Middle East North Africa Research Articles

The Real Effect and Consequence of Regulation Reform in Corporate Finance and Banking

In order for a country to grow economically, it needs a stable, efficient, and well-functioning banking system. The province should examine systematically and comprehensively its regulations, and examine how to improve the quality of these regulations, reduce their administrative burden, and remove the confusion they sometimes create. Several studies have pointed to the importance of financial regulation to the performance and safety of banks. The reform of regulatory policies and practices makes businesses more competitive and decreases regulatory costs, boosting efficiency, bringing down prices, stimulating innovation, as well as making economies more adaptable and competitive. We investigated how banking regulations affected financial development in MENA (Middle East-North Africa) countries. We measured bank regulation by proxies like foreign banks, capital levels, and liquidity liabilities. We measured financial development by proxies like private credit, z-scores, and private credit. Similarly, a tool to measure bank supervision includes supervisory power, independence, private monitoring, and moral hazard in addition to the size, activity, and stability of the financial sector. In terms of financial development, regulation of banks made a positive and significant contribution. A major contribution of the study is to demonstrate that reform supervision is also an important component of bank regulation, so that banks can achieve their regulatory objectives and impact financial development as strongly as possible. For MENA countries, this benefit is particularly significant, since an analysis of the data shows that more emphasis is placed on regulation than supervision in financial sector reform.

Neutralizing Dromedary-Derived Nanobodies Against BotI-Like Toxin From the Most Hazardous Scorpion Venom in the Middle East and North Africa Region.

Scorpion envenoming is a severe health problem in many regions causing significant clinical toxic effects and fatalities. In the Middle East/North Africa (MENA) region, Buthidae scorpion stings are responsible for devastating toxic outcomes in human. The only available specific immunotherapeutic treatment is based on IgG fragments of animal origin. To overcome the limitations of classical immunotherapy, we have demonstrated the in vivo efficacy of NbF12-10 bispecific nanobody at preclinical level. Nanobodies were developed against BotI analogues belonging to a distinct structural and antigenic group of scorpion toxins, occurring in the MENA region. From Buthus occitanus tunetanus venom, BotI-like toxin was purified. The 41 N-terminal amino acid residues were sequenced, and the LD50 was estimated at 40 ng/mouse. The BotI-like toxin was used for dromedary immunization. An immune VHH library was constructed, and after screening, two nanobodies were selected with nanomolar and sub-nanomolar affinity and recognizing an overlapping epitope. NbBotI-01 was able to neutralize 50% of the lethal effect of 13 LD50 BotI-like toxins in mice when injected by i.c.v route, whereas NbBotI-17 neutralized 50% of the lethal effect of 7 LD50. Interestingly, NbBotI-01 completely reduced the lethal effect of the 2 LD50 of BotG50 when injected at 1:4 molar ratio excess. More interestingly, an equimolar mixture of NbBotI-01 with NbF12-10 neutralized completely the lethal effect of 7 and 5 LD50 of BotG50 or AahG50, at 1:4 and 1:2 molar ratio, respectively. Hence, NbBotI-01 and NbF12-10 display synergic effects, leading to a novel therapeutic candidate for treating Buthus occitanus scorpion stings in the MENA region.

Interests above Influence: China's Security Presence in the Middle East–North Africa Region

Interests above Influence: China's Security Presence in the Middle East–North Africa Region

A review of the molecular epidemiology of Cryptosporidium spp. and Giardia duodenalis in the Middle East and North Africa (MENA) region.

