Evolution of immune systems: specificity and autoreactivity

Multicellularity evolved well before 600 million years ago, and all multicellular animals have evolved since then with the need to protect against pathogens. There is no reason to expect their immune systems to be any less sophisticated than ours. The vertebrate system, based on rearranging immunoglobulin-superfamily domains, appears to have evolved partly as a result of chance insertion of RAG genes by horizontal transfer. Remarkably sophisticated systems for expansion of immunological repertoire have evolved in parallel in many groups of organisms. Vaccination of invertebrates against commercially important pathogens has been empirically successful, and suggests that the definition of an adaptive and innate immune system should no longer depend on the presence of memory and specificity, since these terms are hard to define in themselves. The evolution of randomly-created immunological repertoire also carries with it the potential for generating autoreactive specificities and consequent autoimmune damage.While invertebrates may use systems analogous to ours to control autoreactive specificities, they may have evolved alternative mechanisms which operate either at the level of individuals-within-populations rather than cells-within-individuals, by linking self-reactive specificities to regulatory pathways and non-self-reactive to effector pathways.

A notion of subgame perfect Nash equilibrium under knightian uncertainty

We define a subgame perfect Nash equilibrium under Knightian uncertainty for two players, by means of a recursive backward induction procedure. We prove an extension of the Zermelo-von Neumann-Kuhn Theorem for games of perfect information, i. e., that the recursive procedure generates a Nash equilibrium under uncertainty (Dow and Werlang(1994)) of the whole game. We apply the notion for two well known games: the chain store and the centipede. On the one hand, we show that subgame perfection under Knightian uncertainty explains the chain store paradox in a one shot version. On the other hand, we show that subgame perfection under uncertainty does not account for the leaving behavior observed in the centipede game. This is in contrast to Dow, Orioli and Werlang(1996) where we explain by means of Nash equilibria under uncertainty (but not subgame perfect) the experiments of McKelvey and Palfrey(1992). Finally, we show that there may be nontrivial subgame perfect equilibria under uncertainty in more complex extensive form games, as in the case of the finitely repeated prisoner's dilemma, which accounts for cooperation in early stages of the game.

A notion of subgame perfect nash equilibrium under knightian uncertainty

We define a subgame perfect Nash equilibrium under Knightian uncertainty for two players, by means of a recursive backward induction procedure. We prove an extension of the Zermelo-von Neumann-Kuhn Theorem for games of perfect information, i. e., that the recursive procedure generates a Nash equilibrium under uncertainty (Dow and Werlang(1994)) of the whole game. We apply the notion for two well known games: the chain store and the centipede. On the one hand, we show that subgame perfection under Knightian uncertainty explains the chain store paradox in a one shot version. On the other hand, we show that subgame perfection under uncertainty does not account for the leaving behavior observed in the centipede game. This is in contrast to Dow, Orioli and Werlang(1996) where we explain by means of Nash equilibria under uncertainty (but not subgame perfect) the experiments of McKelvey and Palfrey(1992). Finally, we show that there may be nontrivial subgame perfect equilibria under uncertainty in more complex extensive form games, as in the case of the finitely repeated prisoner's dilemma, which accounts for cooperation in early stages of the game .

Representation and analysis of soccer players' actions using principal components

This paper proposes the use of the Principal Components Analysis (PCA) method to represent and to analyse soccer players' actions distribution in the pitch. The seven games of the Brazilian National Team during the 2002 World Cup were analysed. The player's position actions were measured from videotapes in a computer interface. The results were: a) the graphical representation, given by two orthogonal segments in the two directions of maximal variability and centred at the mean of each player's actions position; b) the eccentricity measurement, given by the variability ratio and c) the actions zone area, given by variability product. The results showed that the individual characteristics of acting were well represented by the PCA, allowing comparisons among games and providing insights related to the tactical organisation of the team.

'A Distortion in the mirror of being': verso un modello liquido di personaggio. Da Nabokov alle sperimentazioni contemporanee in ambito slavo

La tesi mira a ridefinire lo statuto del personaggio nell’ambito del self-conscious novel postmoderno, alla luce delle più recenti tendenze narratologiche, con particolare riferimento all’unnatural narratology. Per poter presentare un modello scientificamente valido si è fatto ricorso alla comparazione della produzione letteraria di due macro-aree: quella britannica e quella slava (Russia - Unione Sovietica - e Polonia). Come figura di mediazione tra queste due culture si pone senza dubbio Vladimir V. Nabokov, cardine e personalità di spicco della ricerca. Tra le analisi testuali proposte sono stati presi in considerazione i seguenti autori: Julian Barnes, Vladimir Nabokov, Daniil Charms, Konstantin Vaginov, Andrej Bitov, Saša Sokolov, Bruno Schulz e Tadeusz Kantor.

