: Qual é o Outro do analista lacaniano na pós-modernidade?

La structure de l'inconscient et le circuit de la pulsion indiquent que les dimensions symbolique et imaginaire convergent vers un référent réel - qui, aussi bien formalisé qu'il soit, est toujours singulier - et peuvent donner lieu, à la fin d'une analyse, à l'émergence du "désir de l'analyste". Pour les appréhender, j'ai me suis servie des rapports du dispositif de passe de l'Association mondiale de psychanalyse et des témoignages d'analystes sur l'avènement du "désir de l'analyste" à la fin de leurs analyses. J'ai souligné que, par contre, les "singularités" suivent aujourd'hui un schéma. Le "désir de l'analyste" est confondu avec le "désir de se montrer et de devenir une célébrité". Cette conclusion m'a conduit à me poser la question suivante : quel est l'Autre de l'analyste lacanien dans la post-modernité?

La estructura del inconsciente y el circuito pulsional indican que las dimensiones simbólica e imaginaria convergen hacia un referente real - que, por muy formalizado que esté, siempre es singular - y, al final de un análisis, puede dar lugar a la aparición del "deseo del analista". Para aprehenderlos, recurrí a los informes del dispositivo de pases de la Asociación Mundial de Psicoanálisis y a los testimonios de analistas sobre el advenimiento del "deseo del analista" al final de sus análisis. Subrayé que, contradictoriamente, las "singularidades" actuales siguen un padrón. El "deseo del analista" se confunde con el "deseo de presumir y convertirse en una celebridad". Esta conclusión me llevó a preguntarme: ¿Cuál es el Otro del analista lacaniano en la posmodernidad?

Neiko-erotic: contemporary erotic literature in the light of Freudian psychoanalysis / Neiko-erótica: a literatura erótica contemporânea à luz da psicanálise freudiana

RESUMO: Este texto objetiva apresentar uma leitura da literatura erótica contemporânea a partir da teoria psicanalítica de Sigmund Freud. Percorrendo a história da escrita feminina e da literatura erótica, verifica-se o surgimento da chamada literatura erótica contemporânea. Entre as características desse gênero, destaca-se o cenário das tramas eróticas que torna central um eixo sombrio no qual gravita a sexualidade das personagens que, à luz da teoria freudiana, pode ser lida como um caráter disruptivo, característica fundamental das relações amorosas. Nesse viés, para que a erótica se valha como tal, torna-se necessária a presença de um traço discordante que nomeamos de neiko-erótico.

ABSTRACT: This text aims to present a reading of contemporary erotic literature based on Freud's psychoanalytic theory. Going through the history of women's writing and erotic literature, we can see the emergence of the so-called contemporary erotic literature. Among the characteristics of this genre, the setting of erotic plots stands out, which makes central a dark axis in which the sexuality of the characters gravitates which, in the light of Freudian theory, can be read as the disruptive character, a fundamental characteristic of love relationships. In this bias, for eroticism to be valid as such, the presence of a discordant trait that we call neiko-erotic is necessary.

Lesión pulmonar autoinfligida por el paciente / Patient self inflicted lung injury / Lesão pulmonar autoinfligida pelo paciente

Resumen: La optimización del esfuerzo espontáneo en la ventilación mecánica tiene un lugar central en la Unidad de Cuidados Intensivos; aporta beneficios a los pacientes como la mejoría en el intercambio de gases, ayuda a recuperar la función del diafragma y el mantenimiento de los músculos periféricos. Por otro lado, también puede estar asociado al deterioro de la oxigenación y la lesión pulmonar. El incremento del impulso respiratorio neural aumenta el esfuerzo muscular inspiratorio, lo que condiciona presiones de distensión pulmonar lesivas, que en el contexto del síndrome de insuficiencia respiratoria aguda es de vital relevancia, ya que puede provocar el colapso y la sobredistensión regional alveolar de forma cíclica, con distribución heterogénea del estrés y tensión pulmonar. Existen tres mecanismos de lesión pulmonar por esfuerzo espontáneo: sobredistensión, aumento de la perfusión pulmonar y asincronía paciente-ventilador. La lesión pulmonar causa fuga capilar, edema pulmonar y alteración del intercambio de gases. Esto conduce a un aumento del impulso respiratorio y mayores volúmenes corrientes de las propias respiraciones espontáneas del paciente, que provocan fuga capilar y mayor daño pulmonar de forma similar a la lesión pulmonar inducida por ventilador.

