Heart Rate Variability to Automatically Identify Hyperbaric States Considering Respiratory Component.

This study's primary objective was to identify individuals whose physiological responses deviated from the rest of the study population by automatically monitoring atmospheric pressure levels to which they are exposed and using parameters derived from their heart rate variability (HRV). To achieve this, 28 volunteers were placed in a dry hyperbaric chamber, where they experienced varying pressures from 1 to 5 atmospheres, with five sequential stops lasting five minutes each at different atmospheric pressures. The HRV was dissected into two components: the respiratory component, which is linked to respiration; and the residual component, which is influenced by factors beyond respiration. Nine parameters were assessed, including the respiratory rate, four classic HRV temporal parameters, and four frequency parameters. A k-nearest neighbors classifier based on cosine distance successfully identified the atmospheric pressures to which the subjects were exposed to. The classifier achieved an 88.5% accuracy rate in distinguishing between the 5 atm and 3 atm stages using only four features: respiratory rate, heart rate, and two frequency parameters associated with the subjects' sympathetic responses. Furthermore, the study identified 6 out of 28 subjects as having atypical responses across all pressure levels when compared to the majority. Interestingly, two of these subjects stood out in terms of gender and having less prior diving experience, but they still exhibited normal responses to immersion. This suggests the potential for establishing distinct safety protocols for divers based on their previous experience and gender.

Enhancing Safety in Hyperbaric Environments through Analysis of Autonomic Nervous System Responses: A Comparison of Dry and Humid Conditions.

Diving can have significant cardiovascular effects on the human body and increase the risk of developing cardiac health issues. This study aimed to investigate the autonomic nervous system (ANS) responses of healthy individuals during simulated dives in hyperbaric chambers and explore the effects of the humid environment on these responses. Electrocardiographic- and heart-rate-variability (HRV)-derived indices were analyzed, and their statistical ranges were compared at different depths during simulated immersions under dry and humid conditions. The results showed that humidity significantly affected the ANS responses of the subjects, leading to reduced parasympathetic activity and increased sympathetic dominance. The power of the high-frequency band of the HRV after removing the influence of respiration, PHF⟂¯, and the number of pairs of successive normal-to-normal intervals that differ by more than 50 ms divided by the total number of normal-to-normal intervals, pNN50¯, indices were found to be the most informative in distinguishing the ANS responses of subjects between the two datasets. Additionally, the statistical ranges of the HRV indices were calculated, and the classification of subjects as "normal" or "abnormal" was determined based on these ranges. The results showed that the ranges were effective at identifying abnormal ANS responses, indicating the potential use of these ranges as a reference for monitoring the activity of divers and avoiding future immersions if many indices are out of the normal ranges. The bagging method was also used to include some variability in the datasets' ranges, and the classification results showed that the ranges computed without proper bagging represent reality and its associated variability. Overall, this study provides valuable insights into the ANS responses of healthy individuals during simulated dives in hyperbaric chambers and the effects of humidity on these responses.

Urban dynamics through the lens of human mobility.

The urban spatial structure represents the distribution of public and private spaces in cities and how people move within them. Although it usually evolves slowly, it can change quickly during large-scale emergency events, as well as due to urban renewal in rapidly developing countries. Here we present an approach to delineate such urban dynamics in quasi-real time through a human mobility metric, the mobility centrality index ΔKS. As a case study, we tracked the urban dynamics of eleven Spanish cities during the COVID-19 pandemic. The results revealed that their structures became more monocentric during the lockdown in the first wave, but kept their regular spatial structures during the second wave. To provide a more comprehensive understanding of mobility from home, we also introduce a dimensionless metric, KSHBT, which measures the extent of home-based travel and provides statistical insights into the transmission of COVID-19. By utilizing individual mobility data, our metrics enable the detection of changes in the urban spatial structure.

Impact of the PPG Sampling Rate in the Pulse Rate Variability Indices Evaluating Several Fiducial Points in Different Pulse Waveforms.

