Financial Innovation Research Articles

Nexus between corporate governance and FinTech disclosure: a comparative study between conventional and Islamic banks

Purpose This study investigates the impact of corporate governance on FinTech disclosure levels in Jordanian conventional and Islamic banks. It aims to determine whether governance mechanisms affect disclosure practices in the FinTech sector, exploring the interplay between governance and transparency in financial innovations. Design/methodology/approach The research methodology entails a thorough analysis of data from all 15 Jordanian conventional and Islamic banks listed on the Amman Stock Exchange, covering the period from 2015 to 2022. This study uses manual content analysis using a custom FinTech Disclosure Index (FDI) and quantitative analysis with a two-way clustered error regression model. Findings The findings show that corporate governance mechanisms, particularly board size, board meetings and “Big4” audit firms, are crucial in enhancing FinTech disclosure across conventional and Islamic banks. However, Islamic banks consistently show higher disclosure levels than their conventional counterparts, attributed to their distinct governance structures that emphasize ethical governance and transparency. These results indicate an awareness among decision-makers about the importance of business model transformation toward FinTech. Originality/value This study pioneers the introduction of FDI, using it for a novel comparative analysis of FinTech disclosure levels between Islamic and conventional banks. By exploring how various governance structures influence FinTech disclosure, this research provides fresh insights into the interplay between corporate governance and financial technologies in the banking sector.

FINANCIAL INCLUSION AND THE INFORMAL SECTOR DURING AND POST-COVID 19 ERAS: STATUS, CHALLENGES AND WAY FORWARD

COVID 19 is one of the major disasters that significantly disrupted the socio-economic statuses of various businesses and nations at large. The purpose of the study was to explore the extent to which COVID 19 affected financial inclusion in Zimbabwe. The quantitative research methodology and the purposive sampling technique were employed. Data was collected using in-depth and focus discussion group interviews from 35 participants. Data was analysed using thematic data analysis approach. Barred people in rural areas from accessing financial services which directly and indirectly increased the magnitude of poverty among people running informal businesses. Financial inclusion, is a key driver to poverty reduction; hence the negative impact of on financial inclusion significantly propels poverty in societies. Digitalizing financial services is one of the strategies which can be utilized to promote financial inclusion in the post- era. Financial institutions should use technology in financial services, so that those in rural areas do not incur transport and logistical costs for accessing financial services. Digital finance and other various financial innovations should be used to achieve financial inclusion in rural areas. Policies that encourage the delivery of formal financial services in rural areas should be developed. Governments should consider granting subsidy to providers of financial services so that they can offer basic financial services at low cost to the excluded population. Thus, governments ought to commit themselves to the delivery of accessible, affordable, appropriate and cost-effective financial services to unserved or underserved households. The study provides managers of financial institutions with various techniques of providing financial services to the informal sector in the post- eras in rural areas. It also provides managers with information pertaining to the risks in providing financial services in post-pandemic era in rural areas. Managers of internet service providers has a role in making sure that the rural folk have access to the facility so that digital banking systems become realizable.

The Role of Financial Innovations in the Relationship between Open Market Operations and Access to Credit by Small and Medium Enterprises in Kisumu County, Kenya

