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We examine the role of macroeconomic uncertainty in the cross section of corporate bonds and find a significant uncertainty premium for both investment-grade (IG) (0.40% per month) and non-investment-grade (NIG) (0.81% per month) bonds. The economic-uncertainty premium declines as we progressively remove downgraded bonds, indicating that the premium represents an increase in required returns for bonds with higher credit and macroeconomic risk. The economic-uncertainty premia vary across equities and bonds in a manner consistent with the heterogeneous risk-aversion levels of dominant players in equities (retail investors) versus bonds (institutional investors).
To demonstrate the usefulness of N-Terminal Pro-B-Type natriuretic peptide (NT-proBNP) as an early biomarker of carbon monoxide-induced myocardial injury in children. It also aimed to identify the correlation between NT-proBNP and left ventricular systolic dysfunction findings shown by echocardiography.
Prospective, observational study conducted at a paediatric emergency department between October 2017 and April 2019 which involved children aged 0–17 years. The patients were divided into three groups based on severity; mild, moderate and severe groups. The patient characteristics, carboxyhaemoglobin, CK-MB Mass (CKMB-M), troponin-T, and NT-proBNP levels were measured, and echocardiography was performed and left ventricular ejection fraction was measured.
Sixty-nine patients and 60 healthy controls were included. Male gender, younger age, higher carboxyhaemoglobin levels, and altered mental status were found as independent predictors of carbon monoxide-induced myocardial injury. If the cut-off value for NT-proBNP level is >480 pg/ml, the sensitivity–specificity for decreased left ventricular ejection fraction, which is the strongest carbon monoxide-induced myocardial injury sign, were 100–96%, respectively. A high negative correlation was found between NT-proBNP levels and left ventricular ejection fraction (r = −0.769, p < 0.01) in the carbon monoxide poisoning group, and there was a positive correlation between the carboxyhaemoglobin and NT-proBNP levels (r = 0.583, p < 0.01).
Echocardiography is an ideal tool and very sensitive, but its routine use is limited due to its non-availability. An increased level of NT-proBNP (>480pg/ml) may be useful as an ideal biomarker for early detection of carbon monoxide-induced myocardial injury sign and reduced left ventricular ejection fraction which is the most crucial point in making a decision on hyperbaric oxygen therapy.
Dikmen Valley is a slum district where the Municipality of Ankara intended to start an urban transformation project. Dikmen neighborhood includes nearly 1000 houses which the Municipiality attempted to pull down suddenly at night in the winter of 2007.
Residents of Dikmen Valley resisted and managed to stop this attempt. Whole event was experienced as an acute trauma as well as a continuous experience of anxiety because of ongoing risk of another attack.
The aim of the present study was to investigate the psychological consequences of the whole process.
The study sample consisted of 201 individuals from 106 households, and a total of 178 individuals from 102 households was taken as comparison group from another slum neighborhood where residents did not experience any threat to their houses. The Beck Depression Inventory, the Spielberger Trait Anxiety Scale, and the General Self-Efficacy Scale were used for assessment.
Dikmen sample was found to have a statistically significant higher mean score of anxiety and depression compared to the comparison group. Dikmen had a higher level of general self-efficacy belief than the comparison group after controlling for depression and anxiety scores.
Although the traumatic process after an attack of pulling down and the threat of losing one's house resulted with a depressive state and anxiety in Dikmen residents, unexpectedly they had a high level of general self-efficacy. To the researchers’ observations, a social transformational process has been realized resulting with an overall high general self-efficacy level in Dikmen neighborhood.
Insight is a well-documented phenomenon for psychotic disorders. It has been studied extensively in schizophrenia and its association with clinical outcomes has drawn increased attention. Although less is known for affective disorders, recent studies point out that impaired insight in bipolar disorder may take part in patients’ overall well-being.
Exploring the main components of insight in psychiatry, particularly in bipolar disorder.
