Testing for unemployment hysteresis in Turkey: evidence from nonlinear unit root tests

Unemployment rate is one of the most critical indicators of labor market and is generally an important measurement tool to identify the status of the economies of countries. The impact of transitory shocks on unemployment is analyzed via the Natural Unemployment Rate-NAIRU and the Hysteresis Hypothesis. The term hysteresis describes a situation in which transitory shocks have persistent effects. According to hysteresis hypothesis, the cyclical supply shocks lead to structural changes and have a persistent effect on unemployment in the long run. Therefore this causes the natural unemployment rate to go up. Unemployment is an important economic problem for Turkish economy. Finding a solution to the unemployment problem that causes significant economic and social problems is one of the most important fields of work for policymakers. Therefore, it is important to identify the impact of transitory shocks on unemployment in order to develop effective employment policies to solve the unemployment problem. Different from the other studies in literature that made use of linear techniques, the presence of the hysteresis hypothesis for Turkey is analyzed using the nonlinear unit root tests Kapetanios et al. J Econom 112 359-379, (2003) and Kruse Stat Pap 52 71-85, (2011) for the period 1970-2014. The findings indicate that the hysteresis hypothesis is not valid for Turkey

Relationships between dissociation, obsessive beliefs, and self-esteem in juvenile obsessive-compulsive disorder: a case-controlled clinical study

A body of accumulating evidence showed that dissociation, obsessive-beliefs, and poor self-esteem are causally implicated in obsessive-compulsive disorder (OCD) in adult samples. This study aimed at expanding and refining the current evidence in children and adolescents. A total of 41 patients with OCD and 51 healthy individuals, aged between 11 and 17, were included in the study. The Coopersmith Self-Esteem Inventory (CSEI), Adolescent Dissociative Experiences Scale (A-DES), Revised Child Anxiety and Depression Scale - Child Version (RCADS- CV), and Obsessive Beliefs Questionnaire - Child Version (OBQ-CV) were completed by participants. The Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version DSM-5 (K-SADS PL DSM-5) and Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS-C) were further administered among juvenile OCD patients. Specific phobias (39.0%), depressive disorders (22.0%), social phobia (17.1%), and attention deficit hyperactivity disorder (12.2%) were the more prevalent comorbid clinical conditions in the OCD group. A-DES scores were significantly associated with both obsessions and compulsions subscales of the CY-BOCS-C in the clinical group. OCD-afflicted youths had lower levels of general self-esteem than healthy controls (HC). Most and foremost, low general self-esteem and maternal psychopathology significantly contributed to the development and maintenance of juvenile OCD. We found no support for the significant associations of obsessional beliefs with obsessive-compulsive symptoms. Compared to healthy youths, the results suggested that juvenile OCD seems to pursue a different developmental pathway concerning dissociative symptomatology and self-concept

Detection of tooth numbering, frenulum attachment, gingival overgrowth, and gingival inflammation signs on dental photographs using convolutional neural network algorithms: a retrospective study.

Objectives: This study aimed to develop an artificial intelligence (AI) model that can able automatic tooth numbering, frenulum attachments, gingival overgrowth areas, and gingival inflammation signs on intraoral photographs and to evaluate the performance of this model. Method and materials: A total of 654 intraoral photographs were used in the study (n=654). All photographs were reviewed by 3 periodontists, and all teeth, frenulum attachment, gingival overgrowth areas, and gingival inflammation signs on photographs were labeled using the segmentation method in a web-based labeling software. In addition, tooth numbering was carried out according to the FDI system. An AI model was developed with the help of YOLOv5x architecture with labels of 16795 teeth, 2493 frenulum attachments, 1211 gingival overgrowth areas, and 2956 gingival inflammation signs. The confusion matrix system and ROC analysis were used to statistically evaluate the success of the developed model. Results: The sensitivity, precision, F1 score, and AUC for tooth numbering were found as 0.990, 0.784, 0.875, and 0.989; were found as 0.894, 0.775, 0.830, and 0.827 for frenulum attachment; were found as 0.757, 0.675, 0.714, and 0.774 for gingival overgrowth area, and were found as 0.737, 0.823, 0.777, and 0.802 for gingival inflammation sign, respectively. Conclusion: The results of the present study have shown that AI systems can be successfully used to interpret intraoral photographs. These systems have the potential to accelerate the digital transformation in the clinical and academic functioning of dentistry with the automatic determination of anatomical structures and dental conditions from intraoral photographs</p

Management of Priapism: Results of a Nationwide Survey and Comparison with International Guidelines

Objective: The aim of this study is to evaluate current urologic practice regarding the management of priapism in Turkey and compare with international guidelines. Methods: Urologists and urology residents were invited to an online survey consisting of 30 multiple-choice questions on priapism-related clinical practices that were considered most important and relevant to practices by using Google Forms. Results: Total number of responses was 340. Respondents reported that they recorded a detailed patient’s medical history and physical examination findings (n = 340, 100%) and laboratory testing, which includes corporal blood gas analysis (n = 323, 95%). Participants announced that they performed Doppler ultrasound for 1/4 cases (n = 106, 31%), but 22% of the participants (n = 75) replied that they performed in >75% of cases. Participants (n = 311, 91%) responded that the first-line treatment of ischemic priapism is decompression of the corpus cavernosum. Moreover, most respondents (n = 320, 94%) stated that sympathomimetic injection drugs should be applied as the second step. About three-quarters of respondents (n = 247, 73%) indicated adrenaline as their drug of choice. Phosphodiesterase type 5 inhibitors seems to be the most preferred drug for stuttering priapism (n = 141, 41%). Participants (n = 284, 84%) replied that corpora-glanular shunts should be preferred as the first. A large number of participants (n = 239, 70%) declared that magnetic resonance imaging can be performed in cases with delayed (>24 hours) priapism to diagnose corporal necrosis. Most of the participants (84%) responded that penile prosthesis should be preferred to shunts in cases with delayed (>48 hours) priapism. Conclusion: It would be appropriate to improve the training offered by professional associations and to give more training time to the management of priapism during residency

Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study

Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians’ migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants’ migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22–1.54) times more likely to emigrate. The push factor that was related to emigration intention was the “working conditions in the country” (OR: 1.89, 95% CI: 1.56–2.28) whereas the “social environment/lifestyle abroad” was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45–2.06). In addition, the quality problem in medical schools also had a significant impact on students’ decisions (OR: 2.20, 95% CI: 1.83–2.65). Insights: Although the percentage of those who want to emigrate “definitely” was at the same level as in the other developing countries, the tendency to migrate “permanently” was higher in Türkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research