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Remote sensing soil moisture products provide an opportunity to improve the forecasting skill of hydrological models since obtaining accurate streamflow data is challenging, especially in ungauged catchments. Soil moisture data can provide additional information about the state of the land surface and can be used to improve the representation of the hydrological processes in the model. However, it is also worth noting that using soil moisture data for model calibration can be more challenging than streamflow data alone, as the soil moisture measurements may be more uncertain or subject to errors. Hence, in this study, ASCAT-derived soil moisture product along with streamflow data is used to calibrate a distributed hydrological model, the Variable Infiltration Capacity (VIC) model, over the Godavari River basin of India. The calibration scheme, based on combining the performance scores of streamflow and soil moisture predictions, was compared with streamflow-only calibration at multiple outlets. Although the joint-calibration scheme reduced the model efficiency for streamflow prediction during the calibration period, it produced better streamflow predictions for the validation period and at gauging sites that were not used for streamflow-only calibration. The improved performance during the validation period and at uncalibrated gauging sites suggests that the use of soil moisture data can still be beneficial in improving the overall accuracy of the model., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

CONTEXT: Mealtime insulin bolus is traditionally administered before meals in children with type 1 diabetes (T1D). Controlled studies on the use of pre-and postprandial insulin bolus have shown variable results. There are no real-world studies on postprandial bolusing of insulin in young children with T1D. METHODS: Children with T1D aged

Hyperphosphatemic familial tumoral calcinosis (HFTC) is an extremely rare autosomal recessive disorder caused by variants in the GALNT3 (N-acetylgalactosaminyltransferase 3), FGF23 (Fibroblast Growth Factor-23) and αKL (α-Klotho) genes, which results in progressive calcification of soft tissues. We describe the case of a 9-year-old girl who presented with recurrent hard nodular swellings on her feet and knees which intermittently discharged chalky white material. Her younger brother also had a similar condition. Both siblings showed hyperphosphatemia, but the parentsbiochemical parameters were normal. The histological features of the material aspirated from a skin lesion were consistent with tumoral calcinosis. Sanger sequencing identified a novel homozygous non-synonymous sequence variant in exon 10 of the GALNT3 gene (NM_004482.3:c.[1681T>A];[1681T>A], NP_004473.2:p. [Cys561Ser];[Cys561Ser] in the proband and her affected brother. The parents were heterozygous carriers for the same sequence variant. In conclusion, we report a new variant in the GALNT3 gene that caused HFTC in a North Indian family.

Devi Dayal, Rajendra Prasad Department of Pediatrics, Pediatric Endocrinology and Diabetes Unit, Postgraduate Institute of Medical Education and Research, Chandigarh, India Abstract: Congenital hypothyroidism (CH), the most common pediatric endocrine disorder with an estimated prevalence of 1:2,000 to 1:4,000, is an under-recognized problem in countries without routine newborn screening (NBS) programs. Thyroid dysgenesis (TD) is the most common cause of primary CH accounting for approximately 85% of all cases; most of the remaining patients have dyshormonogenesis. Transient CH and CH with eutopic gland, are increasingly being identified after introduction of routine NBS. The clinical features of CH are often subtle resulting in delayed diagnosis and eventually poor intellectual outcome. In developed countries, detection by NBS and early initiation of treatment has largely eliminated the intellectual disability caused by this disorder. The lower screening thyroid stimulating hormone (TSH) cutoff and changes in birth demographics in some countries have been associated with an increase in the reported incidence of CH. However, the additional cases detected by the lower TSH cutoff tend to have either milder or transient hypothyroidism. Diagnosis of CH is made on the basis of serum concentrations of TSH and thyroxine (T4). Thyroid ultrasound, radionuclide scintigraphy, serum thyroglobulin (TG) levels and specific genetic tests help ascertaining the exact etiological diagnosis. Non-availability of later tests should not deter the pediatrician from initiation of treatment. Age at initiation of treatment and starting dose of levothyroxine are critical factors that determine the long-term outcome. Higher doses of levothyroxine at 10–15 µg/kg/day are required in infants, with titration based on T4 and TSH levels, which are repeated frequently. Coexistence of other congenital anomalies in children with CH adds to the morbidity. Approximately 70% of babies worldwide are not born in an area with an established NBS program and hence are not detected and treated early. Consequently, the economic burden of mental retardation due to CH remains a significant public health challenge in countries without NBS. The health burden owing to CH continues to be high even in countries with well-developed NBS. Keywords: congenital hypothyroidism, newborn screening, thyroid stimulating hormone, Down syndrome, IQ, mutations