From petrodollars to green power: Fiscal stability and green transition in GCC economies.

This study examines the influence of fiscal stability, characterized by fiscal buffers, on the green transition in the Gulf Cooperation Council (GCC) economies from 2005 to 2023. We apply two-way fixed effects, system generalized method of moments (GMM), method of moments quantile regression (MMQR), and panel causality analysis to explore these dynamics. Our findings underscore that a positive fiscal buffer resulting from a significant spread between oil prices and fiscal breakeven levels exerts a substantial positive impact on green transition efforts in GCC countries. The results reveal that countries with higher levels of renewable energy production capacity and urbanization demonstrate more pronounced advancements in green transition initiatives. Conversely, countries grappling with unstable macroeconomic conditions, such as high inflation and external debt, face considerable challenges in achieving significant improvements in green transition outcomes. Additionally, our analysis shows that fossil fuel energy fiscal subsidies negatively influence green transition efforts in the GCC region. Our study emphasizes that policymakers in GCC countries should pursue a dual-pronged strategy: leveraging positive fiscal buffers to diversify their economies in light of potential benefits from high oil prices, and channelling oil and fiscal revenues towards enhancing renewable energy production capacities. This approach aims not only to diversify economic foundations but also to strategically strengthen the infrastructure necessary for sustainable renewable energy transitions in the region over the long term.

A Systematic Review of the Impact of Dietary and Lifestyle Factors on Colorectal Cancer Prevention in Gulf Cooperation Council Countries.

Colorectal cancer (CRC) remains a significant health burden in the Gulf Cooperation Council (GCC) countries, necessitating a deeper understanding of modifiable risk factors. Thus, the aim of the study was to evaluate the impact of dietary and lifestyle factors on the prevention of CRC in GCC countries. Studies were identified through electronic searches and reviewed based on relevant keywords. Databases searched included Ovid's MEDLINE, EMBASE, Google Scholar, and Web of Science, covering titles and abstracts published between January 1, 2000 and July 25, 2024. The search strategy encompassed four thematic areas: "colorectal cancer," "adults above 18," "risk factors," and "GCC countries." The primary focus was on dietary and lifestyle factors. Two reviewers screened titles and abstracts to determine whether the inclusion criteria were met. A total of 1,883 records were identified across these databases. After removing 513 duplicate records, 1,370 records were screened based on titles and abstracts. Of these, 1,284 records were excluded, leaving 86 full-text articles for assessment. Eight studies were ultimately included in the final systematic review, consisting of seven case-control studies and one cross-sectional study. In GCC countries, a diet rich in fruits, vegetables, and fiber has shown protective effects against CRC, while high red meat and refined carbohydrate intake may increase risk. Regular physical activity reduces CRC risk, though the impact of smoking remains inconclusive. Evidence regarding dairy products is contradictory. There is a shortage of high-quality longitudinal studies, highlighting gaps in current research and underscoring the need for larger studies with consistent methodologies.

TiRNA-Gly-GCC-002 is associated with progression in patients with hepatocellular carcinoma.

Background: The transfer RNA (tRNA)-derived fragments, generated by the cleavage of mature and pre-tRNAs, play a vital role in the tumorigenesis and progression of hepatocellular carcinoma (HCC). However, the relationship between tRNA-derived fragments and the prognosis of patients with HCC has not been thoroughly studied. This study aims to discuss the relationship between tiRNA-Gly-GCC-002 and the prognosis of HCC patients and its role in guiding HCC treatment. Methods: In this study, the differently expressed tRNA-derived fragments were screened out from the tumor tissues and paracancerous tissues. These tRNA-derived fragments were validated in the tissues and serum samples of patients with HCC by quantitative real-time polymerase chain reaction (qRT-PCR). The target genes of the tRNA-derived fragments were predicted with the microRNA target prediction database (miRDB), which was proceeded with gene set enrichment analysis (GSEA). After that, we analyzed the prognostic effect of the tRNA-derived fragment in relapse-free survival (RFS). Based on univariate and multivariate Cox regression analysis, independent prognostic factors for RFS were obtained. In addition, a column chart was constructed based on clinical pathological features and tiRNAGly-GCC-002. Results: The tiRNA-Gly-GCC-002 was ultimately served as the candidate gene. Function analysis indicated that tiRNA-Gly-GCC-002 was primarily involved in adenyl nucleotide binding, cell cycle, cell cycle process and chromosome organization. We found that patients with high expression level of tiRNA-Gly-GCC-002 had worse prognosis than low expression level. The univariable and multivariable Cox regression analyses showed that tiRNAGly-GCC-002 was an important prognostic factor. Furthermore, the nomogram by combining tiRNA-Gly-GCC-002 expression level (P=0.03) and serum gamma-glutamyl transferase (GGT) level (P=0.001) was established to predict the prognosis of patients with HCC [concordance index (C-index): 0.789]. Conclusions: In summary, the tiRNA-Gly-GCC-002 can predict the outcome of patients with HCC, which may play a vital role in directing the treatment of HCC.

