Inconclusive Evidence Research Articles

Assessing corporate climate action: Corporate climate policies and company-level emission reductions

Private investment decisions are expected to play a decisive role in redirecting capital flows in line with the Paris Agreement. The financial sector and policymakers have emphasized the role of corporate climate action and climate-related disclosure, including backward-looking emissions figures and forward-looking information on corporate climate policies to enable investors to reallocate capital to firms with promising emission reduction pathways. However, there is at best inconclusive evidence on the relationship between corporate climate policies and subsequent company-level emission reductions. Previous research was limited by small sample sizes and short observation periods, impeding the analysis of time-lagged effects or the inclusion of company-level fixed effects. To overcome these shortcomings, we draw on a new dataset with 17,198 observations from 1,749 companies that disclosed their corporate climate policies between 2010 and 2022. While our results show only a weak link between individual policies and company-level emissions, we find some evidence for an improved climate performance for absolute emissions for companies that introduced a comprehensive corporate climate policy mix. This is in line with public policy research that has found comprehensiveness to be an important dimension for public policy mixes and emphasizes the role of a mix of corporate climate policies rather than relying on individual measures.

Birthing positions and mother`s satisfaction with childbirth: a cross-sectional study on the relevance of self determination.

Considering the inconclusive evidence regarding the clinical benefits of specific birthing positions, emphasis has been placed on adhering to women's preferences during the second stage of labour. Therefore, the present study aimed to assess the association between birthing position, the freedom to choose a birth position during the second stage of labour, and women's subjective satisfaction with childbirth. We performed a cross-sectional survey of women 8 or 12months after a vaginal birth in a hospital. The women were recruited via two cooperating health insurance companies. Multivariate analyses were conducted to assess the strength of the association between birthing position and maternal satisfaction with childbirth, with a particular focus on interactions with self-determination. In total, the data from 761 women were analysed. The supine position was the most frequently reported birthing position in the second stage of labour at 77.5%. Notably, 39.0% and 30.5% of the women who gave birth in the dorsal and lateral supine positions, respectively, stated that the birth position was not chosen voluntarily. The regression models show a significant negative association between supine birthing position and satisfaction with childbirth, which is significantly related to self-determination. The most common reason for the adoption of a specific birthing position was instructions from medical staff. The data provide insight into the perceived satisfaction with childbirth depending on the birthing position, whereby the relevance of self-determination is particularly evident. At the same time, self-determination is often not given, which is associated with reduced birth satisfaction.

Health outcomes reported by healthcare providers and clients of a community-based medically tailored meal program

BackgroundMedically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA).MethodsClients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients’ body mass index, systolic blood pressure, and hemoglobin A1C. These health outcomes, measured at program intake and 3–6 months later, were linked with administrative data for 1,959 clients who completed at least two months of MTM services in 2020, 2021, and 2022.ResultsClients exhibited substantial heterogeneity in demographics and health status at intake. Self-reported malnutrition risk decreased significantly over program duration (p < .001). Nearly one-third of clients with poor health reported improvement over time. Over 60% of clients with obesity experienced stable BMI. Clients with hypertension experienced significant improvements in systolic blood pressure (p < .001). Clients with diabetes and available data (n = 45) demonstrated significant reduction in hemoglobin A1C (p = .005).ConclusionWe found evidence that participation in MANNA’s MTM program was associated with favorable health outcomes for clients with serious illness and nutritional risk. Community-based organizations can maximize the completeness of their data by focusing on routinely collected internal data like validated health screeners and surveys.

Analysing the influence of digital strategy and innovation on MSMEs' performance in emerging countries

Drawing on the technology–organization–environment (TOE) framework, the diffusion of innovation (DOI) theory and the technology acceptance model (TAM), this research analyses how digital strategic orientation has a direct influence on the performance of micro, small and medium‐sized enterprises (MSMEs) in emerging markets and an indirect influence mediated by innovation. Using a representative sample of Peruvian MSMEs, we shed light on the sometimes inconclusive evidence on why small business struggle to benefit from digitalization, a particularly key issue in emerging economies. The structural equation model used shows that the impact of digitalization on firm performance is significant, as is the mediating effect of innovation. Our results imply that the total effect of digitalization on performance will be greater if the MSMEs develop innovative activities. Furthermore, we show that the performance effect requires not only digital technology but also the involvement of the entire organization.

