International financial crises, term structure of foreign debt and monetary policy in open economies

In this dissertation, I study international financial crises. For this purpose, I build two models. In the first model, I focus on financial crises in developing, large open economies where foreign debt with various maturities and issue dates is available. The objective is to measure the vulnerability of the domestic financial system to domestically triggered bank runs and externally triggered sudden stops. The main contribution of this model is that both types of crises are treated as rational responses of domestic depositors and international creditors. Such vulnerability measures are linked to fundamentals and equilibrium term structure of foreign debt. Banks vulnerability to runs increases if they hold a relatively shorter term debt. Also, a larger cost of liquidating the long-term investment before maturity makes the banks more fragile. In the next step, given a domestic banking crisis, I allow international creditors to decide whether they want to stop lending to domestic banks (in which case a Âsudden stop takes place) or not. A sudden stop is more likely if (i) creditors highly discount future consumption, (ii) creditors current income is small relative to their future income, and (iii) the cost of liquidating the long-term investment before maturity is small. In the second model, I investigate the merits of alternative monetary policies with respect to financial fragility. In this monetary model of an explicit financial system, I motivate the demand for two fiat currencies by spatial separation and limited communication of agents. There is a domestic and a foreign currency freely traded without restrictions. I analyze the policy of a constant growth rate of domestic money supply with a floating exchange rate regime. Both currencies are held in positive amounts at the steady-state only if the growth rate of domestic money supply is equal to the world inflation rate (WIR). If the former rate is larger than the WIR, domestic currency is not held at the steady-state. Also, total real money balances held is negatively related with WIR. Finally, monetary policy in the form of a constant growth rate of domestic money supply is neutral with respect to welfare

Global Credit Supply and External Exposure in Turkey

Present study investigates the link between net capital inflows and the current account balance in Turkey. Using monthly data for the period of 2002-2014, we provide evidence that higher capital inflows are associated with larger deficits in the current account. We include two alternative measures of the net inflows – the financial account and foreign liabilities of the banks in Turkey. The paper analyzes this relationship under the different model specifications with a number of control variables that capture both domestic and external factors. We also show that imbalances in the current account are highly responsive to the fluctuations in the real exchange rates, mostly triggered by the changes in capital flows. The Granger causality test reveals one-directional causal link from the financial account to the external balance but not the reverse. Given exogenous character of the global capital and random nature of the developments in the financial account, high inflows to Turkey have been creating high exposure and fragility of its external balance. Our findings highlight on the importance of the macro-prudential policies to monitor short-term inflows and on minimization of destabilizing effects of the real exchange rate fluctuations on the external account in Turkey

Clonal relation of nasal MRSA carrier status among hospital personnel, hospitalized patients and community

Objectives: Nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) among the healthcare workers(HCWs), hospitalized patients, and healthy individuals was investigated by pulsed field gel electrophoresis (PFGE) for definingof clonally distribution of them.Methods: Totally 403 healthcare personnel, 744 patients, and 204 healthy individuals from the population were enrolled.Microbiological procedures were performed in the Bacteriological Laboratory at the Clinical Microbiology and InfectiousDiseases Department of Firat University, and PFGE procedures were performed in the Microbiology Department of InonuUniversity.Results: Staphylococcus aureus was isolated in 296 (21.9%) of 1351 nasal swabs, and 69 out of 296 (23.3%) were defined asMRSA. Nasal S. aureus carrier state was identical between the patients and HCWs carrier state (p=0.14). It was significantlylower in healthy subjects than the other groups (p=0.02). Seventeen (25.8%) of 66 MRSA strains were defined to be in thecluster. These strains were in 7 different clusters. Among the typed strains, 21 had close relationship, 2 had possible relationship,and 26 had no relation. PFGE pattern was defined in 33 (50%) out of 66 strains and it was inconclusive in 3 strains.Conclusions: MRSA strains can be transferred commonly in the same hospital, among the hospitals located in the sameregion and the population. The results might be the indicators of increasing frequencies in population based MRSA infections.Multi-center studies are required to define clonally distribution of MRSA and the explanation of epidemiology maybe helpful for preventing and controlling of MRSA related infections. J Microbiol Infect Dis 2013; 3(2): 49-55Key words: MRSA, nasal carrier, PFGE

