The presentation, clinical features, complications, and treatment of congenital dacryocystocele

Purpose To determine the incidence and presenting features of congenital dacryocystocele in the United Kingdom. To report on those cases complicated by dacryocystitis, respiratory compromise, and the treatment undertaken. Methods A prospective observational study of cases of congenital dacryocystocele presenting in the United Kingdom between September 2014 and October 2015. Infants <3 months of age presenting with a cystic swelling in the medial canthal area were included. Cases were identified via the British Ophthalmology Surveillance Unit (BOSU) reporting system. Results A total of 49 cases were reported during the study period. This gives an incidence of 1 in 18 597 live births. There was a 71% response rate to the questionnaire. The average age at presentation was 16.94 days. Dacryocystoceles were unilateral in 91% of cases. Dacryocystitis was a complicating factor in 49% of patients and 17% had respiratory distress. Uncomplicated dacryocystocele responded well to conservative measures in 86%. Surgical intervention was required in 23% of patients. Those cases complicated by dacryocystitis (29%) and nasal obstruction (17%) were more likely to require surgical intervention compared to those with dacryocystocele alone (14%). Digital massage appears to reduce the likelihood of requiring surgical intervention. The mean time to resolution was 19 days. Conclusions Congenital dacryocystocele is a rare presentation in the United Kingdom. Dacryocystitis and respiratory compromise commonly complicate a dacryocystocele. The use of digital massage as an early intervention is advocated and conservative measures may be sufficient in cases of uncomplicated dacryocystocele

Two mechanisms drive pronuclear migration in mouse zygotes

A new life begins with the unification of the maternal and paternal chromosomes upon fertilization. The parental chromosomes first become enclosed in two separate pronuclei near the surface of the fertilized egg. The mechanisms that then move the pronuclei inwards for their unification are only poorly understood in mammals. Here, we report two mechanisms that act in concert to unite the parental genomes in fertilized mouse eggs. The male pronucleus assembles within the fertilization cone and is rapidly moved inwards by the flattening cone. Rab11a recruits the actin nucleation factors Spire and Formin-2 into the fertilization cone, where they locally nucleate actin and further accelerate the pronucleus inwards. In parallel, a dynamic network of microtubules assembles that slowly moves the male and female pronuclei towards the cell centre in a dynein-dependent manner. Both mechanisms are partially redundant and act in concert to unite the parental pronuclei in the zygote’s centre

The cost of severe haemophilia in Europe: the CHESS study

Background Severe haemophilia is associated with major psychological and economic burden for patients, caregivers, and the wider health care system. This burden has been quantified and documented for a number of European countries in recent years. However, few studies have taken a standardised methodology across multiple countries simultaneously, and sought to amalgamate all three levels of burden for severe disease. The overall aim of the ‘Cost of Haemophilia in Europe: a Socioeconomic Survey’ (CHESS) study was to capture the annualised economic and psychosocial burden of severe haemophilia in five European countries. A cross-section of haemophilia specialists (surveyed between January and April 2015) provided demographic and clinical information and 12-month ambulatory and secondary care activity for patients via an online survey. In turn, patients provided corresponding direct and indirect non-medical cost information, including work loss and out-of-pocket expenses, as well as information on quality of life and adherence. The direct and indirect costs for the patient sample were calculated and extrapolated to population level. Results Clinical reports for a total of 1,285 patients were received. Five hundred and fifty-two patients (43% of the sample) provided information on indirect costs and health-related quality of life via the PSC. The total annual cost of severe haemophilia across the five countries for 2014 was estimated at EUR 1.4 billion, or just under EUR 200,000 per patient. The highest per-patient costs were in Germany (mean EUR 319,024) and the lowest were in the United Kingdom (mean EUR 129,365), with a study average of EUR 199,541. As expected, consumption of clotting factor replacement therapy represented the vast majority of costs (up to 99%). Indirect costs are driven by patient and caregiver work loss. Conclusions The results of the CHESS study reflect previous research findings suggesting that costs of factor replacement therapy account for the vast majority of the cost burden in severe haemophilia. However, the importance of the indirect impact of haemophilia on the patient and family should not be overlooked. The CHESS study highlights the benefits of observational study methodologies in capturing a ‘snapshot’ of information for patients with rare diseases

