Search Results (273)

Background and Objectives: The uric acid to HDL-cholesterol ratio (UHR) has recently emerged as a promising biomarker reflecting systemic inflammation and metabolic disturbances. Elevated liver transaminases are clinical indicators of hepatic injury and underlying metabolic dysfunction. Many Middle Eastern countries face constrained clinical and laboratory resources, where access to comprehensive diagnostic tools may be limited. In such settings, identifying simple and easily accessible markers could offer significant practical value in detecting and monitoring health disorders. This study investigates the potential association between UHR and elevated liver transaminases levels in the Saudi general population. Materials and Methods: This retrospective cross-sectional study included 9618 subjects, and the association between the UHR and elevated liver transaminases, alanine transaminase (ALT), and aspartate transaminase (AST), was comprehensively analysed. In addition, the study assessed risk indicators including the prevalence ratio (PR) and odds ratio (OR) as well as the diagnostic accuracy of UHR and C-reactive protein (CRP) in detecting liver transaminases abnormalities, with analyses stratified by age and gender. Results: UHR was significantly elevated in subjects with increased ALT and AST activities, and this pattern was consistent across all age and gender categories. High UHR was significantly associated with elevated ALT (OR = 2.32, 95% CI: 2.12–2.53, p < 0.001) and AST (OR = 1.38, 95% CI: 1.25–1.52, p < 0.001), with stronger associations observed in males and for ALT activity. In addition, elevated UHR was more prevalent among individuals with increased liver transaminase activities. Receiver operating characteristic (ROC) analysis showed that UHR outperformed CRP in identifying elevated liver transaminases, with better discriminative ability for ALT than AST activity. Conclusions: These findings highlight a significant association between UHR and liver transaminase abnormalities in the general population, underscoring the potential utility of UHR as a simple and accessible indicator for liver function assessment in clinical settings. Full article

Vaccine equity and access remain critical challenges in global health, particularly in regions with complex socio-political landscapes, like the Middle East. This review examines disparities in vaccine distribution within the Middle Eastern context, analyzing the unique challenges and opportunities across the region. It provides an overview of the area’s diverse finances and its impact on healthcare accessibility. We examine vaccination rates and identify critical barriers to vaccination, which may be particular issues in developing countries, such as vaccine thermostability, logistical hurdles, financial constraints, and socio-cultural factors, or broader problems, like political instability, economic limitations, and deficiencies in healthcare infrastructure. However, we also highlight successful efforts at the regional and national levels to improve vaccine equity, along with their outcomes and impacts. Ultimately, by drawing on the experiences of previous programs and initiatives, we propose strategies to bridge the gaps in vaccine access through sustainable financing, local manufacturing, and the strengthening of health systems. This approach emphasizes the importance of regional collaboration and long-term self-sufficiency in enhancing global health security and achieving more equitable outcomes in the Middle East. Full article

The Yangtze River Economic Belt (YEB), serving as a pivotal transportation corridor connecting eastern and western China and a national strategic development hub, plays a central role in driving high-quality economic development (HQAED) across the country. Based on the new development paradigm with emphasis on green transformation and transportation integration, this study proposes a comprehensive evaluation framework for an HQAED index (HQAED) across five core dimensions. Employing the entropy-weighted CRITIC method to quantify provincial HQAED values, combined with Dagum–Gini coefficient analysis to examine regional inequality patterns and determinants, and complemented by kernel density estimation (KDE) for temporal dynamics analysis, this research reveals four key findings: (1) There are significant disparities in HQEDI levels across the YEB, with a clear east–west gradient: the lower reaches > middle reaches > upper reaches. (2) While the dimensions of green development and shared development have shown steady growth despite initial disadvantages, the openness dimension faces structural challenges that require particular attention. (3) The overall Gini coefficient fluctuates between 0.068 and 0.094, indicating moderate regional disparities with relatively limited inequality. (4) The rightward shift in the HQEDI kernel density curves confirms overall progress, but also highlights widening disparities in the upstream regions and growth stagnation in the midstream areas. Practically, the entropy–CRITIC fusion methodology offers a transferable framework for emerging economies measuring sustainability-transition progress, while the quantified “green transportation empowerment” effects provide actionable levers for policymakers to optimize ecological compensation mechanisms and cross-regional infrastructure investments. Full article