The influence of social, demographic and economic factors on fertility trends in Gulf Cooperation Council countries: A longitudinal time trend analysis-1980-2021.

OBJECTIVES: To analyze the fertility rate trends in the GCC countries and their association with socioeconomic factors so that policymakers may use the study findings for future healthcare plans. METHODS: Total population, crude death rate, life expectancy, literacy rate, human development index (HDI), female employment, unemployment rate, urbanisation, gross domestic product (GDP) per capita and inflation were chosen as possible predictors of TFR trends. The data were collected for the Global Burden of Disease 2021 study and other official databases such as the World Bank, the United Nations Development Program and Our World in Data for the 6 Gulf Cooperation Council (GCC) countries. Mean with standard deviation and percentage change was calculated to assess trends of TFR and all other variables from 1980-2021. RESULTS: The fertility rate declined in all 6 countries in 2021 compared to 1980. The highest decline was found in the United Arab Emirates (75.5%), while the lowest was in Kuwait (60.9%). From 1980-2021, total population, life expectancy, HDI, literacy rate, GDP, urbanisation, and female labor force increased in all GCC countries. The total population, life expectancy, urbanisation, female labor force, GDP and HDI were negatively and significantly correlated with TFR (p<0.01). The literacy rate showed a negative and significant correlation with TFR in Bahrain, Kuwait, Saudi Arabia, and Qatar. CONCLUSION: The TFR is declining in GCC countries. The plausible causes include the inclination towards postponement of marriages and excessive costs of living. These trends and associations need to be evaluated by policymakers so that they identify priority areas for interventions, allocate resources and formulate developmental plans accordingly to ensure strategic progress of the region.

Adaptive Quizzing in nursing education: A narrative review of its potential and considerations in the Gulf Cooperation Council (GCC) region.

OBJECTIVE: This review aims to explore the integration and effectiveness of Adaptive Quizzing (AQ) in nursing education, highlighting its potential to enhance learning outcomes and student engagement with a particular focus on associate degree nurses. BACKGROUND: In the dynamic landscape of healthcare education, the need for innovative teaching methodologies is increasingly crucial. Adaptive Quizzing (AQ) offers personalized learning experiences that cater to individual student needs, which is essential for mastering complex healthcare material and preparing for licensure examinations. DESIGN: This narrative review synthesizes existing research on the implementation and outcomes of AQ in nursing education, providing a comprehensive overview of its pedagogical impact. METHODS: Scholarly articles, book chapters and reviews from key health science and education databases such as PubMed, CINAHL and ERIC from 2013 to 2023 were systematically analyzed. Rayyan QCRI was employed to facilitate independent assessment and selection of articles based on predefined inclusion and exclusion criteria. RESULTS: The findings underscore AQ's significant role in improving examination performance, fostering content mastery and enhancing student engagement. However, variability in outcomes across different demographic groups highlights the need for tailored integration strategies to maximize AQ's effectiveness. CONCLUSIONS: AQ emerges as a valuable educational tool in nursing programs, particularly beneficial for associate degree nurses by offering tailored learning pathways that align with the critical thinking and clinical decision-making skills essential in nursing. Effective implementation and continuous assessment are crucial to realize AQ's full potential. Future research should explore the long-term impacts and cost-effectiveness of AQ to facilitate its broader application in nursing education.

A Call for Adopting High-Dose Influenza Vaccines for Adults Aged 65 and Above in Gulf Cooperation Council (GCC) Countries.

Seasonal influenza poses significant health and economic challenges globally each year, particularly impacting the elderly population (aged ≥ 65 years) with increased rates of hospitalization, and mortality. The population of older adults is steadily increasing in the Gulf Cooperation Council (GCC) countries and is likely to increase even further. In addition, there is a high burden of chronic comorbidities in these countries like diabetes and obesity, which increases the likelihood of severe consequences of influenza infection. The GCC countries also host mass gathering events like Hajj, Umrah pilgrimage, Arba'een (nearby Iraq) pilgrimage, and international sports and business events, which further intensify the risk of outbreaks like influenza. These events facilitate the mixing of visitors from various countries. Thus, influenza activity in this North Hemisphere (NH) geography is usually present even before the availability of NH seasonal influenza vaccine. This is especially problematic for the elderly, whose protection from the previous year's immunization would have waned. Higher dosages of antigens or adjuvants have been used to improve immunogenicity in older people with superior vaccine effectiveness. Therefore, there is a compelling argument in favor of the implementation of high-dose seasonal influenza vaccines in the GCC countries to improve the protection of individuals aged 65 years and older against influenza infection and associated severe complications.

Human papillomavirus vaccination and Pap test uptake, awareness, and barriers among young adults in Gulf Cooperation Council countries: A comparative cross-sectional survey.

BACKGROUND: Human papillomavirus (HPV) vaccination and Pap tests are recognized as effective preventive measures to reduce the incidence of HPV-related diseases among young adults. The objective of this study was to assess HPV vaccination and Pap test uptake, awareness, and barriers among young adults in the Gulf Cooperation Council (GCC) countries, including Bahrain, Kuwait, Oman, Qatar, the Kingdom of Saudi Arabia (KSA), and the United Arab Emirates (UAE). METHODS: A comparative cross-sectional study was conducted from January to April 2024, involving 831 young adults aged 18-39 residing in GCC countries. The main outcome measures were HPV vaccination and Pap test uptake rates, awareness of the HPV vaccine and Pap testing, and barriers to vaccination. Data were collected using online platforms. The Chi-square test and Fisher's exact test were used for data analysis. RESULTS: The UAE had the highest vaccination rate at 18.9% (50/264), followed by Qatar at 5.8% (6/104), and KSA at 4.6% (10/216), p < 0.001. Individuals with health insurance had higher vaccination rates than those without (11% vs. 5.4%, p = 0.006). Awareness of the HPV vaccine was highest in the UAE (49.6%) and KSA (58.8%), while awareness of Pap smear testing among females was similarly high in these countries (62.4% and 65.9%, respectively). However, actual Pap smear testing rates were highest in Bahrain (15.9%) and Qatar (13.4%). The main barriers to vaccination cited by participants were lack of knowledge (53.6%) and the absence of medical recommendations (13.2%). CONCLUSION: The study's findings suggest the need of targeted educational campaigns to increase HPV vaccine uptake among both genders and Pap test participation among females. Additionally, incorporating HPV screening and vaccination into routine national programs in GCC countries and emphasising the crucial role of healthcare providers in influencing vaccination decisions are recommended strategies.

Toward maritime sustainability in GCC countries: What role do economic freedom and human capital play?

Gulf Cooperation Council (GCC) members have recently experienced rapid environmental degradation. Although there has been a boom in studies investigating the causes of environmental degradation, little is known about the drivers of maritime sustainability. This study examines the impacts of economic freedom and human capital on the fishing grounds footprint in GCC countries between 2000 and 2021. To account for potential heterogeneity and nonnormal distribution of the data, the study implements the Method of Moments Quantile Regression (MMQR). The empirical investigation suggests interesting findings. First, the analysis confirms the Marine Environmental Kuznets Curve across GCC countries, with a turning point of $38,177 per capita. In addition, the population has long-term detrimental effects on the fishing grounds footprint. Economic freedom and financial development have also deteriorated maritime sustainability, but only for low and medium quantiles. These factors are neutral for high levels of maritime degradation. Furthermore, improved human capital contributes to maritime sustainability in the long-run. Finally, the adverse repercussions of economic freedom are reduced by improved human capital and environmental awareness.

Overview of online pharmacy regulations in Saudi Arabia and the Gulf cooperation council countries and their impact on online pharmacy service providers in Saudi Arabia: a qualitative analysis.

