Presence of the turn-of-the-month effect in selected Asian stock markets from 2001-2010

Efficient market hypothesis (EMH) has always been challenged with new evidences of calendar anomalies in the stock market. This paper examines the existence of the turn-of-the-month (TOM) effect in the selected Asian stock markets namely, Hang Seng index of Hong Kong, Nikkei 225 index of Japan, SSE index of China, and KOSPI index of Korea from 2001 to 2010 using OLS dummy regressions and descriptive statistics. The results of the study show that the TOM effect exists in both the KOSPI index and Nikkei 225 showed no evidence of the anomaly. U.S. macroeconomic news namely imports and exports price indices and the ISM: manufacturing reports were identified to be the likely cause of the TOM effect in Korea while in China none of the news have a tendency to influence the said anomaly

Effect of Implementation of HEART Chest Pain Protocol on Emergency Department Disposition, Testing and Cost

Background: Symptoms concerning for acute coronary syndromes (ACS) such as chest pain and dyspnea are some of the most common reasons for presenting to an emergency department (ED). The HEART score (history, electrocardiogram, age, risk factors and troponin) was developed and has been externally validated in an emergency setting to determine which patients with chest pain are at increased risk for poor outcomes. Our hospital adopted a HEART score-based protocol in late 2015 to facilitate the management and disposition of these patients. In this study we aimed to analyze the effects of the adoption of this protocol. Prior studies have included only patients with chest pain. We included both patients with chest pain and patients with only atypical symptoms.Methods: This was a retrospective chart review of two cohorts. We identified ED charts from six-month periods prior to and after adoption of our HEART score-based protocol. Patients in whom an electrocardiogram and troponin were ordered were eligible for inclusion. We analyzed data for patients with typical symptoms (chest pain) and atypical symptoms both together and separately.Results: We identified 1546 charts in the pre-adoption cohort and 1623 in the post-adoption cohort that met criteria. We analyzed the first 900 charts in each group. Discharges from the ED increased (odds ratio [OR[1.56, P<.001), and admissions for cardiac workup decreased (OR 0.46, P <.001). ED length of stay was 17 minutes shorter (P = .01). Stress testing decreased (OR 0.47, P<.001). We estimate a cost savings for our hospital system of over $4.5 million annually. There was no significant difference in inpatient length of stay or catheterization rate. When analyzing typical and atypical patients separately, these results held true.Conclusion: After adoption of a HEART score-based protocol, discharges from the ED increased with a corresponding decrease in admissions for cardiac evaluations as well as cost. These effects were similar in patients presenting without chest pain but with presentations concerning for ACS