1. Quantitative PCR (qPCR) has been commonly used to measure gene expression in a number of research contexts, but the measured RNA concentrations do not always represent the concentrations of active proteins which they encode. This can be due to transcriptional regulation or post-translational modifications, or localisation of immune environments, as can occur during infection. However, in studies using free-living non-model species, such as in ecoimmunological research, qPCR may be the only available option to measure a parameter of interest, and so understanding the quantitative link between gene expression and associated effector protein levels is vital. 2. Here we use qPCR to measure concentrations of RNA from mesenteric lymph node (MLN) and spleen tissue, and multiplex ELISA of blood serum to measure circulating cytokine concentrations in a wild population of a model species, Mus musculus domesticus. 3. Few significant correlations were found between gene expression levels and circulating cytokines of the same immune genes or proteins, or related functional groups. Where significant correlations were observed, these were most frequently within the measured tissue (i.e. the expression levels of genes measured from spleen tissue were more likely to correlate with each other rather than with genes measured from MLN tissue, or with cytokine concentrations measured from blood). 4. Potential reasons for discrepancies between measures, including differences in decay rates and transcriptional regulation networks are discussed. We highlight the relative usefulness of different measures under different research questions, and consider what might be inferred from immune assays.

Dear Dr. Cavalleri, I hereby resubmit my paper entitled “Fitting Elephants in the Density Functionals Zoo: Statistical Criteria for the Evaluation of DFT methods as a Suitable Replacement for Counting Parameters” with modifications that address all the concerns raised by the Referees. As such, I believe the manuscript is now ready for publication in the Authorea special issue of the International Journal of Quantum Chemistry. I want to thank the Referees for the clear and very useful remarks. For your convenience, I report below a point-by-point reply to each of the concerns raised by the Referees, and how I've addressed them in the new manuscript: 

There is increasing evidence that COVID-19 infection predisposes to thromboembolism. A 71 years-old male patient was admitted to ICU for COVID-19 related pneumonia. He developed a high troponin rise up to 6715 ng/L. By transthoracic echocardiography, we found akinesia of the full right ventricular apex with a mobile hyperechogenic mass, highly suggestive of thrombus. Unfractionated Heparin was started immediately. A subsequent echocardiogram showed no mass. To our knowledge, this is the first case showing a thrombus formation in the context of right ventricular apical akinesia in COVID-19 patients. There is upcoming evidence that the clinical relevance of thromboembolic complications may be a serious issue in COVID-19 patients even in the absence of any obvious risk factor. Our case clearly demonstrate that, in patients with COVID-19 infection and troponin rise, echocardiography should be performed to rule out possible thrombotic complications

ESP-block produce analgesia. A patient rejects GA for an intervention of capsulated under-apicalular lipoma exeresis. ESP-block is performed. The ESP represents a valid anesthetic alternative for thoracic wall operations whose patients have contraindications to the GA.