Cryptosporidium spp. and Giardia duodenalis are important protozoan parasites which are associated with diarrheal diseases in humans and animals worldwide. Relatively little is known about the molecular epidemiology of Cryptosporidium spp. and Giardia duodenalis in the Middle East Countries and North Africa (MENA region). Therefore, this review aimed to inspect published genotyping and subtyping studies on Cryptosporidium spp. and Giardia duodenalis in the MENA region. These studies indicate that both anthroponotic and zoonotic transmission of Cryptosporidium occurs with the predominance of zoonotic transmission in most countries. Seven Cryptosporidium species were identified in humans (C. parvum, C. hominis, Cryptosporidium meleagridis, C. felis, Cryptosporidium muris, C. canis and C. bovis), with C. parvum by far being the most prevalent species (reported in 95.4% of the retrieved studies). Among C. parvum gp60 subtype families, IIa and IId predominated, suggesting potential zoonotic transmission. However, in four MENA countries (Lebanon, Israel, Egypt and Tunisia), C. hominis was the predominant species with five subtype families reported including Ia, Ib, Id, If and Ie, all of which are usually anthroponotically transmitted between humans. In animals, the majority of studies were conducted mainly on livestock and poultry, 15 species were identified (C. parvum, C. hominis, C. muris, Cryptosporidium cuniculus, C. andersoni, C. bovis, C. meleagridis, C. baileyi, C. erinacei, C. ryanae, C. felis, C. suis, Cryptosporidium galli, C. xiaoi and C. ubiquitum) with C. parvum (IIa and IId subtypes) the dominant species in livestock and C. meleagridis and C. baileyi the dominant species in poultry. With G. duodenalis, five assemblages (A, B, C, E and F) were identified in humans and six (A, B, C, E, D and F) in animals in MENA countries with assemblages A and B commonly reported in humans, and assemblages A and E dominant in livestock. This review also identified a major knowledge gap in the lack of Cryptosporidium spp. and Giardia duodenalis typing studies in water and food sources in the MENA region. Of the few studies conducted on water sources (including drinking and tap water), ten Cryptosporidium species and four genotypes were identified, highlighting the potential role of water as the major route of Cryptosporidium spp. transmission in the region. In addition, three G. duodenalis assemblages (A, B and E) were detected in different water sources with AI, AII and BIV being the main sub-assemblages reported. More research is required in order to better understand the molecular diversity and transmission dynamics of Cryptsporidum spp. and Giardia duodenalis in humans, animals, water and food sources in MENA region.

Projected Air Temperature Extremes and Maximum Heat Conditions Over the Middle-East-North Africa (MENA) Region

This study analyzes projected heat extremes over the Middle-East–North Africa (MENA) region until the end of the twenty-first century with a number of temperature indices based on absolute values and thresholds to describe hot conditions. We use model projected daily near-surface air (2-m) temperature (T_mathrm{{max}} and T_mathrm{{min}}) to derive the indices for the period 1980–2100. The data were taken from 18 CMIP5 models combining historical (1980–2005) and scenario runs (2006–2100 under RCP2.6, RCP4.5, and RCP8.5 pathways). Results show a domain-wide projected warming for all emission scenarios. Our findings for a business-as-usual pathway indicate excessive warming of more than 8 ^circ C in the northern part of the domain (south Europe) for the annual warmest day (TXx) and night (TNx). In the hottest parts of the domain record high temperatures reached 50 ^circ C in the recent past, which could increase to at least 56 ^circ C by the end of the century, while temperatures over 50 ^circ C are expected to occur in a large part of the MENA region. A significant increase is projected in the number of hot days (TX >40^circ C) and nights (TN >30 ^circ C) all over the region. For the period of 2071–2100 excessive hot days and nights will become the normal during summer in large parts of the MENA with some locations expected to exceed 180 and 100 days, respectively. Calculations of the corresponding heat index suggest that several areas across the MENA region may reach temperature levels critical for human survival.

