Mitochondrial DNA sequences (mtDNA) are often found as byproduct in hybrid enrichment data sets originally created to capture anchored hybrid enrichment (AHE) or ultra-conserved element (UCE) nuclear loci. The mtDNA sequences in these data sets are currently rarely used, even though mitochondrial genes such as COI, ND5, CytB, and 16S are of general interest and often not yet known and deposited in public databases. We developed MitoGeneExtractor to extract mitochondrial genes of interest from genomic libraries. Gene sequences are reconstructed through multiple sequence alignments of sequencing reads to an amino acid reference. We applied MitoGeneExtractor to recently published data created for UCE enrichment and were able to extract complete or nearly complete COI and ND5 sequences for a large proportion of the sequencing libraries. MitoGeneExtractor can be used to extract mitochondrial protein coding genes from a wide range of next generation sequencing data sets.

Introduction: Metastasis to the spleen is rare. Case presentation: The patient was a 62-year-old woman with diagnosis of invasive ductal carcinoma of breast and hairy cell leukemia with huge splenomegaly. Discussion: This case has been reported considering the uncommonness of solitary metastasis to the spleen and synchronous hairy cell leukemia.

Background Fatigue is a burden for a substantial proportion of women in the postpartum period. A wide array of patient-reported outcome measures (PROMs) are used for assessment, which makes comparison of data difficult. Objective To identify the best PROM for postpartum fatigue using Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Search strategy We searched Web of Science, Embase, PubMed and CINAHL, with no date limiters, in July 2020 for validated PROMs used to assess fatigue in the postpartum period. Selection criteria Studies evaluating at least one author-defined domain of postpartum fatigue and one psychometric measurement property of a PROM. Data collection and analysis An overall rating was assigned based upon COSMIN criteria and the quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Main results We identified 49 validation studies using 18 PROMs in 21 209 women that evaluated postpartum fatigue. All three fatigue domains (Physical, Mental, Interference) were assessed by four PROMs: Fatigue Assessment Scale (FAS), Brief Fatigue Inventory (BFI), Checklist Individual Strength (CIS) and Fatigue Severity Scale (FSS). The FAS, which is freely available online, was the only PROM to demonstrate adequate content validity and at least a low level evidence of sufficient internal consistency, resulting in a Class A recommendation. Conclusion The FAS is the best available PROM to assess postpartum fatigue. However, it fails to assess important areas of postpartum recovery. Future studies should aim to develop a more specific PROM for postpartum fatigue.

Fluvoxamine is a selective-serotonin reuptake inhibitor (SSRI), well-tolerated and widely available, usually used in the management of mental-health conditions. Fluvoxamine is also a sigma-1 agonist with high affinity to this receptor and this pharmacodynamical effect has been being portrayed as the main explanation in emerging evidence about the potential of using fluvoxamine in COVID-19 patients. This systematic review was conducted according to the PRISMA guidelines. The search was run in MEDLINE, Web of Science, and CENTRAL from the Cochrane databases. The study protocol was registered in PROSPERO (CRD42022302025). Our aim was to assess the present evidence for therapeutic role of fluvoxamine in COVID-19 patients, the review included studies which evaluate the effect of fluvoxamine in COVID-19 patients. The main outcomes evaluated in the review were: mortality, need for hospitalization (outpatients) and clinical deterioration. The quality control of the selected articles was made using Cochrane’s Risk of Bias tool for the randomized controlled trials (RCTs) and the ROBINS-I criteria for non-randomized studies. A total of 4 studies were included in the final qualitative analysis of the review, 2 of which were RCTs, and the others were open-label prospective cohorts. 3 studies assessed outpatient population and 1 evaluated ICU population. Overall, the 4 studies included a total of 1864 participants. In conclusion, 3 studies with outpatients showed that fluvoxamine treatment can prevent clinical deterioration, hospitalisation, or proxy-hospitalisation. The only study with patients hospitalized in the ICU also demonstrated a therapeutic benefit reducing overall mortality.

Phaeochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumors. Some advanced PPGLs are inoperable. Treatment strategies for inoperable PPGLs should be discussed case by case under the coordination of multidisciplinary team. Target organ management is crucial in improving life quality and prognosis.