Biodiversity conservation plays a pivotal role in achieving sustainable development and fostering harmonious coexistence between humans and nature. This study identifies avian conservation priority areas across China by analyzing multi-dimensional biodiversity, incorporating species diversity, functional diversity, and phylogenetic diversity. Through systematic conservation planning using Zonation version 4 software, we delineated priority areas across these diversity dimensions. Our results demonstrate a distinct south-to-north diversity gradient in China’s avifauna, with functional and phylogenetic diversity hotspots concentrated in Yunnan Province, the Hengduan Mountains, Hainan Island, Taiwan Island, and southeastern coastal regions. The identified priority conservation areas cover 14.6% of China’s terrestrial territory, protecting 89.8% of the country’s bird species—including 93.5% of endemic species and 88.9% of critically endangered species. Notably, existing nature reserves encompass merely 8.1% of these priority areas, revealing substantial conservation gaps within the current protection framework. Building upon China’s 3C Zoning Framework (Cities and farms, Shared landscapes, and Large wild areas), we propose zone-specific conservation strategies, with particular emphasis on strengthening protected area networks in the eastern coastal regions and the middle-lower Yangtze River basin, where urbanization pressures are most acute. These findings highlight the critical importance of incorporating multi-dimensional diversity in conservation planning and offer novel perspectives for optimizing China’s protected area system. Full article

Salvia atropatana is a medicinal plant native to Middle Eastern countries. It has been traditionally used in Turkish and Iranian folk medicine to treat infections, wounds, inflammatory diseases, spastic conditions, and diabetes. Its therapeutic potential has been attributed to its essential oil, polyphenolic acid, flavonoid, and diterpenoid content. The aim of the study was to determine the optimal conditions of in vitro S. atropatana shoot culture to enhance proliferation and secondary metabolite production. It examined the effects of various cytokinins and culture duration on culture growth parameters and phenolic compound accumulation. Exogenous cytokinin supplementation significantly enhanced shoot proliferation, with the highest proliferation ratio (6.3) observed with 1 and 2 mg/L 6-benzylaminopurine (BAP). Biomass accumulation was the highest at 0.5 mg/L BAP, followed by 1 and 2 mg/L meta-toplin (mTOP). Phenolic profiling identified nine compounds, with rosmarinic acid (RA) as the dominant metabolite. The highest RA content (16 mg/g dry weight) was achieved with 1 and 2 mg/L BAP and 0.5 mg/L of its ryboside. The TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) method identified 1 mg/L BAP as the optimal treatment, balancing high proliferation, biomass, and polyphenol accumulation. Extending culture duration to 50 days increased biomass and phenolic content reaching 19.25 mg/g dry weight. However, morphological changes, including apical necrosis, were observed, and a significantly longer cultivation period was needed, questioning the value of the procedure. This study provides a basis for scalable in vitro production of bioactive compounds in S. atropatana. Full article

The transition to sustainable, innovation-driven economies has become a global imperative, particularly for resource-dependent regions like the Middle East, where environmental challenges, fossil fuel reliance, and economic diversification pressures intersect. In this context, green innovation plays a pivotal role in mitigating environmental degradation while supporting long-term economic growth. This study examines the short-term and long-term drivers of green innovation across 13 Middle Eastern countries from 1990 to 2023, with a focus on environmental governance, environmental pollution, economic growth, and natural resource abundance. Using a balanced panel dataset, this study applies Frees, Friedman, and Pesaran CSD tests to address cross-sectional dependency and second-generation unit root tests for data stationarity. Both first- and second-generation cointegration tests confirm long-run relationships among variables. The empirical analysis employs the cross-sectional autoregressive distributed lag (CS-ARDL) model, alongside Pooled Mean Group (PMG-ARDL), Average Mean Group (AMG), and Common Correlated Effects CCEMG estimators, ensuring robustness. The findings indicate that, in the long term, environmental governance, economic growth, population size, and natural resource abundance significantly promote green innovation, with respective coefficients of 0.3, 0.01, 0.02, and 0.4. Conversely, human development and environmental pollution exert a negative influence on green innovation, particularly over the long term. These results suggest that, while economic and governance factors drive innovation, human capital development may prioritize immediate growth over sustainability, and pollution may hinder long-term innovation. Enhancing environmental governance, accelerating renewables, using strategic resource revenue for green projects, integrating green growth, and regional collaboration can position Middle Eastern economies as green innovation leaders. Full article