Dear Editor,We would like to comment on the systematic review by Li et al.(1)The use of steroid hormones in the first trimester is a serious issue as organogenesis takes place at this time and therefore there is the possibility of harm from not only congenital anomalies, but also long-term, and even inter-generational effects. Anyone investigating the use of steroid hormones in the first trimester should remember the diethylstilbestrol legacy of devastating harm. Oestrogen (C18H24O2) and diethylstilbestrol (C18H20O2) have similar molecular composition, but their effects are poles apart. In this review, the authors have combined progesterone with progestogens; however they are not the same, in the same way that oestrogen and diethylstilbestrol are not the same. Vaginal micronized progesterone, which we used in our large and high-quality trials (the PROMISE (2) and PRISM (3) trials), has identical molecular structure to natural progesterone, but the other drugs included in this review do not (Table 1). We chose to study vaginal micronized progesterone, as it is identical in structure to natural progesterone, and the available evidence and expert opinion suggested that this is least likely to cause harm. It is important to note that there is evidence of potential harm from dydrogesterone, particularly congenital heart disease.(4)The authors make a bold statement in the abstract about the effects of dydrogesterone on live birth rate. However, they don’t fully address the weaknesses in the evidence. Therefore, we wish to highlight the significant deficiencies in the two trials that contributed live birth data that led to the assertion of beneficial effects from dydrogesterone. Both studies were single centre, open-label studies without placebo control. El-Zibdeh et al did not randomise participants, but instead allocated patients to dydrogesterone on Saturdays, Mondays and Wednesdays, and to no treatment on Sundays, Tuesdays and Thursdays. The trial by Pandian RU was not just a single-centre, but also a single-author study, with insufficient details of the methods to assess its quality. Thus, the effectiveness evidence from these trials cannot be considered reliable.Approximately 80% (4038 of 5056) of the data used in this systematic review come from our PRISM trial.(3) The PRISM trial is a prospectively-registered, randomised, placebo-controlled, multi-centre trial conducted to the highest standards in the UK. The trial found a 3% increase in live birth rate, but with borderline statistical significance (RR, 1.03; 95% CI, 1.00 to 1.07; P=0.08). A pre-specified subgroup analysis in women with the dual risk factors of current pregnancy bleeding and one or more previous miscarriages found a 5% increase in live birth rate (RR, 1.09; 95% CI, 1.03-1.15; P=0.003). In those with three or more previous miscarriages, a 15% increase in live birth rate was observed (RR, 1.28; 95% CI, 1.08 to 1.51; P=0.004).(3, 5) No short-term safety concerns were identified. Based on these data, our recommendation is to consider vaginal micronized progesterone for women with early pregnancy bleeding and one or more previous miscarriages. As for the role of dydrogesterone, we need not only high-quality, randomised trial evidence of its effects but also credible evidence of its safety. As dydrogesterone is a synthetic progesterone-like drug, i.e. a progestogen but not progesterone, the burden of proof to demonstrate short- and long-term safety rests on those promoting this drug.

Dear EditorBirth Trauma organisations advocate on behalf of women and babies who have experienced adverse outcomes and naturally they will take a risk-averse perspective on birth-related care. The latest version of the Assisted Vaginal Birth (AVB) RCOG Guideline (previously called Operative Vaginal Delivery) has focussed specifically on revisions designed to minimise the risk of traumatic injuries for the mother and baby.1 The landmark Montgomery ruling that raised the bar on the standard required for informed consent has been embraced and endorsed within the guideline. 2 It is disappointing to read that Hull et al have concluded that “Montgomery is missing from RCOG’s Assisted Vaginal Birth guideline”.3Hull et al have acknowledged the important counselling advice that has been recommended – antenatal discussion about AVB when planning birth in the third trimester (especially for first-time mothers), review of birth preferences when conducting routine labour ward rounds, and in depth counselling, where circumstances allow, if complications arise during the course of labour particularly during the second stage. However, the guideline apparently falls short of the Montgomery ruling in that we have not recommended “planned caesarean” as an option to prevent assisted vaginal birth.The AVB guideline went through an extensive scoping process. The agreed scope was to address all key questions that arise in relation to labouring women who may require obstetric assistance in the second stage of labour - the assumption being that these women have the intention to labour and deliver vaginally. A guideline addressing maternal request “planned” caesarean section is an entirely different guideline. It is also incorrect to state that the RCOG have provided no direct guidance on this (see Choosing to have a Caesarean section , RCOG Patient Information (2015) based on NICE Clinical Guideline Caesarean Section (2011)).4 The issue of pelvic floor morbidity was included in the literature search and has been discussed in detail.The Montgomery ruling related to a woman with diabetes in pregnancy and a large for gestational age fetus who experienced shoulder dystocia resulting in her baby developing cerebral palsy. The importance of outlining, in advance, the birth options for this woman is clear, given the specific known risks associated with labour in her circumstances. Hull et al suggest on the same basis that all women should be advised that a planned caesarean section is an option to prevent assisted vaginal birth. If taken one step further the Montgomery ruling could be cited to support the argument that all women should be advised that the best way to avoid pregnancy-related complications is to avoid getting pregnant. Common sense would infer that this was not the intention of the Montgomery ruling.Where this RCOG guideline is likely to be consistent with Birth Trauma organisations is in the recommendations on careful assessment, supervision and decision-making; clear communication and transparent consent procedures; and an overall approach that places safety as the first priority when deciding when and when not to attempt a vacuum or forceps assisted delivery, and when to discontinue any such attempt. It is hoped that all relevant health professionals will review and implement the evidence-based, peer-reviewed recommendations within this guideline. They are designed to support women in achieving safe and joyful births, even when obstetric assistance is required.Deirdre J Murphy,1 Rachna Bahl,2Bryony Strachan21) Coombe Women & Infants University HospitalCork St, Dublin 8, Republic of Ireland2) St Michael’s Hospital, Bristol