Purpose: This study investigated the role of financial innovations in the relationship between open market operations and access to credit by small and medium enterprises in Kisumu County. The specific objectives were to assess the effect of open market operations on access to credit by small and medium enterprises and to investigate the role of financial innovations in the relationship between open market operations and access to credit by small and medium enterprises in Kisumu County. The study was guided by Milton Friedman's Monetarism Theory. Methodology: The study adopted a descriptive research design with a target population of 1,472 SME owners/finance officers in Kisumu County. A sample of 420 was obtained, and a closed-ended questionnaire was used to collect primary data. Data was analyzed using descriptive, correlation and regression analyses. Results: Results showed that open market operations had a statistically significant effect on SMEs' access to credit in Kisumu County. Further, financial innovations statistically and significantly moderated the effect on the relationship between open market operations and access to credit by small and medium enterprises. The study concluded that SMEs' access to credit depended on the direct and indirect effects of open market operations and also that financial innovations moderated these effects. Contribution to theory, practice and policy: The implication is that open market operations should be used to gradually and in a predictive manner increase the quantity of money until an equilibrium rate of interest is attained. SMEs will also be able to access credit if the supply is adequate and the interest rate is at the desired level for the clients. The results of the independent variable of this study showed that even though OMO had a significant effect on access to credit, its contribution was minimal. This may imply that the instruments used in the open market operations may not be accessible by small traders due to the minimum amount required for investment. The players of the financial markets could, therefore, think of innovative ways to customize products for the small traders in the open market operations to ensure optimum access to credit by SMEs. This study found that financial innovations increased the effect of open market operations on SMEs' access to credit by increasing the variation of access to credit. The use of financial innovations should, therefore, be encouraged as a bridge that would enhance SMEs' access to credit. This is a major contribution to knowledge, as no study has established this fact. Policies that would ensure implementation and control of the open market operations should be formulated. Mechanisms for firm checks should be crafted to ensure efficient and effective implementation of the same. These policies should be reviewed regularly to ensure they are current and offer proper guidance. Their implementation could ensure optimum utilization of the investment channels, hence ensuring the growth and stability of the economy.

Cultural Evolution of Finance: A Study on Monetary Incentives and Financial Innovation

This study explores the cultural evolution of finance through the analysis of monetary incentives and their impact on financial innovation. Through an interdisciplinary approach, it investigates how financial practices have changed due to economic and cultural pressures, and how these changes have driven new forms of innovation in global financial markets. The results reveal that monetary incentives play a crucial role in the evolution of financial structures, promoting the adoption of new technologies and financial products that have transformed the global economy. This article highlights the importance of understanding the interplay between culture and finance in order to anticipate future trends in the industry.

Financial inclusion in Morocco: the impact of financial development, financial innovation and economic growth

The relationship between financial inclusion, social development, particularly poverty reduction, financial innovation and economic growth has been endorsed by a number of studies. Indeed, the development policies pursued by countries such as Morocco often define financial inclusion, growth, financial development, financial innovation, monetary policy and investment as fields of action for economic and social development. The aim of this study is to assess this choice by examining the short- and long-term relationship between financial inclusion, financial development, financial innovation, growth, inflation and the interest rate. Using the ARDL (AutoRegressive Distributed Lag) model and the Granger causality test, the results show the positive short- and long-term effect of financial development and financial innovation on financial inclusion, and the positive short- and negative long-term effect of economic growth on financial inclusion. The inflation and the interest rate that represents monetary policy influence financial inclusion in the short and long term positively and negatively respectively. In terms of causality, the granger test shows that economic growth has an effect on inclusion in only one direction and that financial inclusion has an effect on financial development in only one direction. On the other hand, innovation, inflation and the interest rate have a bidirectional relationship with financial inclusion.

Return on investments in social determinants of health interventions: what is the evidence?

There has been an increasing recognition of the importance and the value of addressing social determinants of health (SDOH) to improve population health outcomes, manage health care costs, and reduce health inequities. Despite the strong interest in investing in SDOH initiatives by various stakeholders, the literature on the return from such investments is scarce. The differences in study populations and methodologies, and the lack of data on SDOH intervention outcomes and/or costs, make it challenging to quantify and generalize outcomes for decision-making. We reviewed the literature on SDOH interventions focused on food and housing insecurity, and developed a methodology for estimating a key outcome: the return on investment (ROI), defined as the net returns from an intervention divided by its costs. The ROI estimates we report can be used by stakeholders to prioritize among alternative SDOH interventions for fundraising, investing, and implementing purposes. The average ROI for food-insecurity programs was 85% (ranging from 1% to 287%; except for 1 study's ROI, -31%) and for housing-insecurity programs was 50% (ranging from 5% to 224%; except for 1 ROI, -38%). In addition, these estimates can serve as key inputs for designing and employing innovative financing and policy solutions to increase the use of these interventions.