In the digital age, adolescents spend considerable time online, heightening their exposure to both cyberbullying and traditional bullying. However, few studies have investigated both forms of victimization simultaneously, particularly regarding their impact on adolescents in Middle Eastern countries such as Oman. This study used latent profile analysis to identify victimization profiles based on indicators of verbal, social, physical, and cyberbullying victimization. The participants included 1204 Omani students (604 girls, 50.2%; M = 14.04, SD = 0.20, aged 14–15). Three victimization profiles emerged: (1) non-victims (n = 989, 82.1%), (2) traditional victims (n = 156, 13.0%), and (3) dual victims (n = 59, 4.9%). The BCH approach revealed that adolescents in the non-victims profile, with the lowest levels of both traditional and cyberbullying victimization, reported the lowest levels of internalizing (M = 10.14, SD = 0.11) and externalizing symptoms (M = 10.36, SD = 0.10) and the highest academic performance (M = 4.59, SD = 0.02), whereas their prosocial behaviors were relatively low (M = 4.71, SD = 0.08). Adolescents in the traditional victims’ profile had moderate levels on nearly all outcomes. Adolescents in the dual victims’ profile, who experienced both traditional and cyberbullying, reported the highest levels of behavioral symptoms (M_{internalizing} = 11.94, SD_{internalizing} = 0.34; M_{externalizing} = 12.81, SD_{externalizing} = 0.38) and prosocial behaviors (M = 5.63, SD = 0.36), along with the lowest academic performance (M = 4.37, SD = 0.11). These findings underscore the need for culturally sensitive, multi-level interventions to protect Omani adolescents from both traditional and cyberbullying and to support their academic and psychosocial well-being. Full article

China’s ongoing urbanization, expanding land transfer, has reshaped rural land use and generational consumption patterns. Using three waves of China Family Panel Studies data, this study applies a two-way fixed effect model to examine the impact of farmland transfer-out on generational consumption structure and explores the mediating role of household income, the moderating role of non-agricultural income share, and regional and income heterogeneity. Findings show the following: (1) Farmland transfer-out significantly increases subsistence, developmental, and hedonic consumption among middle-aged and young farmers, with the greatest rise in hedonic consumption. For elderly farmers, only subsistence consumption increases, and to a lesser extent. (2) Among middle-aged and young farmers, transfer-out raises household income, boosting all consumption types; a higher share of non-farm income further strengthens subsistence and hedonic consumption. For elderly farmers, while income increases, a higher non-farm income share weakens the income effect on subsistence consumption. (3) Regionally, land transfer-out significantly boosts subsistence and hedonic consumption in the eastern region for younger farmers, and all three types—especially subsistence—in the central and western regions. Elderly farmers in the east also see a rise in subsistence consumption. (4) An income heterogeneity analysis shows stronger effects for low-income younger farmers and high-income elderly farmers. Based on these findings, this study proposes targeted policies to promote farmland transfer-out, offering insights for optimizing land use and enhancing rural consumption, with implications for other countries’ land management. Full article

Highly pathogenic avian influenza (HPAI) A/H5N1 viruses threaten animal and human health worldwide. The first documented cases in the Middle East were reported in 2005; however, despite extensive phylogenetic studies, there is limited information on the transmission dynamics of the virus within this region. We analyzed HA and NA gene sequences from various hosts to address this gap and to understand the virus’s spread and evolution in the Middle East. We hypothesized that H5N1 transmission exhibits host-specific or geographically influenced clade structures in this region. This study traced transmission pathways of HPAI A/H5N1 through a phylogenetic and amino acid sequence analysis of HA and NA gene segments from isolates across different hosts in Middle Eastern countries, using the MUSCLE algorithm for alignments and MEGA11 software for phylogenetic analysis. Sequences were selected from NCBI’s virus database based on geographic and host diversity, including those from birds, humans, and other mammals, and were collected at different time points, predominantly after the early 2000s. An amino acid phylogenetic tree was also constructed to examine the conservation of key HA and NA protein residues, identifying distinct clades linked to specific countries and host species, suggesting a possible interspecies transmission and cross-border spread distinct between Egypt and neighboring countries. These findings underscore the role of migratory birds in regional transmission and point to the need for more targeted surveillance and biosecurity efforts, offering more genomic insights into the spread of HPAI A/H5N1 and contributing valuable information for future prevention strategies. Full article

