To develop a better way of assessing the sustainability efficiency (SE) and profitability efficiency (PE) of mining multinational enterprises (MNEs), the two‐stage data envelopment analysis (DEA) ...network model is proposed. The study shows that slack‐based models (SBM) can strengthen the previous and present measurements of the mining industry. When we assess the SE and PE of 53 mining MNEs from 2016 to 2019, the overall efficiencies of both the sustainability and profitability of mining MNEs are not higher than 70%. Such results are shown to be helpful for suggesting that global mining companies need to improve their efficiencies. This study addresses filling the research gap in the literature review about SE positively and significantly influencing PE with the moderating effect of corporate social responsibility (CSR) in mining MNEs. The result reveals that higher sustainability yields higher returns to the companies. In other words, MNEs have improved their SE to achieve a higher PE. Furthermore, the value of SE significantly influences PE regardless of whether the moderating effect, CSR, is higher or lower. The results show that a higher governance pillar score (GPS) and social pillar score (SPS) lead them to have greater profitability. However, a higher Environmental Pillar Score (EPS) tends to create a weaker relationship between SE and PE. We addressed a few interpretations of why higher EPS negatively influences profitability. Nevertheless, our study strongly recommends companies to increase their CSR score. Last, this study proves that all hypotheses are supported.
Uremic toxins, such as indoxyl sulfate (IS) and p-cresol, or p-cresyl sulfate (PCS), are markedly accumulated in the organs of chronic kidney disease (CKD) patients. These toxins can induce ...inflammatory reactions and enhance oxidative stress, prompting glomerular sclerosis and interstitial fibrosis, to aggravate the decline of renal function. Consequently, uremic toxins play an important role in the worsening of renal and cardiovascular functions. Furthermore, they destroy the quantity and quality of bone. Oral sorbent AST-120 reduces serum levels of uremic toxins in CKD patients by adsorbing the precursors of IS and PCS generated by amino acid metabolism in the intestine. Accordingly, AST-120 decreases the serum IS levels and reduces the production of reactive oxygen species by endothelial cells, to impede the subsequent oxidative stress. This slows the progression of cardiovascular and renal diseases and improves bone metabolism in CKD patients. Although large-scale studies showed no obvious benefits from adding AST-120 to the standard therapy for CKD patients, subsequent sporadic studies may support its use. This article summarizes the mechanisms of the uremic toxins, IS, and PCS, and discusses the multiple effects of AST-120 in CKD patients.
This study aims to investigate the effects of corporate social responsibility (CSR) on corporate performance in the global retail industry. We adopt the modified data envelopment analysis (DEA) game ...cross-efficiency approach in assessing the longitudinal efficiency of a sample of 414 listed retail firm-year observations given by Forbes 2000 between 2013 and 2018. The performance result indicates that the Americas retail industry is growing steadily and continues to dominate other regions. Not only the retail industry but all industries in Europe have severe environmental safety rules and management requirements in business operations, hence, Europe also scored high in both the overall environmental index in CSR and all their component indices. Additionally, panel regression revealed that the environmental dimension in CSR is significantly and directly correlated to firm performance. This study's findings will provide practitioners and policymakers with managerial and strategic implications to enhance their efficiency by applying the CSR dimension in the retail industry.
In the port industry, productivity is one of the vital factors for ports to develop competitiveness and market potential. The paper integrates context-dependent data envelopment analysis and ...forecasting models to conduct an efficient measurement of 53 Vietnamese ports and predict future performance in the port industry. By using the technique to get the measure of performance, this study builds the ports’ benchmark-learning stepping tools for the inefficient ports to enhance increasingly. The attractiveness and progress scores are resulted to assist the ports in situating themselves. Moreover, forecasting port performance results help decision-makers having more detailed information to make better decisions in their strategies and investments.
The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has posed a huge threat to global health because of its rapid spread and various mutant variants. Critical illness occurs in ...the elderly and vulnerable individuals, such as those with chronic kidney disease. The severity of SARS-CoV-2 infection is associated with the severity of chronic kidney disease (CKD)and even kidney transplantation (KT) because of the chronic use of immunosuppressive agents. To develop adaptive immunity against SARS-CoV-2, vaccination against the spike protein is important. Current phase III trials of vaccines against SARS-CoV-2 have not focused on a specific group of individuals, such as patients with CKD or those undergoing dialysis or kidney transplantation. Chronic use of immunosuppressive agents might disturb the immune response to the SARS-CoV-2 spike protein. On the basis of limited evidence, the immune compromised status of CKD patients might decrease neutralizing antibody development after a single dose of a specific vaccine. Boosting dosage more than the protocol might increase the titer of the neutralizing antibody in CKD patients. Further evidence is needed to understand the factors disturbing the immunogenicity of the SARS-CoV-2 vaccine, and CKD patients should receive the recommended dose of the SARS-CoV-2 vaccine due to their relatively immune compromised status.
Mineral bone disorders in chronic kidney disease Hou, Yi‐Chou; Lu, Chien‐Lin; Lu, Kuo‐Cheng
Nephrology (Carlton, Vic.),
October 2018, 2018-Oct, 2018-10-00, 20181001, Volume:
23, Issue:
S4
Journal Article
Peer reviewed
Open access
ABSTRACT
As the GFR loss aggravates, the disturbed mineral metabolism worsens the bone microstructure and remodelling ‐ scenario, which is known as CKD‐mineral bone disease (MBD). CKD‐MBD is ...characterized by : (i) abnormal metabolism of calcium, phosphorus, parathyroid hormone (PTH), or vitamin D; (ii) abnormalities in bone turnover, mineralization, volume linear growth or strength; (iii) soft‐tissue calcifications, either vascular or extra‐osseous. Uremic vascular calcification and osteoporosis are the most common complications related to CKD‐MBD. Disregulated bone turnover by uremic toxin or secondary hyperparathyroidism disturbed bone mineralization and makes it difficult for calcium and inorganic phosphate to enter into bone, resulting in increased serum calcium and inorganic phosphate. Vascular calcification worsens by hyperphosphatemia and systemic inflammation. Since vitamin D deficiency plays an important role in renal osteodystrophy, supplement of nutritional vitamin D is important in treating uremic osteoporosis and vascular calcification at the same time. Its pleotropic effect improves the bone remodeling initiated by osteoblast and alleviates the risk factors for vascular calcification with less hypercalcemia than vitamin D receptor analogs. Therefore, nutritional vitamin D should be considered in managing CKDMBD.