ASSESSMENT OF FUTURE CLIMATE PROJECTIONS IN ALGERIA USING STATISTICAL DOWNSCALING MODEL

In this study, we assess the future changes in minimum temperature (T-min), maximum temperature (T-max), and precipitation (PRCP) for the three periods the 2020s (2011–2040), the 2050s (2041–2070), and the 2080s (2071–2100), with respect to the reference period 1981–2010 over Algeria focusing on a validation of the Statistical DownScaling Model (SDSM). In this approach, to underpin our analysis, we evaluate statistically the SDSM performance by simulating the historical temperatures and precipitation. The NCEP reanalysis data and CanESM2 predictors of three future scenarios, RCP2.6, RCP4.5, and RCP8.5 are used for model calibration and future projection, respectively. The projected climate changes resulting from the application of SDSM show a convincing consistency with those unveiled in previous studies over Algeria based on dynamical regional climate model outputs conducted in the context of Middle East-North Africa region. By the end of the century, the results exhibit strong warming for both extreme temperatures under the worst-case scenario (RCP 8.5), it is more pronounced for the T-max and over the Algerian Sahara region. Under the optimistic scenario (RCP2.6), the strength of the warming is expected to increase for both extreme temperatures. The projected changes of precipitation revealed for all scenarios several discrepancies with significant decrease over the northwest region and central Sahara, while nonsignificant change is projected for the center and eastern coastal regions. Our findings corroborate previous studies using sophisticated tools by demonstrating that Algeria’s climate is expected to warm further in the future. These primary findings could give an overview of the application of the statistical modeling approach using SDSM over a semi-arid and arid vulnerable region like Algeria and would extend our knowledge in the climate-modelling field for the North Africa zone by providing an added value to the existing GCMs and regional climate projections. In addition, reliable information regarding the magnitude of future changes at local scale may be used in impact models to assess changes of other key economic sector variables such as water resources management, energy and agriculture.

POSA287 Transferability of Disease-Related Costs of Chronic Immune-Mediated Diseases within Countries of the Middle East North Africa Region: The Case of Multiple Sclerosis

Financing decisions of innovative health technologies including specialty medicines or biologicals increasingly necessitate health technology assessment (HTA) in the Middle East North Africa (MENA) region. However, lack of cost data hampers health economic evaluations. Therefore, we assessed the possibility of transferring disease-related costs of multiple sclerosis (MS) within countries in the MENA region as a model for chronic-immune mediated disorders (IMIDs).

Knowledge management to foster the entrepreneurship activity: case for Saudi Arabia

It is becoming a topic of increasing significance on a global scale to encourage students in educational institutions of higher learning to behave in an entrepreneurial manner. It is especially true in the countries that make up the Middle East/North Africa (MENA) region, where there is a greater pressing need to cultivate and develop college students into business owners who can financially support themselves through their own businesses. Since only several studies considered the impact of education on aspiring business owners in fast-developing countries like Saudi Arabia, this study helps fill a gap in the existing body of academic research. The primary objective of this research is to evaluate the impact that participation in educational programs about entrepreneurship has on the possibility that college students will be engaged in entrepreneurial activities in the future. It is significant to give education’s central role in cultivating and encouraging entrepreneurship. This investigation utilized the theory of planned behaviour as its primary framework. A convenience sample was used to collect responses to a questionnaire that was administered online. The recruitment process resulted in the participation of a total of 250 individuals who had previously attended institutions in Saudi Arabia and engaged in entrepreneurship education. The findings indicated that an individual’s attitude toward entrepreneurship and their assessment of their level of behavioural control (perceived entrepreneurship abilities) significantly impact an individual’s intention to participate in entrepreneurial activity. On the other hand, subjective norms do not significantly impact the intention to engage in entrepreneurial activity. The most noteworthy finding is that the extent to which students aspire to launch their own businesses is significantly influenced by entrepreneurship education. An explanation of the study’s limitations and some suggestions for more research were presented and discussed further. The study is limited to participation in entrepreneurship education. However, additional research investigating both the quality and quantity of education is also advised.

A review on waste management and compost production in the Middle East-North Africa region.

Over the last two decades, solid waste management in the Middle East-North Africa (MENA) region has been one of the major challenges due to increasing solid waste quantities and poor waste management practices. With the tremendously increasing amounts of organic waste, MENA countries are under great pressure and are facing the threats of acute air pollution, contamination of water bodies and climate change. As a result, these countries are adopting different methods to cope with this rising challenge of waste management, including composting. This review reports on the different MENA countries' organic waste quantities, disposal methods, organic waste management practices and challenges, along with the potential use and demand of compost, where information is available. The reported data are from 2009 to 2021, with the bulk of the papers being from 2014 and onwards. The total amount of municipal waste collected in the 21 countries ranged from 0.56 million tons in Mauritania to 90 million tons in Egypt, with an average of 16.42 million tons, equivalent to 1.08 kg per capita waste generation per day. Around 55% of this material is biogenous. Many treatments and repurposing methods of this material are adopted in the MENA region, mainly through composting, as it presents one of the most sustainable solutions that lead to immediate climate change mitigation. This article also presents the biotic and abiotic stressors faced by this region, which in turn affect the successful implementation of composting solutions, and proposes some solutions based on different studies conducted.