The management of isolated meniscal tears in skeletally immature children. An international expert consensus.

The prevalence and appreciation of meniscal tears in children have increased in both number and complexity. There is currently a paucity of high-quality evidence that can guide surgeons in treating skeletally immature patients with meniscal injuries. The aim of this study was to develop comprehensive recommendations for the management of isolated meniscal tears in skeletally immature children. An international, two-round, modified Delphi consensus was completed. Included 'experts' were identified as having an established adult knee practice, including children and either: (1) Faculty at an international paediatric knee conference, (2) Active members of complex national paediatric multi-disciplinary groups or (3) Members of faculty on recognised national/international instructional courses aimed at teaching the management of meniscal lesions to knee surgeons. The currently available literature was reviewed, and areas of poor quality, inconclusive or absent evidence were examined and formed the focus of the study. A threshold of 70% was used to define consensus for our study based on other similar Delphi consensus studies in the literature. A total of 43 experts (Round 1) and 41 experts (Round 2) took part in the Delphi study, including surgeons from Europe, the United States of America and South America. 34 statements were identified exploring three main domains-clinical assessment, management and complex tears (bucket handle, discoid and radial). Following Round 1, consensus was reached on 17 (50%) statements; subsequently, after completion of Round 2, consensus was reached on 28 (82%) statements, leaving six (18%) with no consensus. The areas of no consensus included investigation of painless clicking, the most sensitive clinical test for meniscal pathology, treatment of small radial tears (less than 1/3 width), ability to reduce chronic bucket handle tears and timing of surgery. This is the first modified Delphi consensus that provides evidence for surgeons treating skeletally immature children with isolated meniscal tears. A valuable level of consensus was reached on the assessment and management of simple and specialist meniscal tears. These consensus statements can both inform clinical practice and be used in the development of further high-quality research studies. Level V.

Divine foreknowledge, evidence and epistemic responsibility

AbstractIn several recent publications, John Martin Fischer proposed a new solution to the problem of divine foreknowledge, which he dubbed the bootstrapping view. On this view, God can have limited knowledge of contingent future based on a combination of (a) God's knowledge of inconclusive evidence about the contingent world available to humans and (b) divine self‐knowledge and more specifically God's knowledge of His essential infallibility. On the basis of the former, God obtains knowledge about contingent future, and by virtue of the latter, God bootstraps this knowledge to certainty. Fischer acknowledges that the mechanism of bootstrapping remains opaque to us, but maintains that his view offers a consistent model of God's limited foreknowledge of contingent future in an indeterministic world. The essay examines the bootstrapping view and some problems it gives rise to, as well as presents a related model of divine foreknowledge that is consistent and simpler and gives God comprehensive foreknowledge.

Vitamin B12 Intake and Cancer Risk: Findings from a Case-Control Study in Vietnam

There is inconclusive evidence on the role of dietary intake of vitamin B12 in cancer. We evaluated the association between vitamin B12 intake and cancer risk in a hospital-based case-control study, comprising 3,758 cancer cases and 2,995 controls in Vietnam. Vitamin B12 intake was derived from the validated food frequency questionnaire. Unconditional logistic regression model was used to calculate the odds ratios (ORs), and respective 95% confidence intervals (CIs) for the association between vitamin B12 and cancer risk. There was a U-shaped association between vitamin B12 intake and overall risk of cancer. Individuals with intakes lower than the median intake had a 6% (OR = 1.06, 95% CI: 0.86–1.31)-107% (OR = 2.07, 95% CI: 1.58–2.71), increased risk of cancer (Ptrend <0.001), whereas those with higher intakes than the median intake had a 20% (OR = 1.20, 95% CI: 0.97–1.48)-52% (OR = 1.52, 95% CI: 1.22–1.89) increased risk of cancer (Ptrend <0.04). The excess risk of cancer associated with low intakes of vitamin B12 was observed among esophageal, lung, and breast cancer patients, whereas with high intakes of vitamin B12 among gastric cancer patients. In summary, a U-shaped association between vitamin B12 intake and increased cancer risk was observed in the Vietnamese population.

