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This paper aims to investigate the effect of L-citrulline supplementation on blood pressure (BP) in middle-aged and elderly populations.

Three electronic databases, namely, Google Scholar, PubMed and Scopus, were searched from 1990 to November 2020. Random effects model analysis was applied for quantitative data synthesis, and 6 trials with 150 participants were identified and included in the analysis.

Results showed an overall non-significant effect of L-citrulline supplementation on both systolic BP (SBP) and diastolic BP (DBP) in middle-aged and elderly participants. However, stratified analysis indicated a significant reduction in SBP (SMD: −0.41, 95% CI: −0.84, 0.02; p = 0.06, heterogeneity p = 0.41; I2 = 10%) but not in DBP (SMD:−0.15, 95% CI: −0.57, 0.28; p = 0.51, heterogeneity p = 0.60; I2 = 0%), following longer-term (= 8 weeks) supplementation of L-citrulline. Additionally, higher doses of L-citrulline (= 6 grams) showed a marginally significant reduction in DBP (SMD: −0.38, 95% CI: −0.78, 0.02; p = 0.06, heterogeneity p = 0.50; I2 = 0%).

In conclusion, a higher dosage and longer duration of supplementation with L-citrulline may have potential BP lowering effects in populations at an increased risk of hypertension

The main purpose of this paper is to predicate financial distress using the worst-practice-frontier data envelopment analysis (WPF-DEA) model and artificial neural network.

In this study, a neural network technique was used to forecast inputs and outputs in the future time-period. Using a WPF-DEA model, financially distressed companies were identified based on the worst performance, and an improvement solution was provided for those decision-making units.

This study’s findings show that dynamic WPF-DEA has high predictability in corporate financial distress, and it can be used with high confidence. Based on the future time-period results, JOUSH & OXYGEN was predicted to be a financially distressed company in the two future time-periods.

In recent decades, globalization, technological changes and a competitive space have increased uncertainty in the economic environment. In such circumstances, economic growth certainly depends on correct decision-making and optimal allocation of resources. It can be done by introducing appropriate tools and models for assessing corporate financial conditions, including financial distress and bankruptcy.

This study aims to investigate the impact of corporate social performance (CSP) on financial performance of manufacturing companies listed on the Tehran Stock Exchange and thus contributes to understanding the significance of socially responsible investments for companies.

The CSP was measured by a questionnaire composed of 53 items related to customers’ social performance of the firm, workers and environmental and community dimensions. Besides, corporate financial performance was measured by two measures, return on equity (ROE) and return on assets (ROA). In this study, 74 observations were investigated from 2006 to 2012. The data were analyzed using the multiple regression method.

The results of the study revealed that customers’ social performance of the firm has a negative impact on ROA of the firm. Besides, social performance of the workers dimension of the firm has a positive impact on ROA. The results, also, showed that none of the CSP dimensions affected the ROE of the firms.

The present study is useful for managers to develop future social performance policies that may lead to better financial performance in the long-term. The paper, also, contributes to the corporate social responsibility literature, as it presents empirical evidence of the effects of CSP on the financial performance in the manufacturing sector of developing countries.

This study explored whether the critical incident management systems (CIMS) model can predict the EMS performance in the COVID-19 context. Past research has established the significance of early detection and response (ER) in the context of Ebola virus disease (EVD), prompting a question of whether the model can also be helpful in the COVID-19 context. Consequently, the authors assessed whether ER influences the impact of communication capacity (CC), reliable information channel (RC) and environment (EN) on COVID-19 EMS performance. Assessing these relationships will advance emerging infectious disease (EID) preparedness.

The authors employed standardized measurement instruments of the CIMS model (CC, ER, RC and EN) to predict the performance of COVID-19 EMS using structural equation modeling (SEM) in a study of 313 participants from frontline responders.

The results show that the relationship of ER and EN with COVID-19 EMS performance is positive, while that of EN on CC is negative. The relationship between EN and COVID-19 EMS performance was insignificant. Contrary to the hypothesis, CC was negatively significant to COVID-19 EMS performance due to poor communication capacities.

The authors acknowledge some limitations due to challenges faced in this study. First, Data collection was a significant limitation as these questionnaires were built and distributed in June 2020, but the response time was prolonged due to the recurring nature of the pandemic. The authors had wanted to implore the inputs of all stakeholders, and efforts were made to reach out to various Ministry of Health, the local CDC and related agencies in the region via repeated emails explaining the purpose of the study to no avail. The study finally used the frontline workers as the respondents. The authors used international students from various countries as the representatives to reach out to their countries' frontline workers. Second, since the study was only partially supported using the CIMS model, future studies may combine the CIMS model with other models or theories. Subsequent research reassesses this outcome in other contexts or regions. Consequently, further research can explore how CC can be improved with COVID-19 and another future EID in the region. This may improve the COVID-19 EMS performance, thereby expanding the lesson learned from the pandemic and sustaining public health EID response. Additionally, other authors may combine the CIMS model with other emergency management models or theories to establish a fully supported theoretical model in the context of COVID-19.

The findings have practical implications for incident managers, local CDCs, governments, international organizations and scholars. The outcome of the study might inform these stakeholders on future direction and contribution to EID preparedness. This study unfolds the impact of lessons learned in the region demonstrated by moderating early detection and responses with other constructs to achieve COVID-19 EMS performance. The findings reveal that countries that experienced the 2013–2016 Ebola outbreak, were not necessarily more prepared for an epidemic or pandemic, judging by the negative moderating impact of early detection and response. However, these experiences provide a foundation for the fight against COVID-19. There is a need for localized plans tailored to each country's situation, resources, culture and lifestyle. The localized plan will be to mitigate and prevent an unsustainable EID management system, post-epidemic fund withdrawals and governance. This plan might be more adaptable and sustainable for the local health system when international interventions are withdrawn after an epidemic. Public health EID plans must be adapted to each country's unique situation to ensure sustainability and constantly improve EID management of epidemics and pandemics in emergency response. The high to moderate importation risk in African countries shows Africa's largest window of vulnerability to be West Africa (Gilbert et al., 2020). Therefore, they should be in the spotlight for heightened assistance towards the preparedness and response for a future pandemic like COVID-19. The West African region has a low capacity to manage the health emergency to match the population capacities. The COVID-19 outbreak in West Africa undoubtedly inflicted many disruptions in most countries' economic, social and environmental circumstances. The region's unique challenges observed in this study with CC and reliable information channels as being negatively significant highlight the poor maintenance culture and weak institutions due to brain drain and inadequate training and monitoring. This outcome practically informs West African stakeholders and governments on aspects to indulge when trying to improve emergency preparedness as the outcomes from other regions might not be applicable.

This study explored the relevance of the CIMS model in the context of the COVID-19 pandemic, revealing different patterns of influence on COVID-19 EMS performance. In contrast to the extant literature on EVD, the authors found the moderating effects of ER in the COVID-19 context. Thus, the authors contribute to the COVID-19 EMS performance domain by developing a context-driven EMS model. The authors discuss the theoretical and practical implications.