In the world today, huge volumes of data are generated in short text form. Many topics modelling techniques have been developed. Among these techniques is the popular Latent Dirichlet Allocation (LDA), however the effectiveness of this and other techniques has been shown to increase linearly with the document size while being less effective when modelling topics from short texts. Furthermore, the generated topics exhibit poor semantic coherence. We present an n-gram based multi-level clustering model for discovering coherent topics from short texts. By taking advantage of the natural arrangement of words in the n-grams in the topic form stage, the model is able to discover semantically coherent topics that are easily interpreted. n-grams are discovered recursively starting with larger n-grams down to n-grams whose length is governed by a pre-defined lower limit. The discovered n-grams are then subjected to a multi-level clustering algorithm, with the lowest clustering level being constituted from the shortest n-grams that occur most frequently in the entire corpus, and the highest level from least common n-grams at level n. We evaluate the model against the standard LDA and Bi-Term models by measuring and presenting the comparative coherence scores achieved by the topics generated from two datasets.

Aims: The aim of this study was to investigate in detail the traumatic birth experiences of midwives in the delivery rooms, and their attitudes, reactions, and coping strategies. Methods: The design of the study is descriptive and the purposive sampling method was used. This approach is ideal for a preliminary exploration of the nature of a phenomenon. Between October 2018 and January 2019, semi-structured interviews were conducted with a purposeful sample of midwives. The research was carried out with the participation of 29 midwives, who work in labour and birth room. They were asked to describe a particular stressful situation they had experienced during the birth process, their emotions about the event, and their coping strategies and support systems. All interviews were digitally recorded, stored in a database, and transferred to MAX Qualitative Data Analysis 18.1.0 for analysis. Results: As a result of the content analysis, three main themes emerged: Psychological impact, defensive practice, and expectations from the hospital. It was revealed that, after the traumatic birth, midwives experienced highly emotional exhaustion in the form of sadness, flashbacks, guilt, fear, and empathy, and that they performed an increasingly defensive practice. Besides, midwives explicitly stated that they were not prepared enough for traumatic events and that most traumatic births were simply ignored in their workplace. Eventually, it was determined that midwives received support mostly from their colleagues in case of a traumatic birth. Conclusion(s): Midwives need to feel valued and be supported by their institutions in coping with emotional stress. Therefore, performing clinical inspections by experienced or specialist midwives may serve as a supporting framework for reducing defensive interventions.

A document by CHENXIANG CAO, written on Authorea.

Since the first description of anaphylaxis in 1902, its clinical importance as an emergency condition has been recognized worldwide. Anaphylaxis is a severe, potentially life-threatening systemic hypersensitivity reaction characterized by rapid onset and the potential to endanger life through respiratory or circulatory compromise. It is usually, although not always, associated with skin and mucosal changes. Although the academic/scientific communities have advocated to promote greater awareness and protocols for management of anaphylaxis based on best evidence, there are few efforts documenting feedback as to the success of these efforts. In this document, we review the key unmet needs related to the diagnosis and management of anaphylaxis, propose a public health initiative for prevention measures and a timetable action plan which intends to strengthen the collaboration among health professionals and especially primary care physicians dealing with anaphylaxis that can encourage enhanced quality of care of patients with anaphylaxis. More than calling for harmonized action for best management of anaphylaxis to prevent undue morbidity and mortality, the Montpellier World Health Organization Collaborating Centre here proposes an action plan as a baseline for a global initiative against anaphylaxis. We strongly believe these collaborative efforts are a strong public health and societal priority that is consistent with the overarching goals of providing optimal care of allergic patients and best practices of allergology.