Role of vitamin D in prevention of type 2 diabetes mellitus: A systematic review and meta‑analysis.

The escalating prevalence of diabetes mellitus, projected to affect over 700 million by 2045, underscores the urgent need for effective management and prevention strategies, with type 2 diabetes mellitus (T2DM) constituting over 90% of these cases globally. The present meta-analysis aims to rigorously evaluate the potential of vitamin D supplementation in mitigating the onset of T2DM, amidst the backdrop of its biological plausibility yet inconclusive evidence regarding its efficacy in reducing new incidences of the disease. A comprehensive literature search up to December 2023 in MEDLINE, EMBASE and the Cochrane Library, employing a strategy focused on diabetes and vitamin D, identified randomized controlled trials (RCTs) that explore the impact of vitamin D supplementation on T2DM onset in adults with impaired glucose regulation, incorporating quality assessment via the Cochrane ROB2 tool and utilizing meta-analysis with RevMan Web to evaluate effect magnitude and heterogeneity. In a meta-analysis of 11 RCTs with 5,221 prediabetic patients, vitamin D supplementation was associated with a 10% reduction in the progression to T2DM [RR, 0.90; 95% CI, (0.81-0.99)] and a significant increase in regression to normoglycemia [RR, 1.24; 95% CI, (1.08-1.43)], with no significant heterogeneity or publication bias observed. This meta-analysis of 11 RCTs shows that vitamin D supplementation in prediabetic patients lowers the risk of T2DM and promotes regression to normoglycemia, with no significant differences in subgroup analyses or interaction with baseline vitamin D levels, ethnicity, or body mass index (BMI). Despite indications from some trials that baseline vitamin D status may influence outcomes, the present comprehensive analysis found benefits of vitamin D across diverse populations, including non-obese individuals, without conclusive evidence linking supplementation to changes in BMI or age-specific advantages.

Sensory impairments associated with cognitive impairment among older adults in China: A community-based, 10-year prospective cohort study.

To address an existing gap in knowledge due to limited and inconclusive evidence, we aimed to investigate the association between sensory impairments and cognitive decline among older Chinese individuals. We retrieved data on 6862 adults aged ≥65 years that were collected through the Chinese Longitudinal Healthy Longevity Study (CLHLS), a nationwide, prospective, community-based elderly cohort study. Visual or hearing impairment in the CLHLS were identified through self-reported questionnaire. Sensory impairments were categorised as no sensory impairment, hearing impairment only, visual impairment only, and dual sensory impairment according to hearing and vision function. Cognitive impairment was defined as having a score <18 on the Chinese version of the Mini Mental State Examination. We used a Cox proportional hazard model to evaluate the relationship between sensory and cognitive impairments. Among 6862 participants, 5.7% had dual sensory impairment, 7.4% had hearing impairment only, and had 17.2% visual impairment only. Compared with participants with no sensory impairment, those with hearing impairment only (adjusted hazard ratio (aHR) = 1.65; 95% confidence interval (CI) = 1.41, 1.92), visual impairment only (aHR = 1.25; 95% CI = 1.11, 1.41), and dual sensory impairment (aHR = 1.47; 95% CI = 1.25, 1.74) were significantly associated with higher risk of cognitive impairment in the fully adjusted model. Our results show that having hearing impairment only, visual impairment only, and dual sensory impairment was significantly associated with a higher risk of cognitive impairment among Chinese older adults aged ≥65 years. This suggest a need for the timely identification and management of sensory impairments for the elderly to reduce dementia risk.

Forecasting U.S. Stock Returns Conditional on Geopolitical Risk and Business Cycles

Using standard predictors in the forecasting literature, we forecast the U.S. stock market returns conditional on geopolitical risk and business cycles over the 1927–2021 period. We find that out-of-sample forecasting performance is significantly better in times of high geopolitical risk versus low geopolitical risk. Consistent with previous research, we find further evidence of improved return predictability in recessions. However, we find little difference in forecasting performance in recessions versus expansions once the level of geopolitical risk is controlled for. We find similar results when using stock market cycles and periods of positive/negative industrial production growth in place of recessions/expansions. Our study contributes to the forecasting literature by documenting that geopolitical risk by itself and in combination with business cycle indicators impacts the forecasting ability of standard forecasting variables in the literature. We also contribute to the literature on the adaptive markets hypothesis with evidence of time-varying return predictability. We find inconclusive evidence as to whether our results are based on time-varying predictability or time-varying risk.