The main aim of this work is to study the effect of the sampling rate of the photoplethysmographic (PPG) signal for pulse rate variability (PRV) analysis. Forehead and finger PPG signals were recorded at 1000 Hz during a rest state, with red and infrared wavelengths, simultaneously with the electrocardiogram (ECG). The PPG sampling rate has been reduced by decimation, obtaining signals at 500 Hz, 250 Hz, 125 Hz, 100 Hz, 50 Hz and 25 Hz. Five fiducial points were computed: apex, up-slope, medium, line-medium and medium interpolate point. The medium point is located in the middle of the up-slope of the pulse. The medium interpolate point is a new proposal as fiducial point that consider the abrupt up-slope of the PPG pulse, so it can be recovered by linear interpolation when the sampling rate is reduced. The error performed in the temporal location of the fiducial points was computed. Pulse period time interval series were obtained from all PPG signals and fiducial points, and compared with the RR intervals obtained from the ECG. Heart rate variability and PRV signals were estimated and classical time and frequency domain indices were computed. The results showed that the medium interpolate point of the PPG pulse was the most accurate fiducial point under different PPG morphologies and sensor locations, when sampling rate was reduced. Being able to reduce the sampling rate to 50 Hz without causing significant changes in time and frequency indices, when medium interpolate point was used as fiducial point.

Autonomic Nervous System characterization in hyperbaric environments considering respiratory component and non-linear analysis of Heart Rate Variability.

OBJECTIVES: an evaluation of Principal Dynamic Mode (PDM) and Orthogonal Subspace Projection (OSP) methods to characterize the Autonomic Nervous System (ANS) response in three different hyperbaric environments was performed. METHODS: ECG signals were recorded in two different stages (baseline and immersion) in three different hyperbaric environments: (a) inside a hyperbaric chamber, (b) in a controlled sea immersion, (c) in a real reservoir immersion. Time-domain parameters were extracted from the RR series of the ECG. From the Heart Rate Variability signal (HRV), classic Power Spectral Density (PSD), PDM (a non-linear analysis of HRV which is able to separate sympathetic and parasympathetic activities) and OSP (an analysis of HRV which is able to extract the respiratory component) methods were used to assess the ANS response. RESULTS: PDM and OSP parameters follows the same trend when compared to the PSD ones for the hyperbaric chamber dataset. Comparing the three hyperbaric scenarios, significant differences were found: i) heart rate decreased and RMSSD increased in the hyperbaric chamber and the controlled dive, but they had the opposite behavior during the uncontrolled dive; ii) power in the OSP respiratory component was lower than power in the OSP residual component in cases a and c; iii) PDM and OSP methods showed a significant increase in sympathetic activity during both dives, but parasympathetic activity increased only during the uncontrolled dive. CONCLUSIONS: PDM and OSP methods could be used as an alternative measurement of ANS response instead of the PSD method. OSP results indicate that most of the variation in the heart rate variability cannot be described by changes in the respiration, so changes in ANS response can be assigned to other factors. Time-domain parameters reflect vagal activation in the hyperbaric chamber and in the controlled dive because of the effect of pressure. In the uncontrolled dive, sympathetic activity seems to be dominant, due to the effects of other factors such as physical activity, the challenging environment, and the influence of breathing through the scuba mask during immersion. In sum, a careful description of the changes in all the possible factors that could affect the ANS response between baseline and immersion stages in hyperbaric environments is needed for better interpretation of the results.

Evaluación de fuentes de variación en pruebas multi-ambientes para rendimiento y sus componentes en algodón / Evaluation of sources of variation in multi-environment tests for yield and its components in cotton

RESUMEN La valoración de las fuentes de variación de los análisis de varianza combinado en las pruebas de evaluación multi-ambientes es de gran importancia en la selección de genotipos para recomendar nuevos cultivares, por su adaptabilidad y estabilidad. El objetivo de esta investigación fue evaluar la significancia estadística y contribución de las fuentes de variación: ambientes, genotipos e interacción genotipo x ambiente para rendimiento de algodón-semilla, porcentaje de fibra y rendimiento de fibra, en las zonas del Caribe seco y húmedo colombiano. Se utilizaron los datos de dos pruebas multi-ambientes por zona, donde se evaluaron 10 genotipos de fibra media diferentes, bajo el diseño de bloques completos al azar, con cuatro repeticiones. Cada prueba estuvo conformada por cuatro ensayos realizados durante las cosechas 2003/2004, 2007/2008 y 2009/2010. Los resultados señalan que, en promedio, el ambiente fue la fuente de variación más importante en significancia (p <0,05 y p <0,01) y variación (>64 %), de los análisis de varianza combinado para rendimiento de algodón-semilla y fibra, con tendencia similar en su comportamiento entre ellas y en las dos zonas del Caribe colombiano. Para el porcentaje de fibra en el Caribe seco, la fuente de variación más importante fue genotipos (74,4 %) y en el Caribe húmedo fue el ambiente (57,2 %). Se sugiere subdividir las dos zonas del Caribe en subzonas más homogéneas ambientalmente o aumentar en más de cuatro el número de ensayos por prueba, para minimizar el efecto del ambiente y la interacción genotipo x ambiente.