The Evolutionary Feature of Turkey’s Soft Power in the Middle East, 2011-2020

Today, soft power plays an important role in advancing states’ foreign policy goals. As one of the world’s emerging economic powers, Turkey pays special attention to the development and maintenance of its soft power. This commentary uses a descriptive-analysis approach to address the components of Turkey’s soft power in the Middle East North Africa (MENA) region in the years 2011-2020, the second decade of AK Party governance. Turkey’s soft power during this time period has mainly targeted and become influential in the Muslim-majority countries of the Middle East and Asia. Although certain events, such as the 2016 failed coup, the Gezi Park protests, the Syrian crisis, restrictions on freedom of expression, fluctuations in the value of the Turkish lira, etc., have somewhat tarnished the country’s image, various indicators of Turkey’s soft power demonstrate that it has remained strong in the MENA region during the time span of the present research. Keywords: Turkey, Soft Power, MENA, AK Party

Telerehabilitation in the Middle East North Africa Region: A Structured Review.

A structured review using the PRISMA guidelines, MeSH keywords and eight health databases was conducted (1990 to March 2021). Telerehabilitation research evidence from the Middle East and North Africa region (MENA) was summarized. Twelve studies from Iran, Israel, Morocco, and Saudi Arabia met inclusion criteria; nearly all had been published within the past five years. Methodological quality was moderate to good in the four randomized controlled trials, five cohort-studies and three cross-section surveys. There were seven intervention studies in cardiovascular, musculoskeletal, neurology or burn rehabilitation and three patient perception and two practitioner perception studies. Narrative synthesis revealed content themes relating to rehabilitation availability and accessibility; patient/practitioner perceptions of telerehabilitation; telerehabilitation to augment traditional services; and barriers to telerehabilitation. Telerehabilitation practice in MENA has been demonstrated as feasible, acceptable to patients, and effective in practitioner-designed cohort specific programs. Practitioners are generally positive but lack experience and need training, enabling technological systems, and policy frameworks.

Lessons learned in stroke care during COVID-19 pandemic and preparing for future pandemics in the MENA+ region: A consensus statement from the MENA+-SINO

BackgroundCOVID-19 pandemic has negatively impacted stroke care services at multiple levels. There was a decline in acute stroke admissions. Fewer interventions have been performed. Increased “door-to-needle times and “door-to-groin puncture” during this pandemic. These factors combined have led to declining in the favoured outcomes of stroke patients' globally. Yet this pandemic permits an opportunity for higher preparedness for future pandemics. Objectives and methodsThis paper aims to shed light on the main lessons learned in the field of stroke care during the first wave of COVID-19 pandemic. Here we are presenting proposals and initiatives for better preparedness in future similar emergencies. These proposals are based primarily on literature review of COVID-19 publications, as well as the first-hand experience gained during the first wave at the regional level. In addition to the consensus and collective ride of stroke experts in the Middle East North Africa Stroke and Interventional Neurotherapies Organization (MENA+-SINO) and interaction and collaboration with international stroke specialists from the Stroke World Organization (WSO), European Stroke Organization (ESO) and stroke and COVID-19 papers authors. ConclusionStroke care is very complex, particularly in the initial hours after onset of symptoms. A successful outcome requires very close collaboration between clinical personnel from multiple specialties. Preparedness for future pandemics requires the improvement of care plans that allow for rapid assessment of stroke patients and ensuring that regular ‘mock exercises’ familiarize quintessential services that care for the stroke patients.

The regulatory landscape of biosimilars: Algeria's efforts and progress made from 2006 to 2021