Prognostic Factors and Changes in Pain, Physical Functioning, and Participation in Patients With Hip and/or Knee Osteoarthritis: A Systematic Review.

This study aimed to systematically synthesize literature on prognostic factors of changes in either direction (ie, worsening or improvement) in pain, physical functioning, and participation in patients with knee and/or hip osteoarthritis (OA). Studies included in two preceding reviews underwent full-text screening for inclusion in the current review. Additionally, an extensive literature search was conducted in five databases. Title/abstract screening was performed using an active learning program. Inclusion criteria comprised patients diagnosed with knee and/or hip OA, with the dependent variable assessing pain, physical functioning, or participation. Potential associated prognostic factors were measured as independent variables. The methodologic quality of studies was assessed with the Hayden criteria. A total of 31 studies were included in this systematic review. In patients with knee OA, pain worsening was associated with lower physical functioning (strong evidence) and with higher body mass index, ethnicity, and a higher comorbidity count (moderate evidence). Also, in patients with knee OA, pain improvement was associated with less pain at baseline (moderate evidence). In patients with knee and/or hip OA, worsening of physical functioning exhibited associations with higher body mass index, more pain, more hip pain, a higher comorbidity count, higher avoidance of activities (strong evidence), and ethnicity (moderate evidence). In patients with knee OA, improvement in physical functioning showed an association with higher vitality (moderate evidence). Regarding the remaining prognostic factors, there is weak, inconclusive, or inconsistent evidence for an association with the outcomes. In patients with hip OA, only weak evidence was found for three factors predicting a change in physical functioning. This review encompasses prognostic factors associated with changes in either direction (ie, worsening or improvement) in pain, physical functioning, and participation. The results are consistent with other reviews. Future research should place a stronger emphasis on patients with hip OA and participation as an outcome.

HPV and Lung Cancer: A Systematic Review

This systematic review aims to explore the diagnostic criteria, epidemiology, etiology, and prognosis of Human Papillomavirus (HPV) infection in lung cancer. This PRISMA-guided review searched the PubMed® and EmbaseTM databases for “lung cancer AND HPV” on 10 June 2023, filtering human subject papers. A total of 97 studies encompassing 9098 patients worldwide, revealing varied HPV infection rates in lung cancer, ranging from 0% to 69%, were analyzed. While HPV16/18 was predominant in some regions, its association with lung cancer remained inconclusive due to conflicting findings. Studies from Asia reported lower HPV infection rates compared to Western populations. Some studies suggested a limited role of HPV in lung carcinogenesis, particularly in non-smokers. However, intriguing associations were noted, including HPV’s potential role in lung adenocarcinoma and squamous cell carcinoma. Discrepancies in HPV detection methods and sample sources highlight the need for further research with standardized methodologies to elucidate HPV’s role in lung carcinogenesis and its clinical implications. Overall, this systematic review offers insights into HPV’s role in lung cancer epidemiology and clinical characteristics. Despite inconclusive evidence, intriguing associations between HPV and lung adenocarcinoma and squamous cell carcinoma have emerged. Further research with standardized methodologies and larger cohorts is needed for clarity.

Diet quality indices are associated with breast cancer by molecular subtypes in Mexican women.

