Cystic Multiglandular Maternal Hyperparathyroidism Diagnosed by Neonatal Hypocalcemic Seizures

A 7-day-old male infant born to a healthy 33-year-old female at 37 weeks of gestation was brought to the local emergency department (ED) with sudden-onset tonic-clonic seizures. Laboratory testing revealed extreme hypocalcemia (ionized calcium of 3.2 mg/dl) and undetectable parathyroid hormone (PTH/ml). Concomitant evaluation of the mother revealed both elevated ionized calcium (5.9 mg/dl) and PTH (116 pg/ml). The mother underwent preoperative ultrasound localization and sestamibi scan, followed promptly by parathyroidectomy. Given the cystic appearance and presence of multiglandular disease, evaluation for familial cystic parathyroid adenomatosis (hyperparathyroidism-jaw bone-tumor syndrome) and MEN 1 were undertaken. The infant was stabilized and discharged home. He returned to the ED with seizures at 1 month of age. After increasing calcium supplementation appropriately, he was monitored with weekly office visits. This represents a unique case of undiagnosed maternal primary hyperparathyroidism manifesting with intrauterine parathyroid suppression and hypocalcemic seizures in the newborn

Esophageal Fistula Complicating Thyroid Lobectomy

Thyroidectomy is associated with low morbidity and mortality. Esophageal perforation following thyroidectomy has been reported only three times previously, with subsequent fistulization occurring in two of these cases. The authors present the first such case report in the English-speaking literature

Luminosities and mass-loss rates of SMC and LMC AGB stars and Red Supergiants

(Abridged) Dust radiative transfer models are presented for 101 carbon stars and 86 oxygen-rich evolved stars in the Magellanic Clouds for which 5-35 \mum\ {\it Spitzer} IRS spectra are available. The spectra are complemented with available optical and infrared photometry to construct the spectral energy distribution. A minimisation procedure is used to fit luminosity, mass-loss rate and dust temperature at the inner radius. Different effective temperatures and dust content are also considered. Periods from the literature and from new OGLE-III data are compiled and derived. The O-rich stars are classified in foreground objects, AGB stars and Red Super Giants. For the O-rich stars silicates based on laboratory optical constants are compared to "astronomical silicates". Overall, the grain type by Volk & Kwok (1988) fit the data best. However, the fit based on laboratory optical constants for the grains can be improved by abandoning the small-particle limit. The influence of grain size, core-mantle grains and porosity are explored. Relations between mass-loss rates and luminosity and pulsation period are presented and compared to the predictions of evolutionary models, those by Vassiliadis & Wood (1993) and their adopted mass-loss recipe, and those based on a Reimers mass-loss law with a scaling of a factor of five. The Vassiliadis & Wood models describe the data better, although there are also some deficiencies, in particular to the maximum adopted mass-loss rate. The OGLE-III data reveal an O-rich star in the SMC with a period of 1749 days. Its absolute magnitude of $M_{\rm bol}= -8.0$ makes it a good candidate for a super-AGB star.Comment: A&A accepte

H2, HD, and D2 in the small cage of structure II clathrate hydrate: vibrational frequency shifts from fully coupled quantum six-dimensional calculations of the vibration-translation-rotation eigenstates

We report the first fully coupled quantum six-dimensional (6D) bound-state calculations of the vibration-translation-rotation eigenstates of a flexible H2, HD, and D2 molecule confined inside the small cage of the structure II clathrate hydrate embedded in larger hydrate domains with up to 76 H2O molecules, treated as rigid. Our calculations use a pairwise-additive 6D intermolecular potential energy surface for H2 in the hydrate domain, based on an ab initio 6D H2–H2O pair potential for flexible H2 and rigid H2O. They extend to the first excited (v = 1) vibrational state of H2, along with two isotopologues, providing a direct computation of vibrational frequency shifts. We show that obtaining a converged v = 1 vibrational state of the caged molecule does not require converging the very large number of intermolecular translation-rotation states belonging to the v = 0 manifold up to the energy of the intramolecular stretch fundamental (≈4100 cm−1 for H2). Only a relatively modest-size basis for the intermolecular degrees of freedom is needed to accurately describe the vibrational averaging over the delocalized wave function of the quantum ground state of the system. For the caged H2, our computed fundamental translational excitations, rotational j = 0 → 1 transitions, and frequency shifts of the stretch fundamental are in excellent agreement with recent quantum 5D (rigid H2) results [A. Powers et al., J. Chem. Phys. 148, 144304 (2018)]. Our computed frequency shift of −43 cm−1 for H2 is only 14% away from the experimental value at 20 K

The Key Role of Heavy Precipitation Events in Climate Model Disagreements of Future Annual Precipitation Changes in California

