Middle East Research Articles

The US Census, the MENA Campaign, and Classification Struggles: Neoliberal Distribution of Pride, Fear, and Deception

In this paper, I explore the history of the Middle Eastern and North African (MENA) campaign, which aims to extract Southwest Asian and North Africa populations from the white legal category on the US Census. I use Bourdieu’s classification struggles and theory of field to make sense of different approaches to this campaign. The data presented in the paper are gathered from 65 qualitative interviews with activists and citizens with Southwest Asian and North African backgrounds. The data manifest that although all participants unanimously reject the relevance of their current legal white racial category, they have divergent reasons for their support, or lack thereof, for the campaign, all of which are different from the advocacy organizations’ framing of it. I draw on these variant perspectives to investigate the classification struggles between different actors at different levels and examine how these actors meet in the field and pursue their goals.

Estimating The Prevalence of Non-Communicable Diseases and Adherence to Dietary Habits And Physical Activity Among Healthcare Professionals in The Middle East And North Africa Regions

The rising number of fatalities linked to food, exercise, and non-communicable illnesses has sparked interest in studying their effects. In society, Healthcare Professionals (HCPs) symbolize health and wellbeing. However, the incidence of chronic illness and healthy habits among Middle East and North Africa (MENA) HCPs remains unclear. To determine the prevalence of chronic diseases and adherence to healthy dietary habits and physical activity among HCPs in the MENA region. Algeria, Egypt, El Yemen, Iraq, Jordan, Kuwait, Libya, Palestine, Saudi Arabia, Sudan, and Syria HCPs (physicians, dentists, nurses, pharmacists, and nutritionists) participated in multicenter cross-sectional research. April to June 2022 data on diet and exercise habits was collected using a pre-tested self-administered questionnaire. Demographics, risk factors, medical history, and nutrition and exercise were included in the questionnaire. HCP diet and exercise were examined using multivariable regression models. A study of 7130 HCPs (mean age 28.6 ± 7.8 years, 57.5% females) was conducted. Physicians held 56.8% of the sample population, followed by pharmacists, nurses, dentists, and nutritionists. Cardiovascular disease (CVD) affected 33.1% of individuals. Alcohol, pork, soda, sugar, and smoking raised the risk of non-communicable diseases. Nutritionists were the most active HCPs. About half of dietitians (45.3%) walked 150 minutes or more per week, while 14.7% and 25.9% did 150 minutes or more of moderate and 75 minutes or more of intense exercise, respectively. HCPs in MENA had high rates of CVD and risk factors such smoking, alcohol, pork, soda, sugar, and less exercise. MENA HCPs must be aware of the significant incidence of these risk factors to enhance health behavior.

Global use of angiotensin receptor neprilysin inhibitor in heart failure and reduced, below normal and supranormal ejection fraction.

The global use of angiotensin receptor neprilysin inhibitor (ARNI) in clinical practice, especially in patients with heart failure and below-normal ejection fraction (HFbnEF), has not been thoroughly evaluated. We aimed to investigate the characteristics, outcomes, and adverse events in patients treated with ARNI for HF with reduced (HFrEF), below-normal (HFbnEF), and supranormal left ventricular EF (HFsnEF). This observational study analyzed data from the electronic healthcare records (EHR) of patients with HF treated with ARNI between 2015 and 2022 in North and South America, Europe, the Middle East, Africa, and Asia-Pacific. Based on the left ventricular EF, patients were categorized as HFrEF (< 40%), HFbnEF (40-60%), and HFsnEF (> 60%). Mortality and the incidence of adverse events were investigated. Of the 11,141 patients analyzed, HFrEF, HFbnEF and HFsnEF accounted for 74%, 22%, and 4%, respectively. Patients with a higher EF were more likely to be older, female, and obese. Hypertension and atrial fibrillation were the most common in HFsnEF. Systolic blood pressure was lower and natriuretic peptide levels were higher in the lower EF groups. Mortality was lowest in HFbnEF (7.7 per 100 patient-years follow-up in HFrEF, 5.8 in HFmrEF, and 6.0 in HFsnEF). Similarly, hypotension and acute kidney injury were the least frequent in HFbnEF. Incidence of elevated serum potassium levels was similar between the groups. In this analysis of large-scale EHR, ARNI was mainly used in HFrEF and HFbnEF, consistent with previous randomized trials and pooled analyses. Adverse events were less common in HFbnEF.

