The dread of living without anticipation: a case of melancholia

It seems that time functions essentially different in melancholia as compared to classical neuroses. We might even say the experience of time dissapears for the melancholicus. No future is anticipated, no past determines the actually lived distress, despair and guilt. This paper illustrates by means of a case study of a melancholic woman how anticipation is necessary for the subject to be able to live. Without desire for things to come, without a past that is experienced as something that anticipated the subject as it is now, there seems to be no more than an eternal now that stupifies the subject and blurs the distinction between death and living. The absence of the structuring function of time results in the experience of utter loneliness and anxiety and consequently also shows the dramatic impact of an absence of anticipation

The impostor anticipates the truth of the other

In this paper, we will elaborate on an article by H�l�ne Deutsch on the psychology of the impostor. The impostor is a specific type of liar who imposes on others dishonest stories about his identity. From a psychoanalytic point of view, identity is by definition fraudulent as there is no real Self. But the impostor duplicates this fraud by presenting dishonest stories about personal attainments, position, or worldly possessions. Referring to Freud?s text on ?Two lies told by children,? we will demonstrate that in the neurotic subject (a) the motive for lying is love, and (b) the purpose of lying is to deny symbolic castration in order to preserve an imaginary ideal. The impostor takes this one step further: here the motive is not love but admiration, and the purpose is not denial but disavowal of the symbolic castration. Finally, we will discuss the ambivalent relation of the public towards the impostor that seems all too willing to be deceived. In that sense, the lies of the impostor anticipate the Other?s truth about castration

MicroRNAs promote skeletal muscle differentiation of mesodermal iPSC-derived progenitors

Muscular dystrophies (MDs) are often characterized by impairment of both skeletal and cardiac muscle. Regenerative strategies for both compartments therefore constitute a therapeutic avenue. Mesodermal iPSC-derived progenitors (MiPs) can regenerate both striated muscle types simultaneously in mice. Importantly, MiP myogenic propensity is influenced by somatic lineage retention. However, it is still unknown whether human MiPs have in vivo potential. Furthermore, methods to enhance the intrinsic myogenic properties of MiPs are likely needed, given the scope and need to correct large amounts of muscle in the MDs. Here, we document that human MiPs can successfully engraft into the skeletal muscle and hearts of dystrophic mice. Utilizing non-invasive live imaging and selectively induced apoptosis, we report evidence of striated muscle regeneration in vivo in mice by human MiPs. Finally, combining RNA-seq and miRNA-seq data, we define miRNA cocktails that promote the myogenic potential of human MiPs

Heart failure in COVID-19: the multicentre, multinational PCHF-COVICAV registry.

AIMS: We assessed the outcome of hospitalized coronavirus disease 2019 (COVID-19) patients with heart failure (HF) compared with patients with other cardiovascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia). We further wanted to determine the incidence of HF events and its consequences in these patient populations. METHODS AND RESULTS: International retrospective Postgraduate Course in Heart Failure registry for patients hospitalized with COVID-19 and CArdioVascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia) was performed in 28 centres from 15 countries (PCHF-COVICAV). The primary endpoint was in-hospital mortality. Of 1974 patients hospitalized with COVID-19, 1282 had cardiovascular disease and/or risk factors (median age: 72 [interquartile range: 62-81] years, 58% male), with HF being present in 256 [20%] patients. Overall in-hospital mortality was 25% (n = 323/1282 deaths). In-hospital mortality was higher in patients with a history of HF (36%, n = 92) compared with non-HF patients (23%, n = 231, odds ratio [OR] 1.93 [95% confidence interval: 1.44-2.59], P < 0.001). After adjusting, HF remained associated with in-hospital mortality (OR 1.45 [95% confidence interval: 1.01-2.06], P = 0.041). Importantly, 186 of 1282 [15%] patients had an acute HF event during hospitalization (76 [40%] with de novo HF), which was associated with higher in-hospital mortality (89 [48%] vs. 220 [23%]) than in patients without HF event (OR 3.10 [2.24-4.29], P < 0.001). CONCLUSIONS: Hospitalized COVID-19 patients with HF are at increased risk for in-hospital death. In-hospital worsening of HF or acute HF de novo are common and associated with a further increase in in-hospital mortality

The anticipation of enjoyment by the body in the case of trauma: a case of repetition compulsion

In his article � Le temps logique et l?assertion de certitude anticip�e � Lacan makes a distinction between three different instances of time : � l? instant de voir, le temps de comprendre et le moment de conclure �. The purpose of this paper is to explain how the body and its jouissance in the case of trauma may function as a kind of ?moment the conclure? in such a way that the body acts without the subject?s understanding of what is happening. Based on a case of trauma we will show how the body anticipates on a kind of enjoyment, without the subject knowing it, let alone being able to speak about it. ?Le temps pour comprendre? comes with the subject wanting to know because this wanting initiates ?l?instant de voir?. If the subject comes to a real understanding via symbolization of what happens, this bodily inscribed knowledge may be transformed into symbolic knowledge. Ideally, this will provide the subject with the possibility of making a choice, instead of being subjected to the traumatic repetition compulsion

Urinary peptidomic biomarkers of renal function in heart transplant recipients.