Summary at a Glance
This article is a systematic review of the mechanism of CKDMBD and the complication about CKDMBD, including uremic vascular calcification and osteoporosis. Nutritional vitamin D, should play a role in managing CKDMBD.
Because of its high prevalence worldwide, osteoporosis is considered a serious public health concern. Many known risk factors for developing osteoporosis have been identified and are crucial if ...planning health care needs. Recently, an association between uric acid (UA) and bone fractures had been explored. Extracellular UA exhibits antioxidant properties by effectively scavenging free radicals in human plasma, but this benefit might be disturbed by the hydrophobic lipid layer of the cell membrane. In contrast, intracellular free oxygen radicals are produced during UA degradation, and superoxide is further enhanced by interacting with NADPH oxidase. This intracellular oxidative stress, together with inflammatory cytokines induced by UA, stimulates osteoclast bone resorption and inhibits osteoblast bone formation. UA also inhibits vitamin D production and thereby results in hyper-parathyroidism, which causes less UA excretion in the intestines and renal proximal tubules by inhibiting the urate transporter ATP-binding cassette subfamily G member 2 (ABCG2). At normal or high levels, UA is associated with a reduction in bone mineral density and protects against bone fracture. However, in hyperuricemia or gout arthritis, UA increases bone fracture risk because oxidative stress and inflammatory cytokines can increase bone resorption and decrease bone formation. Vitamin D deficiency, and consequent secondary hyperparathyroidism, can further increase bone resorption and aggravated bone loss in UA-induced osteoporosis.
The development of sodium-glucose transporter 2 inhibitor (SGLT2i) broadens the therapeutic strategies in treating diabetes mellitus. By inhibiting sodium and glucose reabsorption from the proximal ...tubules, the improvement in insulin resistance and natriuresis improved the cardiovascular mortality in diabetes mellitus (DM) patients. It has been known that SGLT2i also provided renoprotection by lowering the intraglomerular hypertension by modulating the pre- and post- glomerular vascular tone. The application of SGLT2i also provided metabolic and hemodynamic benefits in molecular aspects. The recent DAPA-CKD trial and EMPEROR-Reduced trial provided clinical evidence of renal and cardiac protection, even in non-DM patients. Therefore, the aim of the review is to clarify the hemodynamic and metabolic modulation of SGLT2i from the molecular mechanism.
This paper applies dynamic network slacks‐based data envelopment analysis to measure financial performance based on the interrelationship among investment, financing, and dividend decisions. The ...empirical results show that financial performance is determined simultaneously by the efficiency of decisions, and sample firms have good performance in investment stage, but need to improve their financing and dividend policies. The proposal financial performance measure explains the multicriteria of decision‐making rather than the single financial ratios. Besides, the research contributes a novel on the significant relationship between firm's ownership structure in the form of managers, government and foreign shareholders, and the firm's financial performance.
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is still an ongoing global health crisis. Immediately after the inhalation of SARS-CoV-2 ...viral particles, alveolar type II epithelial cells harbor and initiate local innate immunity. These particles can infect circulating macrophages, which then present the coronavirus antigens to T cells. Subsequently, the activation and differentiation of various types of T cells, as well as uncontrollable cytokine release (also known as cytokine storms), result in tissue destruction and amplification of the immune response. Vitamin D enhances the innate immunity required for combating COVID-19 by activating toll-like receptor 2. It also enhances antimicrobial peptide synthesis, such as through the promotion of the expression and secretion of cathelicidin and β-defensin; promotes autophagy through autophagosome formation; and increases the synthesis of lysosomal degradation enzymes within macrophages. Regarding adaptive immunity, vitamin D enhances CD4+ T cells, suppresses T helper 17 cells, and promotes the production of virus-specific antibodies by activating T cell-dependent B cells. Moreover, vitamin D attenuates the release of pro-inflammatory cytokines by CD4+ T cells through nuclear factor κB signaling, thereby inhibiting the development of a cytokine storm. SARS-CoV-2 enters cells after its spike proteins are bound to angiotensin-converting enzyme 2 (ACE2) receptors. Vitamin D increases the bioavailability and expression of ACE2, which may be responsible for trapping and inactivating the virus. Activation of the renin–angiotensin–aldosterone system (RAS) is responsible for tissue destruction, inflammation, and organ failure related to SARS-CoV-2. Vitamin D inhibits renin expression and serves as a negative RAS regulator. In conclusion, vitamin D defends the body against SARS-CoV-2 through a novel complex mechanism that operates through interactions between the activation of both innate and adaptive immunity, ACE2 expression, and inhibition of the RAS system. Multiple observation studies have shown that serum concentrations of 25 hydroxyvitamin D are inversely correlated with the incidence or severity of COVID-19. The evidence gathered thus far, generally meets Hill’s causality criteria in a biological system, although experimental verification is not sufficient. We speculated that adequate vitamin D supplementation may be essential for mitigating the progression and severity of COVID-19. Future studies are warranted to determine the dosage and effectiveness of vitamin D supplementation among different populations of individuals with COVID-19.
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