7667 Cushing’s Puzzle: Echinococcal Pituitary Cyst In A Rare Encounter

Abstract Disclosure: E. Sari: None. F. Erenler: None. Introduction: Echinococcus is a rare parasitic infection endemic in the Mediterranean, Middle East, South America and Africa, which can cause cystic disease in several organs. Central nervous system involvement is known to comprise 1-2% of all cystic echinococcal disease. Hereby, we report a case of an opportunistic pituitary echinococcus infection in a patient with hypercortisolism due to adrenocortical adenoma with initial misdiagnosis of Cushing’s disease. Clinical Case: A 40-year-old South American female with poorly controlled T2DM on oral agents and hypertension presented to the ER with abdominal pain and subsequent CT of the abdomen with contrast showed a right adrenal mass measuring up to 2.8 cm. A follow up CT with adrenal protocol confirmed 3.3 cm right adrenal mass, 46 HU in precontrast images with &amp;gt;50% washout. Review of records revealed that a recent MRI brain with contrast was performed for headache evaluation and showed an incidental 5x7x4 mm lesion in the pituitary gland. Endocrinology evaluation revealed 24-hour urine volume 1800 mL, elevated free cortisol levels 277.6 mcg/24hr (RR: 4.0-50.0 mcg/24hr), creatinine of 0.67g/24hr (RR: 0.50-2.15g/24hr). 1 mg dexamethasone suppression test showed AM cortisol of 28.7 mcg/dL. ACTH was elevated at 67 pg/mL (RR: 6-50 pg/mL). FSH, LH, and GH were normal. Presumed diagnosis of ACTH-dependent hypercortisolism was made and she underwent bilateral inferior petrosal sinus sampling with confirmed successful cannulation but this was inconclusive due to low ACTH levels. Follow-up MRI of the pituitary gland showed T1 bright, T2 isointense circumscribed lesion measuring 7x6x3 mm at anterior pituitary gland with a thin rim of peripheral enhancement consistent with cystic features. She underwent transsphenoidal resection of the pituitary lesion and the pathology specimen showed parasites consistent with echinococcosis. Infectious disease was consulted, and the patient started on albendazole. Post-operative laboratory evaluation was notable for persistently elevated AM cortisol, 24-hour urine free cortisol levels, and low ACTH levels, confirming ACTH independent hypercortisolism. She underwent right adrenal nodule resection and pathology was consistent with adrenocortical adenoma. Post-adrenalectomy AM cortisol levels were &amp;lt; 2 mcg/dL, indicating the resolution of hypercortisolism along with substantiating the diagnosis of primary adrenocortical hyperfunction. Conclusion: To the best of our knowledge, this is the first case report of an opportunistic echinococcus infection presenting as a pituitary lesion in the setting of Cushing Syndrome. We would like to highlight the importance of recognizing opportunistic infections, including Echinococcus as a potential etiology in the setting of hypercortisolism, especially for patients from endemic regions. Presentation: 6/2/2024

Refractive errors among schoolchildren in the Middle East: A systematic review and meta-analysis

Refractive errors among schoolchildren in the Middle East: A systematic review and meta-analysis

Geochemical characterization of Upper Cretaceous organic-rich deposits: Insights from the Azraq Basin in Jordan

Cretaceous sedimentary successions in Jordan are among the most promising unconventional global petroleum resources. The Upper Cretaceous deposits in the Azraq Basin in Jordan were analyzed using Rock-Eval pyrolysis, stable carbon isotopes, vitrinite reflectance, and biomarkers, as well as 1D basin modeling. This study aims to evaluate source input, depositional environment, burial history and potential for hydrocarbon generation of the Upper Cretaceous organic-rich deposits in Jordan. The Upper Cretaceous samples exhibit variable source rock potential. Maastrichtian samples are very good, primarily oil-prone, while Campanian and Cenomanian samples range from fair to poor, with Turonian samples showing good petroleum generation potential. Thermal maturity analysis of Cretaceous samples reveals higher maturity in Turonian and Cenomanian samples compared to the thermally immature Maastrichtian and Campanian samples based on the maximum temperature of pyrolytic hydrocarbons generation, vitrinite reflectance, production index and biomarker indicators. The molecular fossils data suggest that the organic matter of these source rocks was primarily of marine phytoplankton origin, with considerable contributions from microbial biomass, and deposited under oxygen-depleted bottom water conditions. Additionally, the resemblance in molecular composition between Cretaceous source rocks and crude oil samples suggests a common origin for the hydrocarbons. The highest contents of organic matter have been recorded at the top of the Maastrichtian and at the bottom of the Turonian sections. These findings correspond with Maastrichtian upwelling deposits in North Africa and the Middle East, as well as with deposits from the Cenomanian-Turonian Oceanic Anoxic Event (OAE2).

