Within the framework of radioactive waste management, the evolution of the gaseous composition inside the underground repository structures must be understood. Indeed, chemical and microbial reactions and exchanges occur between the rock, the structures and the air. These processes are studied in the Andra’s Meuse/Haute-Marne Underground Research Laboratory’s (URL). Recently, a gas monitoring station “Flair soil™” has been designed to monitor the gaseous composition inside this URL. This station is composed by two analyzers: a quadrupole mass spectrometer (QMS) which allows to follow the evolution of several gases and an infrared laser spectroscope (Picarro) providing simultaneous measurements of CH4, CO2 and CO. Thus, a multivariate calibration method for the quantitative detection of interfering and non-interfering gases in a nitrogen matrix has been developed for the QMS. The MS was calibrated from pure gases in a nitrogen matrix, with known concentrations and ion currents obtained from the measurement of each species of gas. This method uses matrix calculations to calculate the relative concentrations of an unknown gas mixture from the ion currents measured directly in the MS. The test gases T1 and T2 were used to assess the accuracy of the method. Daily ion currents are corrected from theoretical ion currents obtained from calibration coefficients and test gas concentrations. Some gases are less well quantified due to their low concentration in the test gases and interferences on the measured masses. One of the motivations of this study lay in developing an advanced measurement tool allowing to be low in sensitivity, and thus to improve the detection and quantification of gases at low concentrations. The objective of this paper is to propose an analytical method to measure the gaseous composition with several molecules. This method was able to detect hydrocarbons, noble gases, sulfides, greenhouse gases, oxygen, hydrogen, nitrogen in the same mixture.

The basic object of investigation is classical Chazy - a nonlinear third-order autonomous differential equation with movable singular line. In this paper, the first integral of Chazy equation is obtained with the help of Backlund transformation, which is a transcendental dependence on the function and its derivatives . The general solution of equation is represented by Laurent series in the punctured neighborhood of point at infinity, and in the domain is represented by Taylor series. It is proved that the obtained Laurent and Taylor series all converge absolutely in their defined domains. Under the situation that the analytic continuation of solutions of differential equation with movable singular line cannot be realized, a necessary and sufficient condition is presented for obtaining the two-parameter rational solution of Chazy equation from its general solution constructed by Taylor series. And the research results can be applied in the analytic theory of ordinary differential equations.

Pastoralist grazing management practices play a vital role in maintaining rangeland productivity and biodiversity. However, the degradation of rangelands and loss of ecosystem services have raised concerns about the future of pastoralism as a form of land use. Despite their importance, we have limited knowledge about the effect of traditional grazing management practices on vegetation attributes, such as species composition, richness, diversity, herbage biomass, and density, and canopy cover. To address this knowledge gap, we studied the changes in vegetation attributes under three traditional grazing management practices in the Somali pastoral ecosystem of Ethiopia. We found a significant difference in herbaceous and woody vegetation attributes among the grazing management practices (p < 0.001). Enclosures supported higher herbaceous species diversity and abundance of desirable species, such as Chloris gayana, Chrysopogon aucheri, Cynodon dactylon, and Themeda triandera, compared to open grazing and browsing management sites. The herbage biomass was three times higher in enclosures than in open grazing and twice higher than in browsing management practices. However, browsing management practices supported significantly higher levels of wood biomass, density, and canopy cover than the other management practices. Our results suggest that transitioning from open grazing to the enclosure and browsing management practices can lead to higher plant productivity, which supports the local pastoral economy in the Somali rangeland of Ethiopia. Thus, dryland restoration programs should consider traditional indigenous knowledge for ensuring the sustainability of future rangeland productivity and biodiversity conservation.