The phosphorylation states of two serine residues within the C-terminal domain of AtPIP2;1 (S280, S283) regulate its trafficking to the plasma membrane in response to salt and osmotic stress. Here we investigated whether the phosphorylation states of S280 and S283 also influence AtPIP2;1 facilitated water and cation transport. A series of single and double S280 and S283 phospho-mimic and -deficient AtPIP2;1 mutants were tested in heterologous systems. In Xenopus laevis oocytes, phospho-mimic mutants AtPIP2;1 S280D, S283D and S280D/S283D, had significantly greater ion conductance for Na+ and K+, whereas the S280A single and S280A/S283A double mutants, had greater water permeability. A phospho-mimic-dependent inverse relationship between AtPIP2;1 water and ion transport with a 10-fold change in both was observed. These results revealed that phosphorylation of S280 and S283 influences the preferential facilitation between ion and water permeability by AtPIP2;1. The results also hint at other sites playing a role that are yet to be elucidated. Expression of the phospho-mimic AtPIP2;1 mutants in Saccharomyces cerevisiae, confirmed that phosphorylation influences plasma membrane localisation, and revealed higher Na+ accumulation for S280A and S283D. Collectively, the results show that phosphorylation in the C-terminal domain of AtPIP2;1 influences its subcellular localisation and cation transport capacity.

Plant growth depends on the diurnal regulation of cellular processes, but it is not well understood if and how transcriptional regulation controls diurnal fluctuations at the protein-level. Here we report a high-resolution Arabidopsis thaliana (Arabidopsis) leaf rosette proteome acquired over a 12 h light : 12 h dark diurnal cycle and the phosphoproteome immediately before and after the light-to-dark and dark-to-light transitions. We quantified nearly 5000 proteins and 800 phosphoproteins, of which 288 fluctuated in their abundance and 226 fluctuated in their phosphorylation status. Of the phosphoproteins, 60% were quantified for changes in protein abundance. This revealed six proteins involved in nitrogen and hormone metabolism that had concurrent changes in both protein abundance and phosphorylation status. The diurnal proteome and phosphoproteome changes involve proteins in key cellular processes, including protein translation, light perception, photosynthesis, metabolism and transport. The phosphoproteome at the light-dark transitions revealed the dynamics at phosphorylation sites in either anticipation of or response to a change in light regime. Phosphorylation site motif analyses implicate casein kinase II and calcium/calmodulin dependent kinases among the primary light-dark transition kinases. The comparative analysis of the diurnal proteome and diurnal and circadian transcriptome established how mRNA and protein accumulation intersect in leaves during the diurnal cycle of the plant.

Ecosystem responses to external inputs of nutrients and organisms are highly variable. Theory predicts that ecosystem traits will determine the responses to spatial subsidies, but evidence for how vegetation structure can modulate those effects is lacking. We investigated how vegetation structure (i.e., leaf area index [LAI] and vegetation height) influenced the ecosystem and community responses to insect spatial subsidies in a subarctic grassland. Our experiment consisted of a 2 x 2 manipulation where in one treatment we either blocked flying insects over a 2-year period in 1-m2 plots near the shore of Lake Mývatn, Iceland where deposition of aquatic adult midges (Diptera: Chironomidae) to land is high, or we left control plots accessible to flying midges. In the second treatment, grassland vegetation was cut (Tall vs. Short) at the start of each season and then allowed to regrow. Within each plot (n = 6 replicates x 4 treatments), we measured litter decomposition and arthropod composition and density. Midge-exclusion cages reduced midge deposition by 81% relative to the open plots. Vegetation cutting initially reduced LAI and vegetation height by 3x and 1.5x, respectively, but these were not different by the end of the second growing season. We found that vegetation structure modulated the effects of midge subsides on litter decomposition, with taller canopies intercepting more insect subsidies than shorter ones, leading to 18% faster litter decomposition. In contrast, the short-vegetation plots intercepted fewer subsidies, had higher temperatures and sunlight, and thus resulted in no effects of midges on decomposition. However, by the end of the experiment when all vegetation structure characteristics had converged across all plots, we found no differences in decomposition between treatments. The effects of midge subsidies on arthropod composition depended on vegetation structure in the last year, suggesting that arthropod predators might also be responding to vegetation structure effects on insect subsidies. Our findings indicate that vegetation structure can modify the quantity of subsidies entering a recipient ecosystem as aerial insects, resulting in ecosystem- and community-level responses. Thus, changing vegetation structure via habitat disturbances will likely have important implications for ecosystem functions that depend on spatial subsidies.