The study of cellular metabolism is often hindered by limitations in the amount of exper- imental data available. Therefore computational methods that exploit maximally the possible measurements, and are able to extract relevant predictions from a minimum of information are always welcome. Maximum Entropy (ME) inference has been succesfully applied to genome-scale models of cellular metabolism in various cell culture contexts, yielding insights into biologically relevant properties which are not accessible to traditional optimization based methods. Recent data-driven studies have suggested that in chemostat cultures, the growth rate and uptake rates of limiting nutrients are the most informative parameters about the metabolism. In this work, we propose the thesis that chemostat dynamics typically drives the culture towards maximally restricted metabolic states. A practical consequence is that experimental values of limiting up- take rates can be replaced by more readily available measurements of metabolite concentrations in the feed media and the steady state cell concentration. We show how these results can be justified from a mechanistic perspective by studying simulations of a simplified model where we test the quality of the inference, and unveil the mechanisms defining the performance of our approach. We then apply our method to E. coli experimental data. We evaluate the effects of heterogeneity in chemostat cultures and its potential impact on flux inference quality of ME and optimization based strategies. Additionally, we evaluate the quality of the inference comparing M E to alternative formulations that rest on a Flux Balance Analysis (F BA).

Abstract Introduction：Surgery is the mainstay of treatment for aortic dissection which lesion affected the aortic arch. Conventional surgical methods usually use unilateral cerebral perfusion by cardiopulmonary bypass (CPB) to maintain the perfusion of the brain, and the reconstruction of arch branches must be performed under CPB. Unilateral cerebral perfusion with prolonged CPB may lead to complications of cerebral hypoperfusion. We propose a new technique that can accomplish aortic arch branches replacement without the use of cardiopulmonary bypass and maintain bilateral cerebral perfusion at all times. Materials and Methods: From January 2018 to July 2021, we performed the new technique in 23 patients. Furthermore, we performed a retrospective analysis with patients undergoing conventional surgery during the same period, comparing perioperative data and follow-up data between two groups. Result: The CPB time, deep hypothermic circulatory arrest time and aortic cross-clamping time of new technique group was significantly shorter than conventional group. Other perioperative data and follow-up data were not statistically different. Discussion: Simplified arch-first technique can significantly shorten CPB, aortic cross-clamping and deep hypothermic circulatory arrest time. The technique is theoretically safer because it can better protect the cerebral perfusion during the operation. The short-term efficacy of this technique is the same as that of conventional surgery, and it is more convenient for surgeons to operate. Conclusions: Compared with the conventional method, the simplified arch-first technique is non-inferior, friendly in operation and safer in theory, and is worthy of promotion. Key words: Aortic dissection; Arch-first; Cardiopulmonary bypass; Aortic arch reconstruction

Objective: To study the outcomes of new pregnancies after previous complete uterine rupture. Design: Descriptive study based on population data from the Medical Birth Registry of Norway, the Patient Administration System, and medical records. Sample: Maternities with previous complete uterine rupture in Norway during the period 1967–2011 (N=72), extracted from 2 455 797 maternities. Method: We measured the rate of new complete ruptures and partial ruptures, as well as the maternal and perinatal outcomes of these pregnancies. The characteristics of both previous ruptures and new ruptures were described. Results: Among 72 maternities, there were thirty-seven with previous ruptures in the lower segment (LS) and 35 outside the LS. We found three new complete ruptures and six uneventful partial ruptures, resulting in a rate of 4.2% and 8.3%, respectively. All three complete ruptures occurred preterm in scars outside the LS. The rate of new complete rupture was 0% in those with previous rupture in the LS, and 8.6% in previous ruptures outside the LS. The corrected perinatal mortality was 1.3%, and prematurity (<37 weeks) was high (36.1%); this was noticed even in the absence of new ruptures and was mostly iatrogenic. Two hysterectomies were performed in the absence of rupture and two cases had abnormal invasive placenta. Conclusion: The prognosis for pregnancies after previous complete uterine rupture is favorable. Prematurity is a problem caused by both obstetrician and mother anxiety, so the timing of delivery is most challenging. Careful counseling, vigilance for symptoms, and immediate delivery are most important.