With this study, we wanted to examine how clinical and cognitive insights change in patients with bipolar disorder through their hospitalization period and how they correlate with symptom severity and neuropsychological functioning.
In this prospective study, inpatients with bipolar I disorder who were presented by manic episode with psychotic features were included. The patients were assessed with Young Mania Rating Scale, Beck Cognitive Insight Scale, Schedule for the Assessment of Insight-Expanded Version (SAI-E) and a neuropsychological test battery both at the time of admission and discharge.
As of October 2015, a total number of 20 patients with bipolar I disorder participated in the study. Preliminary results revealed a significant improvement in the total score of clinical insight, which was measured with SAI-E by the time of discharge (P = 0.001). This transition was strongly correlated with the decrease in symptom severity (P = 0.006, r = −0.61). Improved clinical insight exhibited significant correlation with the increase in patients’ memory span (P = 0.007, r = −0.596).
The preliminary results suggest that changes in symptom severity and working memory might be the determinants of improvement in clinical insight of inpatients with bipolar disorder through manic episode.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Exergy efficiency can be used as an objective function in order to improve systems efficiency. Thus, the most efficient regions for the operation parameters can be searched easily. Exergy efficiency data of a turboprop engine’s components that have been calculated using basic engine parameters in the previous studies are modeled using cubic spline curve fitting methodology. Spline curves are on the two dimensional plane, where x axis is the input parameter and y axis is the exergy efficiency of the component. A spline curve is defined by the points subject to arbitrary selection of number and position. Initially positions of the points are located with two different methods and then in order to obtain better accuracy point positions are improved by ‘Ant colony’ and ‘Goldsection’ optimisation methods. Sum of Squares of the errors between the fitted value and data value was used as the fitness function. Least square error of 5 × 10−9 is assumed as acceptable accuracy which yields to a minimum R = 0.9998 linear correlation coefficient. In the optimisation step, independent engine variable versus calculated engine performance parameters were checked against spline fitted values. Improvement of the fitness function is observed as the number of fitting points is increased. Ant colony optimisation in engine exergy efficiency parametric modeling is a new approach in authors’ point of view.
The Turkish poultry industry has rapidly developed in the last decade. Viral pathogens continue to threaten the industry, causing economic losses worldwide, including Turkey. At present, infectious bronchitis and infectious laryngotracheitis are major challenges, as are, to a lesser extent, avian metapneumovirus, infectious bursal disease, Marek's disease and chicken infectious anaemia. The prevalence and severity of these diseases in Turkish chickens varies depending on environmental and management factors, vaccination strategies and biosecurity measures. In Turkey, infectious bronchitis virus, including vaccine and field strains, were detected in 83.6% (41/49) and 64.2% (9/14) vaccinated broiler and layer flocks, respectively. Virulent and vaccine strains of infectious bursal disease virus were found in 83.5% (1548/1855) of excised bursa Fabricius from vaccinated broilers. Virulent Marek's disease virus was found in 19.93% (120/620) of spleens from vaccinated chickens. Infectious laryngotracheitis virus in commercial poultry and Newcastle disease in backyard chickens have been detected. To date, Newcastle disease and avian influenza virus have not been reported in commercial poultry. Avian metapneumovirus was found in 7.2% (8/110) of the broiler samples. Antibodies to gyrovirus and avian leukosis virus have been detected. Commercial vaccines, such as attenuated, inactivated and vectored vaccines, are being used for prevention and control of viral poultry diseases in Turkey. This review summarises the available information on viral poultry diseases in Turkey. It highlights the need to strengthen surveillance and reporting for diseases and addresses the vaccination practices used in Turkish poultry industry. The future prospects of vaccination and need to empower diagnostic capacity in controlling viral poultry diseases are discussed. The information presented here is aimed at improving research, prevention, and control of poultry diseases for researchers, veterinarians, policy makers and other professions related to poultry industry.