The role of TLR4 (toll like receptor 4), a key molecule of the classical innate immune pathway, in individual tumors requires further exploration. In this study, numerous databases and tools, such as TCGA, GTEx, cBioportal, GSCALite, and GDSC, were utilized to systematically analyze the prognostic and immunological potential of TLR4 in tumors. The expression levels and mutational dynamics of TLR4 in pan-cancer were investigated. The prognostic potential of TLR4 was analyzed using Kaplan-Meier (KM) analysis. Results showed the levels of TLR4 in tumor tissues were significantly lower as compared to those in normal tissues in most cancers and were strongly correlated with the patient’s outcomes. The mutant genes associated with TLR4 were mainly enriched in the PI3K-AKT pathway. This could be a potential pathway for radiotherapy to activate the tumor immune microenvironment via TLR4/MAP. In tumors, the TLR4 mutations were closely associated with the M1/M2 polarization of macrophages. TLR4 and its ligand CD14 were significantly negatively associated with immunosuppressed MDSCs and TAM M2. The intervention of TLR4-dependent signaling pathways might be a promising strategy to reduce tolerance to ICB treatment in the post-immune era. In conclusion, this study expands the potential of TLR4 as an immune target in tumor therapy.

Mitochondria damage is an important cause of heart dysfunction after severe burn. However, the pathophysiological process remains unclear. This study aims to examine the mitochondrial dynamics in the heart after severe burn, and the role of μ-calpain, a cysteine protease, in this scenario. Rats were subjected to thermal injury treatment, and calpain inhibitor MDL28170 was given intravenously 1 h before burn injury. Compared with the sham group, the rats in the burn group displayed weakened heart performance and decreased mean arterial pressure, which was accompanied by a diminishment of mitochondria function. Furthermore, severe burn increased the level of calpain in mitochondria, reflected by immunofluorescence staining and activity test. In contrast, treatment with MDL28170 diminished these responses to a severe burn. Severe burn induced morphological defects of mitochondria, and decreased the abundance of mitochondria. Of note, severe burn increased the percentage of the mitochondria with bigger size, but decreased the smaller ones. Analysis of dynamic proteins revealed that severe burn caused an increase of fission protein DRP1 in the mitochondria and a decrease of inner membrane fusion protein OPA1. Similarly, these alterations were also blocked by MDL28170. Last but not the least, inhibition of calpain yielded the emergence of more elongated mitochondria along with membrane invagination in the middle of the longitude, an indicator of the fission process. Overall, these results for the first time provide evidence that mitochondria recruitment of calpain confers heart dysfunction after severe burn, which involves mitochondrial dynamics damage.

OBJECTIVE: To retrospectively analyze the clinical characteristics of overweight/obese children with asthma and their influence on the degree of asthma control in outpatient clinics of Children’s Hospital of Chongqing Medical University. METHODS: Outpatient medical records of children with bronchial asthma attending the outpatient clinic of the Children’s Hospital of Chongqing Medical University from January 2021 to October 2022 were collected, and the clinical characteristics of overweight/obese children with asthma and their influence on the degree of asthma control were analyzed by the propensity score method. Results: A total of 496 children with bronchial asthma were included. 130 of the 496 children were overweight/obese, 302 of the total population were male (60.9%), and the ratio of male to female children was approximately 1.5:1. All children were from the southwest region of China. The mean age of the children in the total population was 6.10±0.20 years. The risk of poor asthma control was 1.30 times higher in the overweight/obese population compared to the non-obese/overweight population using traditional logistic regression, with a 95% CI of 0.82-2.05. Logistic regression models were constructed using propensity score methods to balance confounding factors, i.e. propensity score weighting and propensity score matching methods, all of which consistently concluded that overweight/obesity was positively associated with asthma control. Obesity was positively associated with asthma control, with the propensity score weighting method yielding an OR=1.2, 95% CI=0.92-1.57 and the propensity score matching method yielding an OR of 1.09, 95% CI=0.61-1.97. Conclusion: Being overweight/obese has an impact on the degree of control in children with asthma, and overweight/obese children are at higher risk of poor asthma control.

