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Sfogliando l'autobiografia di Chaplin e il lungo e sofferto racconto dei traumi che hanno costellato la sua infanzia, l'autrice cerca nelle esperienze miserevoli vissute nell'ambiente del vaudeville, le radici del suo bisogno di fantasticare e creare nuove rappresentazioni che gli permettano di elaborare i lutti patiti. Il suo appare, data l'ampiezza del-la sua produzione artistica, un "ostinato" bisogno di sopravvivere psichicamente. I genitori lavoravano insieme in teatro ed egli aveva frequentato il palcoscenico fin da bambino insieme al fratello; per lui il mondo della rappresentazione era indissolubilmente legato all'esperienza vivificante della coppia genitoriale unita nella comune passione, che la madre terrà viva con i suoi racconti fantastici, e che rimarrà impressa nella memoria del bambino Chaplin, anche dopo la perdita del padre per alcolismo e abbandono e della madre per i suoi ricoveri ospedalieri. Da questo nucleo di memorie vitali nascerà l'indimenticabile personaggio di Charlot, che assume in sé e sintetizza la miseria delle origini e la straordinaria energia per continuare a narra-re e così ricostruire la famiglia perduta e ritrovata, in particolare, per ricomporre la coppia padre e figlio, alla quale è dedicato in buona par-te "Il monello". Il suo amore per Dickens, in particolare per Oliver Twist, gli offrono il background letterario per costruire il suo personaggio più famoso ed amato, Charlot appunto.

"Why are we so fascinated by beauty?" is a question many of us have asked ourselves, as have many who came before us. This book investigates the moment of ecstatic solitude in which everyone can experience emotions through films, works of art or natural phenomenon, when, even if for a "magic" instant, we feel "alive" and masters of our own Self. Expanding from the author’s personal experience, this book is a series of applied psychoanalytic essays on film, literature, and aesthetic pleasure. It explores the complexity of loss and mourning, destructivity, perversion, and revenge, as well as an exploration of what can facilitate transformation and how to lead a blocked healing process back to motion. This fascinating and insightful book will be of interest to psychoanalysts, psychologists, teachers and students, and all those with an interest in psychoanalysis and the arts.

The aim of the study is to compare the small-size objects detection of synthetic 2D (2D-S), breast tomosynthesis (DBT) and standard full-field digital mammography (FFDM) images for different mammography systems. 8 mammography systems of 6 different models and vendors were compared using a home-made phantom composed of CDMAM (Artinis), homogeneous PMMA slabs and BR3D tissue-equivalent slabs (Cirs) containing an anatomic noise. In this study we performed a 4AFC study relative to details with diameters ranging from 100 to 500 μm. We simulate different phantom configurations equivalent to small, standard and large breast adding homogeneous PMMA slabs in order to obtain 3 different equivalent thicknesses. Each phantom configuration was imaged with 2 different dose levels. The processed images were successively divided into squared sub-images, each containing a detail of different size and contrast. The sub-images were rotated and displayed in random order on a 5MP calibrated monitor to 4 trained readers. A percentage correct PC relative each detail was calculated for each mammography, modality and configuration. Preliminary results obtained for configuration A (small breast) and “fixed” dose show that FFDM and DBT images have a significant better detection rates respect to 2D-S for details in the whole range 100-500 μm (p 0.06). Besides these general results, some different behaviours among mammography systems were found.

Based on the novel by Edoardo Sacheri, the action of the film2 is set in 1974, just before the military coup in Argentina. The country is on the edge, ready to fall under a terrible dictatorship wh...

(2017). El secreto de sus ojos: la dificil busqueda de la verdad y de los afectos a traves de la escritura. The International Journal of Psychoanalysis (en espanol): Vol. 3, No. 5, pp. 943-952.

