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According to the theory of institutional economics, local culture has a profound impact on individuals and groups. It fundamentally affects individual preferences and attitudes, guiding decision-making behaviors to develop homogeneous regional cultural characteristics. This, in turn, reflects in the business decisions of companies, leading to imbalances in the development of different regional enterprises. This article reviews the relevant literature on regional culture and corporate finance, aiming to investigate how regional culture plays a significant role in corporate governance and corporate performance. It explores the limitations of existing research and further analyzes issues related to the quantification of culture, its mechanism of influence, and endogeneity in regression models.

This paper aims to explore whether cultural inclusivity has a significant impact on corporate social responsibility (CSR). The research shows that firms located in regions with higher cultural inclusivity tend to take on more social responsibilities, suggesting that corporate humanistic care and environmental awareness are linked to cultural inclusivity. Furthermore, the effect of cultural inclusivity is more evident in large firms, state-owned enterprises, and firms with high board independence. The use of natural disasters as an instrumental variable in the analysis helped to address endogeneity concerns. Additionally, the outcomes indicate that regions with greater exposure to cultural inclusivity tend to exhibit more characteristics of “gender equality” and fewer characteristics of “power gap”, which have a strong correlation with CSR. These findings shed light on the impact of cultural inclusivity on corporate governance and help explore the informal institutional factors influencing CSR at the geographical level.

As society continues to develop, a growing body of research is focusing on how informal institutions, such as culture, influence corporate behavior and economic outcomes. The aim of this study is to explore the impact of cultural inclusiveness, as a non-formal institution, on firm performance. Using Chinese A-share listed firms as our sample, we employ econometric methods to analyze the relationship between cultural inclusiveness and firm performance. Our findings reveal that cultural inclusiveness enhances firm performance, particularly evident in regions with higher levels of cultural inclusiveness, where firms tend to exhibit higher return on equity. To address concerns of endogeneity, instrumental variable regression using regional topographical changes is employed. Mechanism testing indicates that cultural inclusiveness primarily improves firm performance by reducing financial constraints and optimizing employee structure. Additionally, the study finds that cultural inclusiveness has a more pronounced impact on firms with higher corporate social responsibility (CSR) performance as well as those with greater investment in research and development (R&D). This study provides a comprehensive empirical explanation of how cultural inclusiveness influences the sustainable operation of businesses.

Background Recently, the BAOCHE trial and ATTENTION trial registry have demonstrated the efficacy of endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO), however, the proportion of patients with favorable post-EVT outcomes remains low. The present study aimed to investigate the individual and joint prognostic values of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with acute BAO who have undergone EVT. Methods We enrolled patients who underwent EVT from the BASILAR registry. Patients were divided into the following groups based on their modified Rankin Scale (mRS) scores at 90 days: favorable-outcome (mRS score: 0–3) and poor-outcome (mRS score: 4–6) groups. Multivariable logistic regression was performed to analyze the association of NLR and PLR with favorable post-EVT outcomes. Results In total, 585 patients with EVT were recruited. Of these, 189 and 396 patients were in the favorable-outcome and poor-outcome groups, respectively. According to the multivariable logistic regression analyses, both NLR (adjusted odds ratio [aOR], 0.950; 95% confidence interval [CI], 0.920–0.981; P  = 0.002) and PLR (aOR, 0.997; 95% CI, 0.995–0.999; P  = 0.002) were related to favorable post-EVT outcomes in patients with acute BAO. The optimal cutoff values for the NLR and PLR were 7.75 and 191, respectively. Furthermore, stratified analysis using the multivariable logistic regression model revealed that both NLR and PLR (NLR values ≥ 7.75 and PLR values ≥ 191) were associated with a low rate of favorable outcomes (aOR, 0.292; 95% CI, 0.173–0.494; P  < 0.001). Conclusions Low NLR and PLR were both associated with favorable post-EVT outcomes in patients with acute BAO. Furthermore, the combined value of both inflammatory markers is potentially reliable in predicting clinical post-EVT outcomes.