Background: E. coli O83 (Colinfant Newborn) is a Gram-negative (G-) probiotic bacterium used in the clinic. When administered orally, it reduces allergic sensitisation but not allergic asthma. Intranasal administration may be more effective as it reaches the lungs directly. G- bacteria release outer membrane vesicles (OMVs) to communicate with the environment. Here we investigate whether intranasally administered E. coli O83 OMVs (EcO83-OMVs) can reduce allergy in mice. Methods: EcO83-OMVs were isolated by ultracentrifugation and characterised with respect to their number, morphology (shape and size), composition (proteins and lipopolysaccharide; LPS), recognition by innate receptors (using transfected HEK293 cells) and immunomodulatory potential (in naïve splenocytes and bone marrow-derived dendritic cells; BMDCs). Their allergy-preventive effect was investigated in a mouse model of allergic airway inflammation. Results: EcO83-OMVs are spherical nanoparticles with a size of about 110 nm. They contain LPS and protein cargo. We identified a total of 1120 proteins, 136 of which were enriched in OMVs compared to parent bacteria. Proteins from the flagellum dominated. OMVs activated the pattern recognition receptors TLR2/4/5 as well as NOD1 and NOD2. EcO83-OMVs were internalised by epithelial cells and induced the production of pro- and anti-inflammatory cytokines in splenocytes and BMDCs. Intranasal administration of EcO83-OMVs inhibited airway hyperresponsiveness, decreased airway eosinophilia, Th2 cytokine production and mucus secretion. Conclusion: We demonstrate for the first time that intranasally administered OMVs from probiotic G- bacteria have an anti-allergic effect. Our study highlights the advantages of OMVs as a safe platform for prophylactic treatment of allergy.

DNA methylation (DNAm) is a dynamic, age-dependent, epigenetic modification that can be used to study interactions between genetic and environmental factors. Environmental exposures during critical periods of growth and development may alter DNAm patterns, leading to increased susceptibility to diseases such as asthma and allergy. One method to study the role of DNAm is the epigenetic clock – an algorithm that uses DNAm levels at select age informative Cytosine-phosphate-Guanine (CpG) dinucleotides to predict epigenetic age (EA). The difference between EA and calendar age (CA) is termed epigenetic age acceleration (EAA) and reveals information about the biological capacity of an individual. Associations between EAA and disease susceptibility have been demonstrated for a variety of age-related conditions and, more recently, phenotypes such asthma and allergic diseases which often begin in childhood and progress throughout the lifespan. In this review, we explore different epigenetic clocks and how they have been applied, particularly as related to childhood asthma and in utero and early life exposures (e.g., smoking, diet, and drugs) that result in methylation changes.

This work demonstrates protein aggregation and oligomerization can be evaluated by solid-state nanopore method. A silicon nitride nanopore sensor is used to characterize a model protein ß-lactoglobulin variant A (βLGa) amyloid formation and native-state oligomerization in close to biological solution condition at single molecule level. To verify the results obtained from nanopore measurements, atomic force microscopy (AFM) and dynamic light scattering (DLS) techniques are used to measure and calibrate the same βLGa protein samples incubated at different stages. Using the parameters measured by DLS, AFM, and by measuring linear and circular dsDNA molecules in the same nanopore, we estimate the length and diameter of amyloid fibrils, and the number of βLGa aggregation and the distribution of these species. Furthermore, as a demonstration of the nanopore technique, βLGa self-association and aggregation at pH 4.6 as a function of temperature are measured in 2M and 0.1M salt. Protein aggregation has been linked to many chronic and devastating neurodegenerative human diseases and is also strongly associated with aging. This study shows the advantages and limitations of evaluating protein aggregation by solid-state nanopore technology.

Stress has been shown to influence working memory (WM). However, little is known about the effects of acute stress on pilots’ WM with varying WM loads. The current study aims to shed more light on this issue. Forty-two pilots were randomly assigned to the stress or the control group. The stress group experienced acute stress induced by the modified Trier Social Stress Test (TSST), and the control group did not receive any stress induction. Then, all participants performed N-back tasks under varying levels of WM load (0-back, 1-back, and 2-back) to examine their WM. We measured their State-Trait Anxiety Inventory scores and salivary cortisol concentrations repeatedly throughout the experiment to determine the effects of induced stress. The results showed that (1) the modified TSST effectively induced acute stress in the stress group; (2) as the WM load level increased, the reaction time increased, and the accuracy decreased; and (3) there were no significant differences in reaction time between the two groups at different WM load conditions. However, there was an interaction effect for accuracy, which showed that the accuracy of the stress group was higher than that of the control group at the medium WM load (1-back). These findings suggest that acute stress improves pilots’ WM accuracy during moderately difficult tasks. The results of this study provide a theoretical basis for improving stress management and training pilots’ WM abilities.