Controlling Narrative Generation with Planning Trajectories: The Role of Constraints

Abstract. AI planning has featured in a number of Interactive Storytelling prototypes: since narratives can be naturally modelled as a sequence of actions it has been possible to exploit state of the art planners in the task of narrative generation. However the characteristics of a “good ” plan, such as optimality, aren’t necessarily the same as those of a “good ” narrative, where errors and convoluted sequences may offer more reader interest, so some narrative structuring is required. In our work we have looked at injecting narrative control into plan generation through the use of PDDL3.0 state trajectory constraints which enable us to express narrative control information within the planning representation. As part of this we have developed an approach to planning with such trajectory constraints. The approach decomposes the problem into a set of smaller subproblems using the temporal orderings described by the constraints and then solves these subproblems incrementally. In this paper we outline our method and present results that illustrate the potential of the approach.

現地観測に基づく河川流の乱流特性に関する研究

博士（工学）神戸大

Endothelial Injury in Human Atherosclerosis

A light and electron microscopic investigation (scanning and transmission electron microscopy) was performed on 51 human atherosclerotic carotid lesions. The purpose of this study was to establish whether features of endothelial injury such as those described in animals occur in man and whether these features can be related to specific stages of human atherosclerosis. Irrespective of their histological appearance the atherosclerotic lesions were covered with endothelium which showed non-specific changes in cell shape and size. However, all complicated lesions appeared denuded. Moreover, a peculiar interaction of endothelium with monocytes and lymphocytes as well as blood components (e.g., fibrin and lipoproteins) was observed in intimal thickenings, fatty streaks and uncomplicated plaques. The surface exposure of macrophage-derived foam cells was seen on florid fatty lesions. Large areas of the arterial surface lacking any endothelial coverage Were characteristic of complicated plaques. They appeared to be a consequence of the arterial wall degeneration with an associated failure in endothelial repair

Interactive storytelling with literary feelings

In this paper, the authors describe the integration of Natural Language Processing (NLP) within an emotional planner to support Interactive Storytelling. Their emotional planner is based on a standard HSP planner, whose originality is drawn from altering the agents’ beliefs and emotional states. Each character is driven by its own planner, while characters are able to operate on their reciprocal feelings thus affecting each other. Our baseline story is constituted by a classic XIXth century French novel from Gustave Flaubert in which characters feelings play a dominant role. This approach benefits from the fact that Flaubert has described a specific ontology for his characters feelings. The objective of NLP should be to uncover from natural language utterances the same kind of affective elements, which requires an integration between NLP and the planning component at the level of semantic content. This research is illustrated with examples from a first fully integrated prototype comprising NLP, emotional planning and real-time 3D animation

The IRIS Network of Excellence:: Integrating Research in Interactive Storytelling

Abstract. Interactive Storytelling is a major endeavour to develop new media which could offer a radically new user experience, with a potential to revolutionise digital entertainment. European research in Interactive Storytelling has played a leading role in the development of the field, and this creates a unique opportunity to strengthen its position even further by structuring collaboration between some of its main actors. IRIS (Integrating Research in Interactive Storytelling) aims at creating a virtual centre of excellence that will be able to progress the understanding of fundamental aspects of Interactive Storytelling and the development of corresponding technologies

Under the influence::Using natural language in interactive storytelling

Interacting in natural language with virtual actors is an important aspect of the development of future Interactive Storytelling systems. We describe a paradigm for speech interfaces in interactive storytelling based on the notion of influence. In this paradigm, the user is mainly a spectator who is however able to interfere with the course of action by issuing advice to the characters. This is achieved by recognising corresponding speech acts and mapping them to the plans which implement characters&apos; behaviours in the story. We discuss some examples based on a preliminary, yet fully implemented, prototype

Stepping into the Interactive Drama

Interactive Drama is the ultimate challenge of digital entertainment. In this paper, from our seven year experience in Interactive Drama, we try to shape the history of the field and envision what will be (or should be) the future of this history. Two main directions in particular are stressed, because we feel that the success of Interactive Drama lies in these two directions. The first one concerns the architecture of systems and how it would manage both narrative constraints and character&apos;s intelligence, believability and roundness. The second one focuses on project management by sketching a methodology of co-design fo