After forming either Manchu, or Qing and selecting to use the Missions Extended mission trees the game crashes to desktop on the monthly tick. I am not a modder myself so I cannot debug this but the following is what I found in the "exception.txt" file generated on crash:

Application: EUIV
Version: EU4 v1.35.3.0 Ottomans
Date/Time: 2023-06-03 16:16:03

Unhandled exception C0000005 (EXCEPTION_ACCESS_VIOLATION) at address 0x00007FF6090F3601

Stack Trace:
1 eu4.exe (function-name not available) (+ 0)
2 eu4.exe (function-name not available) (+ 0)
3 eu4.exe (function-name not available) (+ 0)
4 eu4.exe (function-name not available) (+ 0)
5 eu4.exe (function-name not available) (+ 0)
6 eu4.exe (function-name not available) (+ 0)
7 eu4.exe (function-name not available) (+ 0)
8 eu4.exe (function-name not available) (+ 0)
9 eu4.exe (function-name not available) (+ 0)
10 eu4.exe (function-name not available) (+ 0)
11 eu4.exe (function-name not available) (+ 0)
12 eu4.exe (function-name not available) (+ 0)
13 eu4.exe PHYSFS_writeULE64 (+ 540002)
14 eu4.exe PHYSFS_writeULE64 (+ 142071)
15 KERNEL32.DLL BaseThreadInitThunk (+ 20)
16 ntdll.dll RtlUserThreadStart (+ 33)
17 ntdll.dll RtlUserThreadStart (+ 33)

No idea if there is a fix available, but I guess I will have to play this Manchu playthrough somewhat "vanilla" for now.