Monitoring the genetic structure of pathogen populations may be an economical and sensitive approach to quantify the impact of control on transmission dynamics, highlighting the need for a better understanding of changes in population genetic parameters as transmission declines. Here we describe the first population genetic analysis of the major human malaria parasites, Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) populations following nationwide distribution of long-lasting insecticide treated nets (LLIN) in Papua New Guinea (PNG). Parasite isolates from pre- (2005-6) and post-LLIN (2010-2014) were genotyped using microsatellite markers. Despite parasite prevalence declining substantially (East Sepik: Pf=54.9-8.5%, Pv=35.7-5.6%, Madang: Pf=38.0-9.0%, Pv: 31.8-19.7%), genetically diverse and intermixing parasite populations remained. Pf diversity declined modestly post-LLIN relative to pre-LLIN (East Sepik: Rs = 7.1-6.4, He = 0.77-0.71; Madang: Rs= 8.2-6.1, He = 0.79-0.71). Unexpectedly, population structure present in pre-LLIN populations was lost post-LLIN, suggesting that more frequent human movement between provinces may have contributed to higher gene flow. Pv prevalence initially declined but increased again in one province, yet diversity remained high throughout the study period (East Sepik: Rs=11.4-9.3, He=0.83-0.80; Madang: Rs=12.2-14.5, He=0.85-0.88). Although genetic differentiation values increased between provinces over time, no significant population structure was observed at any time point. For both species, a decline in multiple infections and increasing clonal transmission and significant multilocus linkage disequilibrium (mLD) post-LLIN was a positive indicator of impact on the parasite population using microsatellite markers. These parameters may be useful adjuncts to traditional epidemiological tools in the early stages of transmission reduction.

Hybridization is accepted as a common and important evolutionary force in plants and animals. It can occur randomly or in spatially and temporarily dynamic hybrid zones where the geographic ranges of closely related species meet. Here, I propose that poleward increases in the seasonality of day length promote the maintenance of circumpolar hybrid zones at higher latitudes. Hybridization at higher latitudes should be most prevalent among species that use seasonal changes in day length to coordinate their reproductive phenology but may apply to other species as well if their fitness is dependent on species that are adapted to photoperiodic cues. Given that climate change is expanding species ranges across latitudes and creating opportunities for reproductive interactions between formerly isolated and genetically distinct populations and species, a better understanding of the evolutionary role of hybridization and its consequences for biodiversity, ecosystem functions and services is needed. At the global scale, I predict that day length-promoted circumpolar hybrid zones and consequent hybrid speciation are play significant roles in maintaining genetic admixture and species diversity on a geological time scale because species' range shifts across latitudes during the cycles of Earth's cooler and warmer periods cause recurrent isolation of and contact among species.

Appropriate estimation of the effects of species interactions on ecosystem function is essential for understanding biodiversity effects and supporting development of environmental policies. Species undergo changes in competitive environment from monocultures to mixtures; highly productive species are generally more competitive and increase their performance and less productive species reduce their performance in mixtures, resulting in net increases of ecosystem function. This positive biodiversity effect, largely due to species differences in monoculture yield, does not involve complementary interactions (niche differentiation or facilitation) and therefore should not be included in biodiversity effect estimation. To reduce impacts of the ‘sampling effect’ and overestimation of biodiversity effects by additive biodiversity partitioning, we present a method to adjust species expected performance based on their monoculture performance and proportion in mixtures. Our method offers more appropriate estimations and interpretations of biodiversity effects for biodiversity experiments.

