Sustainability Clauses in International Supply Chain Contracts: Regulation, Enforceability and Effects of Ethical Requirements

Our current society is not successful in mitigation of global social and environmental challenges. States lack legal tools, and sometimes also the will, to secure social and environmental interests transnationally and the existing soft and private regulation is criticized for its weak legitimacy, effectiveness and enforcement. Regardless of this regulatory gap, companies who do not comply with the globally accepted sustainability standards run reputational risks that can lead to long-term negative economic effects. Moreover, stakeholders expect companies not only to follow the standards themselves but also to do business exclusively with socially responsible partners. Unawareness, either intentional or negligent, of unethical behaviour within a company’s supply chain may lead to an assumption that the company is complicit in such a conduct. The paper discusses a hypothesis that sustainability contractual clauses (SCCs) in international supply chain agreements may help to overcome the regulatory gap in relation to global sustainability while concurrently protect companies against potential social, economic and legal risks threatening in connection to unethical behaviour of their suppliers. As parts of enforceable business contracts, SCCs are considered to overcome the heavily criticized softness of other CSR regulation and, therefore, to be more successful in fostering ethical behaviour of suppliers who are legally independent but often in economic and business terms dependent on the sourcing companies. However, this hardening function is questionable faceto- face the lack of case law or another proof of SCCs’ formal enforcement. This article aims to shed a light on the question whether SCCs can be the efficient regulatory solution for global challenges we are looking for or whether they are yet another corporate social responsibility tool ‘without teeth’. The central questions are: why SCCs are presumed to be effective regulatory means for global sustainability, how these clauses are seen through the lenses of international contract law and whether they can actually contribute to a positive change in suppliers’ social and environmental performance. Based on the analysis of SCCs’ features and the underlying regulatory framework, the author concludes that while SCCs would not be enforceable by courts in most cases, they can still be successful in regulating global sustainability. Their positive effects on suppliers’ behaviour will depend on how companies draft and use such clauses. It is suggested that the full potential of private contracting could be triggered by adequate governmental regulation

One-hour postload plasma glucose levels as a new criterion for assessing insulin secretion in obese children

BACKGROUND: Incidence of Type 2 Diabetes Mellitus (T2DM) and associated dysglycemic conditions, increasing the risk of diabetes development, continues to rise worldwide, most notably due to ever-growing obesity rate. Early identification of the persons who are exposed to the risk of T2DM development holds much significance for prevention of both this disease and associated cardiometabolic complications.AIM: To study characteristics of insulin secretion and insulin sensitivity among obese children and adolescents versus the glycemic level 60 minutes (GL60) after the standard oral glucose tolerance test (OGTT).METHODS: This open-label comparative cross-sectional study involved 613 children in the age between 6 and 17.9 years old with constitutive-exogenous obesity, divided into 2 groups: 173 patients with GL60 level ≥ 8.6 mmol/L and 440 children with GL60 level < 8.6 mmol/L. They underwent a screening for dyslipidemia, non-alcoholic fatty liver disease, arterial hypertension and impaired glucose tolerance (IGT). Insulin secretion was evaluated on the basis of maximal (IRI max), average level (IRI avg) of insulin in the course of OGTT and insulinogenic index (IGI), insulin resistance (IG) — by Matsuda index.RESULTS: The groups were comparable in the terms of age, sex, sexual maturation stage and obesity level. Children with GL60 level ≥ 8.6 mmol/L were characterized by higher IR (Matsuda 2.8 ± 2.3 vs 3.5 ± 2.2, р < 0.01), hyperinsulinemia (IRI max 190.0 ± 59.5 vs 157.1 ± 63.4 μU/ml, р < 0.001, IRI avg 115.3 ± 59.7 vs 90.2 ± 54.1 μU/ml, p < 0.001) along with low IGI value (1.84 ± 1.62 vs 2.61 ± 1.3, р < 0.01), which is indicative of the first phase insulin secretion impairment. The lowest IGI values were found among the "GL60 level ≥ 8.6 mmol/L" group patients with IGT (1.4 ± 0.9). Besides, the patients with GL60 level ≥ 8.6 mmol/L are characterized by the higher rate of metabolic complications in the form of impaired glucose tolerance, arterial hypertension, fatty hepatosis and steatohepatitis.CONCLUSIONS: GL60 level ≥ 8.6 mmol/L can be used as an additional marker for metabolically complicated obesity among children and adolescents with a high risk of the carbohydrate metabolism disorder development