Abstract: The optimization of spontaneous effort in mechanical ventilation has a central place in the intensive care unit; provides benefits to patients such as improved gas exchange, helps to regain function of the diaphragm and maintenance of peripheral muscles. On the other hand, it can also be associated with impaired oxygenation and lung injury. The increase in the neural respiratory drive increases the inspiratory muscular effort, conditioning damaging pulmonary distension pressures, which in the context of acute respiratory distress syndrome is of vital importance, since it can cause collapse and regional alveolar overdistention in a cyclical way. with heterogeneous distribution of pulmonary stress and strain. There are three mechanisms of lung injury due to spontaneous effort: overdistention, increased pulmonary perfusion, and patient-ventilator asynchrony. Lung injury causes capillary leakage, pulmonary edema, and impaired gas exchange. This leads to increased respiratory drive and higher tidal volumes of the patient's own spontaneous breaths, causing capillary leakage and increased lung damage like ventilator-induced lung injury.

Resumo: A otimização do esforço espontâneo na ventilação mecânica tem lugar central na unidade de terapia intensiva; Proporciona benefícios aos pacientes como melhora nas trocas gasosas, auxilia na recuperação da função do diafragma e na manutenção da musculatura periférica. Por outro lado, também pode estar associada ao deterioro da oxigenação e lesão pulmonar. O incremento do impulso respiratório neural aumenta o esforço muscular inspiratório, condicionando pressões de distensão pulmonar prejudiciais, o que no contexto da síndrome de insuficiência respiratória aguda é de vital relevância, pois pode causar colapso e hiperdistensão alveolar regional de forma cíclica, com distribuição heterogênea do estresse e tensão pulmonar. Existem três mecanismos de lesão pulmonar espontânea por esforço: hiperdistensão, aumento da perfusão pulmonar e assincronia paciente-ventilador. A lesão pulmonar causa vazamento capilar, edema pulmonar e troca gasosa prejudicada. Isso leva ao aumento do impulso respiratório e aos volumes correntes mais altos das próprias respirações espontâneas do paciente, causando vazamento capilar e danos pulmonares adicionais semelhantes aos danos pulmonares induzidos pelo ventilador.

Ventilación mecánica de protección pulmonar y diafragmática en terapia intensiva / Mechanical ventilation for lung and diaphragm protection in intensive care / Ventilação mecânica para proteção pulmonar e diafragmática em terapia intensiva

Resumen: El enfermo crítico con ventilación mecánica presenta múltiples cambios deletéreos en la estructura y función del diafragma, denominados colectivamente disfunción diafragmática inducida por ventilador. Existen cuatro posibles mecanismos de miotrauma diafragmático: sobreasistencia ventilatoria, baja asistencia ventilatoria, miotrauma excéntrico y miotrauma espiratorio; los procesos moleculares y celulares subyacentes incluyen disfunción metabólica, estrés oxidativo mitocondrial y desequilibrio en la homeostasis proteica que culmina en atrofia diafragmática. La creciente comprensión en los mecanismos del miotrauma diafragmático, lesión pulmonar inducida por ventilador y lesión pulmonar autoinfligida da pie a un enfoque de ventilación mecánica en terapia intensiva que integre medidas de protección pulmonar y diafragmática: drive respiratorio, esfuerzo respiratorio, presión transpulmonar, presión intraabdominal, presión positiva al final de la espiración, manejo de asincronías, oxigenación y analgesia-sedación, además de considerar el tratamiento médico de las condiciones concurrentes con el objetivo de favorecer la liberación de la ventilación mecánica (VM), prevenir la discapacidad a largo plazo y aumentar la supervivencia, así como fomentar futuras investigaciones para la implementación en el entorno clínico.

