A COMPARATIVE EARTHWORK AND COST ANALYSIS OF IMPROVING AN EXISTING RAILWAY LINE AND CONSTRUCTING A NEW HIGH-SPEED LINE IN TURKEY

In the past few decades, high-speed railways have become an important transportation system due to their high operational speed, and globally, the networks of these railways have been extended. In addition, there is ongoing work on the construction of new high-speed railways as well as improving existing lines to achieve the same operational speed. To contribute to high-speed railway works in Turkey, this study compared two high-speed railway lines; an existing conventional line, the design of which was improved, and a new high-speed line. The design of an existing conventional railway line was improved according to optimal geometric characteristics of high-speed railways and an alternative line was simulated. These two lines were evaluated on three different types of land in terms of the required volume of earthworks, engineering structures and total cost. The results show that the length of the conventional line was reduced after the improvement process; however, new engineering structures are needed. Furthermore, compared to the alternative line, the track length and total length of engineering structures required for the improvement of the existing line was shorter and the volume of required earthworks was less resulting in lower costs

Diagnosis And Treatment Of Hyperinsulinaemic Hypoglycaemia And Its Implications For Paediatric Endocrinology

Glucose homeostasis requires appropriate and synchronous coordination of metabolic events and hormonal activities to keep plasma glucose concentrations in a narrow range of 3.5–5.5 mmol/L. Insulin, the only glucose lowering hormone secreted from pancreatic β-cells, plays the key role in glucose homeostasis. Insulin release from pancreatic β-cells is mainly regulated by intracellular ATP-generating metabolic pathways. Hyperinsulinaemic hypoglycaemia (HH), the most common cause of severe and persistent hypoglycaemia in neonates and children, is the inappropriate secretion of insulin which occurs despite low plasma glucose levels leading to severe and persistent hypoketotic hypoglycaemia. Mutations in 12 different key genes (ABCC8, KCNJ11, GLUD1, GCK, HADH, SLC16A1, UCP2, HNF4A, HNF1A, HK1, PGM1 and PMM2) constitute the underlying molecular mechanisms of congenital HH. Since insulin supressess ketogenesis, the alternative energy source to the brain, a prompt diagnosis and immediate management of HH is essential to avoid irreversible hypoglycaemic brain damage in children. Advances in molecular genetics, imaging methods (18F–DOPA PET-CT), medical therapy and surgical approach (laparoscopic and open pancreatectomy) have changed the management and improved the outcome of patients with HH. This up to date review article provides a background to the diagnosis, molecular genetics, recent advances and therapeutic options in the field of HH in children.PubMe