59Background: Unique among cnidarians, jellyfish have remarkable morphological and 60 biochemical innovations that allow them to actively hunt in the water column. One of the first 61 animals to become free-swimming, jellyfish employ pulsed jet propulsion and venomous 62 tentacles to capture prey. 63Results: To understand these key innovations, we sequenced the genome of the giant Nomura's 64 jellyfish (Nemopilema nomurai), the transcriptomes of its bell and tentacles, and transcriptomes 65 across tissues and developmental stages of the Sanderia malayensis jellyfish. Analyses of 66 Nemopilema and other cnidarian genomes revealed adaptations associated with swimming, 67 marked by codon bias in muscle contraction and expansion of neurotransmitter genes, along with 68 expanded Myosin type II family and venom domains; possibly contributing to jellyfish mobility 69 and active predation. We also identified gene family expansions of Wnt and posterior Hox genes, 70 and discovered the important role of retinoic acid signaling in this ancient lineage of metazoans, 71 which together may be related to the unique jellyfish body plan (medusa formation).72 Conclusions: Taken together, the jellyfish genome and transcriptomes genetically confirm their 73 unique morphological and physiological traits that have combined to make these animals one of 74 the world's earliest and most successful multi-cellular predators. 75 76 Background 80 Cnidarians, including jellyfish and their predominantly sessile relatives the coral, sea anemone, 81 and hydra, first appeared in the Precambrian Era and are now key members of aquatic 82 ecosystems worldwide [1]. Between 500 and 700 million years ago, jellyfish developed novel 83 physiological traits that allowed them to become one of the first free-swimming predators. The 84 life cycle of the jellyfish includes a small polypoid, sessile stage which reproduces asexually to 85 form the mobile medusa form that can reproduce both sexually and asexually [2]. The class 86 Scyphozoa, or true jellyfish, are characterized by a predominant medusa life-stage consisting of a 87 bell and venomous tentacles used for hunting and defense [3]. Jellyfish medusae feature a 88 radially symmetric body structure, powered by readily identifiable cell types such as motor 89neurons and striated muscles that expand and contract to create the most energy-efficient 90 swimming method in the animal kingdom [4, 5]. Over 95% water, jellyfish are osmoconformers 91 that use ion gradients to deliver solutes to cells and tissues where sodium and calcium ions 92 activate the muscle contractions that power their propulsion. Notably, many jellyfish species can 93 survive in habitats with varying levels of salinity and are successful in low-oxygen environments, 94 allowing them to bloom even in dead zones [6]. These innovations have allowed them to 95 colonize aquatic habitats across the globe both in brackish and marine environments, spanning 96 the shallow surface waters to the depths of the seas. 97 98 Results and discussion 99

Purpose To compare the responses to dry eye treatment of patients sorted by the degree of lower lid laxity. Methods Sixty patients were grouped into three groups according to the degree of lower lid laxity. Tear break‐up times (TBUT), Schirmer test (ST) scores, ocular surface disease index (OSDI) scores, and changes in OSDI score in each group were compared, before and at 3 months after treatment. Results TBUT, ST, and OSDI scores were not different among the three groups at baseline. TBUT improved in each group at 3 months after treatment, and no differences between groups were found. ST scores were not increased after treatment, while OSDI were improved to 22.57±5.243, 31.16±11.353, and 37.85±13.342 in the no, moderate, and high laxity groups, respectively; these improvements were statistically significant (p=0.003, <0.001, <0.001, respectively). Patients with greater than moderate lower lid laxity saw the smallest improvement in response to dry eye treatment, as assessed by change in OSDI score (p=0.005 vs. moderate laxity group, p=0.005 vs. no laxity group). Conclusion Lower lid laxity is one of the factors contributing to the manifestation of dry eye symptoms, independently of TBUT and ST scores.