For the assessment of existing slab-between-girder bridges, the shear capacity and failure mode are under discussion. In particular, preliminary assessment calculations showed that the critical ...failure mode of the girders is shear-tension. In this paper, four girders taken from a demolished bridge that were tested in the lab are analyzed according to existing codes. The comparison between the experiments and the analysis shows that the Dutch RBK provisions are conservative and the ACI 318-19 provisions result in good predictions of the shear capacity at inclined cracking and at ultimate. These observations are then combined into recommendations for the assessment of prestressed concrete girders in existing slab-between-girder bridges for shear cracking and the ultimate shear capacity. Keywords: bridge assessment; concrete bridges; flexure-shear; large-scale testing; prestressed concrete; shear; shear-compression; shear-tension.
Congenital hyperinsulinism (CHI) is a rare metabolic disease characterized by inappropriate insulin secretion in the presence of hypoglycemia. We describe the clinical presentation and management of ...congenital hyperinsulinism and persistent hypoglycemia in two infants. Both patients had an initial clinical diagnosis of Beckwith-Wiedemann syndrome (BWS) but normal methylation analysis for
and
status. Both patients were eventually found to have mosaic uniparental disomy 11p diagnosed by single nucleotide polymorphism (SNP) array in DNA isolated from lymphoblasts and fibroblasts, respectively. We report that patients with mosaic BWS are at increased risk for both transient and refractory hypoglycemia that may need aggressive management with diazoxide, octreotide, high glucose infusion rates, and a frequent feeding regime. Our patient experience supports the case for pursuing further testing in patients with features of BWS with normal methylation studies, karyotype, and SNP arrays on blood. The next logical step is SNP array on skin biopsy to rule out mosaicism.