Background: Road traffic injuries (RTIs) significantly contribute to disability and death in Qatar. This observational study aimed to explore RTI mortality and injury severity trends from 2011 to 2022. Methods: Data from the national trauma database were analyzed retrospectively for mortality rates, injury severity, and characteristics of the injured populations over the years (2011–2022). Results: RTIs represented around 61.3% (n = 12,644) of 20,642 trauma hospitalizations over 12 years. The aggregate RTI mortality rate decreased from 12 to 8 per 100,000 persons, with a mean patient age of 31.8 years. The sum of deaths was 2464, comprising 1022 (41%) in-hospital and 1442 (59%) out-of-hospital fatalities. Among in-hospital deaths, bike-related mortalities totaled 35 (3%), motorcycle-related mortalities 53 (5%), motor vehicle mortalities 561 (55%), and pedestrian mortalities 373 (36%). Based on the injury severity score (ISS), RTIs were divided into four categories, namely, mild (ISS: 1–9), moderate (ISS: 10–15), severe (ISS: 16–24), and fatal (ISS: 25–75). The ISS ranged from 12 to 14, while the median ranged from 10 to 12. The injury frequency showed that mild injuries comprised 40.6% (4545), moderate injuries 26.2% (2934 subjects), and severe 16.7% (1873 subjects). Profound injuries accounted for 13.3% (1490 subjects). Severe and fatal injuries combined dropped from 30% in 2011 to 25% by 2022. Inversely, moderate injuries increased from 24% to 30%, representing a downward trend of the injury severity. Motorcycle-related injuries rose from around 3% to 28% between 2011 and 2022. Motor vehicle and pedestrian injuries declined from about 67% to 54% and 27% to 15%, respectively. Winter, Autumn, Spring, and Summer accounted for 27%, 26%, 24%, and 23% of the total injuries (11,153), respectively. Conclusions: RTI in-hospital mortality and injury severity decreased over the study period. Injury prevention programs should target frequent injury seasons and high-risk populations, such as motorcyclists. Full article

The middle and upper Eocene sedimentary successions exposed along the northwestern and northeastern portions of the Nile Valley, Egypt, have been thoroughly examined for their ostracod assemblages. This study enhances the understanding of biostratigraphic zonations and evaluates the paleobiogeographic distribution and paleoenvironmental conditions that prevailed during the deposition of this sedimentary record. Lithostratigraphically, the studied successions are subdivided into four stratigraphic units, arranged in ascending order as follows: the Qarara, the El Fashn, the Gehannam, and the Beni Suef formations. A total of 125 rock samples were selected and well analyzed, resulting in the identification of sixty-five ostracod species and subspecies belonging to thirty-three genera, fifteen families, and three superfamilies. The stratigraphic distribution of the recorded ostracod taxa contributed to the construction of four local biozones, spanning the interval from the upper Lutetian to lower Priabonian: Schizocythere fadlensis Zone (upper Lutetian–lower Bartonian), Loxoconcha pseudopunctatella Zone, Dygmocythere ismaili Zone (Bartonian), and Asymmetricythere hiltermanni Zone (Bartonian–Priabonian). These biozones are well described, discussed, and correlated with those previously documented in different areas of Egypt and neighboring countries. The statistical analysis, supported by ternary plot diagrams, indicates that the depositional environments of the studied rock units fluctuated between shallow inner neritic and deeper outer neritic marine environments. The identified taxa display a wide geographic distribution and show a significant similarity with those identified in the southern, northern, and eastern Tethyan provinces, suggesting a direct marine connection during the Eocene. Full article

Background: It is well known that supportive care clinics are vital in medical oncology practice. This study aims to present a portrait of the supportive care clinic of a tertiary cancer center in a low-middle-income country. Methods: This study included patients admitted to our supportive care clinic between January 2019 and December 2023. This study included patients who attended the supportive care clinic. For patients who were readmitted more than once throughout the study period, only the first readmission was included in the analysis. The primary outcome of this study was a better understanding of the risk factors associated with hospital readmissions in cancer patients, which could lead to improved patient outcomes. In addition, the secondary objective was to identify the characteristics of patients and clinical decisions regarding follow-ups as inpatients or outpatients referred to the supportive care clinic. Results: This study included 477 patients; 300 (62.9%) were directed to oncology inpatient care, while 177 (37.1%) were treated as outpatients. The most common diagnoses were lung cancer (20.5%), colorectal cancer (13.6%), and breast cancer (8.4%). Most patients (71.5%) were evaluated for symptom palliation. In multivariate analysis, metastatic disease (OR: 2.52 95% CI 1.48–4.29 p = 0.001), Eastern Cooperative Oncology Group (ECOG) performance status (OR: 1.58 95% CI 1.04–2.42 p = 0.034), and a decrease in albumin levels (OR: 0.42 95% CI 0.29–0.61 < 0.001) were significantly related to hospitalization. In univariate analyses, albumin level (p < 0.001), disease stage (p = 0.007), and ECOG performance status (p = 0.025) were statistically associated with unplanned hospital readmission. Among these factors, a decrease in albumin levels was significantly associated with the outcome, with an odds ratio of 0.54 (95% CI 0.39–0.75, p < 0.001), indicating a protective effect of higher albumin levels. In univariate analyses, sex (p = 0.016), cancer treatment type (p = 0.010), albumin level (p < 0.001), disease stage (p < 0.001), unplanned hospital readmission (p < 0.001), ECOG performance status (p < 0.001), and hemoglobin (p = 0.008) were statistically related to overall survival. Among these factors, sex (HR: 1.28 95% CI 1.03–1.59 p = 0.025), a decrease in albumin levels (HR: 0.67 95% CI 0.56–0.82 p < 0.001), disease stage (HR: 1.52 95% CI 1.11–2.09 p = 0.008), unplanned hospital readmission (HR: 1.30 95% CI 1.03–1.63 p = 0.027), and ECOG performance status (HR: 3.45 95% CI 2.68–4.45 p < 0.001) remained significant in the multivariate analysis. Conclusions: This study shows that supportive care clinics are a key element of patient care. Early evaluation of patients in supportive care clinics may aid clinicians in identifying high-risk patients who may require closer follow-up or inpatient care. Several factors were identified as predisposing to hospitalization, unplanned hospital readmission, and overall survival. Further prospective studies are needed to determine the risk factors associated with hospitalization, readmission, and overall survival. Full article

