Epidemiology of type 2 diabetes in the Middle East and North Africa:Challenges and call for action

Type 2 diabetes continues to be a serious and highly prevalent public health problem worldwide.In 2019,the highest prevalence of diabetes in the world at 12.2%,with its associated morbidity and mortality,was found in the Middle East and North Africa region.In addition to a genetic predisposition in its population,evidence suggests that obesity,physical inactivity,urbanization,and poor nutritional habits have contributed to the high prevalence of diabetes and prediabetes in the region.These risk factors have also led to an earlier onset of type 2 diabetes among children and adolescents,negatively affecting the productive years of the youth and their quality of life.Furthermore,efforts to control the rising prevalence of diabetes and its complications have been challenged and complicated by the political instability and armed conflict in some countries of the region and the recent coronavirus disease 2019.Broad strategies,coupled with targeted interventions at the regional,national,and community levels are needed to address and curb the spread of this public health crisis.

Potential for human immunodeficiency virus parenteral transmission in the Middle East and North Africa: An analysis using hepatitis C virus as a proxy biomarker

The Middle East and North Africa(MENA) region has endured several major events of infection parenteral transmission. Recent work has established the utility of using hepatitis C virus(HCV) as a proxy biomarker for assessing the epidemic potential for human immunodeficiency virus(HIV) parenteral transmission. In this review, we use data on the prevalence of HCV infection antibody(seroprevalence) among general population and high risk population groups to assess the potential for HIV parenteral transmission in MENA. Relatively low prevalence of HCV infection in the general population groups was reported in most MENA countries indicating that parenteral HIV transmission at endemic levels does not appear to be a cause for concern. Nonetheless, there could be opportunities for localized HIV outbreaks and transmission of other blood-borne infections in some settings such as healthcare facilities. Though there have been steady improvements in safety measures related to parenteral modes of transmission in the region, these improvements have not been uniform across all countries. More precautions, including infection control training programs, surveillance systems for nosocomial infections and wider coverage and evaluation of hepatitis B virus immunization programs need to be implemented to avoid the unnecessary spread of HIV, HCV, and other blood-borne pathogens along the parenteral modes of transmission.

The Middle East and North Africa （MENA） Oil Exporters After the Global Crisis

Our research topic is about the economic situation in the Middle East and North Africa （MENA） oil exporters after the global crisis in 2008. The authors tried to find the answers to the questions such as ＂How bad or good is the situation there？＂ and ＂what is the expectation about the future of the region？＂ Like other countries around the world, the MENA oil exporters, comprised of Algeria, Bahrain, Iran, Iraq, Kuwait, Libya, Oman, Qatar, Saudi Arabia, Sudan, United Arab Emirates, Yemen were adversely affected by the global crisis. The MENA oil exporters are recently recovering from their recession in 2009 when the global crisis was felt intensively there. GDP in the region has grown by 3.5 percent in 2010 after a low growth of 0.7 percent in 2009. The average real GDP growth excluding Libya is projected to reach 4.9 percent in 2011. Two developments mark the outlook： the unrest in the region and the surge in global fuel and food prices. For most oil exporters, the expected increase in oil prices and production volumes will lead to higher growth in 2011 and stronger fiscal and external balances, notwithstanding recent increases in government spending. The oil exporters＇ combined external current account surplus is estimated to increase. The effects of the political events in Tunisia and Egypt have spread in varying degrees to the MENA oil exporters in the region, and many of these countries are responding with public spending and job-creation measures to alleviate social tensions. The social unrest also highlights the need to pursue fundamental economic reforms--social policy, fiscal management, governance, business environment, labor markets, and financial sector access to facilitate more inclusive economic growth. While the MENA countries are generally divided into two sub-regions such as ＂oil exporters＂ and ＂oil importers＂ in the economic literature, the authors will deal with only the MENA oil exporters in this work. The negative effects of the global crisis in these countries on growth, inflation, current account balance, budget balance, and finally financial sector will be reviewed in this work and the expectations and the developments which occurred after the crisis in these countries will be dealt with especially in the context of the IMF reports.

Hepatitis C virus among blood donors and general population in Middle East and North Africa:Meta-analyses and meta-regressions