I giochi d'azzardo a Bologna nelle carte di polizia

Questa ricerca si pone come obbiettivo lo studio e l’analisi delle diverse manifestazioni del gioco d’azzardo nella Bologna della fine del XIX secolo. Partendo dall’assunto che le forme ludiche non rappresentino solo una pratica, né soltanto un fatto sociale o economico ma sono piuttosto la somma di diverse componenti, ci si è proposti di studiare la storia a partire da uno specifico punto di vista: quello dei giochi e dei giocatori legati alle pratiche del rischio. Tramite le carte d’archivio della polizia e altri documenti dell’epoca si sono indagati i diversi aspetti del fenomeno dell’azzardo: i luoghi in cui essi venivano praticati, le norme che li regolavano, gli strati sociali entro cui venivano giocati, le mutazioni delle condizioni politiche e sociali che portarono al cambiamento delle diverse forme ludiche e delle comunità che lo hanno praticato e contestualmente si è cercato di comprendere come cambino e come permangano la percezione del rischio, l’idea di competizione, la stessa attitudine al gioco.

Shading Silhouettes of Smaller Ones

I am truly honored to have been given the amazing opportunity to create this original piece, this powerful journey through memory and emotive exploration of the loss of childhood. How do we feel about the loss of our child-self? Could we ever get them back? How long, how deep would one have to dig in the graveyards, the playgrounds of memory, to uncover what was buried there... to un-erase what waserased? shading silhouettes of smaller ones will ultimately encourage a reconnection with the Inner Child hidden inside all of us, as well as an intimate awareness of the adult version of the self by looking back to the smaller ones. The main inspiration for this piece is then of course, Inner Child Work. Most people may not be familiar with this therapeutic exploration of childhood... It wasimportant to me then, to present this concept in an imaginative, theatrical way, as a gift to you - a comprehensive and intensely moving gift. Speaking from experience, working on my Inner Child - my little Bianca - has been the most painful, frightening, yetrewarding and powerful experience within my personal life. Some people spend their entire lives trying to love themselves, to prove themselves, or be accepted. Some are too afraid to look back to where it all began. The characters within this piece will face thatfear... in a regression from the complexities of adulthood to the confusion of adolescence, all the way back to the wonder and bliss of childhood. They will reveal memories, of both joy and pain, love and abandonment, journeying backwards through time - through memory - through a playground - back to the beginning... We will enter a world where a push of a merry-go-round spins us to games of Truth or Dare after a high school dance at 16 - or the slam of a metal fence reminds us of the door Dad slammed in our face at 9 - where the sound of chain links swings us back to scrapping our knee by the sandbox at 5 This piece will attempt to connect everyone, both cast and audience, through a universal understanding and discussion of what it means to grow up, as well as a discovery of WHY we are the way we are - how experiences or relationships from our childhood have shaped our adult lives. We will attempt to challenge your honesty and nerve by inviting you to ask questions of yourselves, your past - to remember what it's like to have the innocence and hope of a child, to engage with and discover your Inner Child, to realize when or why you left them behind, and if you want to this magical part of yourself. It is my hope that you will join us in a collective journey - gather the courage to dig up the little kid you buried so long ago...* The creation, design, choreography, and direction for shading silhouettes of smaller ones mark the culminating experience of a year-long independent study in Theatre.

The significant effect of endometriosis on physical, mental and social wellbeing: results from an international cross-sectional survey.

STUDY QUESTION To what extent do the management of endometriosis and the symptoms that remain after treatment affect the quality of life in women with the disease? SUMMARY ANSWER Many women with endometriosis had impaired quality of life and continued to suffer from endometriosis-associated symptoms even though their endometriosis has been managed in tertiary care centres. WHAT IS KNOWN ALREADY The existing literature indicates that quality of life and work productivity is reduced in women with endometriosis. However, most studies have small sample sizes, are treatment related or examine newly diagnosed patients only. STUDY DESIGN, SIZE, DURATION A cross-sectional questionnaire-based survey among 931 women with endometriosis treated in 12 tertiary care centres in 10 countries. PARTICIPANTS/MATERIALS, SETTING, METHODS Women diagnosed with endometriosis who had at least one contact related to endometriosis-associated symptoms during 2008 with a participating centre were enrolled into the study. The study investigated the effect of endometriosis on education, work and social wellbeing, endometriosis-associated symptoms and health-related quality of life, by using questions obtained from the World Endometriosis Research Foundation (WERF) GSWH instrument (designed and validated for the WERF Global Study on Women's Health) and the Short Form 36 version 2 (SF-36v2). MAIN RESULTS AND THE ROLE OF CHANCE Of 3216 women invited to participate in the study, 1450 (45%) provided informed consent and out of these, 931 (931/3216 = 29%) returned the questionnaires. Endometriosis had affected work in 51% of the women and affected relationships in 50% of the women at some time during their life. Dysmenorrhoea was reported by 59%, dyspareunia by 56% and chronic pelvic pain by 60% of women. Quality of life was decreased in all eight dimensions of the SF-36v2 compared with norm-based scores from a general US population (all P < 0.01). Multivariate regression analysis showed that number of co-morbidities, chronic pain and dyspareunia had an independent negative effect on both the physical and mental component of the SF-36v2. LIMITATIONS, REASONS FOR CAUTION The fact that women were enrolled in tertiary care centres could lead to a possible over-representation of women with moderate-to-severe endometriosis, because the participating centres typically treat more complex and referred cases of endometriosis. The response rate was relatively low. Since there was no Institute Review Board approval to do a non-responder investigation on basic characteristics, some uncertainty remains regarding the representativeness of the investigated population. WIDER IMPLICATIONS OF THE FINDINGS This international multicentre survey represents a large group of women with endometriosis, in all phases of the disease, which increases the generalizability of the data. Women still suffer from frequent symptoms, despite tertiary care management, in particular chronic pain and dyspareunia. As a result their quality of life is significantly decreased. A patient-centred approach with extensive collaboration across disciplines, such as pain specialists, psychologists, sexologists and social workers, may be a valuable strategy to improve the long-term care of women with endometriosis. STUDY FUNDING/COMPETING INTEREST(S) The WERF EndoCost study is funded by the World Endometriosis Research Foundation (WERF) through grants received from Bayer Schering Pharma AG, Takeda Italia Farmaceutici SpA, Pfizer Ltd and the European Society of Human Reproduction and Embryology. The sponsors did not have a role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript. L.H. is the chief executive and T.D. was a board member of WERF at the time of funding. T.D. holds the Merck-Serono Chair in Reproductive Medicine and Surgery, and the Ferring Chair in Reproductive Medicine at the Katholieke Universiteit Leuven in Belgium and has served as consultant/research collaborator for Merck-Serono, Schering-Plough, Astellas and Arresto.

Intrauterine instillation of diluted seminal plasma at oocyte pick-up does not increase the IVF pregnancy rate: a double-blind, placebo controlled, randomized study.

STUDY QUESTION Does intrauterine application of diluted seminal plasma (SP) at the time of ovum pick-up improve the pregnancy rate by ≥14% in IVF treatment? SUMMARY ANSWER Intrauterine instillation of diluted SP at the time of ovum pick-up is unlikely to increase the pregnancy rate by ≥14% in IVF. WHAT IS KNOWN ALREADY SP modulates endometrial function, and sexual intercourse around the time of embryo transfer has been suggested to increase the likelihood of pregnancy. A previous randomized double-blind pilot study demonstrated a strong trend towards increased pregnancy rates following the intracervical application of undiluted SP. As this study was not conclusive and as the finding could have been confounded by sexual intercourse, the intrauterine application of diluted SP was investigated in the present trial. STUDY DESIGN, SIZE, DURATION A single-centre, prospective, double-blind, placebo-controlled, randomized, superiority trial on women undergoing IVF was conducted from April 2007 until February 2012 at the University Department of Gynaecological Endocrinology and Reproductive Medicine, Heidelberg, Germany. PARTICIPANTS/MATERIALS, SETTING, METHODS The study was powered to detect an 14% increase in the clinical pregnancy rate and two sequential tests were planned using the Pocock spending function. At the first interim analysis, 279 women had been randomly assigned to intrauterine diluted SP (20% SP in saline from the patients' partner) (n = 138) or placebo (n = 141) at the time of ovum pick-up. MAIN RESULTS AND THE ROLE OF CHANCE The clinical pregnancy rate per randomized patient was 37/138 (26.8%) in the SP group and 41/141 (29.1%) in the placebo group (difference: -2.3%, 95% confidence interval of the difference: -12.7 to +8.2%; P = 0.69). The live birth rate per randomized patient was 28/138 (20.3%) in the SP group and 33/141 (23.4%) in the placebo group (difference: -3.1%, 95% confidence interval of the difference: -12.7 to +6.6%; P = 0.56). It was decided to terminate the trial due to futility at the first interim analysis, at a conditional power of 62%. LIMITATIONS, REASONS FOR CAUTION The confidence interval of the difference remains wide, thus clinically relevant differences cannot reliably be excluded based on this single study. WIDER IMPLICATIONS OF THE FINDINGS The results of this study cast doubt on the validity of the concept that SP increases endometrial receptivity and thus implantation in humans. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by the department's own research facilities. TRIAL REGISTRATION NUMBER DRKS00004615.