The Synergy of Financial Innovation, Corporate Social Responsibility, and HRM Morale: A Systematic Review on Their Impact on Firm Image and Business Interest

This study aims to explore the synergy between financial innovation, Corporate Social Responsibility (CSR), and Human Resource Management (HRM) morale, focusing on their collective impact on firm image and business interest. Utilizing a qualitative approach through a systematic literature review, this research synthesizes findings from recent empirical studies to provide a comprehensive understanding of how these elements interact to create a sustainable competitive advantage. The systematic review follows the PRISMA guidelines to ensure rigor and transparency in identifying, selecting, and analyzing relevant literature. The results of the study indicate that financial innovation, particularly through fintech and blockchain technologies, enhances operational efficiency and aligns with broader societal goals through sustainable finance practices. CSR is shown to significantly improve firm image by fostering trust and loyalty among stakeholders, while HRM morale is identified as a critical factor in enhancing organizational resilience, especially during crises such as the COVID-19 pandemic. The most significant finding is the synergistic relationship between financial innovation, CSR, and HRM morale, which collectively contribute to a sustainable competitive advantage that enhances firm performance and stakeholder engagement. The study concludes that integrating these elements into a cohesive strategy is essential for firms seeking long-term success in the modern business environment. The implications are significant for both theory and practice, offering a novel framework for future research and practical guidance for managers.

The Impact of Prospect Theory on Asset Forecasting: A Comparative Study Based on Random Forest and Linear Regression

This study focuses on the application of predictive models and prospect theory in the field of machine learning to predict financial asset prices. Here, the linear regression and random forest algorithms were employed to forecast the price values and fluctuations of two different financial assets: the S&P 500 index and Bitcoin prices. Meanwhile, this study compared the performance of different financial asset datasets before and after the introduction of prospect theory models. Through calculation and comparative analysis, this article provides an in-depth discussion on the predictive performance of regression models and classification models. The research results indicate that in most cases, simple linear regression models have high prediction accuracy. Meanwhile, this paper also found that introducing prospect theory can effectively improve the accuracy of prediction models for specific financial assets. This result has a positive impact on the financial industry, helping to optimize risk management and investment decision-making, improving efficiency at the market level and promoting information transparency, while also promoting the development of emerging financial formats in financial innovation

Identifying Barriers and Implementation Strategies to Inform TBI Screening Adoption in Behavioral Healthcare Settings.

Identify barriers to the adoption of the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) in behavioral healthcare organizations and match these barriers to implementation strategies to inform future implementation efforts. Twenty behavioral health providers. Qualitative study involving individual, semi-structured interviews regarding barriers to adopting the OSU TBI-ID. Data were thematically analyzed around constructs from the Consolidated Framework for Implementation Research (CFIR). Results were matched to strategies using the Expert Recommendations for Implementing Change (CFIR/ERIC) matching tool. Ten barriers were identified across 4 CFIR domains. Inner-Setting barriers were inadequate leadership engagement, priorities, resources, and organizational incentives. Individual-Characteristics barriers were insufficient knowledge about the connection between TBI and behavioral health and how to conduct the OSU TBI-ID with fidelity, low self-efficacy to conduct screening, and inadequate motivation and buy-in to conduct screening. Outer-Setting barriers were lack of state-level mandates and inadequate incentives to conduct screenings. The Process domain barrier was an insufficient engagement of key personnel. Strategy recommendations include: identify and prepare champions; alter incentive and allowance structures; inform local opinion leaders; build a coalition; access new funding; conduct local consensus discussions; involve executive boards; capture/share local knowledge; conduct educational meetings; assess for readiness and identify determinants; identify early adopters; fund and contract for the clinical innovation; create a learning collaborative; and conduct a local needs assessment. This is the first study to examine barriers to adopting the OSU TBI-ID in real-world practice settings. Our results suggest that multilevel implementation strategies addressing mechanisms of change are necessary at the provider, organizational, and systems levels to overcome the complex barriers affecting TBI screening adoption and implementation. Future research is needed to test these strategies and their mechanisms of action on the adoption, implementation, and sustainment of TBI screening, as well as their effect on client-level outcomes.

