Current crop protection strategies against the fungal pathogen Botrytis cinerea rely on a combination of conventional fungicides and host genetic resistance. However, due to pathogen evolution and legislation in the use of fungicides, these strategies are not sufficient to protect plants against this pathogen. Defence elicitors can stimulate plant defence mechanisms through a phenomenon known as priming. Priming results in a faster and/or stronger expression of resistance upon pathogen recognition by the host. This work aims to study priming of a commercial formulation of the elicitor chitosan. Treatments with chitosan result in induced resistance in solanaceous and brassicaceous plants. In tomato plants, enhanced resistance has been linked with priming of callose deposition and accumulation of the plant hormone jasmonic acid (JA). Large-scale transcriptomic analysis revealed that chitosan primes gene expression at early time-points after infection. In addition, two novel tomato genes with a characteristic priming profile were identified, Avr9/Cf-9 rapidly-elicited protein 75 (ACRE75) and 180 (ACRE180). Transient and stable overexpression of ACRE75, ACRE180 and their Nicotiana benthamiana homologs, revealed that they are positive regulators of plant resistance against B. cinerea. This provides valuable information in the search for strategies to protect Solanaceae plants against B. cinerea.

Background & Purpose: The constitutive androstane receptor (CAR) belongs to nuclear receptor superfamily. The administration of CAR agonist TCPOBOP to mice leads to hepatomegaly but the mechanism is unclear. Yes-associated protein (YAP) is a downstream factor of Hippo signaling pathway, which is a potent regulator of organ size and tissue homeostasis. This study examined the role of YAP in CAR-promoted hepatomegaly and liver regeneration. Experimental Approach: The effect of CAR on liver enlargement and liver regeneration was evaluated in wild-type (WT) mice, liver-specific YAP-deficient mice, and partial hepatectomy (PHx) mice. KI67 and CTNNB1 staining were performed to evaluate the proliferation response and hepatocytes size. The protein levels of YAP and its downstream targets were measured and Co-IP was conducted to explore the protein-protein interaction between CAR and YAP. Key Results: The results suggested TCPOBOP increases the liver/body weight ratio in WT mice and PHx mice. Hepatocytes enlargement occurred around the central vein area, while the number of KI67+ cells increased around portal vein area. The translocation of YAP was induced and its downstream targets were upregulated after CAR activation via TCPOBOP. Co-IP results revealed a potential protein-protein interaction between CAR and YAP. However, CAR-induced hepatomegaly was still observed in Yap-/- mice. Conclusion and Implications: CAR activation promotes hepatomegaly and liver regeneration in part by inducing nuclear translocation of YAP and interaction with YAP pathway, which provides new insights for understanding the physiological functions of CAR, and suggests the potential for manipulation of liver size.

Objective The study objective was to examine maternal and infant outcomes for obese GDM women who lost weight or gained 0-5 kg during pregnancy. Design A 7-year retrospective study of pregnancy outcomes for obese GDM women. Setting The ATLANTIC DIP consists of 5 antenatal centres along the Irish Atlantic seaboard. Population A total of 754 women met the inclusion criteria. Methods Women were stratified into 3 distinct groups according to their weight gain status: lost weight or gained less than 5 kg (Group 1, n=237 (31.4%)), gained 5-9kg (Group 2, n=77 (10.2%)) or gained >9kg (Group 3 n=440 (58.4%)). The groups were further subdivided according to treatment modality: diet alone (GDM-D) or diet and insulin (GDM-I). Main outcome measures Maternal (eg.preeclampsia, pregnancy induced hypertension (PIH)) and infant outcomes (eg.mortality, prematurity, macrosomia, large for gestational age (LGA)) were assessed. Results Women in Group 1 were older with a higher booking BMI compared to Groups 2 and 3. Logistic regression analysis adjusted for baseline BMI, insulin use, smoking status, parity, family history, ethnicity and age determined no significant difference in maternal or infant outcomes for women in Group1 compared to those in Group 2. Women with excessive weight gain had higher rates of PIH, macrosomia and LGA. Conclusion In our population, weight gain less than IOM guideline does not appear to be associated with adverse outcomes. However, further validation through a prospective study with a larger obese GDM cohort is required before these findings could be recommended for routine clinical use.

