• Title/Summary/Keyword: risk indicators

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The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

Nutritional Status of Continuous Ambulatory Peritoneal Dialysis Patients (지속성복막투석 환자의 영양상태에 관한 연구)

  • Park, Jin-Kyung;Son, Sook-Mee
    • Journal of Nutrition and Health
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    • v.39 no.7
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    • pp.624-640
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    • 2006
  • Dialysis patients are at risk of malnutrition not only because of losses of nutrients during peritoneal dialysis but also because of anorexia that results in inadequate nutrient intakes. The aim of this study was to estimate the nutritional status of 154 patients receiving continuous ambulatory peritoneal dialysis (CAPD), especially focused on protein-energy malnutrition and vitamin and mineral status. The mean age of the subjects was $5.12\;{\pm}\;12.4\;y$ with educational years of $12.3\;{\pm}\;0.4\;y$ for male and $9.6\;{\pm}\;0.4\;y$ for female. The mean duration of dialysis was $22.7\;{\pm}\;21.7\;mo$. The causes of renal failure included diabetes (32.7), chronic glomerulonephritis (15.0%), and hypertension (8.5%). The main complications associated with chronic renal failure were hypertension (86.1%), diabetes (35.4%) and liver disease (9.0%). The mean daily energy intake was $1216.8\;{\pm}\;457.3\;kcal$ and increased to $1509.2\;{\pm}\;457.2\;kcal$ when added with the energy from dextrose in dialysate. The latter was still much lower than estimated energy requirement but energy intake per kg of body weight (28.1 kcal/1 g) was within the range of that recommended for CAPD patients' diet therapy (25 - 30 kcal/kg). The average daily intake of protein was $49.2\;{\pm}\;25.1\;g$ with 37.6% of the patients showing their intakes less than Estimated Average Requirement. The average protein intake per kg of weight was 0.9 g/kg, which is less than that recommended for CAPD patients (1.2-1.5g/kg) with mean serum albumin level $3.2\;{\pm}\;0.5\;g/dl$. The proportion of the patients with dietary calcium intake less than EAR was 90.9%, but when added with supplementary calcium (phosphorus binder), most patients showed their total calcium intake between EAR and UL. Fifty percent of the patients were observed with dietary iron intake less than EAR, however most patients revealed their total iron intake with supplementation above UL. The addition of folic acid with supplementation increased mean total folic intake to $1126.0\;{\pm}\;152.4\;{\mu}g$ and ninety eight percent of the subjects showed their total folic acid intake above UL. The prevalence of anemia was 83.1 % assessed with hemoglobin level, even with high intakes of iron with supplementation. Thirty four percent of the patients showed their fasting blood glucose was not under control $(\geq\;126\;mg/dl)$ even with medication or insulin probably due to dextrose from dialysate. The mean blood lipid levels were within the reference levels of hyperlipidemia, but with 72.1 % of the patients showing lower HDL-C. In conclusion, Fairly large proportion of the patients were observed with protein malnutrition with low intake of protein and serum albumin level. Few patients showed their vitamins and minerals intake less than EAR with supplementation. For iron and folic acid, their intakes were increased to above UL for large proportion of he patients. However, more than eighty percent of the patients were still anemic associated with decreased renal function. The serum blood glucose and lipid level were not under control for some patients with medication. It seems that supplementation and medications that patients are taking should be considered for dietary consulting of CAPD patients.

Optimization of Support Vector Machines for Financial Forecasting (재무예측을 위한 Support Vector Machine의 최적화)