The study of inversion polymorphisms along environmental gradients has long attracted the attention of evolutionary biologists. Currently, the application of genomic approaches has provided new evidences about the role that these rearrangements might have played as drivers of ecological adaptation and speciation. The grasshopper Trimerotropis pallidipennis is considered a “species complex” composed of several genetic lineages distributed from North to South America in arid and semi-arid high-altitude environments. The southernmost lineage, Trimerotropis sp., bears inversion polymorphisms whose frequencies vary along environmental gradients. These polymorphisms may have allowed this grasshopper to adapt to more temperate environments. Herewith, we analyze chromosomal, mitochondrial and genome-wide SNP markers in 19 populations of Trimerotropis sp. mainly distributed along two altitudinal gradients. We show that populations across Argentina are formed by two main chromosomally differentiated lineages: one distributed in the southernmost border of the “Andes Centrales”, adding evidence for a differentiation hotspot in this area; and the other widely distributed in Argentina. Within the latter, footprints of secondary contact between divergent populations were detected, probably leading to incipient speciation through selective disadvantages of heterozygous individuals and asymmetrical gene flow. We demonstrated the stability of inversion polymorphisms for more than 30 generations and the occurrence of non-neutral markers associated with environmental and chromosomal gradients. These results confirm the adaptive nature of the chromosomal gradients and provide a framework to future investigations about candidate genes that may be implicated in the rapid adaptation to new environments.

Floods are among the most dangerous natural disasters that affect the development of a region. Flood events worldwide cause the utmost casualties and property damage. Increasing urbanization and population have significant impacts on the natural environment. Human activities such as uncontrolled building constructions in urban areas, land use changes and lack of urban planning, all affect floods. In urban flood management, determining the size and risk areas of the flood is extremely important in order to reduce the possible losses. In this study, five basins which have been experiencing floods caused by climate change and increasing urbanization in Bodrum, which is one of Turkey’s most important tourism centers, have been examined. Maximum flood flow rates were calculated in these basins by using Soil Conservation-Curve Number (SCS-CN) precipitation-flow model with the effect of urbanization changes in 1984, 2010, 2011 and 2019. Flood hydrographs of the basins for the years studied were determined. In addition, Multiple Criteria Decision Making (MCDM) model was used to create flood risk maps of basins. As a result of the study, it was determined that the increase in urbanization in the period from 1984 to 2019, caused the flood flows to increase as well as the areas at risk to increase. The flood problems caused by urban growth and distorted urbanization were identified and measures and suggestions to be taken in urban flood management were introduced.

The structure of heterotetrameric sarcosine oxidase (HSO) contains a highly complex system composed of a large cavity and tunnels, which are essential for the reaction and migration of the reactants, products, and intermediates. Previous molecular dynamics (MD) simulation of HSO has identified the regions containing the water channels from the density distribution of water. The simulation is consistent with the selective transport hypothesis of the migration of the iminium intermediate, 5-oxazolidinone (5-OXA), of the enzyme reaction whereby tunnel T3 is the exit pathway of 5-OXA. In the present study, the potential of mean force (PMF) for the transport of 5-OXA through tunnels T1, T2, and T3 was calculated using umbrella sampling (US) MD simulations and the weighted histogram analysis method. The maximum errors of the calculated PMF were estimated by repeating the US simulations using different sets of initial positions. The PMF profiles for the three tunnels support the notion that tunnel T3 is the exit pathway of 5-OXA and that 5-OXA tends to stay at the middle of the tunnel. The PMF profile for the transport of glycine through tunnel T3 was also calculated to investigate where 5-OXA is converted into glycine, and how glycine is released to the outside of HSO was explained.

Continued instances of serious birth asphyxia following intermittent auscultation (IA) need not wholly imply inherent limitations. This review uses analytical modelling to establish a safer and improved regime. It demonstrates that the Doppler-device is superior to Pinard stethoscope, with observation of the numerical read-out of fetal heart rate (FHR) from the later part of contraction till the onset of next contraction. Current recommendation of actually counting heart tones for 1 minute has many fallacies. IA should focus on the baseline FHR and late decelerations. Detection of additional FHR changes like accelerations, overshoots or cycling is cumbersome and adds little value.