This paper associates the speculative culture with the corporate total factor productivity (TFP), aiming to explore the influence of speculative culture on corporate high-quality development. The results reveal that the presence of a speculative atmosphere varies across different regions in China, leading to uneven development among companies located in these regions. Specifically, companies situated in regions with a weaker speculative culture demonstrate higher TFP. The finding suggests a causal relationship between speculative culture and corporate high-quality development by adopting an instrumental variable test using natural calamities. Moreover, the research indicates that speculative culture can impact corporate high-quality development by influencing their innovation activities. Additionally, the study identifies heterogeneous effects of speculative culture on companies of different sizes and levels of analyst attention. The implications of this research shed light on the influence of speculative culture on the real economy, providing insights into the informal institutional factors contributing to the corporate high-quality development in different geographical areas. These findings contribute to the promotion of economic high-quality development at the geographical level and inform related policy formulation.

BackgroundClinical evidence of the potential influence of stress hyperglycemia ratio (SHR) for patients with large ischemic stroke whether or not receiving endovascular therapy is not clear.MethodsThis study was a subanalysis of a prospective, multicenter registry, and included 745 patients with large ischemic stroke across 38 centers in China. A total of 427 patients were included in this study, with 285 received endovascular therapy (EVT) and 142 received standard medical therapy (SMT). SHR was defined as glucose (mmol/L)/(1.59 × HbA1C)–2.59. The primary outcome was a moderate neurological outcome (modified Rankin Scale (mRS) score ≤3) at 90 days.ResultsA significant interaction was observed between SHR and whether received EVT (p=0.017). Among patients who received EVT (adjusted OR (aOR) 0.46; 95% CI 0.23 to 0.92; p=0.029), patients in the highest tertile of SHR were significantly less likely to achieve a moderate neurological outcome at 90 days compared with those in the lowest tertile. However, this association was not observed in patients receiving SMT (aOR 2.46; 95% CI 0.74 to 8.21; p=0.142). EVT patients with higher SHR had a significantly higher incidence of symptomatic intracranial hemorrhage compared with lower SHR (aOR 3.29; 95% CI 1.08 to 10.06; p=0.036), while such an association was not observed in the SMT group (aOR 1.52; 95% CI 0.56 to 4.12; p=0.410).ConclusionsIn patients with large ischemic stroke treated with EVT, SHR is associated with a reduced likelihood of achieving a moderate neurological outcome, as well as an increased risk of symptomatic intracranial hemorrhage.Trial registration numberChiCTR2100051664.

Background Stress hyperglycemia ratio (SHR) reflects a true acute hyperglycemic state during acute basilar artery occlusion (ABAO). We aimed to investigate the association between SHR and short-term and long-term outcomes in patients with ABAO receiving endovascular treatment (EVT). Methods We selected patients treated with EVT from the BASILAR study, a nationwide prospective registry. A total 250 patients with documented glucose and glycated hemoglobin (HbA1C) values at admission were included. SHR was calculated as the ratio of glucose/HbA1C. All 250 patients completed 90 days of follow-up and 234 patients (93.6%) completed 1 year of follow-up. The primary outcome was the favorable outcome defined as modified Rankin Scale (mRS) score ≤ 3 at 90 days. Safety outcomes included mortality at 90 days and 1 year, and intracranial hemorrhage. Results Among the 250 patients included, patients with higher tertiles of SHR were associated with decreased odds of a favorable functional outcome at 90 days (adjusted OR, 0.26; 95% CI, 0.12–0.56; P  = 0.001 and adjusted OR, 0.37; 95% CI, 0.18–0.80; P  = 0.01; respectively) and 1 year (adjusted OR, 0.34; 95% CI, 0.16–0.73; P  = 0.006 and adjusted OR, 0.38; 95% CI, 0.18–0.82; P  = 0.01; respectively) after adjusting for confounding covariates. The mortality was comparable across tertiles of SHR groups at 90 days and 1 year. Conclusions Our study showed that SHR was associated with a decreased probability of favorable functional outcome both at 90 days and 1 year after EVT in patients with ABAO. The relationship was more pronounced in non-diabetes patients. Trial registration Clinical Trial Registry Identifier: ChiCTR1800014759 (November 12, 2013).