Background: Spontaneous preterm birth (sPTB) is a syndrome with clinical and genetic heterogeneity. Few studies have focused on genetic and epigenetic defects and pathogenic mechanisms associated with premature uterine contraction (PUC) of sPTB. Objective: To investigate the (epi)genetic variations associated with premature uterine contraction (PUC) of sPTB. Design: An integrated omics approach of systems biology was employed. Genomics, transcriptomics, methylomics, and proteomics were employed to focus on genetic loci/genes related to uterine muscle contraction, and specifically on genes associated with sarcomeres and desmosomes. Methods: Pregnant cohort with biobank of pregnant tissues was subjected to multiomic studies. Results: Thirteen SNVs and pathogenic variants were identified in the sarcomere gene, TTN, from 146 women with sPTL. DEPs of five lncRNAs were identified from loci that overlap with four sarcomeric genes. Longitudinally, the lncRNA TPM3 was found to significantly regulate the messenger RNA (mRNA) of TPM3 in the placenta, compared to maternal blood. The majority of GMPs related to PUC were also identified in the CpG promoters of sarcomeric genes/loci. DEP of PCU mRNAs showed 22 genes associated with the sarcomere and three with the desmosome. Conclusion: The results demonstrated that PUC was associated mainly with pathogenic variants of the TTN gene and that transcription of sarcomeric PUC genes is likely regulated by epigenetic factors, including methylation and lncRNA.

Objective: To review studies published with pregnant women infected with SARS-CoV-2 and analyze the evolution of them and also of the newborn in order to learn about this pathology in pregnant women. Search strategy: Systematic review in the PUBMED and GOOGLE Scholar databases until March 30, 2020. This research was extended to the references of such articles. Selection criteria: Observational studies that examined maternal and perinatal outcomes of pregnant women with SARS-CoV-2 are published. Data collection and analysis: Data about study characteristics, maternal y perinatal outcomes variable extracted. Main results: We found 14 publications regarding a total of 83 pregnant women with SARS-CoV-2 and results of 84 newborns. The average gestational age was 37 weeks. The most common symptom was fever, and 30% of the pregnant women had lymphopenia on admission to hospital. Cesarean section was performed in 89% of the patients; 70% of them were indicated by SARS-CoV-2. The most common obstetric complication was premature rupture of membranes in 9.6% of them. The need for ventilation support was low. The use of antivirals, corticosteroids, and drugs for the pathology management was scarce, except for antibiotics. Preterm birth was 25%, perinatal mortality was low, and there was no maternal death. There was no evidence of vertical transmission. Conclusion: Maternal and perinatal morbidity-mortality is lower than in other known respiratory diseases. Currently, it appears to be no benefit from antivirals and other drugs, beyond the general support of the disease, and vertical transmission of the virus has not been demonstrated.

