Modelling spectral and timing properties of accreting black holes: the hybrid hot flow paradigm

The general picture that emerged by the end of 1990s from a large set of optical and X-ray, spectral and timing data was that the X-rays are produced in the innermost hot part of the accretion flow, while the optical/infrared (OIR) emission is mainly produced by the irradiated outer thin accretion disc. Recent multiwavelength observations of Galactic black hole transients show that the situation is not so simple. Fast variability in the OIR band, OIR excesses above the thermal emission and a complicated interplay between the X-ray and the OIR light curves imply that the OIR emitting region is much more compact. One of the popular hypotheses is that the jet contributes to the OIR emission and even is responsible for the bulk of the X-rays. However, this scenario is largely ad hoc and is in contradiction with many previously established facts. Alternatively, the hot accretion flow, known to be consistent with the X-ray spectral and timing data, is also a viable candidate to produce the OIR radiation. The hot-flow scenario naturally explains the power-law like OIR spectra, fast OIR variability and its complex relation to the X-rays if the hot flow contains non-thermal electrons (even in energetically negligible quantities), which are required by the presence of the MeV tail in Cyg X-1. The presence of non-thermal electrons also lowers the equilibrium electron temperature in the hot flow model to <100 keV, making it more consistent with observations. Here we argue that any viable model should simultaneously explain a large set of spectral and timing data and show that the hybrid (thermal/non-thermal) hot flow model satisfies most of the constraints.Comment: 26 pages, 13 figures. To be published in the Space Science Reviews and as hard cover in the Space Sciences Series of ISSI - The Physics of Accretion on to Black Holes (Springer Publisher

EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

A cross-cultural study of ICT competency, attitude and satisfaction of Turkish, polish and Czech university students

Due to various factors, countries begin to have different levels of information and communication technologies (ICT) and they have their own unique culture of ICT usage. This case appears interesting especially when we consider university students' proficiency, attitudes and satisfaction in use of ICT. The purpose of this study is to examine the similarities and differences of university students in Turkey, EU candidate, and in Poland and Czech Republic, new members of EU, in terms of their proficiency, attitudes and satisfaction in use of ICT. The data of this study, composed of open-and closed-ended questions, were collected from students studying at departments of social and computational sciences. Statistical analyses of data collected were performed by SPSS 17, statistical package program. Results showed that a) despite the fact that Turkish students use computer for a shorter time than Polish and Czech students, there is no statistically significant difference between them, b) in terms of attitudes toward computer and their satisfaction, there is no difference between students studying at social departments whereas there is a statistically significant difference between students studying at departments of computational sciences. © The Turkish Online Journal of Educational Technology

Analgesia and sedation in neonates [Yenidoganda analjezi ve sedasyon]

It has been known for a long-time that neuroanatomical, neuroendocrinal and neurophysiological systems are sufficiently developed to allow transmission of painful stimuli in the neonate. But still many practitioners perform many procedures with no or minimal analgesia. One of the main reasons is the fear of adverse effects related to complications of analgesics. Endocrinometabolic and stress responses in newborn to invasive and surgical operations are more potent than adults. Newborns are regularly subjected to routine stressful and/or painful procedures every day in newborn intensive care units. It has been reported that the incidence of morbidity has increased in neonates subjected to severe and prolonged pain

The Influence of Skill Development Training Program for Spiritual Care of Elderly Individual on Elderly Care Technician Students' Perception of Spiritual Support

PMID = 2712970