Women who were previously treated for breast cancer (BC) are an important particular subgroup of women at intermediate BC risk. Their breast follow-up should be planned taking in consideration a 1.0-1.5 % annual rate of loco-regional recurrences and new ipsilateral or contralateral BCs during 15-20 years, and be based on a regional/district invitation system. This activity should be carried out by a Department of Radiology integrating screening and diagnostics in the context of a Breast Unit. We recommend the adoption of protocols dedicated to women previously treated for BC, with a clear definition of responsibilities, methods for invitation, site(s) of visits, methods for clinical and radiological evaluation, follow-up duration, role and function of family doctors and specialists. These women will be invited to get a mammogram in dedicated sessions starting from the year after the end of treatment. The planned follow-up duration will be at least 10 years and will be defined on the basis of patient's age and preferences, taking into consideration organizational matters. Special agreements can be defined in the case of women who have their follow-up planned at other qualified centers. Dedicated screening sessions should include: evaluation of familial/personal history (if previously not done) for identifying high-risk conditions which could indicate a different screening strategy; immediate evaluation of mammograms by one or, when possible, two breast radiologists with possible addition of supplemental mammographic views, digital breast tomosynthesis, clinical breast examination, breast ultrasound; and prompt planning of possible further workup. Results of these screening sessions should be set apart from those of general female population screening and presented in dedicated reports. The following research issues are suggested: further risk stratification and effectiveness of follow-up protocols differentiated also for BC pathologic subtype and molecular classification, and evaluation of different models of survivorship care, also in terms of cost-effectiveness.

L’autore presenta alcune riflessioni su aspetti della vita psichica con i quali noi tutti ci confrontiamo quotidianamente nel lavoro e in privato. Questi stessi aspetti, in certe circostanze storiche insieme ad elementi di diversa origine, possono espandersi, raggiungendo dimensioni e provocando conseguenze incontrollabili ed estremamente pericolose per l’intera collettivita. L’autore chiama queste, aree di "fondamentalismo psichico", che ritroviamo nella vita privata, nel lavoro clinico e nelle relazioni istituzionali con i colleghi quando affrontiamo discussioni teoriche. Puo accadere ogni volta che chiudiamo la porta in faccio alle ragioni e al pensiero degli altri, difendendo cio che ci e gia noto e percio ci rassicura, rispetto al non noto, che ci spaventa. Le due vignette cliniche che concludono il lavoro descrivono situazioni in cui aspetti ideologici e difensivi molto forti, frutto di cause diverse anche traumatiche, possono evolvere in senso meno rigido nel corso dell’analisi.

Psychoanalysts took great care to keep their offices immersed in silence, protected from the outside world. Even telephones and answering machines were seen as dangerous objects for a long time; they could infringe on the neutrality of analysis and the resultant request from patients to adapt to it. The information revolution arrived, and our offices experienced a gradual invasion of cell phones. Imperceptible sounds would break the silence: beep tones, signalling the arrival of messages, or ringtones, which even if “silenced” would alert to an incoming phone call. If psychoanalysts think of telephone and Skype analysis spreading, the picture becomes particularly disturbing, getting all the more vivid thanks to how the virtual excludes and gets used to the absence of direct contact between bodies, with the complexities, limits, fragilities, and consistency that physical co-presence carries with it.

We present a comparison between full field digital mammography and synthetic mammography, performed on several mammography systems from four different manufacturers. The analysis is carried out on both the digital and synthetic images of two commercially available mammography phantoms, and focuses on a set of objective metrics that encode the geometrical appearance of imaging features of diagnostic interest. In particular, we measured sizes and contrasts of several clusters of microcalcification specks, shapes and contrasts of circular masses, and the power spectrum of background regions mimicking the heterogeneous texture of the breast parenchyma. Despite the potential issues of tomosynthesis in terms of image blurring, the synthetic images do not highlight any globally significant differences in the rendering of the details of interest, when compared to the original digital mammograms: relative contrasts are generally preserved, as well as the geometry of broad structures. We conclude that, as far as the considered objective metrics are concerned, the image quality of synthetic mammography does not exhibit significant differences with respect to the one of full field digital mammography, for all the considered systems.