Dear Editor,We read the letter from colleagues Dr. Seedat and Dr. Marshall, commenting on our article, with great interest (1, 2). Their clarifications on the UK National Screening Committee (UK NSC) position are very clear. The UK NSC decided against a general screening since they cannot assess the benefits and harms in the patient populations of women (3) but they could indeed in newborns. The on-going clinical trial (GBS3 Trial; ISRCTN49639731) in the UK will compare the current risk-based strategy to two different screening tests. A lab based culture test at 3 to 5 weeks before anticipated delivery date will use an established microbiological technique [Enriched Culture Medium Testing] to reduce false-negative results and a molecular point of care test at the onset of labour. The latter test reduces the time period between screening and the start of labour. The predictive value of antenatal GBS cultures decreases if the interval between culture and delivery is longer than 5 weeks. The results of the trial will help to determine the appropriate screening technique and the rational use of antibiotics for the prevention of early onset GBS sepsis in newborn babies.Perinatal empirical therapy of newborns at risk for or with suspected EOS represents the main contributor to the use of antibiotics in early life (4). There is growing concern about the effects that unnecessary exposure to antibiotics in the perinatal period may have on the future health of these children (5, 6). Antibiotic-related alterations in the microbiome may have downstream effects on the developing immune system and may increase the risk of allergic, autoimmune, and metabolic diseases (5, 6).Seedat and Marshall state that according to another study, the use of IAP would indeed increase if screening were implemented, and that the portion of women receiving IAP would be ‘low risk women’ who… ‘would not have a neonate with EOGBS in the absence of IAP’ (1). In this statement is embedded the assumption that the currently established risk factors are indeed a good prediction of EOGBS transmission. However, 50% of neonates with early onset sepsis with GBS did not have risk factors. To the contrary, we confirm in our meta-analysis and systematic review that universal screening lowered the incidence of early onset GBS sepsis in newborn whereas risk-based approaches did not (2). This might indicate that although screening is imperfect, risk factors might be worse in predicting EOGBS outcomes.Besides, we found no evidence that the rate of intrapartum antibiotic treatment was different in risk-based screening than in universal screening. Administration of antibiotics in risk-based policies was in our study neither lower nor associated with a reduction in the burden of disease in early onset GBS sepsis (2). We are looking forward to the results of the GBS3 trial since there is a need for unbiased evidence on the appropriate policy. A trial comparing screening with risk-factor based intrapartum antibiotic prophylaxis is hard to conduct in areas that currently have a screening policy. Recruitment of participants is very challenging and a premature stop for futility is very likely. A lot of women might not want a risk-based protocol if screening is already the standard of care or easily available. Therefore, the UK data will be very helpful in guiding the future way.References1. Seedat F, Marshall J. Re: Universal screening versus risk-based protocols for antibiotic prophylaxis during childbirth to prevent early-onset Group B streptococcal disease: A systematic review and meta-analysis. (First comment letter. Reference to be added). BJOG. 2020.2. Hasperhoven GF, Al-Nasiry S, Bekker V, Villamor E, Kramer B. Universal screening versus risk-based protocols for antibiotic prophylaxis during childbirth to prevent early-onset Group B streptococcal disease: a systematic review and meta-analysis. BJOG. 2020. https://doi.org/10.1111/1471-0528.160853. Seedat F, Geppert J, Stinton C, Patterson J, Freeman K, Johnson SA, et al. Universal antenatal screening for group B streptococcus may cause more harm than good. BMJ. 2019;364:l463.4. Achten NB, Klingenberg C, Benitz WE, Stocker M, Schlapbach LJ, Giannoni E, et al. Association of Use of the Neonatal Early-Onset Sepsis Calculator With Reduction in Antibiotic Therapy and Safety: A Systematic Review and Meta-analysis. JAMA Pediatr. 2019.5. Cotten CM. Adverse consequences of neonatal antibiotic exposure. Curr Opin Pediatr. 2016;28(2):141-9.6. Esaiassen E, Fjalstad JW, Juvet LK, van den Anker JN, Klingenberg C. Antibiotic exposure in neonates and early adverse outcomes: a systematic review and meta-analysis. J Antimicrob Chemother. 2017;72(7):1858-70.

Coronavirus disease (COVID-19) with orbital complication in young childCOVID-19 is a current ongoing global health emergencyCoronaviruses cause sinonasal symptoms similar to common cold and loss of smellEndoscopic sinus surgery is an aerosol-generating procedure with high risk of COVID-19 transmissionCOVID-19 infection was related to a case of preseptal orbital cellulitisCovid-19 infection should be suspected in current cases of orbital cellulitis and management plan modified to protect medical professionals

Environmental DNA and metabarcoding have great potential for the biomonitoring of freshwater environments. However, successful application of metabarcoding to biodiversity monitoring requires universal primers with high taxonomic coverage that amplify highly-variable, short metabarcodes with high taxonomic resolution. Moreover, reliable and extensive reference databases are essential to match the outcome of metabarcoding analyses with the available taxonomy and biomonitoring indices. Benthic invertebrates, particularly insects, are key taxa for freshwater biomonitoring. Nevertheless, so far, no formal comparison has assessed primers for metabarcoding of freshwater macrobenthos. Here we combined in vitro and in silico analyses to test the performance of metabarcoding primers amplifying regions in the 18S rDNA (Euka02 metabarcode), 16S rDNA (Inse01), and COI (BF1_BR2-COI) genes, and developed an extensive database of benthic invertebrates of France and Europe, with a special focus on three key insect orders (Ephemeroptera, Plecoptera and Trichoptera). In vitro analyses on 1514 individuals, belonging to 578 different taxonomic units showed very different amplification rates across primer combinations. The Euka02 marker showed the highest universality, while the Inse01 marker showed excellent performance for the amplification of insects. The BF1_BR2-COI metabarcode showed the highest resolution, while the resolution of Euka02 was often limited. By combining in vitro data with GenBank information, we developed a curated database including sequences representing 822 genera. The heterogeneous performance of the different metabarcodes highlights the complexity of the identification of the best markers, and advocates for the integration of multiple metabarcodes for a more comprehensive and accurate understanding of ecological impacts on freshwater biodiversity.