Inconclusive epidemiological evidence suggests that diet quality indices may influence breast cancer (BC) risk; however, the evidence does not consider the molecular expression of this cancer. We aimed to evaluate if diet quality is related to molecular subtypes of BC, in women residing in Northern Mexico. This is a secondary analysis of 1,045 incident cases and 1,030 population controls from a previous case-control study, conducted between 2007 and 2011 in Northern Mexico. Information about the expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) was obtained from medical records to classify BC as luminal (ER + and/or PR+/HER2-), HER2+ (ER+/-and/or PR+/-/HER2+), or triple-negative (TN) (ER- and PR-/HER2-) cases. Food consumption was assessed with a semi-quantitative food frequency questionnaire. Diet quality was evaluated using the Mexican Diet Quality Index (MxDQI) and the Mexican Alternative Healthy Eating Index (MxAHEI). We used unconditional logistic regression models to estimate the association between Mexican diet quality indices and BC molecular subtypes. The MxDQI was related to lower odds of BC (ORT3vsT1=0.24; 95%CI: 0.18, 0.31). Similarly, MxAHEI was negatively associated with BC (ORT3vsT1=0.43; 95%CI: 0.34, 0.54). The associations of both indices remained significant in the ER + and ER- tumors, and in the BC luminal and HER2 + molecular subtypes, except in the TN molecular subtype for MxAHEI, which was not statistically significant. Our findings showed that MxDQI and MxAHEI were negatively associated with BC risk regardless of its molecular subtype.

Iatrogenic atrial septal defects in structural heart interventions: Opening the Pandora's box

AbstractIn the modern era of structural heart interventions, the total number of transseptal procedures is growing exponentially, thus increasing the rate and need for management of iatrogenic atrial septal defects (iASDs). To date, there are no official guidelines on the assessment and management of iASDs, due to inconclusive evidence on whether patients benefit more from the percutaneous closure of iASD than from conservative management and vigorous follow‐up. Despite the abundance of observational studies on iASDs, there is still a lack of randomized studies. Evidence so far show that percutaneous closure is no superior over conservative treatment in patients with iASDs, however, it has been demonstrated that patients with spontaneous closure of iASDs experience less heart failure (HF) hospitalizations. On the other hand, researchers have investigated the beneficial nature of interatrial shunt therapy in patients with HFpEF and, more recently, with HFrEF, due to the presumed hemodynamic benefits. Herein, we provide an updated review of relevant literature, focusing on iASD persistence rates, predicting factors for their persistence, and clinical outcomes of iASD persistence, to summarize available evidence and discuss future directions in the field.

Financial incentives to increase engagement across the hepatitis C care cascade among people at risk of or diagnosed with hepatitis C: A systematic review

BackgroundReversing declining rates of people initiating and completing hepatitis C (HCV) treatment, observed in many countries, is needed to achieve global HCV elimination goals. Providing financial incentives to increase HCV testing and treatment uptake among people at-risk of or living with HCV infection could be an effective intervention. We conducted a systematic review to assess evidence regarding the effectiveness of financial incentives to improve engagement and progression through the HCV care cascade. MethodsWe searched MEDLINE, PubMed and EMBASE for studies published from January 2013 to January 2023 that evaluated financial incentives offered to people living with and at-risk of HCV to increase HCV antibody and or RNA testing, linkage to care, treatment initiation, treatment adherence, treatment completion, and sustained viral load (SVR) testing. Open-label randomised controlled trials (RCTs), controlled non-randomised studies, cohort or observation studies and mixed-methods studies were included, whereas literature reviews, case series and studies which did not report data were excluded. ResultsWe identified 1,278 studies, with 21 included after full-text screening (14,913 participants); three randomised controlled trials and 18 non-randomised studies. Studies evaluated incentives aimed at improving test uptake (n = 11), engagement in care (n = 13), treatment initiation (n = 8), adherence (n = 3), completion (n = 3) and attainment of SVR (n = 5). Findings provided inconclusive evidence for the effectiveness of incentives in improving engagement in the HCV cascade of care. Determining incentive effectiveness to improve care cascade engagement was limited by low quality study designs, heterogeneity in type (cash or voucher), value (US$5 to $600) and cascade stage being incentivised. No randomised controlled trials assessed the effectiveness of incentives to promote HCV testing, and none showed an impact on treatment uptake. In non-randomised studies (observational comparative), some evidence suggested that incentives promoted HCV testing, but evidence of their role in promoting linkage to care, HCV treatment adherence and treatment completion were mixed. ConclusionCurrently, there lacks high-quality evidence evaluating whether financial incentives improve HCV testing and treatment outcomes. Future research should seek to standardise methodologies, compare incentive types and values to enhance engagement in HCV care, and determine factors that support incentives effectiveness.