We provide new evidence on the economic role of growth options behind the profitability, distress, lotteryness, and volatility anomalies. We use idiosyncratic skewness to measure growth options and estimate expected idiosyncratic skewness capturing investors’ expectations about the firm’s mix of growth options versus assets-in-place. We find that investors require a positive premium to hold stocks of inflexible firms with low growth options and negative expected skewness and that a newly proposed skewness factor based on growth options explains the aforementioned anomalies. Thus, the new measure of expected idiosyncratic skewness may serve to reduce the number of anomalies in the literature.
OBJECTIVES/SPECIFIC AIMS: Our primary objective was to understand the relationship between incident or recent stressful events and adherence to HIV care in the context of other person, environment, and HIV-specific stressors in a sample of Black women living with HIV (WLWH). METHODS/STUDY POPULATION: Thirty in-depth interviews were conducted with Black women living with HIV who receive care at an academic HIV primary care clinic in the Southern region of the United States to elicit stressful events influencing adherence to HIV care. Semi-structured interview guides were used to facilitate discussion regarding stressful events and adherence to HIV care. Interviews were audiotaped and transcribed verbatim. Transcripts were independently coded using a theme-based approach by two experienced coders, findings were compared, and discrepancies were resolved by discussion. RESULTS/ANTICIPATED RESULTS: Participants described frequently experiencing incident stressful events including death or serious illness of a close friend or family member, and relationship, financial, and employment difficulties. Furthermore, participants reported experiencing traumatic events such as sexual and physical abuse during childhood and adolescents. While experiencing traumatic events such as sexual and physical abuse during childhood and adolescence may be distressing, these events did not influence adherence to HIV care. However, incident stressful events as defined above did influence adherence to HIV care for some participants, but not for others. For participants who reported that stressful events did not influence adherence to HIV care, factors such as personal motivation, access to social support, and adaptive coping strategies facilitated their engagement in care. DISCUSSION/SIGNIFICANCE OF IMPACT: Experiencing stressful events, incident or traumatic, is common among Black WLWH and have the potential to negatively influence adherence to HIV care. Thus, Interventions aimed at identifying and addressing stress, social support, and coping are essential to improve adherence to HIV care behaviors.
OBJECTIVES/SPECIFIC AIMS: The National HIV/AIDS strategy aims to increase retention in care (RIC) to reduce HIV transmission and mortality. Previous studies have evaluated clinic-level interventions such as appointment reminders and peer navigation. However, few studies have investigated the association between multiple clinic-level factors and RIC among PLWH across the United States. We conducted a multi-site cohort study to identify clinic-level factors associated with RIC in the United States from 2010-2016. METHODS/STUDY POPULATION: We included PLWH with at least one HIV primary care visit from 2010-2016 at seven sites of the Center for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS). Individual-level data collected as part of routine clinical care were abstracted from the electronic health record. Clinic-level data were gathered through a survey and included questions on site characteristics (i.e. clinic volume) as well as services available at the site during each year of the study: peer navigation, RIC posters/brochures, laboratory test timing, flexible scheduling, appointment reminder types, and stigma support services defined as intensive HIV education and advocacy regarding support to address stigma at outreach visits. RIC was defined as ≥2 encounters per year, ≥90 days apart, observed until death, administrative censoring (December 31, 2016), or loss to follow-up (no visit for >12 months with no future visits). Poisson panel regression with robust error variance, clustering by site and adjusting for calendar year, age (modeled with a cubic spline), sex, race/ethnicity, and HIV transmission risk factor, was used to estimate incident rate ratios (IRR) with 95% confidence intervals (CI) for RIC. Clustering by site has been shown to absorb for clustering that could occur at the individual level as well. RESULTS/ANTICIPATED RESULTS: Among 21,046 patients contributing 103,348 person-years, 67% of person-years were RIC. Text appointment reminders (IRR = 1.13; 95% CI: 1.03-1.24) and stigma support services (IRR=1.11; 95% CI:1.04-1.19) were significantly associated with RIC. RIC disparities in individual-level patient characteristics were observed even after accounting for clinic-level characteristics. Older patients were more likely to be RIC demonstrated through year comparisons due to the use of a spline; for age 50 years (IRR = 1.07, 95% CI: 1.06-1.08) and 60 years (IRR = 1.15, 95% CI: 1.13-1.17) compared to 45 years. Female PLWH were more likely to be RIC compared to males (IRR = 1.03, 95% CI: 1.02-1.05) and Hispanic PLWH were more likely to be RIC compared to white, non-Hispanic PLWH (IRR = 1.09, 95% CI: 1.05-1.13). Although commonly found to be associated with worse RIC, Black race and injection drug use were not associated with RIC in this population. DISCUSSION/SIGNIFICANCE OF IMPACT: In this multi-site US cohort study from 2010-2016, availability of text appointment reminders and stigma support services at a clinic were associated with approximately 10% higher probability of RIC than at clinics without those services. RIC disparities persisted with respect to individual-level characteristics of age, sex, and race/ethnicity even after accounting for these clinic-level factors. Prospective studies examining the impact of these clinic-level factors and individual-level uptake of these services on RIC are needed.