ABSTRACT The assessment of the sources of variation of the combined analysis of variance in the multi-environment evaluation tests is of great importance in the selection of genotypes to recommend new cultivars for their adaptability and stability. The objective of this research was to evaluate the statistical significance and contribution of the sources of variation: environments, genotypes and genotype x environment interaction for cotton-seed yield, fiber percentage and fiber yield, in the dry and humid Colombian Caribbean zones. Data from two multi-environment tests per zone were used, where 10 different medium fiber genotypes were evaluated, under a randomized complete block design with four replications. Each test consisted of four experimentos carried out during the 2003/2004, 2007/2008 and 2009/2010 harvests. The results indicate that on average the environment was the most important source of variation in significance (p <0.05 and p <0.01) and variation (>64 %) of the combined analysis of variance for cotton-seed yield and fiber, with a similar trend in their behavior between them and in the two zones of the Colombian Caribbean. For the percentage of fiber in the dry Caribbean, the most important source of variation was genotypes (74.4 %) and in the humid Caribbean it was the environment (57.2 %). It is suggested to subdivide the two zones of the Caribbean into more environmentally homogeneous subzones and / or to increase the number of trials per test, to minimize the effect of the environment and the genotype x environment interaction.

Interplay between mobility, multi-seeding and lockdowns shapes COVID-19 local impact.

Assessing the impact of mobility on epidemic spreading is of crucial importance for understanding the effect of policies like mass quarantines and selective re-openings. While many factors affect disease incidence at a local level, making it more or less homogeneous with respect to other areas, the importance of multi-seeding has often been overlooked. Multi-seeding occurs when several independent (non-clustered) infected individuals arrive at a susceptible population. This can lead to independent outbreaks that spark from distinct areas of the local contact (social) network. Such mechanism has the potential to boost incidence, making control efforts and contact tracing less effective. Here, through a modeling approach we show that the effect produced by the number of initial infections is non-linear on the incidence peak and peak time. When case importations are carried by mobility from an already infected area, this effect is further enhanced by the local demography and underlying mixing patterns: the impact of every seed is larger in smaller populations. Finally, both in the model simulations and the analysis, we show that a multi-seeding effect combined with mobility restrictions can explain the observed spatial heterogeneities in the first wave of COVID-19 incidence and mortality in five European countries. Our results allow us for identifying what we have called epidemic epicenter: an area that shapes incidence and mortality peaks in the entire country. The present work further clarifies the nonlinear effects that mobility can have on the evolution of an epidemic and highlight their relevance for epidemic control.

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3-5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant's success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes.

Photoplethysmographic Waveform and Pulse Rate Variability Analysis in Hyperbaric Environments.

The main aim of this work is to identify alterations in the morphology of the pulse photoplethysmogram (PPG) signal, due to the exposure of the subjects to a hyperbaric environment. Additionally, their Pulse Rate Variability (PRV) is analysed to characterise the response of their Autonomic Nervous System (ANS). To do that, 28 volunteers are introduced into a hyperbaric chamber and five sequential stages with different atmospheric pressures from 1 atm to 5 atm are performed. In this work, nineteen morphological parameters of the PPG signal are analysed: the pulse amplitude; eight parameters related to pulse width; eight parameters related to pulse area; and the two two pulse slopes. Also, classical time and frequency parameters of PRV are computed. Notable widening of the pulses width is observed in the stages analysed. The PPG area increases with pressure, with no significant changes when the initial pressure is recovered. These changes in PPG waveform may be caused by an increase in the systemic vascular resistance as a consequence of of vasoconstriction in the extremities, suggesting a sympathetic activation. However, the PRV results show an augmented parasympathetic activity and a reduction in the parameters that characterise the sympathetic response. So, only a sympathetic activation is detected in the peripheral region, as reflected by PPG morphology. The information regarding the ANS and the cardiovascular response that can be extracted from the PPG signal, as well as its compatibility with wet conditions make this signal the most suitable for studying the physiological response in hyperbaric environments.