Aims: To evaluate the efficacy of estradiol in the treatment of menopausal hot flushes in women, quantify its efficacy characteristics as well as the placebo effect, and explore the influencing factors to establish an efficacy scale for the development of drugs for the treatment of menopausal hot flushes. Data and methods: A literature search was conducted to include clinical studies on estradiol for the treatment of menopausal hot flushes. Data of demographics, dose, administration route and efficacy were extracted and used to construct an efficacy model. Model simulations were used to obtain the efficacy in different populations with different doses and administration routes. Results: Seventeen studies, including 17 groups of placebo (1698 subjects) and 29 groups of estradiol (3013 subjects) with daily doses of estradiol ranging from 0.01 to 2 mg, were included. There were significant effects of administration route (oral or transdermal), ethnicity (Caucasian or Asian) and duration of menopause on model parameters. The efficacy was higher in non-Asians than in Asians, and weaker in menopausal women with > 60 weeks of menopause than < 60 weeks. The placebo effect was higher for shorter menopause duration, with a time to ED50 of 3.15 weeks for Asian and 1.96 weeks for non-Asians. Conclusion: The standard longitudinal efficacy scales of estradiol on menopausal hot flushes were constructed, and no difference was found in the efficacy of estradiol in Asians and non-Asians. The standard efficacy of estradiol in this study could inform the efficacy evaluation in new drug development.

While the response of Arabidopsis thaliana to either drought, herbivory or fungal infection has been well-examined, the consequences of exposure to a series of such (a)biotic stresses are not well studied. This work reports on the genetic mechanisms underlying Arabidopsis response to single osmotic stress, and to combinatorial stress, either fungal infection using Botrytis cinerea or herbivory using Pieris rapae caterpillars followed by an osmotic stress treatment. Several small effect genetic loci associated with rosette dry weight (DW), rosette water content (WC), and the projected rosette leaf area (PLA) in response to combinatorial stress were mapped using univariate and multi-environment genome wide association approaches. A SNP associated with DROUGHT INDUCED 19 (DI19) was identified by both approaches, supporting its potential involvement in the response to combinatorial stress. Several SNPs were found to be in linkage disequilibrium with known stress-responsive genes such as PEROXIDASE 34 ( PRX34), BASIC LEUCINE ZIPPER 25 ( bZIP25), RESISTANCE METHYLATED GENE 1 ( RMG1), and WHITE RUST RESISTANCE 4 (WRR4). An antagonistic effect between biotic and osmotic stress was found for the prx34 and arf4 mutants, which suggests PRX34 and ARF4 to play an important role in the response to the combinatorial stress.

Seed production and dispersal are crucial ecological processes impacting plant demography, species distributions, and community assembly. Plant-animal interactions commonly mediate both seed production and seed dispersal, but current research often examines pollination and seed dispersal separately, which hinders our understanding of how pollination services affect downstream dispersal services. To fill this gap, we propose a conceptual framework exploring how pollen limitation can impact the effectiveness of seed dispersal for endozoochorous and myrmecochorous plant species. We summarize the quantitative and qualitative effects of pollen limitation on plant reproduction and use Optimal Foraging Theory to predict its impact on the foraging behavior of seed dispersers. In doing so, we offer a new framework that poses numerous hypotheses and empirical tests to investigate downstream effects of pollen limitation on seed dispersal effectiveness and, consequently, post-dispersal ecological processes occurring at different levels of biological organization. Finally, considering the importance of pollination and seed dispersal outcomes to plant eco-evolutionary dynamics, we discussed the implications of our framework for future studies exploring the demographic and evolutionary impacts of pollen limitation for animal-dispersed plants.