The COVID-19 pandemic has disproportionately impacted vulnerable populations, such as internally displaced Syrians and Syrian refugees (SSRs) in Middle Eastern host countries, through a syndemic interplay of health, social, and economic challenges. Movement restrictions disrupted their livelihoods resulting in increased food insecurity. A mixed-methods approach was used to address the research question: “What is the relationship between Food Insecurity (FI), Mental Health (MH), and COVID-19 among displaced SSRs working in agriculture”? One hundred SSR participants working in agriculture were recruited from northern Syria and neighbouring countries to participate in a Household Survey. The survey data were analysed using correlation and regression analysis. Additionally, interviews with Household Survey researchers were conducted and thematically analysed. Increasing food insecurity was significantly correlated with worse mental health outcomes among SSR participants (r_s = −0.24, p = 0.018). No moderation effects were found with COVID-19 measures or household responses to the pandemic. However, smaller food portions and storing food were positively correlated with poor mental health and food insecurity. The COVID-19 pandemic exacerbated food insecurity and mental health challenges among displaced Syrians and refugees, particularly during Ramadan in 2020, highlighting the compounded effects of overlapping crises and the need for further research into resilience strategies. Full article

Business groups comprise independently owned firms based on different types of owner solidarity, such as kinship, ethnicity, religion, or political identity. However, research has been slow to account for how the adverse effects of ethnic solidarity influence BG-affiliate firm performance. We investigate the interplay of owner ethnicity and their firms’ innovation and export performance. We find variations in affiliates’ performance based on their self-identified ethnicities by analyzing data from the World Bank’s Enterprise Surveys (WBES) across 20 sub-Saharan African countries. Notably, long-established migrant communities, including Indian, Middle Eastern, and European entrepreneurs, experienced waning performance within the BG structure. In contrast, group-affiliated firms led by Chinese entrepreneurs show significant outperformance compared to their African counterparts and minority group affiliates. This study contributes to a novel understanding of the heterogeneous relationship between ethnic solidarity and BG-affiliated firms’ performance across sub-Saharan Africa. Full article

The durable nature of supply chains in the Middle Eastern region is critical, given the region’s strategic role in global trade corridors, yet geopolitical conflicts, territorial disputes, and governance challenges persistently disrupt key routes like the Suez Canal, amplifying vulnerabilities. This study addresses the urgent need to predict and mitigate supply chain risks by evaluating machine learning (ML) models for forecasting economic complexity as a proxy for resilience across 18 Middle Eastern countries. Using a multidimensional secondary dataset, we compare gated recurrent unit (GRU), support vector regression (SVR), gradient boosting, and other ensemble models, assessing performance via MSE, MAE, RMSE, and R². The results demonstrate the GRU model’s superior accuracy (R² = 0.9813; MSE = 0.0011), with SHAP, sensitivity, and sensitivity analysis confirming its robustness in identifying resilience determinants. Analyses reveal infrastructure quality and natural resource rents as pivotal factors influencing the economic complexity index (ECI), while disruptions like trade embargoes or infrastructure failures significantly degrade resilience. Our findings underscore the importance of diversifying infrastructure investments and stabilizing governance frameworks to buffer against shocks. This research advances the application of deep learning in supply chain resilience analytics, offering actionable insights for policymakers and logistics planners to fortify regional trade corridors and mitigate global ripple effects. Full article