BACKGROUND Despite the Middle East and North Africa(MENA)Region reported to have the highest prevalence of hepatitis C virus(HCV)globally,HCV infection levels in the majority of MENA countries remain inadequately characterized.Blood donor data have been previously used as a proxy to assess levels and trends of HCV in the general population,however,it is unclear how comparable these populations are in MENA and whether blood donors provide an appropriate proxy.AIM To delineate HCV epidemiology among blood donors and the general population in the MENA.METHODS The data source was the systematically gathered MENA HCV Epidemiology Synthesis Project Database.Random-effects meta-analyses and meta-regressions were conducted.For comparison,analyses were conducted for Europe,utilizing the Hepatitis C Prevalence Database of the European Centre for Disease Prevention and Control.RESULTS One thousand two hundred and thirteen HCV antibody prevalence measures and 84 viremic rate measures were analyzed for MENA.Three hundred and seventyseven antibody prevalence measures were analyzed for Europe.In MENA,pooled mean prevalence was 1.58%[95%confidence interval(CI):1.48%–1.69%]among blood donors and 4.49%(95%CI:4.10%–4.90%)in the general population.In Europe,pooled prevalence was 0.11%(95%CI:0.10%–0.13%)among blood donors and 1.59%(95%CI:1.25%–1.97%)in the general population.Prevalence in the general population was 1.72-fold(95%CI:1.50–1.97)higher than that in blood donors in MENA,but it was 15.10-fold(95%CI:11.48–19.86)higher in Europe.Prevalence was declining at a rate of 4%per year in both MENA and Europe[adjusted risk ratio:0.96(95%CI:0.95–0.97)in MENA and 0.96(95%CI:0.92–0.99)in Europe].Pooled mean viremic rate in MENA was 76.29%(95%CI:67.64%–84.02%)among blood donors and 65.73%(95%CI:61.03%–70.29%)in the general population.CONCLUSION Blood donor data provide a useful proxy for HCV infection in the wider population in MENA,but not Europe,and could improve HCV burden estimations and assess progress toward HCV elimination by 2030.

Hepatocellular Carcinoma in Chad: A Retrospective Study of 219 Cases

Background: Although hepatocellular carcinoma was historically considered an important scourge in Middle Africa, there is no publication describing this disease in Chad. Methods: We conducted a retrospective analysis of 219 patients with hepatocellular carcinoma (HCC) attending care at the University Reference Hospital of Ndjamena between 2007 and 2016. Results: This series of HCC was characterized by a male predominance (M:F = 2.4) with a mean tumor onset at the end of the fifth decade of life (49.9 ± 14.7 years). Tumors appear on a cirrhotic liver in 70% of cases and were already multifocal at diagnosis in two thirds of the patients. Alpha-fetoprotein was above the physiological threshold (10 ng/mL) in 73.4% of cases measured and above the so-called diagnostic level (400 ng/mL) in 53.4% of patients. The principal risk factor was chronic infection with hepatitis B virus, detected in 52.6% of cases. Patients seropositive for hepatitis C virus were infrequent (8.6%) and heavy alcohol intake was even less prevalent (5.9%). Remarkably, a very large subset of patients did not present any infectious or lifestyle risk factor (43.4%). Mean AFP values or fibrosis assessment scores are usually lower in these patients than in HBV-infected ones. Conclusions: The etiological spectrum of HCC is far from being fully established in Chad. Further epidemiological research is warranted to identify risk factors involved in a large proportion of cases. Exposure to aflatoxin B1 and dysmetabolic conditions affecting the liver have to be investigated as priority.

Is a correlation‑based investment strategy beneficial for long‑term international portfolio investors?

Using negative to low-correlated assets to manage short-term portfolio risk is not uncommon among investors,although the long-term benefits of this strategy remain unclear.This study examines the long-term benefits of the correlation strategy for portfolios based on the stock market in Asia,Central and Eastern Europe,the Middle East and North Africa,and Latin America from 2000 to 2016.Our strategy is as follows.We develop five portfolios based on the average unconditional correlation between domestic and foreign assets from 2000 to 2016.This yields five regional portfolios based on low to high correlations.In the presence of selected economic and financial conditions,long-term diversification gains for each regional portfolio are evaluated using a panel cointegration-based testing method.Consistent across all portfolios and regions,our key cointegration results suggest that selecting a low-correlated portfolio to maximize diversification gains does not necessarily result in long-term diversification gains.Our empirical method,which also permits the estimation of cointegrating regressions,provides the opportunity to evaluate the impact of oil prices,U.S.stock market fluctuations,and investor sentiments on regional portfolios,as well as to hedge against these fluctuations.Finally,we extend our data to cover the years 2017–2022 and find that our main findings are robust.

Youth Role in the Arab Spring

Middle East and North Africa （MENA） has been experiencing a unique demographic transition in the world especially after September 11, whilst, its social, political and economic structures have considerably remained inflexible and can hardly meet the increasing demands of employment among the youth whose expectations are raised through expansion in education. In spite of various common causes for the Arab uprisings, the paper spotlights the ＂Youth role＂ and its regarded issues of ＂Youth Bulge＂, ＂Education＂ and ＂Unemployment＂ with a glimpse to the overturned regimes of ＂Tunisia, Egypt, Libya, and Yemen＂. According to published statistics these countries are among the countries with the highest rate of youth as working age population in MENA. Therefore, the paper is to present the importance and impact of youth as a social parameter in challenging political structure of the countries in the MENA and leading to topple their political systems. Thus, the paper reasons the MENA political upheavals, in general, and the mentioned countries＇ uprisings, in particular, can not be well understood disregarding to natural tensions between economic, population structures, and political demographic challenges. This is to be done drawing on data from different international institutions. The intervened variables such as ＂ethnicity, race, religion and sexuality＂ and international parameters have not been considered.