Background: Laws and regulations are needed to regulate the growing online pharmacy (OP) services. The main objective of this work was to provide an overview of the laws and regulations for OP services in the Gulf Cooperation Council (GCC) countries. In addition, the perception of how these laws and regulations in Saudi Arabia (SA) affect the online ordering of medications and health-related products from national and international OPs was explored. Methods: A secondary data collection through emails and a qualitative descriptive analysis was used to gain insight into the OP regulations in the GCC countries. Then, a qualitative study was carried out with semi-structured interviews to investigate the impact of these regulations on the practice and the market from the OP service providers' perspective. The interviews were carried out with a sample of major OP service providers in SA, to represent the GCC countries. During the interviews, multiple open-ended questions were used to explore opinions about the OP regulations and how these regulations affected the practice. The interviews were then transcribed and thematically analysed. Results: Responses were mainly received from regulators in SA, Bahrain, Oman and United Arab Emirates (UAE). SA and UAE allow for offering of OP services as add-on service for existing community pharmacy, while UAE also allows for standalone OP providers. SA, Bahrain, and Oman allow online ordering of both over-the-counter (OTC) and prescription-only medications (POM) from international OP; a prescription is required for POM and quantities allowed should be no more than 3 months' supply in case of SA and Oman while this was not specified in case of Bahrain. Invoice of purchase was also required for any POM to be released from customs in SA and Bahrain but not in Oman and UAE. Controlled medications were prohibited to be ordered online in SA, UAE, and Bahrain while it was allowed in Oman if the prescription was issued within 6-month, and the quantity dispensed was for 1 month only. Apart from online ordering of medications in these countries, no specific regulations existed to regulate ordering of other health-related products from local or international OPs. Whether Kwait and Qatar have regulations for OP could not be established due to lack of response. Two of the four interviewed representatives of OP service providers in SA were not aware of the existence of specific regulations for OP services. The representatives who were aware of these regulations were satisfied with them and found them beneficial for their business and for the patients at the same time. However, representatives raised concerns regarding the enforcement of regulations on international OP providers. Conclusion: The existing regulations for online ordering of medications are somewhat comparable between the GCC countries, with no specific regulations for ordering of other health-related products from local or international OPs. In SA, there is limited awareness of the existing regulations for OP services by providers. Nevertheless, the need for detailed regulations on certain aspects of OP services was highlighted, such as regulations for international OPs and importing medications for personal use.

tRF-Gly-GCC in Atretic Follicles Promotes Ferroptosis in Granulosa Cells by Down-Regulating MAPK1.

Follicle development refers to the process in which the follicles in the ovary gradually develop from the primary stage to a mature state, and most primary follicles fail to develop normally, without forming a dense granular cell layer and cell wall, which is identified as atretic follicles. Granulosa cells assist follicle development by producing hormones and providing support, and interference in the interaction between granulosa cells and oocytes may lead to the formation of atretic follicles. Ferroptosis, as a non-apoptotic form of death, is caused by cells accumulating lethal levels of iron-dependent phospholipid peroxides. Healthy follicles ranging from 4 to 5 mm were randomly divided into two groups: a control group (DMSO) and treatment group (10 uM of ferroptosis inducer erastin). Each group was sequenced after three repeated cultures for 24 h. We found that ferroptosis was associated with atretic follicles and that the in vitro treatment of healthy follicles with the ferroptosis inducer erastin produced a phenotype similar to that of atretic follicles. Overall, our study elucidates that tRF-1:30-Gly-GCC-2 is involved in the apoptosis and ferroptosis of GCs. Mechanistically, tRF-1:30-Gly-GCC-2 inhibits granulosa cell proliferation and promotes ferroptosis by inhibiting Mitogen-activated protein kinase 1 (MAPK1). tRF-1:30-Gly-GCC-2 may be a novel molecular target for improving the development of atretic follicles in ovarian dysfunction. In conclusion, our study provides a new perspective on the pathogenesis of granulosa cell dysfunction and follicular atresia.

The human SMAD9 (GCC) repeat links to natural selection and late-onset neurocognitive disorders.