To Enact or to Implement?

Abstract This study analyses Ghana’s climate-change legal and policy frameworks, pinpointing significant gaps and offering targeted recommendations to bolster the nation’s resilience against climate change. Despite Ghana’s commitments under international agreements and the formulation of national policies, challenges persist in policy implementation, sectoral integration, research, stakeholder engagement, funding and adaptation strategies. The paper argues for a robust, integrated approach to enhance Ghana’s climate governance, highlighting the necessity for improved implementation capacity, cross-sectoral policy harmonisation, enhanced climate data collection, active stakeholder participation, innovative financing and a stronger focus on adaptation and resilience. Key recommendations advocate for political commitment, collaborative efforts and resource mobilisation to ensure effective climate action. This condensed analysis contributes to the broader dialogue on climate-change management in emerging economies, offering insights for policy-makers and stakeholders on advancing climate resilience and sustainable development.

The Global Burden of HIV and Progress toward the 2030 UNAIDS Targets: A Comprehensive Review

The Human Immunodeficiency Virus (HIV) epidemic, since its emergence in the early 1980s, claimed millions of lives and remained a significant global public health challenge. As of 2023, approximately 38.4 million people were living with HIV, with Sub-Saharan Africa and key populations disproportionately affected. In response, the international community had set ambitious targets to end the AIDS epidemic by 2030, encapsulated in the UNAIDS 95-95-95 goals. This comprehensive review, conducted through a synthesis of current literature and global data, assessed the global burden of HIV, the progress made toward achieving these targets, and the challenges that threatened this progress. The review also explored opportunities and innovations, including advances in HIV prevention, integration of services, community-led approaches, digital health technologies, and innovative financing models. Addressing the identified challenges and leveraging these innovations were crucial to achieving the 2030 targets. The article concluded that while substantial progress has been made, a renewed commitment to equity and human rights is essential for ending the AIDS epidemic as a public health threat by 2030. Keywords: HIV epidemic, UNAIDS 2030 targets, Global health, Antiretroviral therapy (ART), Prevention and innovation.

Innovations in HIV Prevention and Treatment: The Future of HIV Care

The Human Immunodeficiency Virus (HIV) continues to pose a significant global health challenge, despite substantial progress in treatment and prevention. This review explored recent innovations in HIV prevention and treatment, highlighting advancements such as long-acting pre-exposure prophylaxis (PrEP), long-acting injectable antiretroviral therapy (ART), and emerging research into potential cures. It also examined integrated care approaches, digital health innovations, and innovative financing models that are shaping the future of HIV care. The review synthesized recent research, evaluated the impact of these innovations, and discussed future directions to advance global health goals. The methodology for this review involved a comprehensive analysis of current literature, clinical trial data, and expert opinions to provide a holistic overview of how these advancements are transforming HIV care and addressing existing challenges. Keywords: HIV Innovations, Prevention Strategies, Long-Acting ART, Integrated Care Models, Digital Health Technologies.

Biophilic Urbanism's Impact on Sustainable Development: Challenges and Opportunities