This study examined the relations between receptive language development and other developmental domains of preschoolers from low-income families, through an inter-cultural perspective involving the United States and Turkey. A total of 471 children and their caregivers participated in Turkey, while 287 participated in the United States. Children's development was assessed using the Ages and Stages Questionnaire for both samples. Different versions of the Peabody Picture Vocabulary Test were used for Turkish and US samples, to measure receptive language development. Results revealed similar patterns, with some differences, between the two countries. Receptive language predicted only communication and personal–social scales in the Turkish sample, while the US children's receptive language skills were associated with communication, problem solving, personal–social, and fine and gross motor development scales. These results were discussed in the context of each country, and the comparative conclusions contribute to the extant literature by illustrating the importance of language for three domains.
There is still a need for short, practical, and daily-appropriate scales to distinguish between normal cognitive aging, mild cognitive impairment (MCI), or dementia for patients with memory complaints. This study aimed to determine validity and reliability of AD8 (Dementia Screening Interview) to detect both MCI and dementia in Turkish geriatric outpatients.
Comprehensive geriatric assessment was performed in 334 patients, who attended with their informants to the geriatric outpatient clinic for memory complaints. In addition to the AD8, they were screened using Clinical Dementia Rating scale (CDR) and Mini-Mental State Examination. The diagnosis of dementia and MCI was made according to the Diagnostic and Statistical Manual of Mental Disorders - fifth edition (DSM-5) criteria.
The mean age of the patients was 74.5±8.5. Of them, 156 were considered as non-cognitive impairment, 60 as MCI, and 118 as dementia. Cronbach's α value of the AD8 was 0.928. The total AD8 scores were found to be negatively correlated with the MMSE scores (r = −0.801), and positively correlated with CDR score (r = 0.879) (p < 0.001, for each). The area under the receiver-operating characteristics curve was 0.979 for cognitive impairment, and 0.999 for dementia. We found that AD8 can show dementia and MCI when the cut-off values are ≥5 and 3–4, respectively, with a sensitivity of 100% and 81.67% and specificity of 96.3% and 93.59%.
AD8 is one of the fast, simple, and sensitive screening methods for detecting both minor and major cognitive impairments. With regard to these features, it can be used in older adults attending the primary care settings with memory complaints.
We read with interest the comment by Williamson and Larner on our recent study titled “Attended With and Head-Turning Sign can be clinical markers of cognitive impairment in older adults” (Soysal et al., 2017). After the authors read the study, they re-examined their data according to the presence of Attended With (AW) and Head-Turning Sign (HTS), and compared their results with ours (Larner, 2014). Then, they found that while the sensitivity, specificity, positive predictive value, and negative predictive value of AW in detecting cognitive impairment were similar to ours, HTS had lower sensitivity (80.95% vs. 65.0%) and higher specificity (64.7% vs. 95.0%) than our results (Larner, 2014; Soysal et al., 2017). We think that some methodological and cultural differences may explain these discrepancies between the two.