Climate model simulations disagree on whether future precipitation will increase or decrease over California, which has impeded efforts to anticipate and adapt to human-induced climate change. This disagreement is explored in terms of daily precipitation frequency and intensity. It is found that divergent model projections of changes in the incidence of rare heavy (\u3e60 mm day−1) daily precipitation events explain much of the model disagreement on annual time scales, yet represent only 0.3% of precipitating days and 9% of annual precipitation volume. Of the 25 downscaled model projections examined here, 21 agree that precipitation frequency will decrease by the 2060s, with a mean reduction of 6–14 days yr−1. This reduces California\u27s mean annual precipitation by about 5.7%. Partly offsetting this, 16 of the 25 projections agree that daily precipitation intensity will increase, which accounts for a model average 5.3% increase in annual precipitation. Between these conflicting tendencies, 12 projections show drier annual conditions by the 2060s and 13 show wetter. These results are obtained from 16 global general circulation models downscaled with different combinations of dynamical methods [Weather Research and Forecasting (WRF), Regional Spectral Model (RSM), and version 3 of the Regional Climate Model (RegCM3)] and statistical methods [bias correction with spatial disaggregation (BCSD) and bias correction with constructed analogs (BCCA)], although not all downscaling methods were applied to each global model. Model disagreements in the projected change in occurrence of the heaviest precipitation days (\u3e60 mm day−1) account for the majority of disagreement in the projected change in annual precipitation, and occur preferentially over the Sierra Nevada and Northern California. When such events are excluded, nearly twice as many projections show drier future conditions

The effect of the condensed-phase environment on the vibrational frequency shift of a hydrogen molecule inside clathrate hydrates

© 2018 Author(s). We report a theoretical study of the frequency shift (redshift) of the stretching fundamental transition of an H 2 molecule confined inside the small dodecahedral cage of the structure II clathrate hydrate and its dependence on the condensed-phase environment. In order to determine how much the hydrate water molecules beyond the confining small cage contribute to the vibrational frequency shift, quantum five-dimensional (5D) calculat ions of the coupled translation-rotation eigenstates are performed for H 2 in the v=0 and v=1 vibrational states inside spherical clathrate hydrate domains of increasing radius and a growing number of water molecules, ranging from 20 for the isolated small cage to over 1900. In these calculations, both H 2 and the water domains are treated as rigid. The 5D intermolecular potential energy surface (PES) of H 2 inside a hydrate domain is assumed to be pairwise additive. The H 2 -H 2 O pair interaction, represented by the 5D (rigid monomer) PES that depends on the vibrational state of H 2 , v=0 or v=1, is derived from the high-quality ab initio full-dimensional (9D) PES of the H 2 -H 2 O complex [P. Valiron et al., J. Chem. Phys. 129, 134306 (2008)]. The H 2 vibrational frequency shift calculated for the largest clathrate domain considered, which mimics the condensed-phase environment, is about 10% larger in magnitude than that obtained by taking into account only the small cage. The calculated splittings of the translational fundamental of H 2 change very little with the domain size, unlike the H 2 j = 1 rotational splittings that decrease significantly as the domain size increases. The changes in both the vibrational frequency shift and the j = 1 rotational splitting due to the condensed-phase effects arise predominantly from the H 2 O molecules in the first three complete hydration shells around H 2

Probabilistic estimates of future changes in California temperature and precipitation usingstatistical and dynamical downscaling

Sixteen global general circulation models were used to develop probabilistic projections of temperature (T) and precipitation (P) changes over California by the 2060s. The global models were downscaled with two statistical techniques and three nested dynamical regional climate models, although not all global models were downscaled with all techniques. Both monthly and daily timescale changes in T and P are addressed, the latter being important for a range of applications in energy use, water management, and agriculture. The T changes tend to agree more across downscaling techniques than the P changes. Year-to-year natural internal climate variability is roughly of similar magnitude to the projected T changes. In the monthly average, July temperatures shift enough that that the hottest July found in any simulation over the historical period becomes a modestly cool July in the future period. Januarys as cold as any found in the historical period are still found in the 2060s, but the median and maximum monthly average temperatures increase notably. Annual and seasonal P changes are small compared to interannual or intermodel variability. However, the annual change is composed of seasonally varying changes that are themselves much larger, but tend to cancel in the annual mean. Winters show modestly wetter conditions in the North of the state, while spring and autumn show less precipitation. The dynamical downscaling techniques project increasing precipitation in the Southeastern part of the state, which is influenced by the North American monsoon, a feature that is not captured by the statistical downscaling

Pathways to Mathematics College Readiness in Maine

The goal of this study was to examine the pathways to being college ready in mathematics. Students who enter high school already having demonstrated mathematics proficiency on a standardized test in the 8th grade have already taken a significant step towards being college ready. The best scenario is to enter high school proficient in mathematics and having already completed Algebra I, then to complete at least Algebra II and Calculus before graduating from high school. Students completing this pathway are virtually guaranteed to be college ready in mathematics. There also is an alternative path to being college ready. Being proficient entering high school, and then completing a course sequence that includes at least Algebra I, Algebra II, and pre-Calculus significantly increased students\u27 chances of being college ready in mathematics. Thus, it appears 8th grade proficiency is key to becoming college ready in mathematics. It affords opportunities for students to complete Algebra I before entering high school and then take higher level mathematics courses in high school. Alternatively, even if students wait to take Algebra I in high school, if they are proficient and complete at least pre-Calculus, they have a high likelihood of being college ready. The key is 8th grade mathematics proficiency. It opens the gate to a successful high school and college experience in mathematics. The typical sequence of courses completed by most high school students is Algebra I, Geometry, and Algebra II. The Common Core State Standards Initiative (2012) has endorsed this three course sequence as preparing students for college. However, the evidence from this study does not support this endorsement. Completing Geometry does not substantially ensure college readiness, nor does completing Algebra II ensure college readiness. Students also need to successfully complete either a pre-Calculus or Calculus course in high school to be college ready