This research systematically reviews and synthesizes existing literature on the impact of biophilic urbanism on sustainability, aiming to elucidate its effects on urban environments across both environmental and social dimensions. Biophilic urbanism, which integrates natural elements into urban settings, is explored for its potential to address the challenges of urbanization, including environmental degradation and social inequality. The review aggregates findings from diverse studies to offer a comprehensive understanding of how biophilic principles contribute to urban sustainability, highlighting both the benefits and obstacles associated with their implementation. A key focus of this research is the identification and critical analysis of challenges in adopting biophilic urbanism, such as economic, social, and practical barriers. Addressing these challenges is crucial for developing effective strategies to enhance the adoption of nature-integrated design principles in urban planning. In parallel, the research explores the opportunities presented by biophilic urbanism, emphasizing its potential to improve environmental health, community well-being, and urban resilience. The research employs a qualitative methodology, including a thorough literature review and content analysis, to investigate the role of biophilic urbanism in sustainable urban development. It examines potential solutions to environmental and financial challenges, aiming to provide insights that inform future research, policy-making, and urban planning practices. In conclusion, biophilic urbanism is posited as a transformative approach to urban design, offering a framework that integrates natural systems to promote ecological health and human well-being. By aligning with contemporary sustainability objectives, this approach contributes to creating resilient and livable urban environments. Despite facing economic and implementation barriers, strategic solutions and innovative funding mechanisms can facilitate the broader integration of biophilic urbanism into urban planning, supporting global sustainability goals and enhancing the quality of urban life.

Modelling energy trilemma and economic growth on renewables in N11 economies: Do economic complexity matter?

Utilizing renewable energy is a necessity for accomplishing global agendas, including combating climate change and promoting sustainable development programs. Although much literature has investigated the nexus between energy sources and their affected regressors during the last few years, no appreciable emphasis is available in the previous studies respecting the influence of the energy trilemma index and economic expansion on the influence of the energy trilemma index and economic the renewables in N11 economies. Therefore, the current study analyzes the crucial influencing factors, including the energy trilemma, economic growth, economic complexity, financial development, and urban population, as drivers of renewable energy in N11 economics from 1990 to 2021 by utilizing a panel quantile regression approach. The empirical outcomes certify that renewable energy is positively connected with the energy trilemma, economic growth, financial development, and urban population, but not with economic complexity, which has the inverse result. As a result, legislators responsible for monitoring the deployment of renewables should stimulate their attempts to consider the energy trilemma dimensions into account when determining energy structural policies, increase the use of greener energy subsidies, pose high-carbon taxes, promote green financial innovation, and improve energy efficiency.

Abstract P105: Comparative Effectiveness between Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors on Mortality: a Nationwide, Population-based, Prospective Cohort Study in China

Background: Contemporary evidence comparing the efficacy of angiotensin-converting enzyme inhibitors (ACEIs) versus angiotensin II receptor blockers (ARBs) on long-term outcomes in patients with hypertension is sparse and inconsistent. The aim is to compare the effectiveness of ACEI monotherapy versus ARB monotherapy on all-cause death and cardiovascular death. Methods: Based on a nationwide, population-based prospective cohort project, which covered 318 study sites from 2014 to 2021 in China. Detailed information was collected by questionnaire, physical measurement, and blood test. Participants aged 35-75 years with hypertension and taking ACEI or ARB monotherapy once daily, and with good medication adherence at baseline were included. Information on mortality was followed up until 31 December 2021. Stabilized inverse probability treatment weighting (IPTW) was applied to compare the effectiveness. Results: 68 771 (49326 ARB, 19445 ACEI) participants were finally included, with a mean age of 59.9±8.3 years and 40.2% being female. During a median follow-up time of 44 months, 785 cardiovascular deaths and 1657 deaths were recorded. Compared with ACEI monotherapy, ARB monotherapy was associated with a quarter relative risk reduction of cardiovascular death (IPTW rates: 0.95 % Vs 1.43%, HR =0.73 [ 95%CI , 0.62-0.87]) and one-fifth relative risk reduction of all-cause death (IPTW rates: 2.13% Vs 2.84%, HR =0.80 [ 95%CI , 0.71-0.89]). These differences remained consistent after further adjusting for blood pressure and with differences more pronounced in patients with controlled and newly onset hypertension. Sensitive analysis and subgroup analysis yielded consistent results. Conclusions: Attention should be paid that ARB can be preferred to ACEI in patients with hypertension in terms of long-term health outcomes. Funding: This work was supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Science (2021-I2M-1-011), and the National High Level Hospital Clinical Research Funding (2022-GSP-GG-4, NCRCSZ-2023-016). Keywords: Hypertension, Angiotensin receptor blocker, Angiotensin-converting enzyme inhibitor, Mortality, Comparative effectiveness

The Growth and Development of a Research Division in the Plastic Surgery Department of a Large Urban Academic Medical Center.