Depression is a common and serious healthcare problem for older adults. This study aimed to determine the validity and reliability of GDS-4 and GDS-5 in Turkish, and to establish a new short-form Geriatric Depression Scale (GDS) for our population, and also determine the superiority of each short scale to another.
A total of 437 outpatients were enrolled in the study. A researcher evaluated all participants according to the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) diagnostic criteria, and then another researcher applied GDS-15 to all participants. We obtained the answers of short GDS forms, examined in this study, from GDS-15 forms. After Cohen's κ analysis, we compared the diagnostic value of each question for geriatric depression according to their κ values, and developed three (TGDS-3), four (TGDS-4), five (TGDS-5), and six (TGDS-6) question scales to screen geriatric depression in Turkish population.
A total of 437 participants were assessed. The mean age (SD) of the patients was 72.95 years (7.37).Cronbach's α values of GDS-4 and GDS-5 were <0.70. Cronbach's α values of TGDS-3, TGDS-4, TGDS-5, and TGDS-6 were >0.70. The best cut-off values were ≥5 for GDS-15 and GDS-5, and ≥1 for others.
GDS-15 is the most powerful screening scale for geriatric depression. GDS-4 and GDS-5 are not eligible for depression screening in Turkish older adults. All new short scales are valid and reliable, and TGDS-4 is a practical, less time-consuming option for daily practice.
Surface texturing of transparent conductive oxides is crucial to improve the fraction of incident light trapped in the absorber layer of thin film silicon based solar cells to improve the device performance. In this work, we fabricate and compare periodic, overlapping, and random surface textures and patterns on aluminium doped zinc oxide (AZO) using direct laser processing. The effects of the used laser wavelength, laser operating frequency, and pulse periodicity on the structural, morphological, and optical response of the AZO films were investigated. By optimizing the laser parameters and the associated process conditions, a drastic increase up to 60% in the transmittance haze over the entire solar was achieved.
The low (high) abnormal returns of stocks with high (low) beta, which we refer to as the beta anomaly, is one of the most persistent anomalies in empirical asset pricing research. This article demonstrates that investors’ demand for lottery-like stocks is an important driver of the beta anomaly. The beta anomaly is no longer detected when beta-sorted portfolios are neutralized to lottery demand, regression specifications control for lottery demand, or factor models include a lottery demand factor. The beta anomaly is concentrated in stocks with low levels of institutional ownership and it exists only when the price impact of lottery demand is concentrated in high-beta stocks.
Comprehensive neurocognitive assessment may not be performed in clinical practice, as it takes too much time and requires special training. Development of easily applicable, time-saving, and cost effective screening methods has allowed identifying the individuals that require further evaluation. The aim of present study was to assess the diagnostic value of the Attended With (AW) and Head-Turning Sign (HTS) for screening cognitive impairment (CI).
Comprehensive geriatric assessment was performed in 529 elderly outpatients, and the presence or absence of AW and HTS was investigated in them all.
Of the 529 patients, of whom the mean age was 75.67 ± 8.29 years, 126 patients were considered as CI (102 dementia, 24 mild CI). The patients with positive AW had significantly lower scores on Mini-Mental State Examination, Cognitive State Test, and Montreal Cognitive Assessment, and activities of daily living compared to AW (−) patients (p < 0.001). Similar significant findings were obtained in the patients with positive and negative HTS (p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of AW in detecting CI were 92%, 37%, 31.4%, and 93.7%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of HTS were 80%, 64%, 41.8%, and 91.5%, respectively. The area under the receiver-operating characteristics curve was 0.90 for AW and 0.82 for HTS.
AW and HTS are fast, simple, effective, and sensitive methods for detecting CI. Therefore, they can be used for older adults attending the primary care settings with memory loss. Those with positive AW or HTS can be referred to the relevant centers for detailed cognitive assessment.