Neutrality, Leverage, and Timing: China s Middle East Peace Diplomacy in Perspective

Neutrality, Leverage, and Timing: China s Middle East Peace Diplomacy in Perspective

Vascular complications during appendectomy: severe adhesion of the appendix to the right iliac artery: a case report

IntroductionAppendicitis is a common cause of acute abdomen. Rarely, it may form adhesions to nearby structures, complicating surgeries, especially when involving vascular structures such as the internal iliac artery, potentially causing severe intraoperative hemorrhage.Case presentationA 65-year-old Middle Eastern male presented with abdominal pain and anorexia for 5 days. Examination and imaging confirmed acute appendicitis with complications. Additionally, a large pelvic mass was noted. During surgery, severe bleeding was encountered due to an adhesion between the appendix and the right internal iliac artery, managed by ligating the artery. The patient recovered well and was discharged in stable condition. Histopathology confirmed the diagnosis.ConclusionThis case highlights a rare vascular complication of appendectomy due to abnormal adhesions between the appendix and the internal iliac artery, associated with a large pelvic mass. This study emphasizes the need for thorough preoperative evaluation and careful surgical planning in patients with unusual anatomical variations or specific underlying conditions such as neurofibromatosis. Early recognition and strategic management of vascular adhesions are essential to optimize patient outcomes in appendectomies complicated by such rare scenarios.

From Arab-Israeli Conflict to Arab-Israeli Integration: A New Curriculum for Understanding the Contemporary Middle East

ABSTRACT This proposition paper introduces a novel curriculum designed to explore the trends of normalization and integration transforming the Middle East. The curriculum includes a comprehensive textbook and an accessible digital archive for scholars, students, and individuals seeking to deepen their understanding of this subject. The study investigates how academic politicization, biased content, and limited accessibility have contributed to a significant gap in comprehending Israel’s integration in the Middle East, particularly within US Middle East Studies. Our methodology involves a comparative analysis of the academic approaches of the Edward Said and Bernard Lewis “camps,” representing contrasting perspectives within US academia. Additionally, we assess the divergence between academic and state-led approaches to Middle Eastern integration in the United States. By identifying and analyzing six critical factors – impact on the field of Middle East Studies, impact on academic freedom, impact on religious tolerance, impact on regional stability, fresh research on the US Peace to Prosperity Plan and Arab Peace Initiative, and Israeli-Palestinian peace – this research underscores the necessity for the proposed curriculum and its resources. This curriculum aims to bridge the existing knowledge gap and provide a more balanced and comprehensive understanding of Middle Eastern dynamics.

Global health impacts of high BMI: A 30-Year analysis of trends and disparities across regions and Demographics

ObjectiveThis study explores the global disease burden associated with high Body Mass Index (BMI) from 1990 to 2021, using data from the Global Burden of Disease Study 2021 (GBD 2021). MethodsWe applied Joinpoint regression to assess trends in deaths and Disability-Adjusted Life Years (DALYs) and employed ARIMA models to project future BMI-related burdens. ResultsFrom 1990 to 2021, global deaths linked to high BMI surged by 153.97%, rising from 1.46 million to 3.71 million. DALYs increased by 167.57%, with the highest rises in North Africa, the Middle East, and South Asia. Women, particularly those aged 75 and above, experienced the most significant burden, with a faster rate of increase in disease burden compared to men post-2000. Future projections indicate a continued rise in BMI-related health impacts, particularly in low- and middle-income countries. ConclusionsThe global disease burden attributable to high BMI is increasing rapidly, particularly in low- and middle-income regions. Targeted public health interventions, especially for women and the elderly, are crucial to addressing this growing health challenge.

A chromosome-level genome assembly of Cape hare (Lepus capensis)

The Cape hare (Lepus capensis) is among the most widely distributed hare species globally, inhabiting extensive regions across Africa, the Middle East, and Central Asia. However, evolutionary and genetic research on L. capensis was seriously impeded by the absence of a reference genome. Here, we assembled and constructed a chromosome-level genome of L. capensis (with scaffolds anchored to 25 chromosomes and a total assembled length of 2.9 Gb, achieving a contig N50 length of 124.44 Mb) using PacBio HiFi sequencing and Hi-C assembly technology. Evaluation using BUSCO indicated the genome assembly to be 98.2% complete. The de novo prediction revealed that repetitive sequences constitute 46.13% of the entire genome, and long interspersed nuclear elements (LINEs) constituted the largest portion. We annotated a total of 13, 868 protein-coding genes using transcriptomes from two tissues (muscle and skin). This high-quality reference genome serves as a valuable genomic resource for advancing genetic studies in this species.