  • Kim, Kyoung-Jae;Ahn, Hyun-Chul
    • Journal of Intelligence and Information Systems
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    • v.17 no.4
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    • pp.241-254
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    • 2011
  • Financial time-series forecasting is one of the most important issues because it is essential for the risk management of financial institutions. Therefore, researchers have tried to forecast financial time-series using various data mining techniques such as regression, artificial neural networks, decision trees, k-nearest neighbor etc. Recently, support vector machines (SVMs) are popularly applied to this research area because they have advantages that they don't require huge training data and have low possibility of overfitting. However, a user must determine several design factors by heuristics in order to use SVM. For example, the selection of appropriate kernel function and its parameters and proper feature subset selection are major design factors of SVM. Other than these factors, the proper selection of instance subset may also improve the forecasting performance of SVM by eliminating irrelevant and distorting training instances. Nonetheless, there have been few studies that have applied instance selection to SVM, especially in the domain of stock market prediction. Instance selection tries to choose proper instance subsets from original training data. It may be considered as a method of knowledge refinement and it maintains the instance-base. This study proposes the novel instance selection algorithm for SVMs. The proposed technique in this study uses genetic algorithm (GA) to optimize instance selection process with parameter optimization simultaneously. We call the model as ISVM (SVM with Instance selection) in this study. Experiments on stock market data are implemented using ISVM. In this study, the GA searches for optimal or near-optimal values of kernel parameters and relevant instances for SVMs. This study needs two sets of parameters in chromosomes in GA setting : The codes for kernel parameters and for instance selection. For the controlling parameters of the GA search, the population size is set at 50 organisms and the value of the crossover rate is set at 0.7 while the mutation rate is 0.1. As the stopping condition, 50 generations are permitted. The application data used in this study consists of technical indicators and the direction of change in the daily Korea stock price index (KOSPI). The total number of samples is 2218 trading days. We separate the whole data into three subsets as training, test, hold-out data set. The number of data in each subset is 1056, 581, 581 respectively. This study compares ISVM to several comparative models including logistic regression (logit), backpropagation neural networks (ANN), nearest neighbor (1-NN), conventional SVM (SVM) and SVM with the optimized parameters (PSVM). In especial, PSVM uses optimized kernel parameters by the genetic algorithm. The experimental results show that ISVM outperforms 1-NN by 15.32%, ANN by 6.89%, Logit and SVM by 5.34%, and PSVM by 4.82% for the holdout data. For ISVM, only 556 data from 1056 original training data are used to produce the result. In addition, the two-sample test for proportions is used to examine whether ISVM significantly outperforms other comparative models. The results indicate that ISVM outperforms ANN and 1-NN at the 1% statistical significance level. In addition, ISVM performs better than Logit, SVM and PSVM at the 5% statistical significance level.

Relevance of Vitamin D and Dyslipidemia Among Korean Adults - Using Data from the Sixth Korea National Health and Nutrition Examination Survey, 2013~2014 (한국 성인의 비타민 D 수준과 이상지질혈증과의 관련성 - 제 6기(2013년, 2014년) 국민건강영양조사 자료를 이용하여)

  • kim, han-soo;Han, Yeo-Jung;Kim, Byung-Cheol;Ryu, So-Yeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.3
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    • pp.647-656
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    • 2017
  • Purpose: This study investigated the relationship between vitamin D level and dyslipidemia in Korean adults aged 19 years and older. The data for analysis were obtained from the sixth Korea National Health Nutrition Examination Survey 2013 and 2014. Result: This study showed that 74.4% of the specified adult population had vitamin D deficiency. Moreover, the prevalence of dyslipidemia was found to be 39.6% in the same population. Dyslipidemia differed significantly according to gender (p<0.001), age (p<0.001), smoking status (p<0.001), subjective health status (p<0.001), BMI (p<0.001), blood pressure (p<0.001), FBS (p<0.001), physical activity (p<0.001), and vitamin D level (p<0.001). When vitamin D deficiency was less than 20.0 ng/mL, there was a significant risk of dyslipidemia with an odds ratio of 1.29 (95% Cl, 1.11-1.51). The relationship between vitamin D level and a diagnosis index of dyslipidemia with controlled status of physical activity was statistically significant; in Korean adults, the odds ratio for total cholesterol was 1.41 (95% CI, 1.04-1.81) and for triglyceride was 1.36 (95% CI, 1.11-1.66). Conclusion: Our results showed the relationship between vitamin D level and dyslipidemia was significant in Korean adults, and total cholesterol and triglycerides, which are indicators of dyslipidemia, was significant. Future studies, such as a more systematic cohort study investigating the relationship between vitamin D level and dyslipidemia may be helpful in confirming the causal relationship between vitamin D and dyslipidemia.