We introduced a patient with fetal EBV-triggered who finally developed multidrug-resistant septicemia, perianal abscess, massive alimentary tract bleeding due to gastrointestinal vascular malformation, and acute respiratory distress syndrome.

Drought stress at germination stage is an important environmental stress limiting crop yield. Hence, our study investigated comparative root transcriptome profiles of four contrasting soybean genotypes viz., drought-tolerant (PI342618B/DTP & A214/DTL) and drought-sensitive (NN86-4/DSP & A195/DSL) under drought stress using RNA-Seq approach. Total of 4850 and 6272 differentially expressed genes (DEGs) were identified in tolerant (DTP & DTL) and sensitive (DSP & DSL) genotypes, respectively. Principle component analysis (PCA) and correlation analysis revealed higher correlation of DTP with DTL. Both gene ontology (GO) and MapMan analyses showed drought response was enriched in the DEGs associated with water and auxin transport, cell wall/membrane, antioxidant activity, catalytic activity, secondary metabolism, signaling and transcription factor (TF) activities. Out of 981 DEGs screened from above terms, only 547 showed consistent opposite expression between contrasting genotypes. Twenty-eight DEGs of 547 were located on Chr.08 rich in QTLs and “Hotspot regions” associated with drought stress, and eight of them showed non-synonymous SNP polymorphism. Hence, ten genes (including above eight genes plus two hub genes) were predicated as possible candidates regulating drought tolerance, which needs further functional validation. Overall, the transcriptome profiling provided in-depth understanding about the genetic mechanism and candidate genes underlying drought tolerance in soybean.

Land degradation is a critical issue globally putting our future generations at risk. The decrease in farm productivity over the years is evidence of land degradation severity in Nepal. Among the many strategies in place, agroforestry, which is an integrated tree-based farming, is widely recommended to address this productivity issue. This paper thoroughly examines what influences the choice of agroforestry adoption by farmers and what discourages the adoption. For this, a total of 288 households were surveyed using a structured questionnaire. Two agroforestry practices were compared with conventional agriculture with the help of the Multinomial Logistic Regression (MNL) model. The likelihood of adoption was found to be influenced by gender; the male-headed households were more likely to adopt the tree-based farming practice. Having a source of off-farm income was positively associated with the adoption decision of farmers. Area of farmland was found being the major constraint to agroforestry adoption for smallholder farmers. Some other variables that affected positively included livestock herd size, provision of extension service, home-to- forest distance, farmers’ group membership and awareness of farmers about environmental benefits of agroforestry. Irrigation was another adoption constraint that the study area farmers were faced with. The households with means of transport and with larger family (household) size were found to be reluctant towards agroforestry adoption. A collective farming practice could be a strategy to engage the smallholder farmers in agroforestry.

Increasing anthropogenic loading of phosphorus (P) threatens aquatic ecosystems. The bioavailability of P in sediments for algal growth depends on several physiochemical properties such as particle size distribution, mineralogy, pH, electrical conductivity (EC), and carbonate-content. This study was aimed on selecting the best chemical extraction method to characterize P-availability for the algae Selenastrum capricornutum. Principal component analysis (PCA) of the data identified two components that cover 79.3% of the total variation, and these components were dominated by particle size distribution, active calcium carbonate equivalence (ACCE), and EC. Many of the considered extractions were positively correlated with each other, with the exception being Bray-II. The sediments of some rivers had a higher Olsen-extractable P than 20 mg kg-1, that is considered a threshold value above which the aquatic environment may become negatively affected. The average rank order of P extraction by single extractants was: Colwell > Mehlich III > NaOH 0.1 M > Olsen > Morgan > AB-DTPA > Bray II. The Colwell-extractable P concentrations of sediments varied from 1.44 to 88.0 mg kg-1. This extractant significantly correlated with algal growth (r2=0.92, P<0.001) and was the best single extraction method to characterize sediment P-bioavailability. Algae (S. capricornutum) growth was also well correlated with Mehlich III, NaOH 0.1 M, Olsen, and Morgan extractable-P concentrations. Algae growth was highly significantly correlated with EC.

