This study examines the interplay between environmental management (EM), environmental performance (EP), and corporate financial performance (CFP) within the global food and beverage (F&B) industry to advance the discourse on sustainable development. By leveraging the natural resource-based view (NRBV) and stakeholder theory, it investigates how internal environmental policy translates into financial outcomes and evaluates the moderating role of brand visibility in facilitating stakeholder engagement. Using system generalized method of moments (GMMs) on panel data from 540 firms spanning 2015 to 2023, the findings reveal that EM significantly improves market-based CFP (Tobin's Q), but has no direct effect on accounting-based measures (ROA and ROE). EP shows no direct financial impact, though EM positively influences EP. Brand visibility significantly moderates the EM-CFP and EP-CFP relationships, amplifying their effects. The study clarifies the distinct roles of EM and EP, addresses mixed findings in prior research, and highlights the strategic importance of integrating environmental and marketing capabilities to drive competitive advantage and enhance firm performance.
Rheumatoid Arthritis (RA) is a chronic auto-immune condition marked by swelling of synovial membrane, leading to joint discomfort, swelling, and the erosion of bone and cartilage. While the exact origin of rheumatoid arthritis remains uncertain, various medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, disease-modifying antirheumatic drugs (DMARDs), and biologic drugs have been utilized for its treatment. However, upon administration, these drugs distribute throughout the body, resulting in both wastage and potential side effects. Targeted drug delivery has been proposed to overcome the limitations of conventional therapy, while precision medicine is widely acknowledged to tailor treatments according to individual patient needs. This narrative review focuses on various advanced drug delivery strategies for management of RA, with a particular emphasis on active targeting approaches, stimuli responsive drug delivery and progressive integration of artificial intelligence in enabling precision diagnosis, treatment, and optimized therapeutic outcomes. Methods: An exhaustive literature review was conducted using PubMed, Scopus and Web of sciences databases on various targeted drug delivery strategies for management of RA. Mechanistically, folate, CD44, scavenger receptor or CD163 receptor targeting coupled with stimuli-responsive approach ensures targeted delivery of therapeutic agents, leading to reduction of TNF and IL-6 biomarkers. AI models, including deep learning, supervised and unsupervised machine learning models based on datasets, help in early detection of joint erosion, bone damage, and synovial inflammation more accurately than traditional methods. It helps to identify individuals at high risk of developing RA by analyzing multiple data sources including electronic health records (EHR) data, lab biomarkers, medication history, and clinical documentation. Supervised machine learning helps to predict disease severity and treatment responses. This allows for individualized dose adjustments and precision therapeutics. Further, AI enables treatment optimization based on each patient’s clinical profile. This narrative review concluded that various targeting strategies enhance the efficacy of therapeutic agents while the integration of AI in RA helps in early diagnosis, individualized treatment, and substantial precision in therapy. Furthermore, it emphasizes the need for future research to concentrate on creating versatile nanocarrier systems that can target multiple pathways related to RA simultaneously. Earlier reviews on RA dwelled only on targeting strategies for drug delivery and very few have focused on the AI integration in RA. Unlike those reviews, this review integrates three main approaches such as active targeting, stimuli-responsive delivery systems, and AI. It emphasizes how AI not only helps in the diagnosis of RA but it also helps in ligand selection, design of nanocarriers and therapy customization for precision therapy. Additionally, the prognostic outlook on personalized, data-driven AI-integrated nanocarriers for RA is provided.
Traditionally recognized for its role in calcium homeostasis and bone metabolism, vitamin D is increasingly acknowledged for its broader physiological effects, particularly in cardiovascular health. One area of growing interest is its influence on cardiac autonomic function. Cardiac autonomic dysfunction, characterized by an imbalance between sympathetic and parasympathetic activity, is a well-established predictor of adverse cardiovascular outcomes. This narrative review aims to synthesize the current literature on the association between vitamin D status and cardiac autonomic function. Accumulating observational data indicate that individuals with vitamin D deficiency exhibit poorer cardiac autonomic function, reflected by reduced heart rate variability indices, compared to vitamin D-sufficient individuals. Interventional trials, though limited, suggest that vitamin D supplementation may improve autonomic balance, especially in those with baseline deficiency. The relationship appears to be affected by factors such as glycemic control, disease state, and vitamin D binding protein levels. Vitamin D may modulate autonomic regulation largely via the vitamin D receptor, which activation influences multiple downstream pathways, including central nervous system effects, neurotrophic properties, regulation of the renin-angiotensin-aldosterone system, calcium-parathyroid hormone axis, and immune modulation. However, inconsistencies in study design, population characteristics, and assessment methods limit the strength of current evidence. Further longitudinal and interventional studies are warranted to establish causality and determine whether vitamin D repletion can reduce cardiovascular risk by restoring autonomic balance.
PurposeThis study aims to investigate whether diversification stabilizes bank lending over the business cycle, with a particular focus on differences between Islamic and conventional banks in dual-banking systems.Design/methodology/approachUsing a dynamic panel of 65 banks from the Gulf Cooperation Council between 2008 and 2021, the analysis uses the system generalized method of moments estimator to examine the effects of loan and income diversification, measured using inverse Herfindahl-Hirschman Index (inverse HHI) indicators, on credit cyclicality.FindingsThe results reveal a nonlinear, inverted U-shaped relationship between GDP growth and credit expansion. Conventional banks remain procyclical throughout the cycle, while Islamic banks are procyclical mainly during downturns. Income diversification supports overall credit growth but increases procyclicality in highly diversified conventional banks. Loan portfolio diversification reduces procyclicality in both bank types, particularly at moderate diversification levels.Research limitations/implicationsThe study focuses on Gulf Cooperation Council banks and may not generalize to other banking systems. Future research could explore broader regional contexts and alternative diversification measures beyond inverse HHI-based measures.Practical implicationsPolicymakers should consider institutional and portfolio differences in macroprudential frameworks, encouraging loan diversification while carefully monitoring the systemic risks of income-based expansion.Social implicationsThis study shows how diversification strategies influence credit stability over the business cycle in dual-banking systems. By identifying when loan diversification dampens procyclicality and when income diversification may amplify it, the findings inform macroprudential policy design aimed at reducing excessive credit contractions. In bank-based economies, a more stable credit supply supports the continuity of investment and the resilience of small businesses. The results also contribute to a more balanced understanding of Islamic and conventional banking models, highlighting that financial resilience depends on portfolio structure rather than institutional form alone.Originality/valueThis study offers novel evidence on the nonlinear and bank-type-specific effects of diversification on lending cyclicality, providing policy-relevant insights for dual-banking systems.
While continuous positive airway pressure (CPAP) reduces cardiovascular risk in obstructive sleep apnea (OSA), its effects on renin–angiotensin–aldosterone system (RAAS) modulation remain controversial. This meta-analysis investigates CPAP's differential impacts on RAAS components and identifies responsive patient subgroups. Sixteen studies were included in the systematic review and eight (231 patients) in the meta-analysis. Primary outcomes included plasma aldosterone concentration (PAC), plasma renin activity (PRA), and angiotensin II (AngII) changes. Subgroup analyses examined age, BMI, and CPAP duration thresholds, with meta-regression assessing moderating factors. CPAP significantly reduced PAC (d + of -0.72, 95