Emergence and spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic resulting in unprecedented efforts to reduce transmission and develop therapies and vaccines (WHO Emergency Committee, 2020; Zhu et al., 2020). Rapidly generated viral genome sequences have allowed the spread of the virus to be tracked via phylogenetic analysis (Worobey et al., 2020; Hadfield et al., 2018; Pybus et al., 2020). While the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced, allowing continent-specific variants to emerge. However, within Europe travel resumed in the summer of 2020, and the impact of this travel on the epidemic is not well understood. Here we report on a novel SARS-CoV-2 variant, 20E (EU1), that emerged in Spain in early summer, and subsequently spread to multiple locations in Europe. We find no evidence of increased transmissibility of this variant, but instead demonstrate how rising incidence in Spain, resumption of travel across Europe, and lack of effective screening and containment may explain the variant's success. Despite travel restrictions and quarantine requirements, we estimate 20E (EU1) was introduced hundreds of times to countries across Europe by summertime travellers, likely undermining local efforts to keep SARS-CoV-2 cases low. Our results demonstrate how a variant can rapidly become dominant even in absence of a substantial transmission advantage in favorable epidemiological settings. Genomic surveillance is critical to understanding how travel can impact SARS-CoV-2 transmission, and thus for informing future containment strategies as travel resumes.

Structural Statistical Quantifiers and Thermal Features of Quantum Systems.

This paper deals primarily with relatively novel thermal quantifiers called disequilibrium and statistical complexity, whose role is growing in different disciplines of physics and other sciences. These quantifiers are called L. Ruiz, Mancini, and Calvet (LMC) quantifiers, following the initials of the three authors who advanced them. We wish to establish information-theoretical bridges between LMC structural quantifiers and (1) Thermal Heisenberg uncertainties ΔxΔp (at temperature T); (2) A nuclear physics fermion model. Having achieved such purposes, we determine to what an extent our bridges can be extended to both the semi-classical and classical realms. In addition, we find a strict bound relating a special LMC structural quantifier to quantum uncertainties.

Autonomic Nervous System Measurement in Hyperbaric Environments Using ECG and PPG Signals.

The main aim of this paper was to characterize the Autonomic Nervous System response in hyperbaric environments using electrocardiogram (ECG) and pulse-photoplethysmogram (PPG) signals. To that end, 26 subjects were introduced into a hyperbaric chamber and five stages with different atmospheric pressures (1 atm; descent to 3 and 5 atm; ascent to 3 and 1 atm) were recorded. Respiratory information was extracted from the ECG and PPG signals and a combined respiratory rate was studied. This information was also used to analyze Heart Rate Variability (HRV) and Pulse Rate Variability (PRV). The database was cleaned by eliminating those cases where the respiratory rate dropped into the low frequency band (LF: 0.04-0.15 Hz) and those in which there was a discrepancy between the respiratory rates estimated using the ECG and PPG signals. Classical temporal and frequency indices were calculated in such cases. The ECG results showed a time-related dependency, with the heart rate and sympathetic markers (normalized power in LF and LF/HF ratio) decreasing as more time was spent inside the hyperbaric environment. A dependence between the atmospheric pressure and the parasympathetic response, as reflected in the high-frequency band power (HF: 0.15-0.40 Hz), was also found, with power increasing with atmospheric pressure. The combined respiratory rate also reached a maximum in the deepest stage; thus, highlighting a significant difference between this stage and the first one. The PPG data gave similar findings and also allowed the oxygen saturation to be computed; therefore, we propose the use of this signal for future studies in hyperbaric environments.

Unconstrained Estimation of HRV Indices After Removing Respiratory Influences From Heart Rate.