INTRODUCTION: Whereas (GCC)-repeats are overrepresented in genic regions, and mutation hotspots, they are largely unexplored with regard to their link with natural selection. Across numerous primate species and tissues, SMAD9 (SMAD Family Member 9) reaches highest level of expression in the human brain. This gene contains a (GCC)-repeat in the interval between + 1 and + 60 of the transcription start site, which is in the high-ranking (GCC)-repeats with respect to length. METHODS: Here we sequenced this (GCC)-repeat in 396 Iranian individuals, consisting of late-onset neurocognitive disorder (NCD) (N = 181) and controls (N = 215). RESULTS: We detected two predominantly abundant alleles of 7 and 9 repeats, forming 96.2% of the allele pool. The (GCC)7/(GCC)9 ratio was in the reverse order in the NCD group versus controls (p = 0.005), resulting from excess of (GCC)7 in the NCD group (p = 0.003) and (GCC)9 in the controls (p = 0.01). Five genotypes, predominantly consisting of (GCC)7 and lacking (GCC)9 were detected in the NCD group only (p = 0.008). The patients harboring those genotypes received the diagnoses of Alzheimer's disease (AD) and vascular dementia (VD). Five genotypes consisting of (GCC)9 and lacking (GCC)7 were detected in the control group only (p = 0.002). The group-specific genotypes formed approximately 4% of the genotype pool in the human samples studied. CONCLUSION: We propose natural selection and a novel locus for late-onset AD and VD at the SMAD9 (GCC)-repeat in humans.

Retinal Vascular Abnormalities and Clinical Parameters in Systemic Sclerosis.

Background: Systemic sclerosis is a complex autoimmune disease characterized by vasculopathy, fibrosis, and immune dysregulation. Ocular manifestations in these patients are increasingly recognized, suggesting potential correlations between systemic vascular abnormalities and ocular microvascular changes. Advancements in molecular immunology and imaging technology using ocular coherence tomography (OCT) have unveiled intricate pathways underlying possible disease pathogenesis. Understanding the interplay between retinal vascular abnormalities and molecular immunology parameters could provide insights into disease mechanisms and potential biomarkers. Purpose: The aim of this study was to investigate vascular abnormalities, detected with optical coherence tomography angiography (OCT-A), in systemic sclerosis patients and to find correlations between the severity of the disease detected with molecular immunology findings and OCT-A parameters. Methods: A group of 32 systemic sclerosis patients were compared with 9 healthy controls. Ganglion cell complex thickness (GCC), retina thickness of the fovea and parafovea, nerve fiber layer thickness (RNFL) and cup/disc area ratio were investigated using OCT. Vessel density (VD) of the superficial (SCP) and deep capillary plexus (DCP) of the whole macular area and ETDRS grid, size of the foveal avascular zone (FAZ) and vessel density of the radial peripapillary capillary plexus (RPCP) were evaluated using OCT-A. Modified Rodnan skin score (mRSS), capillaroscopy and disease duration were used to stage disease severity. Results: There was a statistically significant reduction in retina thickness of the fovea and parafovea, VD of the whole DCP, VD of the SCP and DCP in ETDRS grid in the patient group compared to controls (p < 0.001). The patients presented a significant enlargement of the FAZ (p 0.005). No significant correlation between OCT and OCT-A parameters and disease severity scores was found. Conclusions: OCT-A could represent a non-invasive tool to detect retinal microvascular damage in systemic sclerosis.

BRCA testing and management of BRCA-mutated early-stage breast cancer: a comprehensive statement by expert group from GCC region.

BReast CAncer (BRCA)1 and BRCA2 gene pathogenic variants account for most hereditary breast cancers (BC). Identification of BRCA mutations can significantly influence both prognosis and treatment outcomes. Furthermore, it enables the identification of individuals who are at heightened risk of developing BC due to inherited genetic mutations. Many developing countries rely on western guidelines for BRCA testing and BC management; however, there exist wide disparities in the prevalence of risk factors, availability of medical resources, and practice patterns. Guidelines tailored to specific regions can help mitigate healthcare variations, promote consistency in treatment, and aid healthcare providers in identifying effective therapies for improving patient outcomes. Hence, oncologists from the Gulf Cooperation Council (GCC) congregated virtually in March 2023 and reviewed existing data on the epidemiology of BC, BRCA mutations, practices and challenges associated with BRCA testing and management of BRCA mutated early-stage BC in the GCC region. They also provided insights on the real-world diagnostic and treatment practices and challenges in the GCC region in the BRCA-mutated early-stage BC domain and suggested some variations to international guidelines to aid their uptake in this region.

The Burden Cancer-Related Deaths Attributable to High Body Mass Index in a Gulf Cooperation Council: Results from the Global Burden of Disease Study 2019.