The Effects of Health Promotion Initiatives with Community Participation and Parterships: The Case of Sabong-Myeon in Jinju City (지역사회참여와 파트너쉽에 기반을 둔 지역건강증진사업의 효과: 진주시 사봉면 사례)

  • Jeong, Baekgeun;Kim, Jang-Rak;Kang, Yune-Sik;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.39 no.4
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    • pp.209-221
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    • 2014
  • Objectives: The objective of this study was to identify the effects of area-based health promotion initiatives with community participation and partnerships conducted in Sabong-Myeon, Jinju City for three years. Methods: We used data from the '2008 Sabong-Myeon Health Survey' and the '2011 Health Plus Happiness Plus Community Health Survey'. The study comprised 520 systematically sampled individuals, composed of 300 adults in 2008 and 200 adults in 2011. We compared some health behavior and mental health indicators as well as social capital levels between these two surveys. Results: The prevalences of smoking and walking exercise in 2011 were significantly higher than those in 2008. The prevalences of high risk alcohol consumption in men, stress perception, depressive symptoms experience, and suicide ideation were significantly lower than those in 2008. The proportion of people having a high level of social capital in 2011 was significantly higher than that in 2008, regardless of sex or marital status. However, the difference in the proportion was not statistically significant among people with a high educational background. Conclusions: This study suggested that the 3 years' implementation of area-based health promotion initiatives conducted in Sabong-Myeon might help to improve the mental health and social capital level of this community. The long-term health effects of area-based health promotion initiatives with community participation and partnerships need to be studied further, and lessons from these initiatives can be obtained by adapting proper evaluation methods.

A Study of a Correlation Between Groundwater Level and Precipitation Using Statistical Time Series Analysis by Land Cover Types in Urban Areas (시계열 분석법을 이용한 도시지역 토지피복형태에 따른 지하수위와 강수량의 상관관계 분석)

  • Heo, Junyong;Kim, Taeyong;Park, Hyemin;Ha, Taejung;Kang, Hyungbin;Yang, Minjune
    • Korean Journal of Remote Sensing
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    • v.37 no.6_2
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    • pp.1819-1827
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    • 2021
  • Land-use/cover change caused by rapid urbanization in South Korea is one of the concerns in flood risk management because groundwater recharge by precipitation hardly occurs due to an increase in impermeable surfaces in urban areas. This study investigated the hydrologic effects of land-use/cover on groundwater recharge in the Yeonje-gu district of Busan, South Korea. A statistical time series analysis was conducted with temporal variations of precipitation and groundwater level to estimate lag-time based on correlation coefficients calculated from auto-correlation function (ACF), cross-correlation function (CCF), and moving average (MA) at five sites. Landform and land-use/cover within 250 m radius of the monitoring wells(GW01, GW02, GW03, GW04, and GW05) at five sites were identified by land cover and digital map using Arc-GIS software. Long lag-times (CCF: 42-71 days and MA: 148-161 days) were calculated at the sites covered by mainly impermeable surfaces(GW01, GW03, and GW05) while short lag-times(CCF: 4 days and MA: 67 days) were calculated at GW04 consisting of mainly permeable surfaces. The results suggest that lag-time would be one of the good indicators to evaluate the effects of land-use/cover on estimating groundwater recharge. The results of this study also provide guidance on the application of statistical time series analysis to environmentally important issues on creating an urban green space for natural groundwater recharge from precipitation in the city and developing a management plan for hydrological disaster prevention.

Performance of Investment Strategy using Investor-specific Transaction Information and Machine Learning (투자자별 거래정보와 머신러닝을 활용한 투자전략의 성과)