Rising temperatures and sinking hopes: An in-depth analysis of the interplay between climate change, land use patterns, and the desiccation of a global biosphere reserve

Global ecosystems and communities are significantly impacted by climate change and extreme events. The rapid desiccation of massive wetlands, which are essential for controlling water cycles, and biodiversity, preventing floods, and supplying essential ecosystem services, is one of the most upsetting effects. The once-largest lake in the Middle East, Lake Urmia, had a significant impact on ecology, economy, and human life contributing to climate regulation, species preservation, habitat conservation, tourism and recreation, and a wide range of other ecosystem services. The Ramsar Convention classified the lake as a Wetland of International Importance, and UNESCO designated it as a Biosphere Reserve. The ecological, agricultural, and societal challenges caused by rising temperatures, improper water resource management and overuse, enhanced salinity, and declining water levels have made Lake Urmia an acute symbol of environmental vulnerability. Using Landsat imagery, this study begins a thorough analysis of changes in the Lake Urmia basin from 1990 to 2020. The endeavor aims to develop effective conservation and restoration strategies by identifying the multiple reasons that led to its vulnerable situation. The study attempts to identify the role of precipitation, temperature trends, agricultural development, population growth, water consumption, evapotranspiration, and atmospheric salt and aerosol concentrations in the desiccation of the lake. This study presents a comprehensive knowledge of the complex interplay between climate change, human activity, and water management and may have implications for the holistic recovery of the lake. The findings have the potential to improve prognostic models and inform targeted mitigation strategies for not only Lake Urmia but also for other globally threatened wetlands.

In the Shade of the Sunna: Salafi Piety in the Twentieth-Century Middle East, written by Aaron Rock-Singer

In the Shade of the Sunna: Salafi Piety in the Twentieth-Century Middle East, written by Aaron Rock-Singer

The Landscape of Cutaneous T-Cell Lymphoma (CTCL) in the Middle East and North Africa (MENA) and the Establishment of the MENA CTCL Working Group

The high cancer burden in the Middle East and North Africa (MENA region) is coupled with an increasing cancer incidence. While the MENA region constitutes 6% of the world’s population, it remains underrepresented in clinical trials. Cutaneous T-cell lymphomas (CTCLs) represent a heterogeneous group of rare extranodal non-Hodgkin lymphomas with variable clinical presentation. In the MENA region, where darker skin colors are more common than in the West, CTCL generally presents at a younger age and with distinct clinical features that necessitate special expertise and management across disciplines: rare forms of CTCL are more common (hypo- and hyperpigmented MF) and a higher prevalence of pediatric MF is noticed. The multidisciplinary approach to cancer management is growing worldwide and is necessary for the comprehensive management of CTCL. The MENA CTCL group was established with the aim of creating a collaborative environment for the diagnosis and treatment of CTCL in the region. Its first meeting was held in May 2023. The group plans to increase the global representation of the MENA region and establish CTCL registries and patient advocacy groups in the region.

Agri-Food Sector in Ukraine and Poland: A Comparative Analysis Using the Input–Output Model

The war in Ukraine and the COVID-19 pandemic have shown that Ukraine is strongly integrated with global agricultural markets, is of great importance for the world’s food security, and can effectively compete with Poland in exporting to EU markets. Contrary to Poland, the agri-food sector in Ukraine has not yet been the subject of research using input–output tables. The input–output model has many advantages in studying the structures of individual sectors and their connections with other sectors of the economy and with foreign countries. Therefore, the current study fills the existing research gap. The aim of the article is a comparative analysis of the agri-food sectors in Ukraine and Poland in 2020 (during the COVID-19 pandemic) using the input–output model. The data source is the OECD TiVA database. The main conclusion is that Poland is further along the path of agricultural and food sector development than Ukraine. The study also reveals that in terms of value, the agri-food sector in Ukraine is significantly smaller than in Poland, but it is more important in the Ukrainian economy, with agriculture being its dominant link, while in Poland it is the food industry. The Polish agri-food sector is characterized by a higher import dependency of gross output. Exports play a significant role in the distribution of the gross output of Ukraine’s agriculture and Poland’s food industry. However, the export directions differed significantly. Poland exported mainly to the EU, while Ukraine exported to Asian and Middle Eastern countries.