Abstract: Critically ill patients with mechanical ventilation present multiple deleterious changes in the structure and function of the diaphragm, collectively called ventilator-induced diaphragmatic dysfunction. There are four possible mechanisms of diaphragmatic myotrauma: ventilatory over-assistance, low ventilatory assistance, eccentric myotrauma and expiratory myotrauma; underlying molecular and cellular processes include metabolic dysfunction, mitochondrial oxidative stress, and imbalance in protein homeostasis culminating in diaphragmatic atrophy. The growing understanding of the mechanisms of diaphragmatic myotrauma, ventilator-induced pulmonary injury and self-inflicted pulmonary injury gives rise to a mechanical ventilation approach in intensive care that integrates pulmonary and diaphragmatic protection measures: Respiratory drive, respiratory effort, transpulmonary pressure, intraabdominal pressure , positive end-expiratory pressure, management of asynchronies, oxygenation and analgesia-sedation, in addition to considering the medical treatment of concurrent conditions, with the aim of favoring the release of MV, preventing long-term disability and increasing the survival, as well as encourage future research for implementation in the clinical setting.

Resumo: O paciente em estado grave com ventilação mecânica apresenta múltiplas alterações deletérias na estrutura e função do diafragma, denominadas coletivamente como disfunção diafragmática induzida pelo ventilador. Existem quatro mecanismos possíveis de miotrauma diafragmático: sobrecarga ventilatória, baixo suporte ventilatório, miotrauma excêntrico e miotrauma expiratório; processos moleculares e celulares subjacentes incluem disfunção metabólica, estresse oxidativo mitocondrial e desequilíbrio na homeostase proteica culminando na atrofia diafragmática. A crescente compreensão dos mecanismos de miotrauma diafragmático, lesão pulmonar induzida por ventilador e lesão pulmonar autoinfligida dá origem a uma abordagem de ventilação mecânica em Terapia Intensiva que integra medidas de proteção pulmonar e diafragmática: drive respiratório, esforço respiratório, pressão transpulmonar, intra-pressão abdominal, pressão positiva ao final da expiração, manejo da assincronia, oxigenação e analgesia-sedação, além de considerar o tratamento médico das condições concomitantes, com o objetivo de favorecer a liberação da VM, prevenir incapacidades a longo prazo e aumentar a sobrevivência, bem como encorajar pesquisas futuras para implementação no ambiente clínico.

Quantitative analysis of Robertsonian chromosomes inherited by descendants from multiple Rb heterozygotes of Mus m. Domesticus.

Robertsonian translocation is the most common chromosomal rearrangement in mammals, and represents the type of chromosomal change that most effectively contributes to speciation in natural populations. Rb translocations involve double-strand DNA breaks at the centromere level in two telocentric chromosomes, followed by repair ligation of the respective long arms, creating a metacentric Rb chromosome. Many different chromosomal races have been described in Mus musculus domesticus that show reduced chromosome numbers due to the presence of Rb metacentric chromosomes. The crossroads between ancestral telocentrics and the new metacentric chromosomes should be resolved in the meiotic cells of the heterozygote individuals, which form trivalents. The preferential segregation of metacentric chromosomes to the egg during female meiosis I has been proposed to favor their fixation and eventual conversion of a telocentric karyotype to a metacentric karyotype. This biased segregation, a form of meiotic drive, explains the karyotype changes in mammalian species that have accumulated Rb fusions. We studied and compared the number of Rb chromosomes inherited by the offspring of multiple Rb heterozygous of M. domesticus in reciprocal crosses. We did not find that the Rb chromosomes were inherited preferentially with respect to the telocentric chromosomes; therefore, we found no evidence for the meiotic drive, nor was there a random distribution of Rb chromosomes inherited by the descendants.