  • Kim, Kyung Mock;Kim, Sun Woong;Choi, Heung Sik
    • Journal of Intelligence and Information Systems
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    • v.27 no.1
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    • pp.65-82
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    • 2021
  • Stock market investors are generally split into foreign investors, institutional investors, and individual investors. Compared to individual investor groups, professional investor groups such as foreign investors have an advantage in information and financial power and, as a result, foreign investors are known to show good investment performance among market participants. The purpose of this study is to propose an investment strategy that combines investor-specific transaction information and machine learning, and to analyze the portfolio investment performance of the proposed model using actual stock price and investor-specific transaction data. The Korea Exchange offers daily information on the volume of purchase and sale of each investor to securities firms. We developed a data collection program in C# programming language using an API provided by Daishin Securities Cybosplus, and collected 151 out of 200 KOSPI stocks with daily opening price, closing price and investor-specific net purchase data from January 2, 2007 to July 31, 2017. The self-organizing map model is an artificial neural network that performs clustering by unsupervised learning and has been introduced by Teuvo Kohonen since 1984. We implement competition among intra-surface artificial neurons, and all connections are non-recursive artificial neural networks that go from bottom to top. It can also be expanded to multiple layers, although many fault layers are commonly used. Linear functions are used by active functions of artificial nerve cells, and learning rules use Instar rules as well as general competitive learning. The core of the backpropagation model is the model that performs classification by supervised learning as an artificial neural network. We grouped and transformed investor-specific transaction volume data to learn backpropagation models through the self-organizing map model of artificial neural networks. As a result of the estimation of verification data through training, the portfolios were rebalanced monthly. For performance analysis, a passive portfolio was designated and the KOSPI 200 and KOSPI index returns for proxies on market returns were also obtained. Performance analysis was conducted using the equally-weighted portfolio return, compound interest rate, annual return, Maximum Draw Down, standard deviation, and Sharpe Ratio. Buy and hold returns of the top 10 market capitalization stocks are designated as a benchmark. Buy and hold strategy is the best strategy under the efficient market hypothesis. The prediction rate of learning data using backpropagation model was significantly high at 96.61%, while the prediction rate of verification data was also relatively high in the results of the 57.1% verification data. The performance evaluation of self-organizing map grouping can be determined as a result of a backpropagation model. This is because if the grouping results of the self-organizing map model had been poor, the learning results of the backpropagation model would have been poor. In this way, the performance assessment of machine learning is judged to be better learned than previous studies. Our portfolio doubled the return on the benchmark and performed better than the market returns on the KOSPI and KOSPI 200 indexes. In contrast to the benchmark, the MDD and standard deviation for portfolio risk indicators also showed better results. The Sharpe Ratio performed higher than benchmarks and stock market indexes. Through this, we presented the direction of portfolio composition program using machine learning and investor-specific transaction information and showed that it can be used to develop programs for real stock investment. The return is the result of monthly portfolio composition and asset rebalancing to the same proportion. Better outcomes are predicted when forming a monthly portfolio if the system is enforced by rebalancing the suggested stocks continuously without selling and re-buying it. Therefore, real transactions appear to be relevant.

Association between dietary protein intake and overweight and obesity among Korean children and adolescents: data from the 2014-2019 Korea National Health and Nutrition Examination Survey (한국 아동 및 청소년의 단백질 섭취와 과체중 및 비만과의 연관성: 2014-2019년 국민건강영양조사 자료를 활용하여)

  • Sumin Kim;Kyungho Ha
    • Journal of Nutrition and Health
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    • v.56 no.1
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    • pp.54-69
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    • 2023
  • Purpose: Proteins are major components of the body and essential nutrients for proper growth and development. However, studies on protein intake in children and adolescents are insufficient. A few previous studies have reported the relationship with growth indicators, but results vary depending on the source of protein. Therefore, the current study investigates the relationship between protein intake and overweight and obesity among children and adolescents in Korea. Methods: Based on the 2014-2019 Korea National Health and Nutrition Examination Survey, 5,567 children and adolescents aged 6-18 years, who participated in a 24-hour dietary recall with information on height and weight, were included in this study. Protein intake was estimated as percentage of total energy (% of energy) and was classified into animal and plant protein according to the food source. Overweight and obesity were defined using the 2017 pediatric and adolescent growth chart. Results: Total protein intake of the subjects was estimated as 14.5% of total energy (animal protein 8.3% and plant protein 6.3%). The group with the highest total protein intake had a higher odds ratio (OR) of overweight/obesity than those with the least protein intake (OR, 1.36, 95% confidence interval (CI), 1.10-1.67, p for trend = 0.003). When classified by food source, the group with the highest animal protein intake had a significantly higher OR of overweight/obesity than subjects with the lowest intake (OR, 1.30, 95% CI, 1.05-1.61, p for trend = 0.016). However, plant protein was not significantly associated with overweight/obesity. Conclusions: These findings suggest that a high intake of animal protein in children and adolescents increases the risk of being overweight and obese. In order to develop normal growth and prevent obesity in the future, it is necessary to determine an appropriate protein intake level through nutrition education programs and prospective studies on balanced protein intake.