Chronic kidney disease (CKD) is common in patients after heart transplantation (HTx). We assessed whether in HTx recipients the proteomic urinary classifier CKD273 or sequenced urinary peptides revealing the parental proteins correlated with the estimated glomerular filtration rate (eGFR). In 368 HTx patients, we measured the urinary peptidome and analysed CKD273 and 48 urinary peptides with a detectable signal in &gt;95% of participants. After 9.1 months (median), eGFR and the urinary biomarkers were reassessed. In multivariable Bonferroni-corrected analyses of the baseline data, a 1-SD increase in CKD273 was associated with a 11.4 [95% confidence interval (CI) 7.25-15.5] mL/min/1.73 m2 lower eGFR and an odds ratio of 2.63 (1.56-4.46) for having eGFR &lt;60 mL/min/1.73 m2. While relating eGFR category at follow-up to baseline urinary biomarkers, CKD273 had higher (P = 0.007) area under the curve (0.75; 95% CI 0.70-0.80) than 24-h proteinuria (0.64; 95% CI 0.58-0.69), but additional adjustment for baseline eGFR removed significance of both biomarkers. In partial least squares analysis, the strongest correlates of the multivariable-adjusted baseline eGFR were fragments of collagen I (positive) and the mucin-1 subunit α (inverse). Associations between the changes in eGFR and the urinary markers were inverse for CKD273 and mucin-1 and positive for urinary collagen I. With the exception of baseline eGFR, CKD273 was more closer associated with imminent renal dysfunction than 24-h proteinuria. Fragments of collagen I and mucin-1-respectively, positively and inversely associated with eGFR and change in eGFR-are single-peptide markers associated with renal dysfunction

Relative and Absolute Risk to Guide the Management of Pulse Pressure, an Age-Related Cardiovascular Risk Factor

BACKGROUND Pulse pressure (PP) reflects the age-related stiffening of the central arteries, but no study addressed the management of the PP-related risk over the human lifespan. METHODS In 4,663 young (18-49 years) and 7,185 older adults (&gt;= 50 years), brachial PP was recorded over 24 hours. Total mortality and all major cardiovascular events (MACEs) combined were coprimary endpoints. Cardiovascular death, coronary events, and stroke were secondary endpoints. RESULTS In young adults (median follow-up, 14.1 years; mean PP, 45.1 mm Hg), greater PP was not associated with absolute risk; the endpoint rates were &lt;= 2.01 per 1,000 person-years. The adjusted hazard ratios expressed per 10-mm Hg PP increments were less than unity (P &lt;= 0.027) for MACE (0.67; 95% confidence interval [CI], 0.47-0.96) and cardiovascular death (0.33; 95% CI, 0.11-0.75). In older adults (median follow-up, 13.1 years; mean PP, 52.7 mm Hg), the endpoint rates, expressing absolute risk, ranged from 22.5 to 45.4 per 1,000 person-years and the adjusted hazard ratios, reflecting relative risk, from 1.09 to 1.54 (P &lt; 0.0001). The PP-related relative risks of death, MACE, and stroke decreased &gt;3-fold from age 55 to 75 years, whereas absolute risk rose by a factor 3. CONCLUSIONS From 50 years onwards, the PP-related relative risk decreases, whereas absolute risk increases. From a lifecourse perspective, young adulthood provides a window of opportunity to manage risk factors and prevent target organ damage as forerunner of premature death and MACE. In older adults, treatment should address absolute risk, thereby extending life in years and quality

Heart failure in COVID-19: the multicentre, multinational PCHF-COVICAV registry

Aims: We assessed the outcome of hospitalized coronavirus disease 2019 (COVID-19) patients with heart failure (HF) compared with patients with other cardiovascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia). We further wanted to determine the incidence of HF events and its consequences in these patient populations. Methods and results: International retrospective Postgraduate Course in Heart Failure registry for patients hospitalized with COVID-19 and CArdioVascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia) was performed in 28 centres from 15 countries (PCHF-COVICAV). The primary endpoint was in-hospital mortality. Of 1974 patients hospitalized with COVID-19, 1282 had cardiovascular disease and/or risk factors (median age: 72 [interquartile range: 62–81] years, 58% male), with HF being present in 256 [20%] patients. Overall in-hospital mortality was 25% (n&nbsp;=&nbsp;323/1282 deaths). In-hospital mortality was higher in patients with a history of HF (36%, n&nbsp;=&nbsp;92) compared with non-HF patients (23%, n&nbsp;=&nbsp;231, odds ratio [OR] 1.93 [95% confidence interval: 1.44–2.59], P&nbsp;&lt;&nbsp;0.001). After adjusting, HF remained associated with in-hospital mortality (OR 1.45 [95% confidence interval: 1.01–2.06], P&nbsp;=&nbsp;0.041). Importantly, 186 of 1282 [15%] patients had an acute HF event during hospitalization (76 [40%] with de novo HF), which was associated with higher in-hospital mortality (89 [48%] vs. 220 [23%]) than in patients without HF event (OR 3.10 [2.24–4.29], P&nbsp;&lt;&nbsp;0.001). Conclusions: Hospitalized COVID-19 patients with HF are at increased risk for in-hospital death. In-hospital worsening of HF or acute HF de novo are common and associated with a further increase in in-hospital mortality