BACKGROUND: BMI has been reported to be a major risk factor for the increased burden of several diseases. This study explores the burden of cancer linked to high body mass index (BMI) in Gulf Cooperation Council (GCC) countries and assesses the correlation with Socio-demographic Index (SDI). METHOD: Using Global burden of disease (GBD) 2019 data, the authors quantified cancer burden through mortality, DALYs, age standardized mortality rate (ASMR), and age standardized DALYs rate (ASDR) across sexes, countries, cancer types, and years. Spearman's correlation tested ASMR against SDI. The authors estimated 95% uncertainty limits (UIs) for population attribution fraction (PAFs). RESULTS: Between 1990 and 2019, all six GCC countries showed increased number of the overall cancer-related deaths (398.73% in Bahrain to 1404.25% in United Arab Emirates), and DALYs (347.38% in Kuwait, to 1479.35% in United Arab Emirates) reflecting significant increasing in deaths, and burden cancer attributed to high BMI. In 2019, across GCC countries, pancreatic, uterine, and kidney cancer accounted for 87.91% of the total attributable deaths associated with high BMI in females, whereas in male, colon and rectum cancer alone accounted for 26% of all attributable deaths associated with high BMI. CONCLUSION: The study highlights the significant impact of high BMI on cancer burden in GCC countries. Moreover, the study identifies specific cancers, such as pancreatic, uterine, and kidney cancer in females, and colon and rectum cancer in males, as major contributors to attributable deaths, urging targeted prevention strategies at reducing weight and encouraging physical activity could greatly lessen the impact of diseases in the GCC countries.

On the versatility of graphene-cellulose composites: An overview and bibliometric assessment.

Practical benefits of graphene-cellulose composites (GCC) are categorical. Diverse salient features like thermal and electrical conductivity, mechanical strength, and durability make GCC advantageous for widespread applications. Despite extensive studies the basic understanding of various fundamental aspects of this novel complex remains deficient. Based on this fact, a critical overview and bibliometric analysis involving the overall prospects of GCC was made wherein a total of 1245 research articles from the Scopus database published during the year 2002 to 2020 were used. For the bibliometric assessment, various criteria including the publication outputs, co-authorships, affiliated countries, and co-occurrences of the authors' keywords were explored. Environmental amiability, sustainability, economy, and energy efficiency of GCC were emphasized. In addition, the recent trends, upcoming challenges, and applied interests of GCC were highlighted. The findings revealed that the studies on GCC related to the energy storage, adsorption, sensing, and printing are ever-increasing, indicating the global research drifts on GCC. The bibliometric map analysis displayed that among the researchers from 61 countries/territories, China alone contributed about 50 % of the international publications. It is asserted that the current article may offer taxonomy to navigate into the field of GCC wherein stronger collaboration networks can be established worldwide through integrated research activities desirable for sustainable development.

Impacts of renewable and disaggregated non-renewable energy consumption on CO2 emissions in GCC countries: A STIRPAT model analysis.

This research investigates the effects of renewable (REC) and disaggregated non-renewable energy consumption (coal, oil, and natural gas) on CO2 emissions (CO2) in GCC countries, employing the STIRPAT model. The research also compares the impact of various non-renewable energy (NREC) sources to identify their contributions to CO2 emissions. Demographic factors like population and economic growth are considered main determinants of CO2. Panel data econometric methods are used, including diagnostic tests and unit root tests, to found long-run relationships among the variables. The study reveals significant positive associations between coal, natural gas, oil consumption and CO2, with oil having the highest impact. Conversely, REC shows a significant negative correlation with CO2. Economic growth and population are also linked to increased CO2. The findings emphasize the need for strategies promoting renewable energy usage, energy efficiency, public transportation, carbon pricing, and research in green technologies to alleviate CO2 and enhance sustainable development in the GCC countries.

Glycaemic control among adults with type 2 diabetes mellitus in the Gulf Cooperation Council countries: an updated review.

Type 2 diabetes mellitus (T2DM) has become a major public health concern, causing significant disability and death worldwide. Fuelled by a modern sedentary lifestyle and poor dietary practices, T2DM affects at least 10.5% of the world's population. This paper seeks to review the progress made by the Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) in addressing T2DM, focusing on glycaemic control proportions and comparing it with the 2015 review. The results indicate no significant improvement in glycaemic control proportions since the last review, with only 9.2% to 56.9% of patients having good control (glycosylated haemoglobin < 7%). However, there are no significant differences in glycaemic control between the GCC countries and other places worldwide despite being considered hotbeds of T2DM. Many factors contribute to poor glycaemic control. Specifically, evidence shows that being overweight or obese is the most common modifiable risk factor for T2DM incidence and poor glycaemic control. The GCC countries have higher rates of obesity. Additionally, poor glycaemic control is mainly related to a lack of adherence to insulin and medication use. Poor diet, rich in calories and low in fruits and vegetables, and a sedentary lifestyle also significantly contribute to poor glycaemic control and obesity. Therefore, to reduce the incidence of disease and improve glycaemic control in diabetic patients, educational programs promoting lifestyle changes should be implemented. Ongoing research is also necessary to assess the trend of glycaemic control and its risk factors in our region.