Background: COVID-19 is a new pandemic disease with severe respiratory outcome. However, there is little evidence of this condition during pregnancy based on small case series reports. Objective: to perform a systematic review and meta-analysis of proportions of case series focused on maternal and perinatal outcomes of COVID-19 during pregnancy. Search strategy: LILACS and Medline were searched from inception until April 24th, 2020. Selection criteria: all case series or case control studies involving SARS-CoV2 infection during pregnancy and neonatal period were identified. Excluded were duplicated data, case reports of individual patients or without clinical data. Data collection and analysis: a total of 14 studies were included. When possible, pooled proportions with 95% confidence interval through a random effect model were estimated. Heterogeneity was estimated with the use of I2 statistics and Tau2 test. Main results: Most common symptoms were fever (58%; I2= 69%) and cough (33%; I2= 65%). A pathognomonic CT-Scan was observed in 92% of patients (I2= 0%). Lymphopenia and increased D-dimer were observed in 50% (I2= 82%), and 80% (I2= 0%) of patients at admission, respectively. There were no maternal deaths, with 2 cases of neonatal death, both with negative SARS-CoV2 PCR. Vertical transmission was observed in 5 neonates. Conclusions: This systematic review and meta-analysis confirms that COVID-19 during pregnancy is associated with good maternal and perinatal outcome. Evidence of vertical transmission should be confirmed with larger cohorts. Funding: none. Key words: meta-analysis, COVID-19, vertical transmission, perinatal outcome, pregnancy.

The manuscript aims to describe the effect of COVID-19 virus on the patients suffering with neurological diseases. The outbreak of COVID-19 is serious and it becomes epidemic worldwide. It is observed from the literature survey that COVID-19 virus can easily affect the persons having neurological diseases. The manuscript also focuses on the mechanism of action of the COVID-19 virus on the nervous system with precaution majors. Patients with COVID-19 show various symptoms of neurological manifestations including stroke, impaired consciousness, seizures, agitation, unsteadiness, dizziness, confusion, localized neuralgia and cognitive impairment. The COVID-19 virus affect the Central Nervous System, makes the patients clinical condition worse and it may cause the death of the patient. It can be concluded from the literatures that COVID-19 virus versen the neurological condition of patients and may leads to severe manifestations.

Objective: Appropriate use of oral anticoagulants (OACs) reduces the risk of stroke in patients with atrial fibrillation (AF). The study characterised the prescribing of OACs in people with AF in the Australian primary care setting over 10 years. Methods: We performed 10 sequential cross-sectional analyses of patients with a recorded diagnosis of AF between 2009 and 2018 using nationally representative general practice data from the NPS MedicineWise’s dataset, MedicineInsight. The proportion of patients with AF who were prescribed an OAC based on their stroke risk was examined. Results: The sample size of patients with AF ranged from 9,874 in 2009 to 41,751 in 2018. The proportion who were prescribed an OAC increased from 39.5% (95% CI 38.6%-40.5%) in 2009 to 52.0% (95% CI 51.5%-52.4%) in 2018 (p for trend <0.001). During this time, the proportion of patients with AF and high stroke risk who were prescribed an OAC rose from 41.7% (95% CI 40.7%-42.8%) to 55.2% (95% CI 54.7%-55.8%; p for trend <0.001) with the direct-acting oral anticoagulants accounting for over three-quarters of usage by 2018. There was substantial variation in OAC prescribing according to stroke risk between general practices. In 2018, the proportion of moderate to high stroke risk patients who were prescribed an OAC was 38.6% (95% CI 37.2%-40.1%) in the lowest practice site quintile and 65.6% (95% CI 64.5%-66.7%) in the highest practice site quintile. Conclusions: Over the ten years, OAC prescribing in high stroke risk patients with AF increased by one-third.

Oral cavity and oropharynx squamous cell carcinoma: CT texture analysis as an independent predictor of survival Brief running title: CT texture analysis in oral cavity and oropharynx squamous cell carcinomaConflict of Interest, acknowledgment: The authors have no conflicts of interest and no acknowledgment to disclose.