OBJECTIVE: This paper proposes an approach to better estimate the sympathovagal balance (SB) and the respiratory sinus arrhythmia (RSA) after separating respiratory influences from the heart rate (HR). METHODS: The separation is performed using orthogonal subspace projections and the approach is first tested using simulated HR and respiratory signals with different spectral properties. Then, RSA and SB are estimated during autonomic blockade and stress using the proposed approach and the classical heart rate variability (HRV) analysis. Both real- and ECG-derived respiration (EDR) are used and the reliability of the EDR is evaluated. RESULTS: Mean absolute percentage errors lower than [Formula: see text] were obtained after removing previously known respiratory signals from simulated HR. The proposed indices were able to improve the quantification of SB during autonomic withdrawal. In the stress data, differences ( ) among relaxed and stressful phases were found with the proposed approach, using both the real respiration and the EDR, but they disappeared when using the classical HRV. CONCLUSION: A better assessment of the autonomic nervous system' response to pharmacological blockade and stress can be achieved after removing respiratory influences from HR, and this can be done using either the real respiration or the EDR. SIGNIFICANCE: This work can be used to better identify vagal withdrawal and increased sympathetic activation when the classical HRV analysis fails due to the respiratory influences on HR. Furthermore, it can be computed using only the ECG, which is an advantage when developing wearable systems with limited number of sensors.

Photoplethysmographic Waveform in Hyperbaric Environment.

The objective of this work is the identification of significant variations of morphological parameters of the photoplethysmographic (PPG) signal when the subjects are exposed to an increase in atmospheric pressure. To achieve this goal, the PPG signal of 26 subjects, exposed to a hyperbaric environment whose pressure increases up to 5 atm, has been recorded. From this record, segments of 4 minutes have been processed at 1 atm, 3 atm and 5 atm, both in the descending (D) and ascending (A) periods of the immersion. In total, four states (3D, 5, 3A and 1A) normalized to the basal state (1D) have been considered. In these segments, six morphological parameters of the PPG signal were studied. The width, the amplitude, the widths of the anacrotic and catacrotic phases, and the upward and downward slopes of each PPG pulse were extracted. The results showed significant increases in the three parameters related to the pulse width. This increase is significant in the four states analysed for the anacrotic phase width. Furthermore, a significant decrease in the amplitude and in both slopes (in the states 1A) was observed. These results show that the PPG width responds rapidly to the increase in pressure, indicating an activation of the sympathetic system, while amplitude and pulse slopes are decreased when the subjects are exposed to the hyperbaric environment for a considerable period of time.

Multivariable relationships between autonomic nervous system related indices in hyperbaric environments.

The main aim of this work is to model the relationships between parameters extracted from the heart rate variability (HRV) signal, which is derived from the electrocardiogram (ECG), at different stages of a simulated immersion in a hyperbaric chamber. The response of the Autonomic Nervous System is known to be affected by changes in atmospheric pressure, reflected in changes in the HRV signal. A dataset consisting of ECG signals from 17 subjects exposed to a controlled hyperbaric environment, simulating depths from 0 m to 40 m, was used. Both linear and nonlinear dependences of HRV parameters were analysed using linear regression and Mutual Information (entropy-based) techniques. Furthermore, relationships between parameters of the HRV signals, biophysical variables of the subjects, and atmospheric pressure changes were characterized by artificial neural networks. In particular, self-organizing maps (SOM) were trained for modelling and clustering all the data. In the mid-term, these models could be the basis to create predictive models of HRV parameters at high depths in order to increase the safety for divers by warning them if some abnormal body response could be expected just by processing the ECG signal at sea level before immersion.

La diferencia entre necesidad, demanda, deseo y pulsión / The difference between need, demand, desire and drive

Este artículo pretende dar cuenta de una clara distinción que es necesario realizar para dar claridad en la teoría psicoanalítica de los conceptos de necesidad, demanda, deseo y pulsión. Dichos conceptos suelen dar cabida a confusiones que pueden terminar afectando, no solo a la comprensión teórica, sino a la práctica clínica de los terapeutas y psicoanalistas.