Ectodermal dysplasia (ED) is defined as a rare hereditary disorder involving two or more of the ectodermal structures, which include the skin, hair, nails, teeth, and sweat glands. The two most common forms of the disease are hypohidrotic/anhidrotic ED and hidrotic ED.

Objective Describe changes over time regarding mode of birth and perinatal outcomes in women with one previous caesarean section in the Netherlands over the past 20 years. Design Population-based study. Setting Nationwide. Population All women with one previous caesarean section and no previous vaginal birth, who gave birth to a term singleton in cephalic presentation between 2000 and 2019 (n=143,308). Methods Analysis of Dutch perinatal registry data. Main outcome measures Primary: mode of birth per year, intended vaginal birth versus planned caesarean section. Secondary: failed versus successful vaginal birth in case of intended vaginal birth after caesarean (VBAC), and adverse perinatal outcome (perinatal mortality up to 28 days, low Apgar score at 5 minutes, asphyxia, and NICU admission >24 hours). Results A decrease of 21.5% was seen in women with one previous caesarean section intending VBAC in a subsequent pregnancy, from 77.2% in 2000 to 55.7% in 2019, with a marked acceleration from 2009 onwards. The VBAC success rate dropped gradually, from 71.0% to 65.3%. Overall caesarean section rate (planned and unplanned) increased from 45.1% to 63.6%. Adverse perinatal outcomes were higher in women intending VBAC compared to planned caesarean section. However, after an initial decrease, perinatal mortality remained stable from 2009 onwards with only a minimal difference between both modes of birth. Conclusions In the Netherlands, the proportion of women intending VBAC after a previous caesarean section has decreased markedly, particularly from 2009 onwards. This decrease was not accompanied by a synchronous decrease in perinatal mortality after that year.

COVID-19 is a multi-system disorder. Bell's palsy is a lower motor neuron lesion that is uncommon after COVID-19 or related vaccinations. We documented two incidences of Bell's palsy in this study, one after she was exposed to COVID-19 and the other after he was exposed to AstraZeneca Vaccine.

Environmental DNA (eDNA) is emerging as a potentially powerful tool to assess aquatic ecosystems, and to monitor fish assemblages. We conducted a pilot eDNA water sampling program at 5 Reserves within the National Estuarine Research Reserve System from temperate and tropical estuaries to better understand how eDNA data can support detection of fish species within an standardized monitoring network. Samples were collected in coordination with an existing long term monitoring program, and the sampling plan was designed to minimize additional work for field teams. We found that results varied; in some estuaries the number and type of fish species was consistent with expected occurrence, and eDNA analysis detected fish that often eluded traditional sampling methods. In warm turbid waters, however, we detected fewer species than expected, suggesting that additional processing is required at these sites. Managers interested in applying standardized eDNA monitoring across a range of sites may want to consider a decision tree protocol, where a baseline methodology is developed for all sites, enhanced by additional laboratory or analysis steps when specific conditions are present.

A search has been conducted, employing ab initio molecular orbital theory, for potential tetrel-bonded complexes between the fluorinated methanes methyl fluoride, difluoromethane and fluoroform, and the related hydrides ammonia, water, hydrogen fluoride, phosphine, hydrogen sulfide and hydrogen chloride. Eleven such complexes have been identified, six containing CH3F and five CH2F2. The complexes are typically less strongly bound than their hydrogen-bonded counterparts, and the interaction energies vary in a consistent way with the periodic trend of the electron donors. The intermolecular separations and changes of the relevant intramolecular bond lengths, the wavenumber shifts of the critical vibrational modes, and the extents of charge transfer for the atoms most closely involved in the interactions correlate, by and large, with the strengths of interaction.