Current practice and safety measures in epilepsy monitoring units in the Gulf Cooperation Council Countries: A cross-sectional study.

BACKGROUND: An increasing number of Epilepsy Monitoring Units (EMU) display various practices and safety protocols. EMU settings should meet clear, standardized safety protocols to avoid seizure adverse events (SAE). We aim to provide the foundational framework facilitating the establishment of unified evidence-based safety regulations to address the practices and safety measures implemented within the Gulf Cooperation Council (GCC). METHODS: In this cross-sectional study, EMU directors in the GCC were contacted directly by phone to personally complete an electronic 37-item questionnaire sent via text messages and email. From January 2021-December 2021. RESULTS: Seventeen EMUs from six GCC countries participated in the study. All EMU directors responded to the study. Twelve (70.6%) EMUs monitored adults and children, five (29.4%) monitored adults, and none monitored children only. The number of certified epileptologists in the EMUs ranged from one to eight per unit. Fifteen (88.2%) EMUs applied a continuous observation pattern, whereas two (11.8%) performed daytime only. The precautions most commonly used in the video Electroencephalogram (EEG) were seizure pads and bedside oxygen in 15 EMUs (88.2%). For invasive EEG, seizure pads were used in 9 EMUs (52.9%), %) and IV access in 8 EMUs (47.1%). The occurrence of adverse events varied among EMUs. The most common conditions were postictal psychosis 10 (58.8%), injuries 7 (41.2%), and status epilepticus 6 (35.3%). Falls were mainly related to missed seizures or delayed recognition by video monitors in 8 EMUs (47.1%). The extended EMU stay was because of an insufficient number of recorded seizures in 16 EMUs (94.1%), poor seizure lateralization and localization in 10 (58.8%), and re-introduction of AEDs in nine (52.9%). All EMUs had written acute seizure and status epilepticus management protocols. A postictal psychosis management protocol was available for 10 (58.8%). Medications were withdrawn before admission in 6 EMUs (35.3%). The specific medication withdrawal speed protocol upon admission was available in 7 EMUs (41.2%). Pre-admission withdrawal of medication demonstrated a shorter length of stay in both video and invasive EEG, which was statistically significant (ρ (15) = -.529, p =.029; ρ (7) = -.694, p =.038; respectively). CONCLUSION: The practice and safety regulations of EMUs in the GCC vary widely. Each EMU reported the occurrences of SAE and injuries. Precautions, protective measures, and management protocols must be reassessed to minimize the number of SAEs and increase the safety of the EMU.

Harnessing rhizospheric core microbiomes from arid regions for enhancing date palm resilience to climate change effects.

Date palm cultivation has thrived in the Gulf Cooperation Council region since ancient times, where it represents a vital sector in agricultural and socio-economic development. However, climate change conditions prevailing for decades in this area, next to rarefication of rain, hot temperatures, intense evapotranspiration, rise of sea level, salinization of groundwater, and intensification of cultivation, contributed to increase salinity in the soil as well as in irrigation water and to seriously threaten date palm cultivation sustainability. There are also growing concerns about soil erosion and its repercussions on date palm oases. While several reviews have reported on solutions to sustain date productivity, including genetic selection of suitable cultivars for the local harsh environmental conditions and the implementation of efficient management practices, no systematic review of the desertic plants' below-ground microbial communities and their potential contributions to date palm adaptation to climate change has been reported yet. Indeed, desert microorganisms are expected to address critical agricultural challenges and economic issues. Therefore, the primary objectives of the present critical review are to (1) analyze and synthesize current knowledge and scientific advances on desert plant-associated microorganisms, (2) review and summarize the impacts of their application on date palm, and (3) identify possible gaps and suggest relevant guidance for desert plant microbes' inoculation approach to sustain date palm cultivation within the Gulf Cooperation Council in general and in Qatar in particular.