LM-3B Launches Tiantong 1 Satellite

China Launched its first satellite for mobile communications on a LM-3B launch vehicle from the Xichang Satellite Launch Center at 0：22 on August 6,2016.The Tiantong 1 satellite was developed by the China Academy of Space Technology under CASC to provide all-weather,all-time stable and reliable mobile communications services to China and surrounding regions as well as to the Middle East,Africa,

Beneficial effects of date palm fruits on neurodegenerative diseases

Date palm tree（Phoenix dactylifera L.）is an important crop,which is cultivated in many countries extending from North Africa to the Middle East,including many of the GCC（Gulf Cooperation Council）Countries（Allaith,2008）.

The Relative Deprivation Theory and Yemen＇s Uprising

The political upheavals in the Arab world during 2011 challenged the political status quo and have irrevocably paved the way toward transformation in the Middle East and North Africa （MENA）, The longstanding structural impediments to equitable growth and social justice afflicting the Arab world came to a head through a combination of persistently poverty, high unemployment, particularly among educated youth, rampant corruption, deficit of democratic governance, and essential freedoms. Yemen is the third country of the Middle Eastern countries which turmoil sparked in. All the uprisings connote of social, political and economic discontent and frustration. The main question and issue of this paper is to answer： What conditions breed change to Yemen？ The paper spotlights ＂relative deprivation＂ of Ted Robert Gurr as the most relevant theory to illustrate roots of the Yemen uprising. Relative deprivation theory holds that instead of an absolute standard deprivation, a gap between expectations and reality leads men to political violence. Therefore, this study is to utilize relative deprivation theory to explain how socio-economic shortages （such as high unemployment and education, along with poverty） and political inefficiencies of the Yemen＇s authoritarian regime led to public and collective discontent and upheaval. The intervened variables such as ＂ethnicity, race, religion, and sexuality＂ and international parameters have not been considered,

The Turbulent Middle East: Analysing Security Issues facing China’s Belt and Road Initiative towards the Region

Since the announcement of the‘Belt and Road Initiative’(BRI)in 2013,China has yet to unveil the greatest challenge facing the implementation of this initiative.The Middle East offers both strategic as well as resource opportunities for China but the region remains fluid and unstable security wise.Shaky regional alliances,a dissatisfied labour force,pressures from non-state actors,gender discrimination and human rights abuses and sustained external intervention are just some of the security issues facing the Middle East.How would China navigate itself in such a volatile region without jeopardizing its interests and without breaking the principles of non-intervention and sovereignty?More importantly,what type of power does China want to project vis-a-vis the region?This paper argues that the Middle East region,among all the world’s regions,is the most critical for the success of the BRI.China’s ability to maximize gains amidst regional security challenges will determine the future of its global political and economic influences.The region is a test for China’s diplomacy and credibility,which are crucial for its status as a future global power.

The Fate of the Arab Spring:Ten Propositions

This article attempts to set the discussion of the Arab Spring in the context of one of the great challenges of our times:how social and international order can develop in the wake of empires.It outlines some of the main events of the Arab Spring–the series of political and social movements that played significant roles in many of the countries of the Middle East and North Africa from December 1990 onwards.It focuses on the central role of civil resistance(i.e.of non-violent action)in the Arab Spring,and mentions some of the main controversies regarding its use.It notes the variations in aims:in some countries demonstrators called for the fall of the regime,while elsewhere the main demand was for reforms.It warns against certain deceptively simple lessons about the Arab Spring generally that are in danger of gaining traction in and beyond the region.It shows,in simple tabular form,how different the countries involved in the Arab Spring are.The outcomes were very varied.They included effective constitutional change in Tunisia,revival of a long-established system of rule in Egypt,internationalized civil wars in Yemen and Syria,and continuation of demands for reform in monarchical states including Morocco,Jordan and Bahrain.Ten propositions about the role of civil resistance in the Arab Spring are advanced.The central arguments are that civil resistance,if it displaces a regime without providing for an effective succession,can involuntarily contribute to social disorder;that the decentralized and ad hoc quality of the leadership of some of the movements in the Arab Spring may have hindered their performance;and,above all,that outcomes depended heavily on the composition and circumstances of each individual country.

Russia’s Peace Initiatives in the MENA Region: Evaluation and Prospects

Russia’s recent thundering‘return’to the Middle East is first and foremost an obvious result of the effective use of hard power,rather than the tools of soft power such as economics or diplomacy,which played important but secondary roles.The most visible symbol of this return is the establishment of two permanent sovereign Russian military bases in Syria.Indeed,Moscow has extensive experience in employing hard power to protect its interests,but political,financial and security costs and risks of its application are aplenty,which will dictate Russia’s more cautious policy on this matter in the future.Having gained a military foothold in the region,Russia now seeks to augment its influence in the MENA region further,and increasingly through the use of soft power,particularly diplomatic initiatives.The Astana-Sochi process is the format that Russia has moulded for this purpose.The study seeks to provide,first,an analysis of the Astana-Sochi process for Syria,its theoretical foundations and practical implementations,evaluation of its strengths and weaknesses,and then explore its applicability in the MENA region considering both objective features of the format and more subjective implications of the wider Russian involvement in the region against the backdrop of rising tensions between Moscow and the West.