Purpose Purpose of this work is to compare image quality of Synthetic Mammography (SM) and Full Field Digital Mammography (FFDM) in four different Digital Breast Tomosynthesis (DBT) systems by using a semi-anthropomorphic phantom. Methods Four DBT systems (FujiFilm, GE, Hologic, IMS) were characterized by means of the semi-anthropomorphic CIRS-BR3D phantom. The phantom contains clusters of microcalcifications, fibers and masses embedded in a breast equivalent tissue having a heterogeneous background. For each DBT system two images (DBT and FFDM) were acquired applying clinical setup conditions. FFDM acquisitions were repeated in manual mode for each system with a fixed exposure ratio between DBT and FFDM. Comparative analyses were carried out on the contrasts and sizes of micro calcifications, on the contrasts and shapes of masses, and on the noise power spectrum of the background. The FFDM image acquired in clinical setup conditions was considered the gold standard of the metric. Results Considering the micro calcifications, contrasts were generally preserved by SM with respect to FFDM, while the sizes of the smaller details slightly increased, probably due to the blurring caused by the filtration stages of the tomographic reconstruction. Regarding the masses, no globally significant differences were noticeable in the contrasts, and the shapes were generally well preserved as well. Finally, concerning the noise power spectra, significant variations only appeared in the high frequency regime, in accordance with the above-mentioned blurring. Conclusions This preliminary analysis confirms for all systems the criticality of the synthetic image in terms of spatial resolution and noise but does not highlight significant differences in the detection capability of the details of interest. Further investigations will be made considering the DBT+SM combination compared to DBT+FFDM, as well as by extending the present analysis to other mammographic phantoms.

This position paper, issued by ICBR/SIRM and GISMa, summarizes the evidence on DBT and provides recommendations for its use. In the screening setting, DBT in adjunct to digital mammography (DM) increased detection rate by 0.5-2.7‰ and decreased false positives by 0.8-3.6% compared to DM alone in observational and double-testing experimental studies. The reduction in recall rate could be less prominent in those screening programs which already have low recall rates with DM. The increase in radiation exposure associated with DM/DBT protocols has been solved by the introduction of synthetic mammograms (sDM) reconstructed from DBT datasets. Thus, whenever possible, sDM/DBT should be preferred to DM/DBT. However, before introducing DBT as a routine screening tool for average-risk women, we should wait for the results of randomized controlled trials and for a statistically significant and clinically relevant reduction in the interval cancer rate, hopefully associated with a reduction in the advanced cancer rate. Otherwise, a potential for overdiagnosis and overtreatment cannot be excluded. Studies exploring this issue are ongoing. Screening of women at intermediate risk should follow the same recommendations, with particular protocols for women with previous BC history. In high-risk women, if mammography is performed as an adjunct to MRI or in the case of MRI contraindications, sDM/DBT protocols are suggested. Evidence exists in favor of DBT usage in women with clinical symptoms/signs and asymptomatic women with screen-detected findings recalled for work-up. The possibility to perform needle biopsy or localization under DBT guidance should be offered when DBT-only findings need characterization or surgery.

Purpose: In recent years, many approaches have been investigated on the development of full-field digital mammography detectors and implemented in practical clinical systems. Some of the most promising techniques are based on flat panel detectors, which, depending on the mechanism involved in the x-ray detection, can be grouped into direct and indirect flat panels. Direct detectors display a better spatial resolution due to the direct conversion of x rays into electron-hole pairs, which do not need an intermediate production of visible light. In these detectors the readout is usually achieved through arrays of thin film transistors (TFTs). However, TFT readout tends to display noise characteristics worse than those from indirect detectors. To address this problem, a novel clinical system for digital mammography has been recently marketed based on direct-conversion detector and optical readout. This unit, named AMULET and manufactured by FUJIFILM, is based on a dual layer of amorphous selenium that acts both as a converter of x rays (first layer) and as an optical switch for the readout of signals (second layer) powered by a line light source. The optical readout is expected to improve the noise characteristics of the detector. The aim is to obtain images with high resolution and low noise, thanks to the combination of optical switching technology and direct conversion with amorphous selenium. In this article, the authors present a characterization of an AMULET system. Methods: The characterization was achieved in terms of physical figures as modulation transfer function(MTF),noise power spectra (NPS), detective quantum efficiency (DQE), and contrast-detail analysis. The clinical unit was tested by exposing it to two different beams: 28 kV Mo/Mo (namely, RQA-M2) and 28 kV W/Rh (namely, W/Rh). Results: MTF values of the system are slightly worse than those recorded from other direct-conversion flat panels but still within the range of those from indirect flat panels: The MTF values of the AMULET system are about 45% and 15% at 5 and 8 lp/mm, respectively. On the other hand, however, AMULET NNPS results are consistently better than those from direct-conversion flat panels (up to two to three times lower) and flat panels based on scintillation phosphors. DQE results lie around 70% when RQA-M2 beams are used and approaches 80% in the case of W/Rh beams. Contrast-detail analysis, when performed by human observers on the AMULET system, results in values better than those published for other full-field digital mammography systems. Conclusions: The novel clinical unit based on direct-conversion detector and optical reading presents great results in terms of both physical and psychophysical characterizations. The good spatial resolution, combined with excellent noise properties, allows the achievement of very good DQE, better than those published for clinical FFDM systems. The psychophysical analysis confirms the excellent behavior of the AMULET unit.