This review article aims to account for a clear distinction that needs to be made to clarify the psychoanalytic theory of the concepts of need, demand, desire and drive. These concepts tend to give rise to confusions that may end up affecting, not only the theoretical understanding, but the clinical practice of therapists and psychoanalysts.

Methodological framework for heart rate variability analysis during exercise: application to running and cycling stress testing.

Standard methodologies of heart rate variability analysis and physiological interpretation as a marker of autonomic nervous system condition have been largely published at rest, but not so much during exercise. A methodological framework for heart rate variability (HRV) analysis during exercise is proposed, which deals with the non-stationary nature of HRV during exercise, includes respiratory information, and identifies and corrects spectral components related to cardiolocomotor coupling (CC). This is applied to 23 male subjects who underwent different tests: maximal and submaximal, running and cycling; where the ECG, respiratory frequency and oxygen consumption were simultaneously recorded. High-frequency (HF) power results largely modified from estimations with the standard fixed band to those obtained with the proposed methodology. For medium and high levels of exercise and recovery, HF power results in a 20 to 40% increase. When cycling, HF power increases around 40% with respect to running, while CC power is around 20% stronger in running.

Inclusion of Respiratory Frequency Information in Heart Rate Variability Analysis for Stress Assessment.

Respiratory rate and heart rate variability (HRV) are studied as stress markers in a database of young healthy volunteers subjected to acute emotional stress, induced by a modification of the Trier Social Stress Test. First, instantaneous frequency domain HRV parameters are computed using time-frequency analysis in the classical bands. Then, the respiratory rate is estimated and this information is included in HRV analysis in two ways: 1) redefining the high-frequency (HF) band to be centered at respiratory frequency; 2) excluding from the analysis those instants where respiratory frequency falls within the low-frequency (LF) band. Classical frequency domain HRV indices scarcely show statistical differences during stress. However, when including respiratory frequency information in HRV analysis, the normalized LF power as well as the LF/HF ratio significantly increase during stress ( p-value 0.05 according to the Wilcoxon test), revealing higher sympathetic dominance. The LF power increases during stress, only being significantly different in a stress anticipation stage, while the HF power decreases during stress, only being significantly different during the stress task demanding attention. Our results support that joint analysis of respiration and HRV obtains a more reliable characterization of autonomic nervous response to stress. In addition, the respiratory rate is observed to be higher and less stable during stress than during relax ( p-value 0.05 according to the Wilcoxon test) being the most discriminative index for stress stratification (AUC = 88.2 % ).

Dynamics of photoexcited Ba(+) cations in (4)He nanodroplets.

We present a joint experimental and theoretical study on the desolvation of Ba(+) cations in (4)He nanodroplets excited via the 6p ← 6s transition. The experiments reveal an efficient desolvation process yielding mainly bare Ba(+) cations and Ba(+)Hen exciplexes with n = 1 and 2. The speed distributions of the ions are well described by Maxwell-Boltzmann distributions with temperatures ranging from 60 to 178 K depending on the excitation frequency and Ba(+) Hen exciplex size. These results have been analyzed by calculations based on a time-dependent density functional description for the helium droplet combined with classical dynamics for the Ba(+). In agreement with experiment, the calculations reveal the dynamical formation of exciplexes following excitation of the Ba(+) cation. In contrast to experimental observation, the calculations do not reveal desolvation of excited Ba(+) cations or exciplexes, even when relaxation pathways to lower lying states are included.

El desencuentro entre los sexos / The disagreement between the sexes

El psicoanálisis plantea que hay un desencuentro del significante con el sexo, y este real está más allá del desciframiento del inconsciente; lo anterior significa que en el inconsciente no hay un saber de los hombres sobre las mujeres y viceversa. Esto, a su vez, tiene consecuencias en el goce del Otro, del Otro sexo, ya que este resultara siempre inadecuado: del lado del hombre se trata de un goce de carácter perverso, y del lado de la mujer se trata de un goce enigmático.

Psychoanalysis suggests that there is a mismatch between the signifier and sex, and this real it is beyond the deciphering of the unconscious; The above means that in the There is no knowledge of men about women and vice versa. This, in turn, it has consequences in the enjoyment of the Other, of the Other sex, since this will always result inadequate: on the man's side it is a wicked enjoyment, and on the side of the woman is an enigmatic enjoyment.