Minimally invasive surgery when treating endometriosis has a positive effect on health and on quality of work life of affected women

STUDY QUESTION: What is the effect of the minimally invasive surgical treatment of endometriosis on health and on quality of work life (e.g. working performance) of affected women? SUMMARY ANSWER: Absence from work, performance loss and the general negative impact of endometriosis on the job are reduced significantly by the laparoscopic surgery. WHAT IS KNOWN ALREADY: The benefits of surgery overall and of the laparoscopic method in particular for treating endometriosis have been described before. However, previous studies focus on medical benchmarks without including the patient's perspective in a quantitative manner. STUDY DESIGN, SIZE, DURATION: A retrospective questionnaire-based survey covering 211 women with endometriosis and a history of specific laparoscopic surgery in a Swiss university hospital, tertiary care center. Data were returned anonymously and were collected from the beginning of 2012 until March 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS: Women diagnosed with endometriosis and with at least one specific laparoscopic surgery in the past were enrolled in the study. The study investigated the effect of the minimally invasive surgery on health and on quality of work life of affected women. Questions used were obtained from the World Endometriosis Research Foundation (WERF) Global Study on Women's Health (GSWH) instrument. The questionnaire was shortened and adapted for the purpose of the present study. MAIN RESULTS AND THE ROLE OF CHANCE: Of the 587 women invited to participate in the study, 232 (232/587 = 40%) returned the questionnaires. Twenty-one questionnaires were excluded due to incomplete data and 211 sets (211/587 = 36%) were included in the study. Our data show that 62% (n = 130) of the study population declared endometriosis as influencing the job during the period prior to surgery, compared with 28% after surgery (P < 0.001). The mean (maximal) absence from work due to endometriosis was reduced from 2.0 (4.9) to 0.5 (1.4) hours per week (P < 0.001). The mean (maximal) loss in working performance after the surgery averaged out at 5.7% (12.6%) compared with 17.5% (30.5%) before this treatment (P < 0.001). LIMITATIONS, REASONS FOR CAUTION: The mediocre response rate of the study weakens the representativeness of the investigated population. Considering the anonymous setting a non-responder investigation was not performed. A bias due to selection, information and negativity effects within a retrospective survey cannot be excluded, although study-sensitive questions were provided in multiple ways. The absence of a control group (sham group; e.g. patients undergoing specific diagnostic laparoscopy without treatment) is a further limitation of the study. WIDER IMPLICATIONS OF THE FINDINGS: Our study shows that indicated minimally invasive surgery has a clear positive effect on the wellbeing and working performance of women suffering from moderate to severe endometriosis. Furthermore, national net savings in indirect costs with the present number of surgeries is estimated to be €10.7 million per year. In an idealized setting (i.e. without any diagnosis delay) this figure could be more than doubled. STUDY FUNDING/COMPETING INTERESTS: The study was performed on behalf of the University Hospital of Bern (Inselspital) as one of the leading Swiss tertiary care centers. The authors do not declare any competing interests.

The comprehensiveness of the ESHRE/ESGE classification of female genital tract congenital anomalies: a systematic review of cases not classified by the AFS system.

