Influence of institutional differences on trade credit use during pandemics

This study examines the formal and informal institutions that affected trade credit during the pandemic periods. To this end, we analyze 590,025 firm-year observations across 107 countries during six recent pandemic crises: SARS (2003), H1N1 (2009), MERS (2012), Ebola (2014), Zika (2016), and COVID-19 (2020). The study finds that formal legal institutions and firms' information transparency during pandemic periods act as a "brake” for trade credit usage. By contrast, informal institutions with religious connotations or attributes, social trust, and policy stability play a "cushion” role in softening the impact of pandemic crises when a firm applies for trade credit. These results remain robust after alternating the estimation techniques, trade credits, pandemic variables, and different samples. This study offers new evidence on the role of trade credit from the perspectives of formal and informal institutions during pandemic crises. The outcomes thus provide information worthy of consideration by policymakers when faced with informal institutional conditions and support government efforts to improve unstable formal systems and prevent severe shocks in the future.

Flap Reconstruction of the Oropharyngeal Defect After Tumor Resection via Combined Transcervical and Transoral Approach in Patients With HPV-Positive and -Negative Oropharyngeal Squamous Cell Carcinoma.

Objective: To investigate a novel surgical approach of combined transcervical parapharyngeal space (PPS) with the transoral approach to dissect oropharyngeal cancer. Methods: 31 patients who were pathologically diagnosed with oropharyngeal cancer and had undergone surgical treatment in Beijing Tongren Hospital during June 2018 and December 2020 were enrolled. All patients were squamous cell carcinoma patients. There were 25 males and 6 females, and the age ranged between 44 and 70 years old. The number of patients with T1, T2, T3, and T4 stage disease was 8, 15, 8, and 0, respectively, according to the American Joint Committee on Cancer staging method, 8th edition. After the dissection of the submandibular and cervical lymph nodes, the parapharyngeal space was exposed, and the parapharyngeal space lymph node and the outer borderline of the tumor were dissected, and then the inner borderline of the tumor was dissected via a transoral approach; the tumor was dissected en bloc, and the defects were reconstructed with the flap from the neck through the parapharyngeal space. Results: Among the patients enrolled, 21 were HPV positive and 10 were HPV negative. 8 patients were free of lymph node metastasis. The tumor resection margins were negative in all 31 patients. Safe and sufficient excision of tumors was feasible by this new surgical approach, avoiding complications associated with mandibulotomy or lip-splitting. All patients had no obvious dysfunctions of swallowing and voice. By the time of this follow-up, none died caused by OPSCC, and only two patients suffered from local recurrence. The 3-year survival rate is 100%, and the 3-year recurrence-free survival rate is 84.58%. Conclusion: The surgical approach of combined transcervical parapharyngeal space with the transoral approach was effective and safe. On this basis, this approach has the advantage of fewer postoperative complications and better functional results.