Super-Eddington accretion discs with 3M ̇ E and 15M ̇ E around black holes with mass 10 M⊙ are examined by two-dimensional radiation hydrodynamical calculations extending from the inner disc edge to 5 × 104rg and lasting up to ∼106 rg/c. The dominant radiation pressure force in the inner region of the disc accelerates the gas vertically to the disc plane, and jets with 0.2–0.4c are formed along the rotational axis. In the case of the lower accretion rate, the initially anisotropic high-velocity jet expands outward and becomes gradually isotropic flow in the distant region. The mass-outflow rate from the outer boundary is as large as ∼1019 –1023 g s−1, but it is variable and intermittent with time; that is, the outflow switches occa- sionally to inflow in the distant region. The luminosity also varies as ∼1040–1042 erg s−1 on a long time-scale. On the other hand, the jet in the case of the higher accretion rate maintains its initial anisotropic shape even after it goes far away. The mass-outflow rate and the luminosity attain steady values of 3 × 1019 g s−1 and 1.3 × 1040 erg s−1, respectively. In accordance with the local analysis of the slim accretion disc model, the disc is thermally unstable in the case of 3M ̇ E but stable in the case of 15M ̇ E. The super-Eddington model with 15M ̇ E promises to explain the small collimation degree of the jet and the large mass-outflow rate observed in the X-ray source SS 433

Antibiotics are the therapeutic agents most often associated with hepatotoxicity. However, this is mainly due to the widespread prescription of these drugs. The relative risk of antibiotic-related hepatotoxicity is low. Causality assessment of suspected drug-induced liver injury (DILI) related to antibiotics can be difficult, particularly because some cases occur long after the drug has been stopped. Among the penicillins, amoxicillin clavulanate is the most associated with hepatotoxicity and is the most frequent cause of DILI-related hospitalisations. Flucloxacillin ranks as the second highest cause of DILI in many countries. The severity of antibiotic-induced DILI varies widely, with the hepatitis-like (hepatocellular) damage tending to be more severe that than cholestatic/mixed type. The pattern is strongly influenced by age. Recently telithromycin (a new generation macrolide) has been linked with DILI, with a typical pattern, which includes abrupt commencement of fever, abdominal pain, jaundice and, in some cases, ascites. Antibiotic-induced DILI appears, in most instances, to be idiosyncratic. Genetic-association studies have recently identified genotypes related to flucloxacillin and possibly to amoxicillin-clavulanate hepatotoxicity.

The clinical and economic analysis of the three phases of our study demonstrates that a Syncope Unit allows an improved management of patients with syncope.

It is well known that the rotating inviscid accretion flows with adequate injection parameters around black holes could form shock waves close to the black holes, after the flow passes through the outer sonic point and can be virtually stopped by the centrifugal force. We examine numerically such shock waves in 1D and 2D accretion flows, taking account of cooling and heating of the gas and radiation transport. The numerical results show that the shock location shifts outward compared with that in the adiabatic solutions and that the more rarefied ambient density leads to the more outward shock location. In the 2D-flow, we find an intermediate frequency QPO behavior of the shock location as is observed in the black hole candidate GRS 1915+105.

Previous research has highlighted that deaf children acquiring spoken English have difficulties in narrative development relative to their hearing peers both in terms of macro-structure and with micro-structural devices. The majority of previous research focused on narrative tasks designed for hearing children that depend on good receptive language skills. The current study compared narratives of 6 to 11-year-old deaf children who use spoken English (N=59) with matched for age and non-verbal intelligence hearing peers. To examine the role of general language abilities, single word vocabulary was also assessed. Narratives were elicited by the retelling of a story presented non-verbally in video format. Results showed that deaf and hearing children had equivalent macro-structure skills, but the deaf group showed poorer performance on micro-structural components. Furthermore, the deaf group gave less detailed responses to inferencing probe questions indicating poorer understanding of the story's underlying message. For deaf children, micro-level devices most strongly correlated with the vocabulary measure. These findings suggest that deaf children, despite spoken language delays, are able to convey the main elements of content and structure in narrative but have greater difficulty in using grammatical devices more dependent on finer linguistic and pragmatic skills.