Assessment of the Correlation Between Types of Orbital Fractures and Ocular Symptoms, and the Effect of Manual Preformed and Patient-Specific Mesh Implants: A Retrospective Study.

Although certain orbital fractures are associated with specific clinical symptoms, these relationships should be reviewed comprehensively. The optimal choice between manual preformed mesh implants (MPIs) and patient-specific mesh implants (PSIs) for orbital reconstruction remains undetermined due to inconclusive evidence regarding their effectiveness. This retrospective study investigated 280 patients with unilateral orbital fractures to explore the correlation between clinical ocular symptoms, including diplopia, enophthalmos, limitation of ocular movement, blindness, and the specific type of orbital fracture. The effects on orbital volume (OV) and orbital volume ratio (OVR) of MPI and PSI with and without the use of navigation were also evaluated in this study. Patients were categorized into 4 groups: MPI, PSI, navigation-assisted MPI, and navigation-assisted PSI. After this categorization, alterations in OV and OVR were analyzed before and after surgical intervention. Significant correlations were observed between the orbital fracture type and diplopia, enophthalmos, and limitation of ocular movement (P < 0.05). Patients in the MPI group exhibited a notable difference in the postoperative OV between the injured and normal sides (P < 0.05), but no statistically significant difference was found in the postoperative OV between the injured and normal sides among the patients in the other 3 groups (P > 0.05). Moreover, the MPI group demonstrated significantly higher postoperative OVR than the other groups (P < 0.05). Notably, PSI remained effective with or without navigation, MPI combined with navigation technology achieved a reconstruction quality similar to that of PSI by rectifying positioning errors during surgery. The authors found significant correlations (P < 0.05) between orbital fracture type and diplopia, enophthalmos, and limitations of ocular movement. Patient-specific mesh implant plays an important role in orbital reconstruction. It is also a good method for reconstructing orbital fractures using MPI assisted by navigation technology.

B - 115 How Training Conditions Impact Performance on a Theoretically-Derived Learning Instrument

Abstract Objective Few neuropsychological measures were developed using an explicit theory that accounts for individual performance. We developed a novel associative learning measure to address this limitation and investigated whether training conditions could influence accuracy and response time. Methods Fifty young, community-dwelling adult participants completed the novel relational learning task, which explicitly trained two stimulus pairs (A- &amp;gt; B, A- &amp;gt; C) and involved a single common stimulus. Participants identify six unique relationships between stimuli: trained relations (A- &amp;gt; B, A- &amp;gt; C), mutually entailed relations (B- &amp;gt; A, C- &amp;gt; A), and combinatorial relations (B- &amp;gt; C, C- &amp;gt; B). Participants were randomly assigned to a congruent (A is opposite B, A is opposite C) or incongruent (A is opposite B, B is the same as C) training condition and completed the procedure when stimuli were observably (e.g., color-coded shapes) or arbitrarily related (e.g., letters). Results Comparisons of accuracy between training conditions using Bayesian independent samples t-tests found moderate evidence of no reliable difference between training groups when stimuli were observably related (BF01 = 3.4, δ = 0.06) and arbitrarily related (BF01 = 3.5, δ = 0.03). Comparisons of response time found strong evidence that participants took longer to identify relations when receiving incongruent training when the stimuli were visually related (BF10 = 38.8, δ = 0.9) but inconclusive evidence when the stimuli were arbitrarily related (BF10 = 1.5, δ = 0.49) (See Table 1). Conclusion These findings suggest that manipulating training conditions does not appreciably impact the ability to identify relationships between stimuli accurately. However, training appears to increase the response time needed to identify visibly related stimuli accurately. While this is a promising theoretically-derived learning paradigm, further research is required for validation in clinical practice.

ESG pay and corporate social irresponsibility: Does culture matter?