Through an analytic reading of the 2 films by Elizabeth Marton and Roberto Faenza, we revisit the relationship between Sabina Spielrein and Carl Gustav Jung, focusing their attention on the contribution it gave to the development of the concept of transference and countertransference. Elisabeth Marton's film is more linked to the historical documentary, and Faenza inserts historical documentary in a fictional frame, bringing the spectator towards the affective, passionate level of this analytic relationship of the beginning. In the history of psychoanalysis, the therapeutic and love encounter of Spielrein and Jung represents the first attempt to testify the sufferings and errors, suffered by the 2 protagonists; they supplied the basic elements for the reflection and research of contemporary psychoanalysis on the theme of transference/countertransference.

The authors consider Giuseppe Tornatore's film from a psychoanalytic perspective as a metaphor of the difficult individuation-separation process of Max. He tells the lifestory of his friend Nineteen Hundred, the main character of the film, a virtuoso pianist who spent all his life on board a transatlantic ship in motion between the old continent and the new. Brought up by a black stoker in the deep noisy belly of the ship, music becomes, for him, the substitute for his unkown mother's body, his only raison d'etre and the structural aspect of his personality. In fact, he can never abandon the transatlantic, where he dies in the final explosion. Max, the trumpeter, telling his story to the old instruments dealer, works through the loss of his grandiose fantasy of perfection and omnipotence, represented by his friend Nineteen Hundred, and he finds a safer dimension of creativity and life. As in the analytic encounter, the possibility to narrate one's story to someone capable of listening and holding, opens t...

(2003). The castaway self: A psychoanalytic reading of Castaway (2000) The International Journal of Psychoanalysis: Vol. 84, No. 1, pp. 169-172.

The author analyzes Nathaniel Kahn's documentary film My Architect: A Son's Journey, a tribute to the writer-director's father Louis, the famous architect, who died suddenly when Nathaniel was eleven years old. The film's poetic, evocative images form a testimony to the silent working through that Nathaniel did in searching for his lost father and to the complex intertwining of mourning and creativity. Creativity is seen as both the cause and the effect of working through, as it gives life to a new meaning and allows replacement of the lost object by an object found again. Bereavement, symbolization, and the birth of representation appear to be connected with one another, both when the most elementary representations are involved and when the more complex and artistic ones are. Where and when it is possible to recover a representation that can survive the absence of the lost object, there is a potentially creative psychic space that can be made fertile again.