The discus fish Symphysodon spp., an Amazonian cichlid, employs an unusual parental care behavior where free-swimming fry feed on parental epidermal mucus after hatching. However, little is known about the mechanism by which discus secrete ‘milk’ and the genes involved. In order to study the unique behavior of discus fry feeding on parental skin mucus on the molecular level, transcriptome sequencing was performed on the skin and brain of female discus. Through the analysis of skin transcriptome sequencing data, 228 differentially expressed genes were obtained by comparing parental with non-parental fish, including 126 up-regulated genes and 102 down-regulated genes. For the brain, 86 differentially expressed genes were obtained including 71 up-regulated genes and 15 down-regulated genes. Through the analysis of pathway in the skin, 7 metabolic pathways were obtained: arachidonic acid metabolism pathway, adhesion pathway, apoptosis, steroid biosynthesis, tuberculosis, P53 signaling pathway, serotonergic synapse, which were related to 10 differentially expressed genes: JUNB, MRC, DPP3, CASP3, PPID, ITGA11, ALOXE3, HBE, PTPRJ, GALE. Meanwhile, the analysis of pathway in the brain, 20 metabolic pathways were obtained e.g., estrogen signaling pathways, inflammatory medlator regulation of TRP channels, non-small cell lung cancer, vascular smooth muscle contraction, which were related to 9 differentially expressed genes: PRKCD, H1-5, EDNRB, LAPTM, FOXB, OTX2, NRIF2, SOX1 and HBE.

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we were designed heterogonous Fe3O4-Au nanocomposite with average size of 27 nm that synthesized by Foeniculum vulgare seeds extract to photodegrade methyl orange, imipenem and imatinib dye/drugs under UV-visible light irradiation. Physicochemical properties of biogenic nanocomposite were characterized by XRD, FTIR, UV-Vis, SEM, EDX and X-ray elemental mapping. The complete degradations of methyl orange, imipenem and imatinib are about 95% after 2100 s, 91% after 1200 s and 93% after 1500 s, respectively under UV light irradiation, whereas under visible light irradiation are about 87% after 4200s and 88% after 4800s for imipenem and imatinib, respectively. In addition, antimicrobial activity was screened by biogenic Fe3O4-Au nanocomposite vs. Estaphilu and Bacillus subtilis and E. coli. Remarkable zone of inhibition was observed for Bacillus subtilis in 25mg/mL concentration of nanocomposites. Photocatalysts that have antimicrobial properties in addition to their unique photocatalytic properties have the potential of being no longer polluting the environment.

One standout observation regarding the clinical epidemiology in the current COVID-19 pandemic is the relatively low incidence and generally mild presentation of the infections in children (Ludvigsson, 2020)⁠. Indeed, only 230 pediatric cases with 3 neonates have been reported in China through February 6 2020 (Lu & Shi, 2020)⁠ with a total of only 9 infected and hospitalized cases identified between December 8 2019 and February 6 2020 out of a total of 31,211 cases of COVID-19 reported (Wei et al., 2020). Moreover the course in infants and children was mild with infection rarely progressing to lower respiratory tract infections (Hong et al., 2020), and no deaths have been reported in this age group (Lu & Shi, 2020)⁠.Since SARS-CoV-2 is highly contagious, it is anomalous that the infection rate is so low in infants and children given the high risk of inevitable close contact they have with adults. So far, several theories to explain this anomaly include lack of nicotine exposure in children, and reduced expression of ACE2 cell surface receptors needed by SARS-CoV-2 to gain entry to host at younger ages (Song et al., 2012).Here we postulate another possibility for lower incidence and milder disease is high lactoferrin content in breast or some infant formula feedings.Lactoferrin (Lf), which is highly concentrated in human milk as well as often added to modern infant formulas has demonstrable broad-range antiviral properties (Wakabayashi et al., 2014) including against SARS-CoV, which uses the same ACE2 surface receptor to invade hosts as SARS-CoV2 (Lang et al., 2011), thus, it is not inconceivable that nutritional lactoferrin in breast milk or infant formula contributed to reduced incidence as well as milder course of COVID-19 in infants and young children. This intriguing possibility can be assessed by carefully noting the feeding history of pediatric COVID-19 cases.Author list:

Background: This case highlights challenges in the assessment and management of the “difficult airway” patient in the SARS-CoV-2 (COVID-19) pandemic era. Methods: A 60-year-old male with history of recent TORS resection, free flap reconstruction and tracheostomy for p16+ squamous cell carcinoma presented with stridor and dyspnea one month after decannulation. Careful planning by a multidisciplinary team allowed for appropriate staffing and personal protective equipment, preparations for emergency airway management, evaluation via nasopharyngolaryngoscopy, and COVID testing. The patient was found to be COVID negative and underwent imaging which revealed new pulmonary nodules and a tracheal lesion. Results: The patient was safely transorally intubated in the operating room. The tracheal lesion was removed endoscopically and tracheostomy was avoided. Conclusions: This case highlights the importance of careful and collaborative decision making for the management of head and neck cancer and other “difficult airway” patients during the COVID-19 epidemic.

The half-metallicity of Heusler alloy is quite sensitive to high pressure and disorder. Therefore, we systematically studied the half-metallic nature, magnetism and thermomechanical properties of FeCrTe and FeCrSe Heusler alloys under high pressure using ab initio calculations based on density functional theory (DFT). The ground state lattice constants for FeCrTe and FeCrSe alloys are 5.93 and 5.57 Å, consistent with available theoretical results. The formation energy, cohesive energy and elastic constant confirmed the thermodynamically and mechanical stability of both compounds. The FeCrTe and FeCrSe alloys showed half-metallic character with the band gap of 0.68 and 0.58 eV at 0 Gpa pressure respectively and magnetic moments of 2.01 µB for both alloys using GGA approximation. The elastic properties have been scrutinized and found that FeCrTe is ductile and FeCrSe is brittle at 0 Gpa pressure. Under pressure, FeCrSe turn into brittle above 10 Gpa pressure. Moreover, the average sound velocity Vm, Debye temperature ƟD and heat capacity CV were predicted under pressure. These outcomes would advantage in integrating Fe-based half-Heusler alloys in spintronic devices.

The fracture of compressor blade’s tenon is a concrete problem in the operation of ironmaking plant. A systematic research on the fracture failure of the tenon of X20Cr13 blade has been carried out in this paper. Systematic research consists of two parts: comprehensive analysis and simulation analysis. Comprehensive analysis includes macroscopic analysis, metallographic structure analysis, SEM characterization, EDS characterization, mechanical property analysis, chemical composition analysis, hardness analysis and assembly structure analysis. The simulation analysis includes heat treatment simulation analysis, static stress software simulation analysis and resonance damage calculation analysis. The comprehensive analysis shows that the performance, chemical composition and hardness of blade are not the cause of failure. The cracks of blade tenon have the obvious fatigue crack characteristics. The fretting wear can produce the failure source which leads to the occurrence and development of cracks. A large number of M23C6 carbides with large particle size appeared in the metallographic structure and distributed unevenly and intensively along the grain boundary. These carbides not only damage the continuity of matrix structure but also create conditions for the initiation and propagation of fatigue cracks. Improper assembly of blades can also lead to excessive local stress. The simulation analysis further confirmed that the stress at the root of blade tenon is too large and the possibility of failure caused by resonance is eliminated. Improper heat treatment is also one of the causes of fracture. Based on the research conclusion, this paper also puts forward some constructive suggestions for this engineering problem.

Analysis of population genetic data often includes the search for genomic re- gions with signs of recent positive selection. One of the approaches involves the concept of Extended Haplotype Homozygosity and its associated statistics. These statistics presume that haplotypes are phased and some of them that variants are polarized. Here we assess the consequences if one of the two con- ditions is not fulfilled. We find that phasing information is indispensable for the accurate estimation of within-population statistics and, if sample sizes are small, for cross-population statistics, too. Ancestry information, in contrast, is of lesser importance for both. We make use of a publicly available update of our R package rehh which, among other features, incorporates the adapted statistics presented here.