Research is a critical component of academic medicine that may or may not be prioritized in centers with high clinical volumes. The benefits of research expansion go beyond notoriety and industry partnerships, expanding into resident training and preparation of the next generation of physician-scientists. Improving a division or department's research portfolio requires a commitment to reorganizing structure, personnel, resources, and a dedication to innovative funding models. To improve research productivity and quality, our group placed several initiatives into motion beginning in August 2017 that we have outlined and evaluated in the present study. Some of these initiatives included restructuring leadership, resourcing both bench and clinical outcomes research, providing initial funding directly from clinical profits and rewarding research fiscally. Reviews of hiring records, publications, grant allocations, and interviews with key personnel were used to generate a road map of initiatives. Average impact factor was calculated by averaging journal impact factors for all publications from the department each year, excluding any publications with greater than 5 times the raw average, and creating a corrected average that more accurately represented the work. Student t tests were used to compare mean number of publications and impact factors from 2010 to 2017 to those from 2018 to 2022. Prior to restructuring (2010-2017), the department published an average of 9 articles annually, which increased to an average of 42 articles since that time (P < 0.01). Average impact increased from 0 in 2010 to 4.02 in 2022, with the number of publications in top 10 plastic surgery journals following a similar trajectory with 1 publication in 2010 and 31 in 2023. Following an initial $1 million investment to create an institutionally directed fund in 2018, the department leveraged its research to earn $3 million in endowments, $1.25 million in industry partnerships, $3.23 million in Department of Defense funding, and $1.65 million from a multi-institutional National Institutes of Health grant. Deliberate prioritization of research initiatives as noted above has led to remarkable growth in academic output.

Effect of an exercise intervention or combined exercise and diet intervention on health-related quality of life-physical functioning after kidney transplantation: the Active Care after Transplantation (ACT) multicentre randomised controlled trial

Robust evidence for interventions to improve health-related quality of life (HRQoL) in people who receive a kidney transplant is scarce. We aimed to assess the effects of a lifestyle intervention in this context. We conducted a multicentre, open-label, parallel-group, randomised controlled trial among people who have received a kidney transplant. Participants from six hospitals across the Netherlands were randomly assigned 1:1:1 by an independent company into: usual care, exercise, and exercise plus diet. The exercise intervention encompassed two phases, a 3-month supervised exercise programme (twice weekly) followed by 12months of lifestyle coaching, with 15months of additional dietary counselling (12 sessions) for the exercise plus diet group. The primary outcome was HRQoL-domain physical functioning, assessed using the 36-item Short Form Survey at 15months. From Oct 12, 2010to Nov 18, 2016, 221participants who had received a kidney transplant (138 [62%] male and 83 [38%] female, with a mean age of 52·5 [SD 13·5] years, who were a median of 5·5 [IQR 3·6-8·4] months post-transplant) were included and randomly assigned to usual care (n=74), exercise intervention (n=77), and exercise plus diet intervention (n=70). In the intention-to-treat analyses, at 15months post-baseline, no significant differences inHRQoL-domain physical functioning were found for the exercise group (5·3arbitrary units, 95% CI -4·2to 14·9; p=0·27), and the exercise plus diet group (5·9arbitrary units, -4·1to 16·0; p=0·25) compared with control. Safety outcomes showed no safety concerns. After 3months of supervised exercise intervention, HRQoL-domain physical functioning improved in the exercise group (7·3arbitrary units, 95% CI 1·2to 13·3; p=0·018) but not in the exercise plus diet group (5·8arbitrary units, -0·5to 12·1; p=0·072). A lifestyle intervention is safe and feasible in people who have received kidney transplants, paving the way for lifestyle intervention studies in other multimorbid populations with polypharmacy. However, improving HRQoL for people who have received a kidney transplant is challenging. The lifestyle interventions in the current study did not show significant improvements in HRQoL at the end of the study at the total group level. Dutch Kidney Foundation, Innovation Fund of the Dutch Medical Insurance Companies, and University Medical Center Groningen.