Deep learning-derived optimal aviation strategies to control pandemics

The COVID-19 pandemic affected countries across the globe, demanding drastic public health policies to mitigate the spread of infection, which led to economic crises as a collateral damage. In this work, we investigate the impact of human mobility, described via international commercial flights, on COVID-19 infection dynamics on a global scale. We developed a graph neural network (GNN)-based framework called Dynamic Weighted GraphSAGE (DWSAGE), which operates over spatiotemporal graphs and is well-suited for dynamically changing flight information updated daily. This architecture is designed to be structurally sensitive, capable of learning the relationships between edge features and node features. To gain insights into the influence of air traffic on infection spread, we conducted local sensitivity analysis on our model through perturbation experiments. Our analyses identified Western Europe, the Middle East, and North America as leading regions in fueling the pandemic due to the high volume of air traffic originating or transiting through these areas. We used these observations to propose air traffic reduction strategies that can significantly impact controlling the pandemic with minimal disruption to human mobility. Our work provides a robust deep learning-based tool to study global pandemics and is of key relevance to policymakers for making informed decisions regarding air traffic restrictions during future outbreaks.

Minilateralism and global governance: effectiveness of hybrid models

ABSTRACT The liberal world order is showing signs of disarray: two recent catastrophes in adjoining parts of the world (the Middle East and South Caucasus) have opened the fissures of the international governance gap; and the continuing ramifications of COVID-19 have already paralysed the world. On top of this post-pandemic disquietude, multiple conflicts this year are either in danger of precipitating or wars have already re-ignited over long-standing continuing conflicts, highlighting the failure of international governance institutions, including the UN system. In recent years, one of the central responses to the multilateral failures at multiple levels has been for states to form ‘narrower’ and ‘more flexible’ frameworks called ‘minilaterals’. Thus minilateralism has been contrasted through the lens of receding multilateralism, which has been a long-standing hallmark of the American-led liberal international order. This paper examines how far global governance would be dependent on minilateralism by exploring this growing trend in the Indo-Pacific and explores how minilateralism models can enhance international governance structures. This paper also attempts to analyse whether minilateralism is a product of regional fragmentation, or whether it can reinvigorate the comatose multilateralism. Then this paper posits that minilateralism helps rejig the chaotic multipolar order and thus re-invent global governance.

Analysis of the global burden of cardiovascular diseases linked to exposure to ambient particulate matter pollution from 1990 to 2019.

This research endeavors to scrutinize the temporal trends and global burden of cardiovascular diseases (CVDs) associated with ambient particulate matter (PM) pollution spanning from 1990 to 2019. Age-standardized death rates (ASDRs) and age-standardized disability-adjusted life years (DALYs) for CVDs, as well as their estimated annual percentage changes (EAPCs), were calculated using data from the Global Burden of Disease Study 2019 (GBD 2019). The global ASDR and age-standardized DALYs due to CVDs associated with PM pollution increased from 1990 to 2019, with a higher increase in males. The burden was higher among middle-aged and older adults. The ASDR and DALYs increased in low-Socio-demographic Index (SDI), low-middle-SDI, and middle-SDI countries, while they decreased in high-SDI countries. The highest burden was observed in Central Asia, North Africa, the Middle East, East Asia, and South Asia. The highest burdens were reported in Iraq, Egypt, and Uzbekistan at the national level. The burden of CVDs linked to PM pollution has grown significantly from 1990 to 2019, with variations across regions and countries, highlighting the need for targeted prevention and pollution management strategies.

Bangladesh-China-India-Myanmar (BCIM) – Economic corridor: an opportunity for regional connectivity and development cooperation in south and Southeast Asia

China is the largest country in terms of the purchasing power parity (PPP); and the country has started to invest hugely in the developing countries of the Southeast Asia, South Asia, Africa, Central Asia and the Middle-East. It wants to be connected with Europe, Africa and Middle East through its economic corridors such as BCIM, BRI, MSR and OBOR. It can be mentioned here that most of the South and Southeast countries are poor and need huge investment in the infrastructural projects. Therefore, the concept of BCIM is a win-win geostrategic and economic policy for South, Southeast and China. On the other hand, India is largest country in terms of the size of population; and its economy is also rising rapidly. And this country also needs huge investment and development cooperation from the different countries including China. Besides, Bangladesh is a lower middle-income country; it also wants to grow rapidly in terms of economic growth, transfer of technology and infrastructural developments. On other hand, Myanmar is a developing country in Southeast Asia which requires vast developments, transfer of technology, foreign investments in the coastal regions and regional connectivity for economic growth and development. Therefore, carrying out study on BCIM economic corridor is extremely important in the region. It’s a qualitative study in the context of mythology. This study has found that implementation of BCIM economic corridor is very important for South and Southeast Asia including Bangladesh for regional connectivity, trade and investment and development cooperation.

A Comprehensive Review and Mapping Citrus Supply Chains from a Sustainability Perspective across the European Union, Middle East, and Africa

A Comprehensive Review and Mapping Citrus Supply Chains from a Sustainability Perspective across the European Union, Middle East, and Africa