Vegetative insecticidal proteins (Vips) are widely used in pest management, but Vip resistance is a big threat. DNA methylation plays important roles in regulating the response of biological organisms to environmental stress. In this study, DNA methylation map was developed for fall armyworm (FAW, Spodoptera frugiperda), and its function in regulating FAW Vip3Aa resistance was explored. FAW was screened by Vip3Aa for 10 generations, and bioassays indicated that Vip3Aa resistance increased trans-generationally. Based on the comparison of DNA methylation maps between Vip3Aa-resistant and -susceptible strains showed that gene body methylation was positively correlated with its expression. Moreover, the study demonstrated that a reduction in the methylation density within the gene body of a 3’5’-cyclic nucleotide phosphodiesterase gene resulted in decreased expression and increased resistance of FAW to Vip3Aa, which was validated through RNAi experiments. The mechanism of Vip3Aa resistance will improve the understanding of DNA methylation and its function in lepidoptera and provide a new perspective for making strategies to pest management.

Abiotic stresses as salinity, and boron toxicity, and deficiency are commonly found in arid and semi-arid areas were broccoli is abundantly grown. In this work, the physiological response of broccoli leaves (including growth, relative water content, stomatal conductance, and mineral concentration) was studied under salinity and boron stresses (deficiency and toxicity), individually or in combination. Also, the molecular study of PIP aquaporins were studied in relation to their presence in plasma membrane PIP presence and their membrane lipid environment. The results showed that only the combination of salinity and boron deficiency decreased plant biomass, suggesting good adaptation to the other treatments. Changes in stomatal conductance and mineral nutrients suggest that the adaptation was related to water and boron transport through leaves, involving aquaporins since avoidance strategy was observed. Furthermore, changes in aquaporins PIP expression revealed that each individual aquaporin is involved in each treatment, either alone or in combination. However, the discrepancy between the presence of aquaporins in the plasma membrane and microsomal fraction pointed towards the regulation of trafficking and membrane composition (lipids and proteins) should be highly present in this plant under stress.

With the vigorous development of power system, fault diagnosis of power transformers is very important to ensure the normal operation of the power system. However, the traditional transformer monitoring methods have blind spots, and the diagnosis results depend heavily on the experience of the managers. At present, it is urgent to develop new technologies to improve the accuracy of transformer fault diagnosis. How to diagnose transformer faults quickly, accurately, and effectively has become a difficult problem. Encouragingly, acoustic imaging, as a visual technology of sound field, promotes the development of transformer fault diagnosis. In this paper, the principles and technical status of acoustic imaging are summarized. Meanwhile, the covariance matrix fitting (CMF) beamforming algorithm is compared with the traditional beamforming algorithm, and the main factors affecting the performance of the array beamforming algorithm are simulated and analyzed. Finally, an acoustic imaging technology for transformer fault diagnosis based on CMF algorithm is proposed. This technology can accurately diagnose the transformer fault state according to the distribution of the internal sound field of the transformer, improve the efficiency of fault diagnosis, and promote the construction of smart grid. Through the analysis and processing of the acoustic test data of seven power transformers with different voltage levels and loads, including 500kV Yanshan, 220kV Tinghu and Laoshan transformers in Wenshan Power Supply Bureau, the test results prove that the acoustic imaging technology based on CMF algorithm can accurately and conveniently diagnose transformer faults.

The role of hydroxychloroquine (HCQ) in lowering the viral load of patients with COVID-19 is controversial. In our Institute, we treated more than 30,000 people with COVID-19 in 2020 and 2021, using the same diagnostic tools and the same treatment dosages. In this retrospective comparative study of data collected over this period, we aimed to compare the viral clearance in the nasopharynx as determined by qPCR in patients who were treated with HCQ and those who were not. As a new feature, we adjusted the data according to the most significant confounding factors (age, initial viral load, and timescale between the onset of symptoms and treatment). Of the 1 276 patients selected from our database, 776 were treated with HCQ and 500 were not. Viral clearance in the treatment group was reached significantly earlier than in the non-treatment group, at days 5, 10 and 30. These differences remain significant after adjustments for confounding factors. In conclusion, although age, initial viral load, and time to treatment do influence the viral load in patients with COVID-19, hydroxychloroquine associated with azithromycin still independently significantly lowered viral load more rapidly than other treatments, including azithromycin alone.