Biologics are tremendously efficacious biological molecules that have enabled the treatment of many life-threatening diseases, which have previously been hard to treat. Biosimilars, also known as “follow-on biologics”, are highly similar versions of another already approved biologic, called the Reference Product. The European Union has been a pioneer in the regulation of biosimilars. WHO guideline on evaluation of biosimilars published in 2009 was an important landmark in biosimilar regulations worldwide, and several countries have adopted its principles in the development of their own regulatory pathway for the approval of biosimilars. Most countries in the Middle East North Africa (MENA) region still lack official and scientific guidelines for biosimilar approval pathways. This article explores the regulatory situation of biosimilar registration pathways in Algeria and describes the progress made and the regulatory landscape changes for biosimilars in Algeria during the past ten years. Our findings indicate that the development of biosimilar regulation in Algeria went through three major phases between 2006 and 2021, during which there has been much progress in drafting guidance documents for biosimilars. Since 2016, Algeria has used the EMA, FDA and WHO guidelines as the basis for approval of several biosimilars and no national guidelines or regulations have been adopted to date. Additionally, there has been no regulation on substitution/interchangeability. The Algerian regulatory authority has gained considerable experience with approval and use of increasingly complex biosimilars over the past 5 years and has the potential to create its own biosimilar-specific regulatory pathway in the near future.

Renewable Energies and Energy Efficiency Adoption’s Impact on the Environmental Quality of Middle East North Africa Countries

Environmental challenges in MENA countries deserve more attention as they are pursuing economic growth and expanding urbanization and the geographical position of these countries make them more exposed to the outcomes of climate change. In this context, this paper focuses on the proposed solutions for the climate change problem that are renewable energies and the use of fossil fuel effectively in the context of growing urbanization in the MENA region. Indeed, using the GMM estimator for 18 MENA countries during the period 2000-2018, we try to quantify the magnitude of the impact of population, economic prosperity, urbanization, fossil fuels, energy efficiency, and renewable energies, especially solar, wind, and hydropower energies on CO2 emissions. Results allow the environmental Kuznets curve validation and highlight the contribution of energy efficiency in improving the environment. However, the used proportion of renewables in the energy mix does not significantly affect environmental quality. Moreover, solar energy contributes to emissions reduction. While the adopted level of wind and hydropower energy does not allow these countries to improve their environment.

Prevalence of and risk factors for non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt

ObjectiveLimited literature has examined the epidemiology of non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt, a country with one of the highest obesity rates globally. We...

Hunting for Gray Rhinos and terrorism in the Middle East, North Africa, and Central Asia

ABSTRACT Statistical modelling of terrorism has advanced the understanding of its underlying drivers. However, numerous questions remain, some have not been empirically tested, and regional dynamics differ. In recent decades, the Middle East/North Africa (MENA) and Central Asia have been focal points of terrorism. An extensive review of global and regional statistical models of terrorism at the country-year level was conducted and hypotheses re-tested on a database for MENA and Central Asia for years 1998–2017. The analysis indicates that the primary drivers of terrorism in this region are corruption, war, state terror, weak democracy, and unemployment. Fuel exports, ethnic and religious fractionalization, youth bulges, and internally displaced persons (IDPs) have little or no statistically significant relationship to terrorism in the region. Collectively, these results indicate that certain factors can anticipate terrorism in the region. Further analysis indicates that some factors have the potential to erupt suddenly and therefore require constant monitoring and sound contingency planning.

Validation of the Arabic Maternal Breastfeeding Evaluation Scale (MBFES-A) among Lebanese women

BackgroundMaternal satisfaction with the breastfeeding experience is an important determinant of breastfeeding success. There is currently no valid tool to measure perceived maternal satisfaction with breastfeeding in the Arab context.MethodsThis cohort study tested the Maternal Breastfeeding Evaluation Scale (MBFES) on 450 healthy Lebanese mothers for internal consistency reliability and construct validity. Participants were recruited between April 2018 and February 2020.ResultsThe Cronbach’s alpha reliability coefficient of the Arabic MBFES (MBFES-A) was 0.87. Exploratory factor analysis revealed that it has three components: Infant Satisfaction/Growth, Maternal Enjoyment/Role Attainment, and Lifestyle/Body Image with reliability coefficients of 0.88, 0.87, and 0.68, respectively. Four items were deleted because of low factor loadings and three items were relocated to the Infant Satisfaction/Growth subscale based on their factor loadings. Participants who were exclusively breastfeeding at one and/or 3 months had higher mean MBFES-A total and Infant Satisfaction/Growth and Maternal Enjoyment/Role Attainment subscale scores than participants who were partially breastfeeding, and significantly higher mean scores than mothers who were not breastfeeding (all p values < 0.001), findings that support the scale’s construct validity. Moreover, scores on the Infant Satisfaction/Growth subscale correlated with exclusive breastfeeding at one (r = 0.37, p < 0.001) and 3 months (r = 0.31, p < 0.001). The MBFES-A score had positive modest correlations with maternal attitude towards breastfeeding (r = 0.30, p < 0.001), exclusive breastfeeding at one (r = 0.27) and at 3 months (r = 0.26, p < 0.001 for both), as well as with the longest previous exclusive breastfeeding (r = 0.27, p < 0.001).ConclusionsThe 26-item MBFES-A is a reliable and valid instrument to use in future breastfeeding research in Middle East North Africa countries. There is a need for replication of our findings in other Arab contexts using new constructs to establish stronger construct validity.