Purpose: In recent years, many approaches have been investigated on the development of full-field digital mammography detectors and implemented in practical clinical systems. Some of the most promising techniques are based on flat panel detectors, which, depending on the mechanism involved in the x-ray detection, can be grouped into direct and indirect flat panels. Direct detectors display a better spatial resolution due to the direct conversion of x rays into electron-hole pairs, which do not need an intermediate production of visible light. In these detectors the readout is usually achieved through arrays of thin film transistors (TFTs). However, TFT readout tends to display noise characteristics worse than those from indirect detectors. To address this problem, a novel clinical system for digital mammography has been recently marketed based on direct-conversion detector and optical readout. This unit, named AMULET and manufactured by FUJIFILM, is based on a dual layer of amorphous selenium that acts both as a converter of x rays (first layer) and as an optical switch for the readout of signals (second layer) powered by a line light source. The optical readout is expected to improve the noise characteristics of the detector. The aim is to obtain images with high resolution and low noise, thanks to the combination of optical switching technology and direct conversion with amorphous selenium. In this article, the authors present a characterization of an AMULET system. Methods: The characterization was achieved in terms of physical figures as modulation transfer function (MTF), noise power spectra (NPS), detective quantum efficiency (DQE), and contrast-detail analysis. The clinical unit was tested by exposing it to two different beams: 28 kV Mo/Mo (namely, RQA-M2) and 28 kV W/Rh (namely, W/Rh). Results: MTF values of the system are slightly worse than those recorded from other direct-conversion flat panels but still within the range of those from indirect flat panels: The MTF values of the AMULET system are about 45% and 15% at 5 and 8 lp/mm, respectively. On the other hand, however, AMULET NNPS results are consistently better than those from direct-conversion flat panels (up to two to three times lower) and flat panels based on scintillation phosphors. DQE results lie around 70% when RQA-M2 beams are used and approaches 80% in the case of W/Rh beams. Contrast-detail analysis, when performed by human observers on the AMULET system, results in values better than those published for other full-field digital mammography systems. Conclusions: The novel clinical unit based on direct-conversion detector and optical reading presents great results in terms of both physical and psychophysical characterizations. The good spatial resolution, combined with excellent noise properties, allows the achievement of very good DQE, better than those published for clinical FFDM systems. The psychophysical analysis confirms the excellent behavior of the AMULET unit.

Performance of Automatic Exposure control in several digital mammography systems (both CR and DR) were evaluated. The test procedure applied was that proposed by the European Guidelines, which requires measurement of contrast-to-noise ratio (CNR) produced by 0.2 mm Al superimposed on variable polymethyl-methacrylate (PMMA) thicknesses. PMMA layers were exposed by full automatic techniques and average glandular dose (AGD) determined. Results demonstrated that AGD values keep below the acceptable limits for all CR and DR systems at almost all equivalent breast thicknesses. CNRabsolute values per each thickness can significantly vary, depending on characteristics of each type of equipment. The application of limits suggested by the European Guidelines for CNRvariation with reference to 50 mm PMMA causes systematic failure for equivalent breast thickness above 50 mm; this may be due to the contradiction between the principles followed by the manufacturers to designed the AEC (signal constancy) and those proposed by the European protocol (CNRconstancy).

Indirect-conversion FFDM systems usually present a lower spatial resolution, with respect to the direct-conversion one. This can put serious issues in mammography, since high resolution is required. Digital software has been developed for restoring the losses in spatial resolution caused by blurring in the scintillation phosphor. GE Senographe DS system gives users the possibility of using such restoration. Basically, a filtering can be performed on the acquired images, by activating the FineView software option. In this work we present a complete characterization of a clinical system, in terms of MTF, NPS, DQE, and contrast-detail analysis. Figures of merit have been calculated on images acquired with and without the FineView software. The effects of the restoration software are investigated, both on image quality parameters, and on contrast-detail visibility. The MTF of the FFDM system is improved when FineView is activated. On the other hand, NPS presents noticeably changes, especially at high frequencies. DQE is fairly independent from the exposure, when FineView filter is not activated, whereas it presents a clear spread over the exposures, when FineView is activated. CDMAM analysis does not show significant differences between images with or without the restoration filter. Besides, the Mo/Mo beam seems to provide slightly better results than the Rh/Rh one.

Contrast-detail analysis is one the most common way for the assessment of the performance of an imaging system. Usually, the reading of phantoms, such as CDMAM, is obtained by human observers. The main drawbacks of this practice is the presence of inter-observer variability and the great amount of time needed. However, software programs are available, for reading CDMAM images in an automatic way. In this paper we present a comparison of human and software reading of CDMAM images coming from three different FFDM clinical units. Images were acquired at different exposures in the same conditions for the three systems. Once software has completed the reading, the interpretation of the results is achieved on the same way used for the human case. CDCOM results are consistent with human analysis, if we consider figures such as COR and IQF. On the other hand, we find out some discrepancies along the CD curves obtained by human observers, with respect to those estimated by automated CDCOM analysis.