Institutional thinking, a concept that underscores the importance of internal perspectives and the enduring purposes of institutions, plays a critical role in maintaining societal stability and ethical governance. This paper explores the dual nature of institutional thinking, highlighting its positive aspects and inherent dangers. Through an examination of economic, political, and philosophical forces, the paper identifies modern challenges that undermine long-term commitments and ethical values within institutions. By drawing on historical and contemporary examples, including slavery, Nazism, and discriminatory practices, the discussion provides a comprehensive understanding of how institutional thinking can both promote human well-being and perpetuate systemic issues. The paper concludes by emphasizing the need to reaffirm institutional values, promote long-term thinking, and balance individual rights with collective responsibilities to harness the positive aspects of institutional thinking while mitigating its risks.

Definitive diagnosis of Craniosynostosis (CS) with computed tomography (CT) is readily available, however, exposure to ionizing radiation is often a hard stop for parents and practitioners. Lowering head CT radiation exposure helps mitigate risks and improves diagnostic utilization. The purpose of the study is to quantify radiation exposure from head CT in patients with CS using a ‘new’ (ultra-low dose) protocol; compare prior standard CT protocol; summarize published reports on cumulative radiation doses from pediatric head CT scans utilizing other low-dose protocols. A retrospective study was conducted on patients undergoing surgical correction of CS, aged less than 2 years, between August 2014 and February 2022. Cumulative effective dose (CED) in mSv was calculated, descriptive statistics were performed, and mean ± SD was reported. A literature search was conducted describing cumulative radiation exposure from head CT in pediatric patients and analyzed for ionizing radiation measurements. Forty-four patients met inclusion criteria: 17 females and 27 males. Patients who obtained head CT using the ‘New’ protocol resulted in lower CED exposure of 0.32 mSv ± 0.07 compared to the prior standard protocol at 5.25 mSv ± 2.79 (p < 0.0001). Five studies specifically investigated the reduction of ionizing radiation from CT scans in patients with CS via the utilization of low-dose CT protocols. These studies displayed overall CED values ranging from 0.015 mSv to 0.77 mSv. Our new CT protocol resulted in 94% reduction of ionizing radiation. Ultra-low dose CT protocols provide similar diagnostic data without loss of bone differentiation in CS and can be easily incorporated into the workflow of a children’s hospital.

This study seeks to explore the information value of financial metrics on corporate sustainability and investigate the moderating effects of institutional shareholders on the association between net cashflows (NCF) and corporate sustainability of the leading ASEAN countries. The dataset consists of companies listed on the Stock Exchange of Thailand, Malaysia and Singapore during 2013–2023. Fixed effects panel regression is executed in this study. Subsequently, the conditional effects served to evaluate the influence of institutional shareholders on the association between NCF and corporate sustainability. This study employs agency theory to explore how the alignment of institutional shareholders influences sustainability outcomes. This study found that institutional shareholders themselves supply information for the sustainability indicator in Thailand and Singapore, but not in Malaysia. Furthermore, adversely correlated with sustainability metrics in all three nations is the interaction term between institutional shareholders and net cashflows. Further investigation reveals that for each nation’s sustainability measures the institutional shareholders offer value relevant to net cashflows at certain amounts. This study not only contributes to existing academic research on sustainability and financial indicators, it also provides practical strategies for companies and investors trying to match financial performance with sustainability goals in a fast-changing global market.