P–723 Ovarian reserve parameters and ovarian stimulation outcome for IVF/ICSI are influenced by ethnicity

Abstract Study question Are the ovarian reserve parameters and the outcome of ovarian stimulation for IVF / ICSI influenced by ethnicity? Summary answer Ethnicity influences ovarian reserve parameters and the outcome of ovarian stimulation for IVF / ICSI What is known already Infertility affects couples worldwide and due to a lack of a standardized reporting system, the real number, especially in developing countries, might be underestimated. The etiology of infertility may differ around the world and is often subjected not only to social, cultural and religious peculiarities, but also to different genetic influences. Published data suggest that ethnicity influences the ovarian reserve as well as the outcome of Assisted-Reproductive-Techniques (ART)-treatments. Key players of a successful ART outcome are the ovarian reserve and consequently the number of oocytes retrieved. Until today, the impact of ethnical differences is not sufficiently addressed in research. Study design, size, duration Prospective observational study, performed in 10 infertility centers worldwide (Europe (4 centers), Middle East North Africa (MENA) region (2 centers), Iran (2 centers), South America (1 center), India (1 center)) between May 2019 and September 2020, evaluating ovarian reserve and outcome parameters of ovarian stimulation treatments for IVF/ICSI. The study was approved by the Ethical Committee of each participating center. Participants/materials, setting, methods Couples with primary / secondary infertility and an indication for an IVF/ICSI treatment were included into this study. Besides anamnestic data regarding the history of the infertility and self-reported ethnicity (Arab, Caucasian, Hispanic, Ohters, Persian and South Asian), data obtained during the basic fertility assessment on the ovarian reserve parameters (Antral follicle count (AFC) and Anti-Muellerian-Hormone (AMH)) as well as stimulation parameters from the ovarian stimulation treatment were collected and analyzed. Main results and the role of chance This study comprised 1032 couples with the following distribution of the ethnicities: Arab 21.5%, Caucasian 15.9%, Hispanic 5%, Others 1.2%, Persian 33.4%, and South Asian 23%. The unadjusted means, SD and 95%CI (Confidence Interval) of AMH (ng/ml) for the groups were 3.33±0.19 [2.95–3.71]; 2.03±0.25 [1.55–2.52]; 2.43±0.74 [0.97–3.88]; 2.76±0.96 [0.88–4.64]; 3.10±0.16 [2.79–3.41]; 3.62±0.19 [3.25–3.98], for AFC 15.52±0.53 [14.49–16.55]; 12.00±0.67 [10.69–13.31]; 12.69±1.08 [10.57–14.81]; 15.11±2.60 [10.01–20.21]; 13.58±0.42 [12.75–14.41]; 13.49±0.51 [12.49–14.48] and for the number of retrieved oocytes (rCOC) 14.08±0.61 [12.88–15.27]; 9.84±0.71 [8.44–11.24]; 7.94±1.26 [5.48–10.41]; 9.92±2.62 [4.78–15.05]; 10.83±0.49 [9.87–11.79]; 17.06±0.59 [15.90–18.21], respectively. Univariate analysis of AMH, AFC and rCOC with the ethnicities revealed highly statistically significant differences for AMH and rCOC (p &amp;lt; 0.001, respectively) and significant differences for AFC (p = 0.0014). As age is a major confounder for the ovarian reserve, multivariate analyses were performed. After adjusting for age, AMH was significantly different between Arab-Persian, Arab-South Asian and Arab-Caucasian (p &amp;lt; 0.001, p &amp;lt; 0.001, p = 0.002) and AFC statistically significant between Arab and all other ethnicities. For rCOC, besides age, also the stimulation-dosage and -duration was taken into account. Highly statistically significant differences were found for the groups Arab-Persian and Arab-Caucasian and no differences towards the other ethnical groups. Limitations, reasons for caution Limitations of the study are an unequal number of included patients per ethnicity and that the data for the ovarian reserve parameters and the stimulation outcome were not available for all of the included patients. Wider implications of the findings: Counselling of couples with infertility have to take, besides all other factors, also the ethnicity of the couple into account as ethnicity influences the ovarian reserve parameters as well as the number of retrieved oocytes in ovarian stimulation cycles for IVF/ICSI. Trial registration number ClinicalTrials.gov Identifier: NCT03927417