Processing and visualising trends in the binary data obtained from fragment analysis methods in molecular biology can be a time-consuming, and often cumbersome process. Scoring and processing binary data (from methods such as AFLPs, ISSRs, and RFLPs) entails complex workflows that require a high level of computational and/or bioinformatic skills. The application presented here (BinMat) is a free, open-source, and user-friendly R Shiny program that automates the analysis pipeline on one platform. BinMat is presented as a Graphical User Interface (GUI) via the Shiny package in R that is available online across different operating systems. It is also available as an R package. BinMat consolidates replicate sample pairs in a dataset into consensus reads, produces summary statistics, and allows the user to visualise their data as ordination plots and clustering trees without having to use multiple software programs and input files, or rely on previous programming experience.

BackgroundClinical skills are important for medical students and doctors for their everyday work and faculties are expected to teach and assess clinical skills and other competencies that medical students should have at the beginning of their career. Among competencies required for a young doctor to begin with his or her career are several clinical skills. The aim of our study was to evaluate in a low-stakes formative assessment the clinical skills level improvement of finishing medical students prior to and after their 9-week Internal medicine clerkship. Methods88 final year medical students participated in the study prior and after their 9-week Internal medicine clerkship. On the first day and on their last day of clerkship, they were assessed in three different clinical skills – history taking, venipuncture and rectal examination. Clinical skills were performed on artificial simulators. Objective Structured Clinical Examination (OSCE) was used to evaluate students and assessors used a prepared checklist for each clinical skill.ResultsA significant improvement was detected in total OSCE (p=0.001), history taking (p=0.001) and rectal examination results (p=0.023) on the second testing. Moreover, reduction of time needed to complete the task was also detected in all clinical skills. ConclusionsFinal year medical students have a lot of practical skills and are well prepared for the clinical environment. They are prepared to perform tested clinical skills on their own, without supervision. Additional activities should be considered to improve performance in the clinical skill.

What is precision medicine? No standard definition is found. Sometimes described as High Definition Medicine which is: “the dynamic assessment , management, and understanding of an individual’s health measured at (or near) its most basic units.” The impetus for this venture was advanced and stimulated by biogenetics, the study of how genes and their products affect health but also contribute to disease or resistance to cure. Medicine is an epistemology: a way of knowing, perceiving, remembering, finding out, proving, inferring, wondering, reflecting, a conceptual knowing relying upon observations fitted to disease concepts.

Objective: report maternal, fetal and neonatal complications associated with single intrauterine fetal death (sIUFD) in monochorionic twin pregnancies Design: prospective observational study Setting: UK Population: 81 monochorionic twin pregnancies with sIUFD after 14 weeks gestation, irrespective of cause Methods: UKOSS reporters submitted data collection forms using data from hospital records. Main outcome measures: aetiology of sIUFD; surviving co-twin outcomes: perinatal mortality, central nervous system (CNS) imaging, gestation and mode of delivery, neonatal outcomes; post-mortem findings; maternal outcomes. Results: The commonest aetiology was twin-twin transfusion syndrome (38/81, 47%), “spontaneous” sIUFD (22/81, 27%) was second commonest. Death of the co-twin was common (10/70, 14%). Preterm birth (<37 weeks gestation) was the commonest adverse outcome (77%): half were spontaneous and half iatrogenic. Only 46/75 (61%) cases had antenatal CNS imaging, of which 33 cases had known results of which 7/33 (21%) had radiological findings suggestive of neurological damage. Postnatal CNS imaging revealed an additional 7 babies with CNS abnormalities, all born at <36 weeks, including all 4 babies exhibiting abnormal CNS signs. Major maternal morbidity was relatively common, with 6% requiring ITU admission, all related to infection. Conclusions: Monochorionic twin pregnancies with single IUD are complex and require specialist care. Further research is required regarding optimal gestation at delivery of the surviving co-twin, preterm birth prevention, and classifying the cause of death in twin pregnancies. Awareness of the importance of CNS imaging, and follow-up, needs improvement.