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Blepharoplasty is a commonly performed cosmetic surgery worldwide to address the excess skin and fat on the upper eyelids. The purpose of this paper is to present a surgical variation on blepharoplasty, achieving more pleasant outcomes. This paper describes the cauterization + plication technique, which involves using a cauterizing tool to remove excess skin and fat from the upper eyelid before using sutures to create a crease. It provides valuable insights into the advantages and limitations of this technique, drawing on relevant literature and clinical experience. Muscle cauterization and plication technique is an upgrade from the traditional technique, producing more esthetically pleasing results. This study highlights the importance of understanding the different techniques available for blepharoplasty to achieve the best possible outcomes for patients.

Introduction Cerebrovascular diseases are the most frequent risk factor for epilepsy in the elderly, and epileptic phenomenon following stroke is known to worsen the prognosis. Although electroencephalography is the gold standard epilepsy biomarker, it is rarely used in post-stroke studies, and the frequency of post-stroke epileptiform activity is still uncertain.Patients and methods We analysed studies indexed to MEDLINE, Embase, Web of Science, PsycINFO and OpenGrey (up to March 2015), reporting post-stroke electroencephalographic epileptiform activity frequency in adults. Epileptiform activity was classified as ictal (electrographic seizures) and interictal (non-periodic spikes and sharp waves). Data selection, extraction and appraisal were done in duplicate. Random-effects meta-analysis was used to pool frequencies.Results The pooled frequency of post-stroke ictal and interictal epileptiform activity was 7% (95% CI 3%–12%) and 8% (95% CI 4%–13%), respectively. The use of continuous electroencephalogram was not associated with an increased frequency of electrographic seizures (p= 0.05), nor did the management setting (Intensive Care Unit versus non- Intensive Care Unit, p= 0.31). However, studies with continuous electroencephalogram showed a higher frequency of interictal epileptiform activity (p= 0.01).Discussion This study provides the best available estimates of the frequency of post-stroke electroencephalographic epileptiform activity. Due to detection bias, it was not possible to correlate clinical and electrographic seizures.Conclusion The frequency of ictal and interictal epileptiform activity in the electroencephalogram was comparable with previous frequency analyses of clinical seizures. The frequency of ictal epileptiform activity did not change with continuous record or clinical setting, while the frequency of interictal epileptiform activity increased with continuous record.

Bottom waters of the northeast Pacific continental shelf naturally experience localized hypoxic conditions, with significant influences on food webs and biogeochemical cycling. In August 2021, extreme hypoxia was detected from several measurement platforms along the southern British Columbia continental shelf, with oxygen concentration <60 μmol kg−1, and a difference from the seasonal climatology of more than 2 standard deviations. Early and intense remote upwelling and local density shifts were associated with an anomalously strong spring phytoplankton bloom, which likely stimulated localized respiration of subsurface organic matter. This event was concurrent with unsuitable habitat for Pacific halibut and calcite and aragonite undersaturation throughout most of the water column. The drivers of this extreme low oxygen event could be enhanced under future climate change, with potentially significant impacts on marine ecology and biogeochemistry. Most marine organisms consume oxygen, and are therefore impacted when seawater oxygen concentrations reach low values. Extreme low oxygen concentrations are rare in the coastal waters of British Columbia, Canada. However, unusually strong oxygen depletion was observed off the coast of Vancouver Island during summer 2021. Unusually strong, early season upwelling winds along the California coast impacted Vancouver Island by causing nutrient‐rich water to be mixed into the surface, stimulating a large and earlier than usual spring phytoplankton bloom. Decomposition of the bloom‐derived organic carbon consumed local subsurface oxygen throughout the spring and summer. These subtle changes in timing and intensity of seasonal processes likely caused this low oxygen event, which was also associated with high concentrations of inorganic carbon, leading to ocean acidification. Such extreme low oxygen events, even if short‐lived, can have a significant impact on marine ecosystems, restricting the habitat available for groundfish species, such as Pacific halibut, and impacting the formation of carbonate shells by various organisms. The drivers of extreme low oxygen events are projected to intensify as climate change progresses. Widespread extreme hypoxia was observed throughout the water column along the southern British Columbia continental shelf in summer 2021Early and intense upwelling followed by a strong biological response contributed to oxygen depletion in subsurface watersMultiple indices suggest that this extreme event was concurrent with unsuitable habitat conditions for groundfish and calcifying organisms Widespread extreme hypoxia was observed throughout the water column along the southern British Columbia continental shelf in summer 2021 Early and intense upwelling followed by a strong biological response contributed to oxygen depletion in subsurface waters Multiple indices suggest that this extreme event was concurrent with unsuitable habitat conditions for groundfish and calcifying organisms