AbstractDespite the detrimental consequences of corporate social irresponsibility (CSiR), the role of monitoring and incentive‐based corporate governance (CG) mechanisms in mitigating stakeholder mismanagement has been largely neglected in the literature. At the same time, there has been growing interest in holding executives accountable for environmental, social, and governance (ESG) performance by linking their compensation to related targets. However, prior research provides scant and inconclusive evidence on the effectiveness of ESG pay in curbing CSiR. This study addresses these shortcomings and contributes to the emerging CSiR/CG literature by harnessing an institution‐based view on executive compensation. Specifically, it recognizes national culture as the “missing determinant” in comparative CG studies and investigates the culturally‐driven boundary conditions for the relationship between ESG pay and CSiR. The hypotheses were tested on a data set of 4066 firms from 56 countries during 2010–2020. The analysis supports a negative, though modest, effect of ESG pay on CSiR. Furthermore, the study shows that this relationship varies in statistical and economic significance across cultural contexts. Particularly, incentives prove effective for firms headquartered in nations characterized by low power distance, individualism, low uncertainty avoidance, and masculinity. Conversely, in other settings, compensation linked to ESG may either lack motivational impact or even yield counterproductive outcomes. These findings have implications for both the CSiR and CG literature, as well as for practice.

China in global digital trade governance: towards a development-oriented agenda?

Abstract Existing literature on the behaviour of rising powers in global trade governance has yielded inconclusive evidence about their role and impact. This article contributes to this literature by examining China's role in global digital trade governance, an issue area which so far has not received sufficient scholarly attention. Specifically, it addresses the following question: as a self-proclaimed leader of the developing world in digital development, to what extent do its preferences and negotiation approach align with the interests of other developing countries? Analysing China's participation in three sets of negotiations using process tracing, the article argues that China's dual identity both as a self-identified developing country and as a rising power has contributed to its strategic ambivalence. In principle China supports a development-oriented approach to digital trade governance, calling attention to issues such as the digital divide and preserving developing countries' policy space on data localization consistent with its domestic regulatory approaches. Yet China's interest in promoting Chinese technology firms' global expansion leads to increasing divergence with other developing countries on issues such as the e-commerce customs duty moratorium and the global taxation of digital firms, paradoxically increasing its interest alignment with developed countries and limiting its support for fundamental reforms.

Association between pregnancy intention and completion of newborn and infant continuum of care in Sub-Saharan Africa: systematic review and meta-analysis

BackgroundThe newborn and infant continuum of care such as essential newborn care, early initiation and exclusive breastfeeding, and immunisation are highly recommended for improving the quality of life and survival of infants. However, newborn and infant mortality remains high across Sub-Saharan African countries. While unintended pregnancies are associated with adverse newborn and infant health outcomes, there is inconclusive evidence on whether pregnancy intention influences newborn and infant continuum of care completion. Therefore, this review aimed to pool findings reported in the literature on the association between pregnancy intention and newborn and infant health care across the continuum of care in Sub-Saharan Africa.MethodsWe searched MEDLINE Complete, EMBASE, CINAHL Complete, and Global Health databases for studies potentially eligible for this systematic review and meta-analysis. Two researchers independently screened the identified articles by abstract and title, and then full-text using Covidence. We used the Newcastle–Ottawa Scale to assess the quality of the included studies. The Cochran’s Q test and I2 were executed to detect and quantify the presence of statistical heterogeneity in the studies. Meta-analysis was done for each outcome when more than one original study reported relevant data, using Stata statistical software version 18.ResultsEleven studies were included from a total of 235 articles identified by the search. The odds of completing essential newborn care (pooled odds ratio: 3.04, 95% CI: 1.56, 5.90), early initiation of breastfeeding (pooled odds ratio: 1.30, 95% CI: 1.13, 1.52), exclusive breastfeeding (pooled odds ratio: 2.21, 95% CI: 1.68, 2.89), and being fully immunised (pooled odds ratio: 2.73, 95% CI: 1.16, 6.40) were higher among infants born to women with intended pregnancies as compared to women with unintended pregnancies.ConclusionIntended pregnancy was positively associated with essential newborn care completion, early initiation and exclusive breastfeeding, and full immunisation of infants in SSA countries. Thus, policy-makers and stakeholders should strengthen the provision of quality family planning services to prevent unintended pregnancy. Furthermore, follow-up of women with unintended pregnancies is needed to increase women’s opportunity to access essential newborn health care services that further reduce the risk of newborn and infant morbidity and mortality.Systematic review registrationPROSPERO registration number CRD42023409148.