Relationships of Peripheral Inflammatory Marker With Suicide Attempt History (자살시도력과 말초혈액의 염증 지표 간의 연관성)

  • Su-Hyun Oh;Seung-Jun Kim;Sang-Ho Shin;Hong-Seok Oh;Jae-Chang Lee;Woo-Young Im;Na-Hyun Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.165-172
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    • 2023
  • Objectives : The purpose of this study is to determine whether there is a significant difference in the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio according to the history of suicide attempt in patients with psychiatric diseases. Methods : A medical record review was conducted on patients who had been hospitalized in Konyang University Hospital since 2021-03-01 to 2023-02-28 to collect demographic and clinical characteristics. T-test for continuous variables and Chi-square test for categorical variables were performed to determine demographic differences according to the history of suicide attempt, and the ANCOVA test was performed to compare the average value of peripheral inflammatory marker according to the history of suicide attempt with gender and age as covariates. One-way variance analysis was performed to determine whether the number of suicide attempt causes significant difference of the peripheral inflammatory marker. Results : The final analysis target of this study was 266 patients, 101 had history of suicide attempt, and 165 had no history of suicide attempt. The neutrophil-to-lymphocyte ratio (p<0.001) and platelet-to-lymphocyte ratio (p<0.001) were higher in patients with the history of suicide attempt than patients without the history of suicide attempt, but the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were not significantly increased depending on the serial increase of number of suicide attempts. Conclusions : This study suggests that peripheral inflammatory markers are meaningful and easily accessible indicators for predicting the risk of suicide attempt in psychiatric patients. We expect that prospective follow-up study will be conducted with more subjects and controlled potential confounding variables.

A Study on Industries's Leading at the Stock Market in Korea - Gradual Diffusion of Information and Cross-Asset Return Predictability- (산업의 주식시장 선행성에 관한 실증분석 - 자산간 수익률 예측 가능성 -)

  • Kim Jong-Kwon
    • Proceedings of the Safety Management and Science Conference
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    • 2004.11a
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    • pp.355-380
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    • 2004
  • I test the hypothesis that the gradual diffusion of information across asset markets leads to cross-asset return predictability in Korea. Using thirty-six industry portfolios and the broad market index as our test assets, I establish several key results. First, a number of industries such as semiconductor, electronics, metal, and petroleum lead the stock market by up to one month. In contrast, the market, which is widely followed, only leads a few industries. Importantly, an industry's ability to lead the market is correlated with its propensity to forecast various indicators of economic activity such as industrial production growth. Consistent with our hypothesis, these findings indicate that the market reacts with a delay to information in industry returns about its fundamentals because information diffuses only gradually across asset markets. Traditional theories of asset pricing assume that investors have unlimited information-processing capacity. However, this assumption does not hold for many traders, even the most sophisticated ones. Many economists recognize that investors are better characterized as being only boundedly rational(see Shiller(2000), Sims(2201)). Even from casual observation, few traders can pay attention to all sources of information much less understand their impact on the prices of assets that they trade. Indeed, a large literature in psychology documents the extent to which even attention is a precious cognitive resource(see, eg., Kahneman(1973), Nisbett and Ross(1980), Fiske and Taylor(1991)). A number of papers have explored the implications of limited information- processing capacity for asset prices. I will review this literature in Section II. For instance, Merton(1987) develops a static model of multiple stocks in which investors only have information about a limited number of stocks and only trade those that they have information about. Related models of limited market participation include brennan(1975) and Allen and Gale(1994). As a result, stocks that are less recognized by investors have a smaller investor base(neglected stocks) and trade at a greater discount because of limited risk sharing. More recently, Hong and Stein(1999) develop a dynamic model of a single asset in which information gradually diffuses across the investment public and investors are unable to perform the rational expectations trick of extracting information from prices. Hong and Stein(1999). My hypothesis is that the gradual diffusion of information across asset markets leads to cross-asset return predictability. This hypothesis relies on two key assumptions. The first is that valuable information that originates in one asset reaches investors in other markets only with a lag, i.e. news travels slowly across markets. The second assumption is that because of limited information-processing capacity, many (though not necessarily all) investors may not pay attention or be able to extract the information from the asset prices of markets that they do not participate in. These two assumptions taken together leads to cross-asset return predictability. My hypothesis would appear to be a very plausible one for a few reasons. To begin with, as pointed out by Merton(1987) and the subsequent literature on segmented markets and limited market participation, few investors trade all assets. Put another way, limited participation is a pervasive feature of financial markets. Indeed, even among equity money managers, there is specialization along industries such as sector or market timing funds. Some reasons for this limited market participation include tax, regulatory or liquidity constraints. More plausibly, investors have to specialize because they have their hands full trying to understand the markets that they do participate in

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