Objective: To determine the prevalence of pre-eclampsia and fetal growth restriction (FGR; <3rd centile) in women with pre-existing cardiac dysfunction. Design: Retrospective cohort study. Setting: Maternity units in UK and Australia. Population: Pregnant women with impaired left ventricular ejection fraction<55%. Methods: Routine clinical data, including medical history and pregnancy outcome were collected retrospectively. Main Outcome Measures: Pre-specified outcomes included pre-eclampsia and FGR prevalence in women with pre-existing cardiac impairment, compared with the general population; and the relationship between pregnancy outcome and pre-pregnancy cardiac phenotype. Results: In this cohort of 282 pregnancies, pre-eclampsia prevalence was not significantly increased (4.6% [95% C.I 2.2-7.0%] versus population prevalence of 4.6% [95% C.I. 2.7-8.2], p=0.99); 12/13 of these women had additional obstetric/medical risk factors. However, prevalences of preterm pre-eclampsia (<37 weeks) and FGR were increased (1.8% versus 0.7%, p=0.03; 15.2% versus 5.5%, p<0.001, respectively). Neither systolic nor diastolic function correlated with pregnancy outcome; however, left ventricular mass index (LVMi) weakly correlated with pre-eclampsia (5g/m2 increase: OR 1.18 [95% C.I. 1.01-1.38], p=0.04). Antenatal ß blockers (n=116) were associated with lower birthweight Z score (adjusted difference -0.33 [95% C.I. -0.63- -0.02], p=0.04). Conclusions: This study demonstrated a modest increase in preterm pre-eclampsia and significant increase in FGR in women with cardiac dysfunction. These results do not support a causal relationship between cardiac dysfunction and pre-eclampsia, especially accounting for the background risk status of the population. The mechanism underpinning the relationship between cardiac dysfunction and FGR merits further research but could be influenced by concomitant ß blocker use.

Phytoplankton plays a fundamental role in the ecology of ocean systems and is the key player in the global carbon cycle. At a time of global warming, understanding the mechanisms of its adaptation to temperature is therefore of paramount importance. Cosmopolitan planktonic species abundant in different marine environments provide both a unique opportunity and an efficient methodological tool to study the genomic bases of their adaptation. This is the case for the eukaryotic picoalga Bathycoccus prasinos, whose genomic variability we chose to study in temperate and polar oceanic waters. Using multiple metagenomic datasets, we found that ~5% of B. prasinos genomic positions are variable, with an overwhelming majority of biallelic motifs. Cold and temperate waters are clearly associated with changes in variant frequencies, whereas in transitional waters we found more balanced polymorphism at most of these positions. Mesophilic and psychrophilic gene variants are distinguished by only a few amino acid changes located at positions critical for physical and functional protein properties. These results provide new information on the genomic diversity of a cosmopolitan eukaryotic planktonic species and suggest “minimal mutational strategies” related to the properties of specific proteins at different temperatures.

THE PATIENT A 24-year-old male patient, known to have tuberous sclerosis complex, developed renal epithelioid angiomyolipomas with hepatic metastasis. Everolimus treatment failed, this lead to a switch to temsirolimus treatment without more efficiency that appeared later on was due to drug-drug interaction which was dealt with in an effective manner

Cardiac dysfunction occurs in hypereosinophilic syndromes is a major cause of morbidity and mortality. In patients with high clinical suspicion for acute myocarditis and confirmed peripheral eosinophilia, timely diagnosis and treatment is imperative to avoid the catastrophic consequence of irreversible fibrotic changes to the cardiac tissue.

Grassland degradation can affect plant eco-physiological properties and thus influence ecosystem productivity and ecosystem function. However, how land degradation affects the relationship between plant biomass and eco-physiological properties of active restoration grasslands and native grasslands in alpine meadow is less understood. A series of degraded grasslands (non-degraded, slightly degraded, moderately degraded, heavily degraded and extremely degraded grasslands) and a series of active restoration grasslands (active restored grasslands with different growth time, 5 years, 9 years, 11 years, 14 years and 17 years) were selected to investigate the relationship between eco-physiological properties and aboveground biomass (AGB) of grasses alongside degradation. Results showed that the AGB, net photosynthetic rate (Pn) and plant nitrogen (N) concentration decreased significantly with increased levels of degradation in native grasslands. Plant photosynthetic capacity, plant N and phosphorus (P) concentration significantly decreased at 9th year or longer than 9 years of replanting time in active restoration grasslands. Plant eco-physiological properties in active restoration grasslands shows stronger association with its AGB than native grasslands. In native grasslands, degradation affect AGB directly and through Pn indirectly. In active restoration grasslands, degradation affect AGB directly and through Pn, plant N and P indirectly. Our results indicated that through improving plant nutrients to restore degraded active grasslands may be more effective than to restore degraded native grasslands.