Management of diabetic ketoacidosis

Although the mortality of diabetic ketoacidosis (DKA) has decreased substantially in the developed world, high mortality rates still prevail in South Africa, thus making this an important condition to recognise early and manage well. This review discusses the treatment of DKA, with emphasis on the controversial aspect of initial fluid replacement therapy. Current guidelines recommend the use of normal saline. The concern is that normal saline, when used in large volumes, leads to the development of a hyperchloraemic metabolic acidosis which is of uncertain clinical significance. This hyperchloraemic acidosis is better quantified using Stewart’s model, as opposed to the “traditional” Henderson-Hasselbalch equation. Ringer’s lactate is an alternative choice for initial fluid resuscitation, but may exacerbate the high lactate to pyruvate ratio in patients in DKA, and may cause hyperkaleamia. Insulin therapy, prevention of electrolyte abnormalities, and the replacement of bicarbonate and phosphate, are other important considerations in the management of the patient with DKA.Keywords: diabetic ketoacidosis, fluid replacement, normal saline, Ringer’s lactate, hyperchloraemic acidosis, insuli

Targeting composite treatment of type 2 diabetes in middle-income countries – walking a tightrope between hyperglycaemia and the dangers of hypoglycaemia

Middle-income countries need a rational and cost-effective approach to optimise management of type 2 diabetes mellitus (T2DM). There is a paucity of data from such countries on the extent of hypoglycaemia and its consequences for their healthcare systems. This review provides the context for health policy change and evaluates available data on diabetes complications, focusing on hypoglycaemia in T2DM patients in non-Western countries. Suitable guidelines are suggested for these communities, which are in transition from poverty to affluence and in transition from an environment where infectious diseases predominate to one where non-communicable diseases are predominant

Quaternion Analysis for Generalized Electromagnetic Fields of Dyons in Isotropic Medium

Quaternion analysis of time dependent Maxwell's equations in presence of electric and magnetic charges has been developed and the solutions for the classical problem of moving charges (electric and magnetic) are obtained in unique, simple and consistent manner

Generalized Electromagnetic fields in Chiral Medium

The time dependent Dirac-Maxwell's Equations in presence of electric and magnetic sources are written in chiral media and the solutions for the classical problem are obtained in unique simple and consistent manner. The quaternion reformulation of generalized electromagnetic fields in chiral media has also been developed in compact, simple and consistent manner

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13

Search for direct stau production in events with two hadronic tau-leptons in root s=13 TeV pp collisions with the ATLAS detector

A search for the direct production of the supersymmetric partners ofτ-leptons (staus) in final stateswith two hadronically decayingτ-leptons is presented. The analysis uses a dataset of pp collisions corresponding to an integrated luminosity of139fb−1, recorded with the ATLAS detector at the LargeHadron Collider at a center-of-mass energy of 13 TeV. No significant deviation from the expected StandardModel background is observed. Limits are derived in scenarios of direct production of stau pairs with eachstau decaying into the stable lightest neutralino and oneτ-lepton in simplified models where the two staumass eigenstates are degenerate. Stau masses from 120 GeV to 390 GeV are excluded at 95% confidencelevel for a massless lightest neutralino

Search for chargino-neutralino production with mass splittings near the electroweak scale in three-lepton final states in √s=13 TeV pp collisions with the ATLAS detector

A search for supersymmetry through the pair production of electroweakinos with mass splittings near the electroweak scale and decaying via on-shell W and Z bosons is presented for a three-lepton final state. The analyzed proton-proton collision data taken at a center-of-mass energy of √s=13  TeV were collected between 2015 and 2018 by the ATLAS experiment at the Large Hadron Collider, corresponding to an integrated luminosity of 139  fb−1. A search, emulating the recursive jigsaw reconstruction technique with easily reproducible laboratory-frame variables, is performed. The two excesses observed in the 2015–2016 data recursive jigsaw analysis in the low-mass three-lepton phase space are reproduced. Results with the full data set are in agreement with the Standard Model expectations. They are interpreted to set exclusion limits at the 95% confidence level on simplified models of chargino-neutralino pair production for masses up to 345 GeV

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente

National identity in fragile states: insights from tertiary students in Melanesia and Timor-Leste

The challenges of nation building in Melanesia and Timor-Leste have often been neglected in the regional focus on state-building challenges. High levels of ethno-linguistic diversity, combined with an array of regional, historical and cultural divisions, continue to present obstacles to the creation of a cohesive sense of national political community leading these nations to be labelled ‘fragile’. This paper presents the findings of a comparative study on the attitudes of tertiary students in Melanesia and Timor-Leste to national identity and nation building. A strong pan-Melanesian pattern of group identification was identified, common to Papua New Guinea, Solomon Islands and Vanuatu. The ongoing importance of traditional authority and custom in informing conceptions of political community and identity was evident in all four case study sites, but was in each case matched by indicators of respect for modern state authority. The survey also reveals some significant gender differences in key attitudes towards national identity, including the role of traditional authorities. Most importantly, the study reveals high degrees of national pride, and faith in democratic principles and citizenship; but conversely, low levels of pride in contemporary democratic performance and inter-group tolerance