Analysing the Relationship between Financial Innovation and Financial Stability

Analysing the Relationship between Financial Innovation and Financial Stability

Exploring fiscal incentives, financial constraints, and firm innovation performance: A multidimensional correlation analysis and mechanism exploration

The article study selects the panel data of 3407 A-share listed companies between 2010 and 2022, aiming at exploring the impact of fiscal incentives on firms' innovation performance and revealing the mediating role of financing constraints. The empirical results show that fiscal incentives have a significant positive impact on both corporate innovation performance and financing constraints; meanwhile, corporate financing constraints are found to play a fully intermediary role between fiscal incentives and corporate innovation performance. This research result is of great significance to both enterprises and governments. Enterprises can take the initiative to utilize fiscal incentives to improve innovation performance, strengthen financing ability, and then promote enterprise development. The government can take fiscal incentives and other measures to support enterprise innovation and promote the healthy development of the national economy. At the same time, governments should also explore more effective financing mechanisms to provide enterprises with a favorable financing environment to further promote enterprise development and innovation capacity.

A transformer-based deep learning model for early prediction of lymph node metastasis in locally advanced gastric cancer after neoadjuvant chemotherapy using pretreatment CT images

Early prediction of lymph node status after neoadjuvant chemotherapy (NAC) facilitates promptly optimization of treatment strategies. This study aimed to develop and validate a deep learning network (DLN) using baseline computed tomography images to predict lymph node metastasis (LNM) after NAC in patients with locally advanced gastric cancer (LAGC). A total of 1205 LAGC patients were retrospectively recruited from three hospitals between January 2013 and March 2023, constituting a training cohort, an internal validation cohort, and two external validation cohorts. A transformer-based DLN was developed using 3D tumor images to predict LNM after NAC. A clinical model was constructed through multivariate logistic regression analysis as a baseline for subsequent comparisons. The performance of the models was evaluated through discrimination, calibration, and clinical applicability. Furthermore, Kaplan-Meier survival analysis was conducted to assess overall survival (OS) of LAGC patients at two follow-up centers. The DLN outperformed the clinical model and demonstrated a robust performance for predicting LNM in the training and validation cohorts, with areas under the curve (AUCs) of 0.804 (95% confidence interval [CI], 0.752-0.849), 0.748 (95% CI, 0.660-0.830), 0.788 (95% CI, 0.735-0.835), and 0.766 (95% CI, 0.717-0.814), respectively. Decision curve analysis exhibited a high net clinical benefit of the DLN. Moreover, the DLN was significantly associated with the OS of LAGC patients [Center 1: hazard ratio (HR), 1.789, P<0.001; Center 2:HR, 1.776, P=0.013]. The transformer-based DLN provides early and effective prediction of LNM and survival outcomes in LAGC patients receiving NAC, with promise to guide individualized therapy. Future prospective multicenter studies are warranted to further validate our model. National Natural Science Foundation of China (NO. 82373432, 82171923, 82202142), Project Funded by China Postdoctoral Science Foundation (NO. 2022M720857), Regional Innovation and Development Joint Fund of National Natural Science Foundation of China (NO. U22A20345), National Science Fund for Distinguished Young Scholars of China (NO. 81925023), Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application (NO. 2022B1212010011), High-level Hospital Construction Project (NO. DFJHBF202105), Natural Science Foundation of Guangdong Province for Distinguished Young Scholars (NO. 2024B1515020091).