Second trimester hepatic rupture in a 35 year old nulliparous woman with HELLP syndrome: a case report

The HELLP syndrome (haemolysis, elevated liver blood tests and low platelets) is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe preeclampsia. Hepatic capsular rupture is a rare yet dramatic complication of HELLP syndrome. The majority of cases occur in multiparous women over the age of 30. Classically it presents with acute onset right upper quadrant pain in the presence of constitutional symptoms such as vomiting and pyrexia. However, symptoms and signs are usually non specific. Spontaneous hepatic rupture can be preceded by signs of hypovolaemic shock; yet the diagnosis is infrequently made prior to emergent laparotomy. We present the case of a 35 year old nulliparous woman with a second trimester gestational hepatic rupture associated with HELLP syndrome. We briefly discuss the aetiology, diagnostic difficulties and treatment options associated with this rare presentation

A coarse geometric approach to graph layout problems

We define a range of new coarse geometric invariants based on various graph-theoretic measures of complexity for finite graphs, including: treewidth, pathwidth, cutwidth, search number, topological bandwidth, bandwidth, minimal linear arrangment, sumcut, profile, vertex and edge separation. We prove that, for bounded degree graphs, these invariants can be used to define functions which satisfy a strong monotonicity property, namely they are monotonically non-decreasing with respect to regular maps, and as such have potential applications in coarse geometry and geometric group theory. On the graph-theoretic side, we prove asymptotically optimal upper bounds on the treewidth, pathwidth, cutwidth, search number, topological bandwidth, vertex separation, edge separation, minimal linear arrangement, sumcut and profile for the family of all finite subgraphs of any bounded degree graph whose separation profile is known to be of the form $r^a\log(r)^b$ for some $a>0$. This large class includes the Diestel-Leader graph, all Cayley graphs of non-virtually cyclic polycyclic groups, uniform lattices in almost all connected unimodular Lie groups, and certain hyperbolic groups.Comment: 19 page

The Role of Mothers and Fathers in Predicting Adolescents\u27 Peer Affiliation and Behavioral Adjustment

The current study aimed to examine the associations between parental warmth and control and adolescents’ social behaviors (altruistic and public prosocial behaviors, aggression, and delinquency) in a low-income, Midwestern sample. The study also aimed to examine how peer relationships may play an indirect role in these associations. The results demonstrated complex links between parenting dimensions and adolescents\u27 peer affiliation and social behaviors. Specifically, maternal and paternal warmth were predictive of peer affiliation, which in turn predicted adolescents\u27 prosocial behaviors as well as negative social behaviors. There were also direct links between maternal and paternal parenting dimensions and social behaviors, highlighting the role of both mothers and fathers in adolescents’ socialization. The discussion focuses on the complex links between parental behaviors, peer relationships, and social behaviors. Additionally, the present study illustrates the differential role of mothers and fathers in adolescents\u27 social relationships, as well as sociobehavioral outcomes

Dark fluxes from electromagnetic cascades

We study dark sector production in electromagnetic (EM) cascades. This problem requires accurate simulations of Standard Model (SM) and dark sector processes, both of which impact angular and energy distributions of emitted particles that ultimately determine flux predictions in a downstream detector. We describe the minimal set of QED processes which must be included to faithfully reproduce a SM cascade, and identify a universal algorithm to generate a dark sector flux given a Monte-Carlo simulation of a SM shower. We provide a new tool, $\texttt{PETITE}$, which simulates EM cascades with associated dark vector production, and compare it against existing literature and "off the shelf" tools. The signal predictions at downstream detectors can strongly depend on the nontrivial interplay (and modelling) of SM and dark sector processes, in particular multiple Coulomb scattering and positron annihilation. We comment on potential impacts of these effects for realistic experimental setups.Comment: 35 pages, 12 figures. Software available at https://github.com/kjkellyphys/PETIT

Misspecification-robust Sequential Neural Likelihood for Simulation-based Inference

Simulation-based inference techniques are indispensable for parameter estimation of mechanistic and simulable models with intractable likelihoods. While traditional statistical approaches like approximate Bayesian computation and Bayesian synthetic likelihood have been studied under well-specified and misspecified settings, they often suffer from inefficiencies due to wasted model simulations. Neural approaches, such as sequential neural likelihood (SNL) avoid this wastage by utilising all model simulations to train a neural surrogate for the likelihood function. However, the performance of SNL under model misspecification is unreliable and can result in overconfident posteriors centred around an inaccurate parameter estimate. In this paper, we propose a novel SNL method, which through the incorporation of additional adjustment parameters, is robust to model misspecification and capable of identifying features of the data that the model is not able to recover. We demonstrate the efficacy of our approach through several illustrative examples, where our method gives more accurate point estimates and uncertainty quantification than SNL

Diversity and evolution of surface polysaccharide synthesis loci in Enterobacteriales.

Bacterial capsules and lipopolysaccharides are diverse surface polysaccharides (SPs) that serve as the frontline for interactions with the outside world. While SPs can evolve rapidly, their diversity and evolutionary dynamics across different taxonomic scales has not been investigated in detail. Here, we focused on the bacterial order Enterobacteriales (including the medically relevant Enterobacteriaceae), to carry out comparative genomics of two SP locus synthesis regions, cps and kps, using 27,334 genomes from 45 genera. We identified high-quality cps loci in 22 genera and kps in 11 genera, around 4% of which were detected in multiple species. We found SP loci to be highly dynamic genetic entities: their evolution was driven by high rates of horizontal gene transfer (HGT), both of whole loci and component genes, and relaxed purifying selection, yielding large repertoires of SP diversity. In spite of that, we found the presence of (near-)identical locus structures in distant taxonomic backgrounds that could not be explained by recent exchange, pointing to long-term selective preservation of locus structures in some populations. Our results reveal differences in evolutionary dynamics driving SP diversity within different bacterial species, with lineages of Escherichia coli, Enterobacter hormaechei and Klebsiella aerogenes most likely to share SP loci via recent exchange; and lineages of Salmonella enterica, Citrobacter sakazakii and Serratia marcescens most likely to share SP loci via other mechanisms such as long-term preservation. Overall, the evolution of SP loci in Enterobacteriales is driven by a range of evolutionary forces and their dynamics and relative importance varies between different species