BackgroundThe optimal anesthetic method for endovascular therapy in acute large core stroke remains unclear. This study aimed to evaluate the impact of anesthetic methods on outcomes in patients with large core stroke.MethodsThis study was a subanalysis of a prospective, multicenter registry at 38 stroke centers in China. Patients with large core stroke, defined as an Alberta Stroke Program Early CT Score (ASPECTS) of 0–5 within 24 hours of witnessed symptom onset, were analyzed. The primary outcome was favorable functional outcome (modified Rankin Scale score 0–3) at 90 days.Results484 eligible patients were included in this analysis. General anesthesia (GA) was used in 84 patients (17.4%), while non-general anesthesia (non-GA) was used in 400 patients (82.6%). Non-GA was comparable to GA in the primary outcome (37.8% vs 32.1%; adjusted odds ratio (aOR) 1.07, 95% confidence interval (95% CI) 0.60 to 1.91, P=0.83). Mortality at 90 days was 40% in the non-GA and 52.4% in the GA (aOR 0.71, 95% CI 0.41 to 1.22, P=0.21). The proportion of symptomatic intracranial hemorrhage at 48 hours was 13.8% in the non-GA and 11.9% in the GA (aOR 1.25, 95% CI 0.62 to 2.77, P=0.56). The results remained consistent in the propensity score-matched cohort and inverse probability of treatment weighting cohort.ConclusionIn this cohort study of patients with large core stroke, no significant differences were found in functional and safety outcomes between non-GA and GA.

Objective The aim of this study was to investigate the factors influencing good outcomes in patients receiving only intravenous tirofiban with endovascular thrombectomy for large vessel occlusion stroke. Methods Post hoc exploratory analysis using the RESCUE BT trial identified consecutive patients who received intravenous tirofiban with endovascular thrombectomy for large vessel occlusion stroke in 55 comprehensive stroke centers from October 2018 to January 2022 in China. Results A total of 521 patients received intravenous tirofiban, 253 of whom achieved a good 90-day outcome (modified Rankin Scale [mRS] 0–2). Younger age (adjusted odds ratio [aOR]: 0.965, 95% confidence interval [CI]: 0.947–0.982; p  < 0.001), lower serum glucose (aOR: 0.865, 95%CI: 0.807–0.928; p  < 0.001), lower baseline National Institutes of Health Stroke Scale (NIHSS) score (aOR: 0.907, 95%CI: 0.869–0.947; p  < 0.001), fewer total passes (aOR: 0.791, 95%CI: 0.665–0.939; p  = 0.008), shorter punctures to recanalization time (aOR: 0.995, 95%CI:0.991–0.999; p  = 0.017), and modified Thrombolysis in Cerebral Infarction (mTICI) score 2b to 3 (aOR: 8.330, 95%CI: 2.705–25.653; p  < 0.001) were independent predictors of good outcomes after intravenous tirofiban with endovascular thrombectomy for large vessel occlusion stroke. Conclusion Younger age, lower serum glucose level, lower baseline NIHSS score, fewer total passes, shorter punctures to recanalization time, and mTICI scores of 2b to 3 were independent predictors of good outcomes after intravenous tirofiban with endovascular thrombectomy for large vessel occlusion stroke. Chinese clinical trial registry identifier ChiCTR-IOR-17014167.

Few studies have reported the clinical outcomes of older adult patients with acute anterior circulation large-vessel occlusion (LVO) who underwent mechanical thrombectomy (MT). Therefore, we investigated the safety, functional outcomes, and predictors of MT for anterior circulation LVO in older adults. We enrolled patients with acute anterior circulation LVO from May 2018 to October 2021 in this retrospective study. Patients were divided into older (≥80 years) and young (<80 years) groups. Multivariable logistic regression analyses determined the safety, functional outcomes, and predictors of MT for anterior circulation LVO. We divided 1182 patients with acute ischemic stroke into young (18-79 years; 1028 patients) and older (≥80 years; 154 patients) groups. Compared with the young group, the older group had more unfavorable functional outcomes and increased mortality (P = .003). In the older adult patients, lower initial NIHSS score and higher ASPECTS were correlated with good outcomes. On the contrary, higher initial NIHSS score and lower ASPECTS were related to increased mortality. No difference was detected in symptomatic intracranial hemorrhage within 48 h between two groups. Increasing age was associated with lower rates of favorable functional outcomes and higher mortality rates. The lower initial NIHSS score combined with the higher ASPECTS may predict functional outcomes post-thrombectomy in older adults.