Market Structure and Bank Conduct in the MENA Region

Abstract The Middle East North Africa (MENA) region is witnessing a wave of bank consolidations, with many mega-mergers taking place in the Gulf Cooperation Council (GCC) countries. These will result in creating large banks, reducing the number of market players and increasing market concentration; which is already high. A further increase in concentration may raise concerns about the resulting dominance of large banks and the consequences on their pricing behaviour. The interrelationships between market structure and pricing behaviour is summarised by the popular model of industrial economics called the structure–conduct–performance (SCP) model. Consequently, we test the prevalence of this model in a sample of 15 MENA banking sectors to detect the possible existence of an impact running particularly from the structure of banking markets to the pricing behaviour (power) of banks in order to predict a possible emergence of oligopolistic behaviour following bank consolidations. Using a two-stage least squares model, we found a positive and significant impact of market concentration on bank pricing, suggesting that an further increase in MENA banking markets’ concentration may boost banks pricing power and persuade them to increase their returns at the expense of their customers.

Navigating the digital revolution and crisis times: humanitarian and innovation-inspired leadership through the pandemic

PurposeThis article examines the leadership vision, values and vigilance of an emerging markets logistics firm in managing customer and humanitarian concerns and critical supply chains during the COVID-19 pandemic. The study explores how an emerging markets firm has contributed to global supply chain mobility and vaccine distribution in the pandemic – keeping cargo moving – drawing on vision, values and vigilance, including attention to the innovation momentum of the firm.Design/methodology/approachThe article concentrates on an exemplar firm, leader and management team to illustrate challenges of helmsmanship during the pandemic for an emerging markets firm, Agility, that operates worldwide in numerous developed and developing economy markets. The article develops a case study analyzing how Agility has met the simultaneous challenges for innovation and transformation in the digital revolution and navigation through the crisis times of the global pandemic. The analysis derives from direct management communications, corporate documents and media sources.FindingsThe vision, values and vigilance of the leadership, with emphasis on digital innovations and disruptions, digital supply chains, humanitarian partnerships, focusing both globally and on emerging markets, and nurturing smaller as well as larger businesses, have enabled the firm to thrive. Given the importance of global supply chains during COVID-19, Agility is a pivotal example of partnering with governments and pharmaceutical companies worldwide in delivering the new array of vaccines, as well as personal protective equipment and other medical supplies, in the battle against the pandemic. Agility in addition illustrates the strategic value of partnering with other logistics firms in humanitarian collaborations as well as in business strategy transactions.Research limitations/implicationsThe article contributes to the emergent research stream on leadership, innovation and internationalization in the Arabian Gulf Cooperation Council and Middle East North Africa (GCC/MENA) region and more generally on the strengths and proficiencies of emerging market firms and leaders. Future research could examine additional firms, industries or regions of the world during the pandemic or other crisis contexts. Further data sources and analyses can be used in validating and extending the findings.Practical implicationsDigital supply chains, humanitarian partnerships and an emphasis on digital communications, storage and transportation innovations can benefit firms from all regions of the world during the global pandemic and other crises, as well as in normal operations.Social implicationsEmerging markets represent the majority of global population and economic growth, as well as of pandemic cases and mortality risk, signifying the importance of leadership, collaboration and innovation around issues such as vaccine delivery into emerging markets regions of the world.Originality/valueThe article takes a revelatory case perspective in the pandemic crisis context from a unique foundation of immersive field research and data access in the GCC/MENA) region.