Efficacy of interventions for prevention and correction of overweight and obesity in children 7–8 years old: a meta-analysis

The rapid increase in overweight and obesity in children is a global public health problem. Interventions to reduce the prevalence of obesity before puberty are considered to be the most effective, but the results of trials are not consistent enough. We performed a meta-analysis of the efficacy of interventions to prevent or correct overweight and obesity in pre-pubertal children. Thirty-one Cochrane systematic reviews were analyzed, the results of 10 RCTs and two prospective comparative studies were extracted. All trials had an moderate or high risk of bias. According to the results of meta-analyzes, the prevention of overweight and obesity through recommendations of lifestyle modification is effective, the difference in a BMI decrease is -0.19, 95% CI [-0.35; -0.03], compared with the absence of intervention, in children 7–8 years old if applied within 2–4 years, but not within one year or less. The effect of non-drug interventions in children with overweight or obesity was not revealed

Published online in Wiley InterScience (www.interscience.wiley. com)

ABSTRACT The mouse incisor has two unusual features: it grows continuously and it is covered by enamel exclusively on the labial side. The continuous growth is driven in part by epithelial stem cells in the cervical loop region that can both self-renew and give rise to ameloblasts. We have previously reported that ectopic enamel is found on the lingual side of the incisor in mice with loss-of-function of sprouty (spry) genes. Spry2 1/À ; Spry4 À/À mice, in which three sprouty alleles have been inactivated, have ectopic enamel as a result of upregulation of epithelial-mesenchymal FGF signaling in the lingual part of the cervical loop. Interestingly, lingual enamel is also present in the early postnatal period in Spry4 À/À mice, in which only two sprouty alleles have been inactivated, but ectopic enamel is not found in adults of this genotype. To explore the mechanisms underlying the disappearance of lingual enamel in Spry4 À/À adults, we studied the fate of the lingual enamel in Spry4 À/À mice by comparing the morphology and growth of their lower incisors with wild type and Spry2 1/À ; Spry4 À/À mice at several timepoints between the perinatal period and adulthood. Ameloblasts and enamel were detected on the lingual side in postnatal Spry2 1/À ; Spry4 1/À incisors. By contrast, new ectopic ameloblasts ceased to differentiate after postnatal day 3 in Spry4 À/À incisors, which was followed by a progressive loss of lingual enamel. Both the posterior extent of lingual enamel and the time of its last deposition were variable early postnatally in Spry4 À/À incisors, but in all Spry4 À/À adult incisors the lingual enamel was ultimately lost through continuous growth and abrasion of the incisor

Long-term glycemic control and factors, associated with response to pump insulin therapy in children

Background: In recent years, pump-based insulin therapy, also known as continuous subcutaneous insulin infusion (CSII), has become a common treatment for children with type 1 diabetes mellitus (T1DM). Despite the fact that, in general, children with type 1 diabetes achieve the best glycemic control indices during pump therapy, while there is a significant heterogeneity of metabolic outcomes among individual patients, many children with CSII do not reach the target level of HbA1c.Objective: To assess the level of glycemic control and factors associated by withdrawal of use, the response to treatment with prolonged use of CSII in children with type 1 diabetes.Materials and methods: The study included 458 children aged 1 to 18 years, treated to pump therapy at least 3 years before the study, the presence of the analyzed data in the register.Results: The level of HbA1c decreased by -0.7% compared with the primary endpoint, which was accompanied by an increase in the number of patients who reached the target level of HbA1c (<7.5%) from 17% to 36%. The best response was observed for patients under 6 years of age with HbA1c over 9% for pump insulin therapy, as well as in patients who regularly use additional bolus and basal functions and CGM. The main reason for stopping the use of the insulin pump is the inconvenience of using and wearing — 47.7%. Risk factors for pump abandonment: later age of start treatment on CSII and frequent episodes of severe hypoglycemia.Conclusion: According to the results of the study, it was shown that pump therapy is an effective method of insulin therapy, which allows to achieve a lower level of HbA1c compared to the initial values