Background: Loneliness is a “hallmark” of dissociative disorders (DD), but its impact on DD patients is understudied in the field. Similarly, therapeutic modalities best suited for DD patients is an area of controversy; with research advocating cognitive therapies (CTs) despite the risk of retriggering trauma in patients. Research objectives: 1. To explore if dissociative episodes or phases are triggered in individuals as a result of loneliness, using mental healthcare professionals’ experiences in treating such patients. 2. To discuss participants’ recommended therapeutic techniques for DD patients experiencing loneliness. Method: Using a qualitative design, fourteen trauma and dissociation practitioners were interviewed with semi-structured questions, and a coded thematic analysis was conducted to extract codes, sub-themes, and themes from the data. Results: The findings show a two-way, yet non-linear relationship between loneliness as a trigger and the use of dissociation to cope with it. Participants strongly advocated the use of trauma-based modalities such as EMDR. Discussion and Conclusion: The severer the trauma and the less effective the patients’ coping mechanisms are, the severer their dissociation is, and their inability to connect to their own selves, and in turn, to others, which causes them to seek isolation. However, supportive, healthy networks, when patients seek/have them, contribute significantly to developing a sense of safety, which allows DD patients to feel more grounded in their outer realities and allows them to lead more satisfying lives. Practitioners agreed that safe therapeutic alliances are pivotal for patients; it allows them to connect more to their therapists, and subsequently to their social networks. Furthermore, all practitioners advocated moving away from using extensive CTs with DD patients in the initial phase of grounding and moving towards trauma-based and psychodynamic-based modalities. Recommendations: For future research, it is recommended that this link be studied by interviewing DD patients themselves, and/or conducted using quantitative designs to raise test-retest reliability.

Non-suicidal self-injury is an important public health problem, which is closely related to suicidal behavior and has attracted wide attention from researchers. This study recruited 1207 adolescents to systematically explore the relationship between cumulative risks and non-suicidal self-injuries using scales and questionnaires. It also compared the influences of various risk factors on self-injurious behaviour and researched the protective effect of personality strengths (mindfulness, hope, openness, grit, and meaning in life) as resilience factors. The results showed that the significant predictive effects of cumulative risks on adolescents’ non-suicidal self-injury and adverse childhood experiences are greater predictors of adolescents’ non-suicidal self-injury than negative life events. Mindfulness and meaning in life are two protectors co-moderating the effects of cumulative risk on adolescents’ non-suicidal self-injury. This study has important implications for a better understanding of resilience. And more intervention and prevention strategies based on personality strengths for individuals experiencing adversity and stress could be effective in improving their psychosocial functioning.

It is challenging for a single development subject to complete complex scientific research tasks due to the peculiarities of saline-alkali land. Collaborative innovation and cooperation between development subjects are increasingly vital. This paper first constructs an undirected weighted collaborative innovation network from the upstream, midstream, and downstream levels of technological innovation for saline-alkali land development, analyzing the network’s structural characteristics and spatial distribution features. Then uses ERGM to explore the internal and external driving mechanism for network formation from network self-organization, subject characteristics, and exogenous environmental factors. The results demonstrate that the distribution of collaborative innovation networks for saline-alkali land development is relatively uniform. However, there are also clusters, and the clusters are mostly centered on universities and scientific research institutions. Both the development subjects and clusters present regional features. Centrality and transitivity are crucial in the internal driving mechanism. In the external driving mechanism, the Matthew effect is modest, and the Homozygous effect is considerable; Organizational and technical proximity play a positive role; Geographical and institutional proximity play a blocking role. This study also provides practical enlightenment for encouraging horizontal and vertical collaborative innovation of sustainable development of saline-alkali land.

