Development of a novel endoscopic suturing simulator: validation and impact on clinical learning curve (with video)

BACKGROUND AND AIMS

Endoscopic suturing is a complex skill with broad applications. The aim of this study was to develop and validate a novel endoscopic suturing simulator and scoring system for the purse-string suture pattern.

METHODS

This was a prospective study of an endoscopic suturing simulator that consists of a circular opening representing a dilated gastrojejunal anastomosis of Roux-en-Y gastric bypass with 12 small target holes around its circumference. Purse-string suturing is performed in a counterclockwise fashion. Time allotted is 5 minutes, and each successful bite is awarded 10 points. Participants were divided into the novice, intermediate, and experienced groups. Validity evidence based on content, validity evidence based on other variables, and validity evidence based on consequences of testing were assessed.

RESULTS

Seventeen subjects (3 novice, 7 intermediate, and 7 experienced) participated in the study. Validity evidence based on content: The content validity index for realism, relevance, and representativeness was 0.89, 1.00, and 1.00, respectively. Validity evidence based on other variables: The novice, intermediate, and experienced groups scored 30.0 ± 8.2, 57.1 ± 28.1, and 131.2 ± 51.7 (P = .001). Validity evidence based on consequences of testing: The simulator group required 5 ± 5 transoral outlet reduction cases before being able to independently complete an entire purse-string, whereas the non-simulator group required 38 ± 11 clinical cases (P < .0001).

CONCLUSIONS

This novel endoscopic suturing simulator seems realistic, relevant, and representative of the clinical suturing experience. In addition, it seems effective at objectively assessing suturing skills and shortening the clinical learning curve.

The Influence of Environmental, Social, and Governance (ESG) Practices on US Firms’ Performance: Evidence from the Coronavirus Crisis

This study explores the influence of total and individual ESG practices and the coronavirus crisis on US firm performance (FP). A large and recent sample of 406 US firms that adopted ESG issues during 2016–2020 was used. This study uses the generalized least-squares (GLS) regression estimator, the dynamic analysis technique, and robustness tests. The results indicate that firms with heightened ESG practices have better performance measures. In most cases, the results suggest that firms with heightened environmental, social, and governance performances have better performance measures. The results suggest that the coronavirus crisis negatively affected FP measures. In addition, the analyses of the differences suggest significant distinctions in FP due to the coronavirus crisis. This study’s findings have important implications for stakeholders. Managers could benefit from the results of this examination by recognizing the status of ESG practices and FP before and during the coronavirus crisis and identifying the linkage between the fulfillment of ESG responsibilities and FP. This study provides noteworthy practical implications that could enable managers to develop strategies and policies for adopting and enhancing ESG practices to achieve the best performance. Furthermore, the results could influence trading processes as investors and financiers pursue attractive financial returns from investments in businesses concerned with ESG issues.

Did ESG Save the Day? Evidence From India During the COVID-19 Crisis

Investors have shown increasing interest in Socially Responsible Investments (SRI) in the past few years, especially during the financial crisis caused due to the outbreak of the COVID-19 pandemic. SRI are evaluated on the basis of Environmental, Social and Governance (ESG) criteria. ESG information allows investors to assess the risks associated with a particular firm and how the firm manages or intends to manage future risks. Amidst the increasing investor interest in ESG products, we attempt to study the value addition of ESG performance to investors during crisis period. Using a sample of ESG rated firms listed on the Bombay Stock Exchange (BSE), we examine the investment performance, trading volumes and return volatility of ESG stocks in an emerging market like India during the COVID-19 crisis. The results of our event study conducted around the important events that have occurred in India during the COVID-19 pandemic provide evidence that investors can use ESG information as a signal of future stock performance. Most importantly, ESG performance provides downside protection during crisis times. Our results show that ESG performance does not prove to be detrimental to investment performance during normal times. Also, ESG performance was found to reduce stock return volatility during the COVID-19 pandemic. Overall, our study attempts to establish an investment case for ESG stocks in emerging markets in India by providing support to the good management hypothesis.

Is bank risk appetite relevant to bank default in times of Covid-19?

The paper aims to analyze the effect of bank risk appetite on banks' default probabilities during the year of COVID-19 in 12 countries while controlling for bank-specific and country-specific effects over time. A System Generalized Methods of Moments (GMM) model of default probabilities is estimated over the periods 2010–2021. This study confirms the ‘risk-mitigation view’, in which banks with higher ESG scores are more prudent in lending and have better relationship management, reducing the probability of bank default. Underperforming banks tend to have a higher portion of risky loans in their credit portfolio and therefore demonstrating a higher default propensity. Bank risk appetite, ESG, asset quality, economic growth, and currency depreciation appear to be material drivers for bank risk. We find that a lower risk appetite ratio (corresponding to higher risk appetite) is associated with higher estimated default probability during the COVID-19 outbreak, identified through interaction with a single time dummy for 2020 (the break-out year of the pandemic).

Connecting the COVID-19 pandemic, environmental, social and governance (ESG) investing and calls for ‘harmonisation’ of sustainability reporting

We critically examine the call for ‘harmonisation’ of sustainability reporting frameworks and standards that occurred alongside an increase in environmental, social and governance (ESG) investing during the COVID-19 pandemic. We identify three myths that have been promulgated in calls for ‘harmonisation’ that seek to: simplify sustainability reporting and ESG analysis and shift the control for standard-setting to an investor-oriented private sector body. We argue that the myths are based on deception, misunderstandings, and disregard for both academic research and the views of sustainability practitioners. They demonstrate a lack of regard for different users of corporate sustainability information, a lack of analysis of the alternatives, an overestimation of the International Financial Reporting Standards (IFRS) Foundation’s expertise and mischaracterisation of sustainable/ESG financing.

Investing in the Sustainable Development Goals: Mobilization, channeling, and impact

Global investment in the Sustainable Development Goals (SDGs) is falling short of the target to close the $2.5 trillion annual financing gap for developing countries. The COVID-19 shock has exacerbated existing constraints for the SDGs and may undo the progress made in he last 6 years in SDG investment. This poses a risk to delivering on the 2030 Agenda for Sustainable Development. This paper assesses the global trends in both investing in and financing the SDGs, including the myriad of financing instruments launched to respond to the COVID-19 health crisis and its economic and social impacts. It analyses the main challenges for mobilizing funds, channeling investment into SDG sectors, and maximizing positive impact, as well as regulatory dilemmas in promoting SDG investment. The article then elaborates on a set of policy measures for accelerating investment in the SDGs, including four principles for guiding private sector investment, mainstreaming the SDGs into national and international investment policies and promotion strategies, harnessing financial instruments for sustainable development, building special SDGs model zones, and promoting better ESG standards, compliance, and reporting.

Green bonds issuance: insights in low- and middle-income countries

Former reports of Environmental, Social and Governance (ESG) tended to focus on the equity side of investing, and today green bonds also offer and introduce sustainability factors. This paper is about the relevance, potential benefits and key arguments for countries with low-and middle-incomes where financial markets are not comparable with those in developed countries. We begin by stating clearly the relevance of a green economy transformation, highlight the development challenges they face and talk about how a green economy approach can help to solve these challenges. Then an outline of the progress that has been made in this panel, and the economic and social benefits that a green economy can potentially offer to Low- and Middle-Income countries (LMIC’s) will be underlined. Finally, we will make recommendations on the range of potential areas for intervention.