STUDY QUESTION How comprehensive is the recently published European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) classification system of female genital anomalies? SUMMARY ANSWER The ESHRE/ESGE classification provides a comprehensive description and categorization of almost all of the currently known anomalies that could not be classified properly with the American Fertility Society (AFS) system. WHAT IS KNOWN ALREADY Until now, the more accepted classification system, namely that of the AFS, is associated with serious limitations in effective categorization of female genital anomalies. Many cases published in the literature could not be properly classified using the AFS system, yet a clear and accurate classification is a prerequisite for treatment. STUDY DESIGN, SIZE AND DURATION The CONUTA (CONgenital UTerine Anomalies) ESHRE/ESGE group conducted a systematic review of the literature to examine if those types of anomalies that could not be properly classified with the AFS system could be effectively classified with the use of the new ESHRE/ESGE system. An electronic literature search through Medline, Embase and Cochrane library was carried out from January 1988 to January 2014. Three participants independently screened, selected articles of potential interest and finally extracted data from all the included studies. Any disagreement was discussed and resolved after consultation with a fourth reviewer and the results were assessed independently and approved by all members of the CONUTA group. PARTICIPANTS/MATERIALS, SETTING, METHODS Among the 143 articles assessed in detail, 120 were finally selected reporting 140 cases that could not properly fit into a specific class of the AFS system. Those 140 cases were clustered in 39 different types of anomalies. MAIN RESULTS AND THE ROLE OF CHANCE The congenital anomaly involved a single organ in 12 (30.8%) out of the 39 types of anomalies, while multiple organs and/or segments of Müllerian ducts (complex anomaly) were involved in 27 (69.2%) types. Uterus was the organ most frequently involved (30/39: 76.9%), followed by cervix (26/39: 66.7%) and vagina (23/39: 59%). In all 39 types, the ESHRE/ESGE classification system provided a comprehensive description of each single or complex anomaly. A precise categorization was reached in 38 out of 39 types studied. Only one case of a bizarre uterine anomaly, with no clear embryological defect, could not be categorized and thus was placed in Class 6 (un-classified) of the ESHRE/ESGE system. LIMITATIONS, REASONS FOR CAUTION The review of the literature was thorough but we cannot rule out the possibility that other defects exist which will also require testing in the new ESHRE/ESGE system. These anomalies, however, must be rare. WIDER IMPLICATIONS OF THE FINDINGS The comprehensiveness of the ESHRE/ESGE classification adds objective scientific validity to its use. This may, therefore, promote its further dissemination and acceptance, which will have a positive outcome in clinical care and research. STUDY FUNDING/COMPETING INTERESTS None.

The Quality of the Evidence According to GRADE Is Predominantly Low or Very Low in Oral Health Systematic Reviews

OBJECTIVES The main objective was to assess the credibility of the evidence using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) in oral health systematic reviews on the Cochrane Database of Systematic Reviews (CDSR) and elsewhere. STUDY DESIGN AND SETTING Systematic Reviews or meta-analyses (January 2008-December 2013) from 14 high impact general dental and specialty dental journals and the Cochrane Database of Systematic Reviews were screened for meta-analyses. Data was collected at the systematic review, meta-analysis and trial level. Two reviewers applied and agreed on the GRADE rating for the selected meta-analyses. RESULTS From the 510 systematic reviews initially identified 91 reviews (41 Cochrane and 50 non-Cochrane) were eligible for inclusion. The quality of evidence was high in 2% and moderate in 18% of the included meta-analyses with no difference between Cochrane and non-Cochrane reviews, journal impact factor or year of publication. The most common domains prompting downgrading of the evidence were study limitations (risk of bias) and imprecision (risk of play of chance). CONCLUSION The quality of the evidence in oral health assessed using GRADE is predominantly low or very low suggesting a pressing need for more randomised clinical trials and other studies of higher quality in order to inform clinical decisions thereby reducing the risk of instituting potentially ineffective and/or harmful therapies.

Analysis of the critical moments in the League ACB 2007-2008

The aim of this paper was to identify the variables that determine winning or losing in the critical moments of the basketball games. A total of forty one critical moments were analyzed, corresponding to 30 games of the regular season from the Spanish Professional League (ACB, season 2007-2008). Games were selected according to the definition of critical moments (described in the available literature), which corresponded to overtime and the last 5 minutes of games with score differences equal or below to six points. The results revealed better values in the winners in defensive rebounds and successful free-throws.