This letter improves the Personal Location Beacon( PLB), designs and implements a prototype personal maritime emergency radio beacon. Unlike the existing PLB, it is compatible with the traditional global search and rescue system( COSPAS-SARSAT) and BeiDou search and rescue system, the vital signs of people monitoring and reporting functions. After the PLB transmits distress information, the Beidou receiver works. The Beidou receiver receives information from the Rescue Centre and controls whether the PLB transmits the distress information again, reducing unnecessary emissions, thereby reducing the average power consumption of the PLB and extending the working time of the PLB. Measurements show that the current is 79mA in the state of receiving Beidou information, and the 7000mAh 7.4 V lithium battery can send distress messages to COSPAS Rescue Centre and Beidou Rescue Centre 200 times each, and the distress message contains the vital signs of people in distress. The vital sign is the temperature information. Ideally, the 7000mAh 7.4V lithium battery can support the continuous working time of the market for 48 hours.

Introduction:Floppy Eyelid Syndrome (FES) describes the disease process whereby extreme laxity of the eyelid can lead to recurrent irritation of the ocular surface and corresponding palpebral keratoconjunctivitis1,2. Clinical exam characteristically reveals an eyelid that is easy to evert with traction superiorly2. However, FES can masquerade as conditions such as dry eye syndrome, keratitis, conjunctivitis, and dermatochalasis1-3. Incidence in the general population has been estimated to range from 2.3% to 15.8%, though notably it may not always be correctly diagnosed and may be more common1,2.We describe a case of unilateral and chronic keratoconjunctivitis unresponsive to standard medical therapy. Applying upward traction on the upper eyelid confirmed the diagnosis, as it revealed extensive laxity of the tarsal plate with resultant lagophthalmos and exposure keratopathy. Tape splint tarsorrhaphy (TST) has been recently described as a novel and non-invasive treatment modality for persistent corneal epithelial defects4. In this case, the TST was used as a novel and non-invasive diagnostic and temporizing tool to splint the eyelid down to address exposure keratopathy from lagophthalmos. Resolution of signs and symptoms was diagnostic and therapeutic confirmation that the keratoconjunctivitis resulted from the lagophthalmos and FES. This is the first such report to our knowledge discussing the specific use of this technique to more effectively diagnose refractory keratoconjunctivitis due to lagophthalmos and FES.

Introduction: Providing adequate analgesia during subcutaneous ICD implantation can be a challenge. The use of regional techniques such as erector spinae plane (ESP) block can provide both analgesia and attenuate the risk of opioid use especially in high-risk patient populations. Methods: This was a single center, prospective study of patients undergoing SICD implantation from February 2020 to February 2022. Patients were older than 18 years of age and randomly assigned to receive ESP block or traditional wound infiltration. The primary outcome was the overall use of perioperative analgesic medications in the ESP block versus the surgical wound infiltration group. Descriptive data are reported as count, mean, or median, as appropriate. For group comparisons, Fisher’s exact test was used for categorical variables; the student t-test was used for normally distributed continuous variables, and the Krustal-Wallis test was used for skewed continuous variables, as appropriate. Results: 24 patients were enrolled in the study. 11 patients received only wound infiltration and 13 patients received left ESP block. A significant reduction of intraoperative fentanyl use was observed in the ESP block. The overall postoperative day zero fentanyl use was also significantly decreased in the ESP group. The day to discharge was shorter in the ESP block group. Conclusion: This feasibility study showed that ESP block is both a safe and effective technique and demonstrated a significant decrease in intraoperative and postoperative opioid consumption that may be of clinical benefit in high risk patients. Larger studies are needed to further validate its use.

Changes in biodiversity reflect processes acting on the success of individual species at multiple spatial scales, including in communities, biogeographic regions, and globally. This complexity makes it difficult to analyse the mechanisms shaping diversity change using traditional approaches. To resolve this, we propose a novel approach to partition total biodiversity changes according to mechanisms reflecting species' success at multiple scales. We apply this approach to study changes in the diversity of invertebrate herbivores from a large-scale, plant community experiment. This partitioning showed that rapid changes in the relative abundances of individual species resulted in surprisingly small changes in diversity across scales. Our novel analytical method reveals how strong ecological effects at different hierarchical levels can counteract each other, resulting in weak effects on diversity across broad spatial scales.