Porcine circovirus-2(PCV-2) is considered the major etiological agent of post-weaning multisystemic wasting syndrome (PMWS) in pigs. The clinical manifestations of the disease are correlated with moderate to high amounts of PCV-2 DNA in biological samples of affected pigs. A threshold of 107DNA copies/ml is suggested as the trigger factor for symptoms. A comparative study was conducted to determine which quantitative method would be more suitable to estimate the PCV-2 DNA load. Two polymerase chain reaction (PCR) assays were developed: a competitive PCR (cPCR) and a SYBR Green–based real-time PCR. The assays were compared for their capacity to detect PCV-2 in DNA samples extracted from liver, lung, spleen, mesenteric lymph nodes, and kidney of PMWS-affected (n= 23) or non–PMWS-affected pigs (n= 9). Both assays could successfully quantify PCV-2 DNA in all tissue samples and were able to detect significant differences between the numbers of PCV-2 DNA copies found in tissues of PMWS-affected and non–PMWS-affected pigs (≥102.5). The highest mean viral loads were detected by the SYBR Green real-time PCR, up to 107.0±1.5copies/100 ng of total DNA sample, while the cPCR detected up to 104.8±1.5. A mean difference of 101.8was found between the amounts of PCV-2 DNA detected, using the SYBR Green real-time PCR and the cPCR, suggesting that the viral load threshold for PMWS should be determined for each particular assay.

The ocean absorbs anthropogenic carbon, slowing atmospheric CO2increase but driving ocean acidification. Long‐term changes in the carbon system are typically assessed from single‐point time series or from hydrographic sections spaced by decades. Using higher resolution observations (1–3 year−1) from the Line P time series, we investigate processes modulating trends in the carbon system of the northeast subarctic Pacific. Dissolved inorganic carbon (DIC) and apparent oxygen utilization (AOU) from 1990 to 2019 reveal substantial trends over most of the upper water column along the 1,500 km coastal to open ocean transect. At the surface, an increasing trend in salinity‐normalized DIC (sDIC33) (+0.5 ± 0.4 μmol kg−1yr−1) is associated with a decrease in pH (0.01–0.02 decade−1) and a decrease in aragonite saturation state (0.04–0.08 decade−1). These observed trends are driven by anthropogenic CO2uptake, partially offset by trends in surface salinity or temperature. Stratification associated with recent marine heat waves appears to have caused anomalously low surface pCO2. sDIC33trends of similar magnitude were found below the seasonal thermocline on the 26.7–26.8 isopycnals (150–300 m), which are ventilated in the western Pacific. Roughly, a third (20%–50%) of the subsurface sDIC33trend is driven by increased remineralization, likely caused by long‐term decreases in ventilation in the western Pacific. Bidecadal oscillations in the ventilation of the 26.7–26.8 isopycnals arising from the Lunar Nodal Cycle cause oscillations in sDIC33and AOU at the offshore end of our transect. We trace the oscillations to alternating periods of higher anthropogenic carbon uptake or higher carbon remineralization. The ocean takes up anthropogenic carbon and slows the rate at which atmospheric carbon dioxide is increasing. Using 30 years of data from the NE Pacific, we show that the surface ocean is indeed absorbing anthropogenic carbon and undergoing ocean acidification in this region. We find that carbon is also increasing in the subsurface waters. This excess carbon was absorbed in the western Pacific, where dense waters sink from the surface to the subsurface and transport anthropogenic carbon and oxygen eastward. This western Pacific breathing process appears to be weakening in time. If this trend continues, less anthropogenic carbon will be taken up and stored in subsurface waters in the future. Despite this reduction, some carbon will still naturally accumulate as the available oxygen is consumed and natural carbon dioxide is produced. Using data from three decades, we demonstrate the impact of climatic events and natural variability on the carbon system. At the surface, recent marine heat waves have reduced the amount of carbon absorbed by the ocean. In the subsurface waters, we observed that anthropogenic carbon increased in decades with stronger ventilation, while natural carbon generated by respiration of organic matter increased during periods of weaker ventilation. Local uptake of anthropogenic CO2decreases surface pH in the NE Pacific but the trend appears modulated by recent temporal variabilityDeclining ventilation in the NW Pacific appears responsible for 20%–50% of the inorganic carbon increase in NE Pacific intermediate waterThe signature of tidally driven bidecadal oscillations propagates east to Line P producing fluctuations in intermediate water preformed DIC Local uptake of anthropogenic CO2decreases surface pH in the NE Pacific but the trend appears modulated by recent temporal variability Declining ventilation in the NW Pacific appears responsible for 20%–50% of the inorganic carbon increase in NE Pacific intermediate water The signature of tidally driven bidecadal oscillations propagates east to Line P producing fluctuations in intermediate water preformed DIC