DETERMINATION OF GENETIC VARIABILITY OF EASTERN AND SOUTHEASTERN ANATOLIA REGION TOBACCOS

Tobacco establishing various ecotypes in different ecological zones is one of the crop plants having high genetic variability. In previous years, tobacco ecotypes were conserved by tobacco farming controlled governmentally. But now tobacco sector is privatized. As a result of privatization, companies in tobacco sector have adopted a few ecotypes based on tobacco farming. This phenomenon has increased the risk of extinction for the present genetic variability and now some cultivars are nearly extinct. In this study, conducted to prevent genetic resource erosion, different tobacco ecotypes were determined by visiting the tobacco fields in Eastern and Southeastern Anatolia Region. Some morphological, technique and yield characters of the cultivars were compared by farming them in field via seed. 12 characters of the cultivars were tabulated. Seeds of cultivars, characters of which were determined were delivered to Seed Gene Bank of Turkey

An unusual finding after adrenal surgery: a case series of adrenal schwannomas

Adrenal schwannomas are rare benign tumors with no specific imaging and laboratory findings to diagnose preoperatively. Due to the limited number of cases in the literature, clinical, imaging, and pathological findings are presented in this study. Case 1 is a 61-year-old woman patient who has a 31-mm mass in the right adrenal gland. This mass was nonfunctional; in imaging studies, this mass had a cystic necrotic component, and high 18-fluorodeoxyglucose (FDG) uptake was seen. There was no metaiodobenzylguanidine (MIBG) uptake. Laparoscopic transabdominal right adrenalectomy was performed, and the pathology result was consistent with adrenal schwannomas. Case 2 is a 63-year-old man patient who presented with a 38-mm mass in the left adrenal gland. This mass was nonfunctional and similar to that in Case 1; this mass had a cystic component. Laparoscopic transabdominal left adrenalectomy was performed. The diagnosis of adrenal schwannoma with degeneration was revealed. Case 3 was a 72-year-old woman patient admitted to the hospital for a 125-mm left adrenal mass. Similar to Case 1, this mass also had a cystic necrotic component in imaging studies. High FDG uptake was seen, and the patient underwent conventional adrenalectomy due to the suspicion of malignancy. After pathological evaluation, a diagnosis of adrenal schwannoma was made. A main diagnostic challenge in adrenal schwannomas is the preoperative diagnosis. These masses have no pathognomonic finding or specific hormonal function. Imaging findings of these masses may increase the suspicion of malignancy, which may affect decisions for surgery and the surgical technique

Magnetic resonance imaging based kidney volume assessment for risk stratification in pediatric autosomal dominant polycystic kidney disease

IntroductionIn the pediatric context, most children with autosomal dominant polycystic kidney disease (ADPKD) maintain a normal glomerular filtration rate (GFR) despite underlying structural kidney damage, highlighting the critical need for early intervention and predictive markers. Due to the inverse relationship between kidney volume and kidney function, risk assessments have been presented on the basis of kidney volume. The aim of this study was to use magnetic resonance imaging (MRI)-based kidney volume assessment for risk stratification in pediatric ADPKD and to investigate clinical and genetic differences among risk groups.MethodsThis multicenter, cross-sectional, and case-control study included 75 genetically confirmed pediatric ADPKD patients (5–18 years) and 27 controls. Kidney function was assessed by eGFR calculated from serum creatinine and cystatin C using the CKiD-U25 equation. Blood pressure was assessed by both office and 24-hour ambulatory measurements. Kidney volume was calculated from MRI using the stereological method. Total kidney volume was adjusted for the height (htTKV). Patients were stratified from A to E classes according to the Leuven Imaging Classification (LIC) using MRI-derived htTKV.ResultsMedian (Q1-Q3) age of the patients was 6.0 (2.0–10.0) years, 56% were male. There were no differences in sex, age, height-SDS, or GFR between the patient and control groups. Of the patients, 89% had PKD1 and 11% had PKD2 mutations. Non-missense mutations were 73% in PKD1 and 75% in PKD2. Twenty patients (27%) had hypertension based on ABPM. Median htTKV of the patients was significantly higher than controls (141 vs. 117 ml/m, p = 0.0003). LIC stratification revealed Classes A (38.7%), B (28%), C (24%), and D + E (9.3%). All children in class D + E and 94% in class C had PKD1 variants. Class D + E patients had significantly higher blood pressure values and hypertension compared to other classes (p > 0.05 for all).DiscussionThis study distinguishes itself by using MRI-based measurements of kidney volume to stratify pediatric ADPKD patients into specific risk groups. It is important to note that PKD1 mutation and elevated blood pressure were higher in the high-risk groups stratified by age and kidney volume. Our results need to be confirmed in further studies

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat